Abstract
This study aimed to assess the causes of the swimming pool-associated viral outbreaks in China and discuss the possible preventive measures for the outbreaks. A systematic search was performed in 4 Chinese and English databases for studies investigating the swimming pool-associated viral outbreaks in China up to June 2024. 29 outbreaks were included in the review. A median of 89 cases per outbreak was observed among 29 outbreaks, and most outbreaks (27/29, 93%) were caused by adenovirus. The findings regarding the difference in attack rate of adenovirus between males and females were not consistent. Poor maintenance and management of the pool (26/29, 90%), difficulty in early identification of outbreaks (21/29, 72%), and lack of public awareness of waterborne diseases (7/29, 24%) were the main causes of the outbreaks. This review reveals the causes of swimming pool-associated viral outbreaks in China, and possible preventive measures could include improving pool maintenance and management, early recognition of the outbreaks, and increasing public awareness of recreational water illnesses.
Published Version
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