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Waterborne illnesses are something that I think about every spring as my thoughts turn to summer swims and keeping cool. These diseases affect over 7 million people in the US annually, and cost our healthcare system over $3B.
Intrigued? This week, we'll tackle three related topics: swimmer's ear, cholera, and the scourge of day cares everywhere—hand, foot, and mouth disease (which, somewhat rarely, is contracted in settings like improperly chlorinated pools).
Drop me a line with thoughts about the newsletter, what music should power me through this week, or your favorite links that could be candidates for my "best of" section below. Thanks and wishing you a salubrious week!
—Dina Fine Maron, 1440 Health & Medicine Section Editor |
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Swimmer's ear 101
Swimmer's ear is America's top waterborne illness, leading to some 4.7 million infections and $280M in emergency room costs annually. This painful ear infection, formally called otitis externa, typically occurs when water remains in the ear after swimming or bathing, creating a moisture-rich environment that allows bacteria or fungi to thrive. Unlike middle ear infections, swimmer's ear is an infection that affects the space between the external ear and the middle ear. Swimmer's ear won't get better on its own and requires medication.
Swimming increases the risk of developing otitis externa fivefold. Other factors can also put people at risk of developing swimmer's ear, including wearing earbuds that can trap perspiration in the ear or using Q-tips to dry or clean the ears, which can cause microtears inside the ear (ear damage is why doctors say we shouldn't ever place them inside our ears).
Swimmer's ear is not contagious. It's also different from surfer's ear, a condition in which frequent exposure to icy cold water causes tiny bony growths to develop in the ear canal. Those growths also increase people's risk of developing swimmer's ear because more water can get trapped in the ear.
Explore everything else we've found on Swimmer's Ear.
Also, check out ...
> Learn how your earwax may be determined by genetics—and geography. (Read)
> Q-tips, invented in the 1920s, were first called "Baby Gays." (Read)
> Why infants are particularly at risk for ear infections. (Read)
> Neanderthals commonly had "surfer's ear," a potential sign of extensive seafood collection. (Read) |
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What's cholera?
Cholera is a diarrheal infection caused by an extremely resilient comma-shaped bacterium called Vibrio cholerae. It's typically ingested via contaminated water or tainted foods. This microscopic pathogen can survive in the environment without a host and reproduces most effectively in slightly salty, brackish water. Consuming large amounts of Vibrio cholerae may cause life-threatening dehydration via drastic diarrhea and vomiting.
Outbreaks often erupt when sanitation systems—clean water access, plumbing, and toilets—are unavailable or poorly maintained, particularly during humanitarian crises. Someone may be a carrier for the disease without feeling sick, releasing pathogens into the environment via their poop. Sewage runoff may spread via rain or flooding and spread the pathogen widely. The bacteria can also spread on the bodies of flies and the feet, feathers, and fur of animals.
The world is currently in the midst of its seventh official cholera pandemic, which began in the 1960s and continues to infect hundreds of thousands of people annually. In 2023, this pandemic sickened more than half a million people and killed more than 4,000.
Explore everything else we've found on Cholera.
Also, check out ...
> This is the sound your stomach makes before intense diarrhea. (Listen)
> John Snow figured out water contamination—cholera—sickened London. (Listen)
> Cholera was once called the "Blue Death." (Read)
> Learn how cholera bacteria sicken humans. (Listen)
> Just-published imaging of the Vibrio bacteria may fuel new treatment targets. (Read) |
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An introduction to HFMD
Hand, foot, and mouth disease primarily affects young children who haven't yet built up immunity to the several viruses known to cause it. HFMD is highly contagious and leads to painful sores and blisters in and around the mouth, hands, and feet—thus the name. There's no cure for this disease, though it typically resolves in about a week. First identified in 1957 in New Zealand, there are more than 200,000 cases of HFMD annually in the US, and they often occur in settings such as day cares and playgrounds.
The disease can spread in several ways, including contact with saliva, mucus, fluid from the blisters and stool, and virus-laden surfaces such as toys or doorknobs. More rarely, people may also become sick after swallowing improperly chlorinated pool water that has tiny bits of virus-laden poop floating around.
Though adults typically have some immunity to HFMD, it can still sicken adults, and the viral disease has been known to spread across college campuses: In 2018, it sickened more than 120 people at Johns Hopkins University alone and also caused outbreaks across six other Eastern colleges. In 2025, for still-unknown reasons the disease caseload spiked in the mid-Atlantic as compared to other recent years, with larger-than-expected outbreaks across Maryland, Virginia, and New Jersey—though they mostly affected young children.
Explore everything else we've found on Hand, Foot, and Mouth Disease.
Also, check out ...
> See the differences between chickenpox and hand, foot, and mouth. (Read)
> Why was there a 2025 HFMD spike? (Read)
> The similarly named foot-and-mouth disease doesn't affect humans. (Read)
> Hand, foot, and mouth disease is part of the same virus family as polio. (Listen)
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Medical Developments Spotlight |
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We love spending time learning about the latest medical breakthroughs and spotlighting research that piques our interest, may influence future research directions, or inform healthcare conversations. Here's what we found this week.
> Pickleball eye injuries are on the rise—especially among older players
Eye | Jainam Shah, Sachin Pathuri, et al. Eye injuries—largely preventable with safety goggles and better awareness—have been a growing issue in this popular sport. Analysis of records from 2014 to 2023 indicates that there were more than 2,500 such pickleball injuries during that period, with the average incident occurring at age 58. (Read)
> How home design can reduce cases of malaria, diarrhea, and respiratory infection
Science | Kai Kupferschmidt. A randomized controlled trial in Tanzania showed that an $8,800 home designed with screens, outdoor latrines, rodent-free storage, and other features reduced malaria cases by 44%, diarrhea cases by 30%, and respiratory infections by 18% compared with typical low-resource housing. The study's authors hope that future housing in low-resource areas could be built cheaply while incorporating effective design fixes to save lives. (Read)
> Gene therapy for a rare form of deafness is enabling near-normal hearing
NPR | Rob Stein. An experimental therapy for people born with a very rare form of deafness—affecting about 50 babies annually in the US—is enabling some children to achieve sustained near-normal hearing, providing the best evidence yet of this approach's safety and effectiveness. The treatment corrects mutations in the OTOF gene, which allows the body to make a protein necessary for hair cells in the inner ear to transmit sound signals to the brain. (Read)
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"You and I may not live to see the day, and my name may be forgotten when it comes, but the time will arrive when great outbreaks of cholera will be things of the past; and it is the knowledge of the way in which the disease is propagated which will cause them to disappear." |
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