With the summer comes family vacations, but the U.S. Centers for Disease Control and Prevention is warning travelers about the risks associated with swimming in hotel pools or hot tubs.

According to the CDC’s Morbidity and Mortality Weekly Report, around one-third of the treated recreational waterborne disease outbreaks reported between 2000 and 2014 occurred in hotel pools or hot tubs.

Of the 493 outbreaks reported during this period, there were 27,219 people who became sick and another eight died. The most common outbreaks were associated with Cryptosporidium, Pseudomonas and Legionella.

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The most common parasite reported is Cryptosporidium, which represents 58 percent of outbreaks where a germ was identified linked to pools, hot tubs, and water playgrounds and 89 percent of the illnesses.

“Swallowing just a mouthful of water with Crypto in it can make otherwise healthy kids and adults sick for weeks with watery diarrhea, stomach cramps, nausea, and vomiting,” CDC’s Healthy Swimming Program chief Michele Hlavsa said. “Chlorine cannot kill Crypto quickly. We need to keep it out of the water in the first place. Don’t go into the water, and don’t let your kids go into the water if sick with diarrhea.”

Of the remaining outbreaks reported to the CDC, 16 percent were caused by Legionella and 13 percent were caused by Pseudomonas. If a hotel pool, hot tub or water playground is not cleaned properly, bacteria can grow and form a slime called biofilm on wet surfaces, which is where Legionella and Pseudomonas can live.

The CDC provided advice for travelers to protect themselves this summer:

  • Don’t swim or let your kids swim if sick with diarrhea. If Crypto is the cause of diarrhea, wait until 2 weeks after diarrhea has stopped to go swimming.
  • Check the pools, hot tubs, and water playground inspection scores.
  • Before getting in the water, use a test strip from your local retailer or pool supply store to check if the water’s pH and bromine or free chlorine level are correct.
  • Don’t swallow the water.
  • Take kids on bathroom breaks hourly, and change diapers in a diaper-changing area and away from the water.