Be aware of waterborne organisms that COULD make you sick....or worse.

There's no beating a day out on the water! Before you load up the cooler, sunscreen and floaties for a day out, you should also equip yourself with knowledge and know-how. Most importantly, be aware that no surface water is ever entirely safe.

There are waterborne organisms that can cause illness -- and sometimes, even death if you come in contact with them. But if you are aware of the potential dangers and take precautions, you and your family can stay safe.

Here's what you should know before you go:

Primary amebic meningoencephalitis (PAM)

Although this is a rare disease, Primary Amebic Meningoencephalitis or PAM is caused by an amoeba that is common in all untreated surface water throughout Texas and the world. Naegleria fowleri is an single-celled organism present in both fresh water and soil. It thrives in water that is warmer than 80 degrees Fahrenheit and is low, stagnant or slow-moving. But it can also be present in fresh, fast-moving water.

For most, coming in contact with the organism is harmless. In rare instances, it could be fatal.

The only way to contract PAM is when water containing the organism is forced into the nasal passages - usually from diving or jumping into water, or from water skiing and similar activities. Once water containing the amoeba enters the nasal passages, it can travel into the brain and spinal cord, destroying brain tissue.

Often mistaken for the flu or meningitis, symptoms of the infection include severe headache, high fever, stiff neck, nausea, vomiting, seizures and hallucinations as the condition worsens.

Until recently, there were no known treatments for the infection. Those infected usually succumb within about 10 days. But in recent years, the Centers for Disease Control and Prevention (CDC) has found that an immediate, aggressive treatment with a combination of antimicrobial drugs has saved lives.

The most important factor is early diagnosis. Because the illness is often mistaken for the flu or even meningitis, patients may be sent home from a doctor or emergency room visit without an accurate diagnosis. According to the CDC, the disease is often not suspected until health care professionals are informed of a patient's recent visit and exposure to freshwater.

PAM is diagnosed through specialized lab tests, MRI or CT scans. Healthcare providers should be informed immediately of any recent visits to the lake or river so that appropriate testing can begin. The healthcare provider should contact the CDC Emergency Operations Center immediately.

PAM cannot be spread through drinking water or person-to-person. Swimming pools and hot tubs that are properly cleaned, maintained and chlorinated are generally safe, as is saltwater.

The CDC recommends that those taking part in freshwater-related activities use nose clips or hold their noses shut while jumping into water or doing other activities where untreated water might be forced up the nose. Since amoebas are often found in soil, it is best to avoid stirring up underwater sediment.

Although PAM is rare, equipping yourself with the right knowledge could save a life. There have been six deaths in Texas from PAM since 2020. If infection is suspected, emergency medical care should be sought immediately.

E. coli

Escherichia coli, commonly known as E. coli, is a bacterium normally found in the intestines of humans and other warm-blooded animals. It can pollute water bodies and other areas through contact with waste or feces.

Researchers have found that contact with some forms of the bacteria can cause gastrointestinal illnesses, with symptoms such as nausea, vomiting, severe diarrhea and abdominal cramps. Healthy adults usually recover from infection within a week, but young children and older adults can develop a life-threatening form of kidney failure called hemolytic uremic syndrome (HUS).

Public water treatment systems are designed to kill bacteria. Well-treated and maintained swimming pools are also safe. However, one can become infected by accidentally swallowing untreated lake or stream water while swimming or by drinking untreated water when camping, hiking or participating in other outdoor activities. The illness can also spread through contaminated foods.

Currently, there are no treatments to cure the infection or relieve symptoms. Getting rest and drinking plenty of fluids is the best option for most people. Those sick with E.coli should avoid anti-diarrheal medications. These slow the digestive system, preventing the body from ridding itself of toxins.

Giardiasis
Giardiasis is an infection of the small intestine caused by single-celled parasites called Giardia. Found worldwide, especially in areas with poor sanitation and unsafe water, the parasite typically infects through exposure to fecal matter through contaminated water or food. Symptoms, which usually begin about a week after infection, include diarrhea, nausea and abdominal cramps.

Giardiasis is one of the most common causes of waterborne disease in the United States. Infections can last up to six weeks, but intestinal problems can continue longer. Although there are drugs to combat the parasites, they do not work for everyone. Efforts should instead be focused on prevention.

Cryptosporidium

Another potentially hazardous contaminant is cryptosporidium, a microscopic parasite that lives in the intestines of warm-blooded animals, including humans, and is passed with waste. In healthy people, the parasite can cause illness with symptoms including diarrhea, vomiting, fever and dehydration, among others. Cryptosporidium can prove deadly for those with weakened immune systems. The parasite is very resistant to chlorine-based disinfectants, and boiling is considered the most effective way of killing it.

Symptoms may last for up to two weeks, though they may occasionally recur for up to a month. Some infected people may have no symptoms. Like Giardia, Cryptosporidium is a common cause of U.S. waterborne illness. Also like Giardia, these parasites are hearty and avoiding them is the best defense.

Prevention
When it comes to waterborne organisms, prevention is the key. Here are some suggestions from the CDC to avoid getting sick or spreading a waterborne illness:

• When swimming, jumping into water, waterskiing or other similar activities, use nose clips or hold your nose closed to prevent untreated water from being forced up your nose.
• Avoid stagnant water and obey "No Swimming" signs.
• Also, be careful to avoid accidentally swallowing untreated water.
• If you get thirsty while hiking, camping or doing any other activity around a stream, lake or other source of untreated water, boil the water before drinking or using it to wash food to be eaten uncooked. While commercially available filters, iodine tablets, and chlorine may eliminate some pathogens, others are hardy enough to survive temperatures below boiling.
• If you depend on a private well for your water, be sure to have it tested annually for contamination.
• Don't swim when you have diarrhea. You can spread germs in the water and sicken others.
• Practice good hygiene. Shower with soap before swimming and wash your hands after using the toilet or changing diapers. Germs on your body end up in the water.
• Take your kids on bathroom breaks or check diapers often. Waiting to hear "I have to go" may mean that it's too late.

For additional safety: If you live near water and have a septic system, have the system checked periodically to make sure it is functioning properly and not leaking waste into the water.

For more information on any of these waterborne illnesses, visit the Centers for Disease Control and Prevention website.