Public Health Significance of Swimming Pool Granuloma

Abstract

Epidemiological study involving 262 cases of granulomatous lesions of the skin resulting from swimming in a warm mineral water pool showed Mycobacterium balnei to be the causative organism. The elbow was the site of 85% of the lesions due to abrasions from rough stones forming the sides of the pool. Maintenance of chlorine residual in pool was not possible due to action of minerals in the water. Tuberculin tests (Vollmer patch test) on 1,648 children in the community showed a reactor rate of 4.3% for those without lesions and a rate of 82% for those with lesions. Of those showing positive tuberculin reactions 77% had converted since their last previous patch test done 1 to 2 years prior to the development of their skin lesions. Chest x-rays of all granuloma cases with positive tuberculin reactions showed no pathological findings suggestive of tuberculosis.