What Diseases Can You Get From a Hot Tub?

Reviewed on 6/24/2021
diseases you can get from a hot tub
Beware of potential diseases you can get if a hot tub hasn’t been cleaned and disinfected properly

When not maintained and cleaned properly, hot tubs provide an ideal environment for bacteria and viruses to grow, causing skin, eye, and ear infections, as well as other serious diseases.

Because of the high temperature of water in a hot tub, some disinfectants like chlorine break down faster and become ineffective, leading to contamination. In addition to waterborne diseases, it’s important to keep in mind that sitting in a hot tub for too long can also cause heat-related illnesses, such as nausea, dizziness, fainting, and even death.

5 diseases you can get from a hot tub

1. Hot tub lung

This infection is caused by a group of bacteria called Mycobacterium avium complex (MAC), which can survive in warm water. The bacteria have an outer layer that enables them to adhere to surfaces. This means that they may not get washed away when the water is drained or if the hot tub is just rinsed with water. 

MAC can also attach to air droplets or bubbles that come to the surface of the hot tub and become aerosolized. If these droplets are inhaled, the bacteria can cause patches of inflammation in the lungs and lead to symptoms such as fever, cough, difficulty breathing, and fatigue.

2. Hot tub rash

Hot tub rash is caused by the bacteria Pseudomonas aeruginosa. The rash is itchy, with bumpy and red or pus-filled blisters in and around hair follicles. 

This type of infection is often worse under the swimsuit, since it keeps the contaminated water on the skin. To prevent a rash from worsening, make sure to shower in soap and water and clean your swimsuit.

3. Legionella infection

Legionella bacteria causes Legionnaires’ disease, a type of pneumonia. Legionella are found in the water droplets of hot steam, and inhaling the contaminated steam can cause infection.

Thoroughly cleaning and disinfecting the hot tubs using the right levels of disinfectants in the water can help prevent a Legionella infection.

4. Urinary tract infection (UTI)

In rare cases, a hot tub can increase the risk of urinary tract infections (UTIs). This is usually caused by the same bacteria that causes hot tub rash, Pseudomonas aeruginosa. If not treated properly, it can lead to a life-threatening complication called urosepsis, where bacteria enter the bloodstream and cause systemic infection.

5. Allergic reaction

Sometimes, chemicals and disinfectants are added to the water to clean the hot tub. These may cause allergic reactions in some people, especially potassium peroxymonosulfate (PPMS). 

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How to clean and disinfect hot tubs

Most pathogens can be controlled by maintaining the cleanliness of the water using disinfectants, the most common being chlorine and bromine. Some pathogens can be hard to kill, however and require additional precautions. For example, Cryptosporidium is resistant to chlorine disinfectant. 

It is also important to maintain proper pH levels of the water in the hot tub. The temperature in a hot tub should not be higher than 104 degrees F, or 102 degrees F for pregnant women. 

The more a hot tub or pool is used, the more often disinfection is required. It is important to check the disinfectant level and add chlorine or other disinfectants if it is low, even if the hot tub or pool will not be used for a while. Hot tubs should also be scrubbed, including the drain, and the filters and pumping systems should also be cleaned and serviced regularly. 

You should keep in mind that bacteria and dirt on the surfaces around the hot tub, such as the deck or floor, can contaminate the water when someone enters the hot tub. Therefore, those areas should also be cleaned with a bleach solution. 

Before and after using a hot tub, make sure to shower or bathe with soap. Avoid hot tubs if you are sick or have an open wound so that you don’t spread bacteria in the water.

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References
Centers for Disease Control and Prevention. Hygiene-related Diseases. https://www.cdc.gov/healthywater/hygiene/disease/hot_tub_rash.html

Centers for Disease Control and Prevention. Facts About Legionella and Hot Tubs/Spas. http://ghk.h-cdn.co/assets/cm/15/11/54ffd05ccc3e2_-_legionella-factsheet.pdf

Kosatsky T, Kleeman J. Superficial and systemic illness related to a hot tub. Am J Med. 1985;79(1):10-2. https://pubmed.ncbi.nlm.nih.gov/3925779/

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