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Thread: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

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    Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Hello ~

    My entire family came down with a rash last night / this morning. After doing some research and talking with a doctor we found out what happened. We all have Hot Tub Rash or Pseudomonas Dermatitis / Folliculitis.

    My husband has been testing the water and on Friday the chlorine and ph level were low but not out of the normal range. He said he was not concerned and we went swimming. The weather has been very hot here and the water felt like a hot tub. Lesson now learned not only do we need to buy a better testing kit, but we need to keep the levels up better and especially when the water is hot.

    If we decide to keep the pool running, how do we make sure the bacteria is completely gone? Do we need to clean all the pool toys? How do we get it back to 100%?

    Edit to add that I just purchased the TF-100 test kit.

    We really appreciate any help and suggestions with this issue!
    Thank you
    AG Vinyl Intex Easy Set 15' x 48" 3,736 Gallon with Intex 1600 GPH Saltwater System & Sand Filter Pump Set

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    Isaac-1's Avatar
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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    It is hard for us to give any advice without good test numbers
    Indoor 20x40 35,000 gallon vinyl pool with 1.5 HP 2 speed Jandy FloPro pump, Hayward EC75 Perflex DE filter, 11 4x12 Techno-Solis solar panels w/ Aquasolar controller, Aquabot Turbo T Robot Cleaner. Also LMI metering chlorine dispenser pump and HotSpring Jetsetter
    I use and endorse TFtestKits TF-100 from http://tftestkits.net
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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Get your test kit and post your results. I would likely go ahead and SLAM the pool as soon as I got the test results in hand since you know your FC levels have been low and you have something active in your pool water causing rashes.

    You will need to get your ph balanced before you start adding the chlorine when you get your test. Ph results are inaccurate when chlorine levels are high.
    Indiana, ABG 24'x52" Galveston by Blue Cascade (Craigslist buy w/part of deck included), 13,500 gallons, Intex SWG, solar panels mix 2, TF-100 test kit.

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Thank you! I will repost when the test kit arrives.
    AG Vinyl Intex Easy Set 15' x 48" 3,736 Gallon with Intex 1600 GPH Saltwater System & Sand Filter Pump Set

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    Richard320's Avatar
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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Quote Originally Posted by rach_osu
    Hello ~

    My entire family came down with a rash last night / this morning. After doing some research and talking with a doctor we found out what happened. We all have Hot Tub Rash or Pseudomonas Dermatitis / Folliculitis.

    My husband has been testing the water and on Friday the chlorine and ph level were low but not out of the normal range. ... Screech!
    Stop right there.

    What's "normal" for free chlorine? 1-3 on a color block tester? The middle dots on the test strip? What have you been chlorinating with, and how high's the CYA?

    I'll wager large sums to anyone who wants to take me up on it that the CYA is well into three figures and the Free Chlorine number is nowhere near the target range on pool-school/chlorine_cya_chart_shock

    The first part of the solution is the test kit you've ordered. Pay particular attention to the CYA level and the CC level when you do your first tests. Those will tell you if you need to do a partial drain and/or SLAM the pool.
    16K freeform gunite with spa; Pentair 4000 DE filter; Century Whisperflow 1 HP; Pentair Minimax heater.
    Troublefree does not mean Maintenancefree. It's like brushing your teeth: You can spend a couple minutes a day and pennies a week or go to the dentist once a year and spend several thousand dollars.
    A pool is like a pet - you have to feed it every day, even the days you don't want to play with it!

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Thank you!! I really appreciate your post and your "screech" made me laugh out loud!! I know it's not funny but it just amplifies how I feel!! We have four little ones and the home is my thing and the outside is his thing. He wanted to take care of it and while I didn't want to challenge him on caring for the pool, I felt he was being too relaxed on the pool testing. I am going to pass along your post to him....

    I will be back in a couple of days when the test kit arrives to figure out what we can do to fix this for the rest of this season.

    Thank you again!!
    AG Vinyl Intex Easy Set 15' x 48" 3,736 Gallon with Intex 1600 GPH Saltwater System & Sand Filter Pump Set

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Given the delay before symptoms, it does seem more like a bacterial infection than a chemical reaction (see this link) and your doctor's diagnosis is the best way to know what you have. Also, the active chlorine level must have been low for more than a day and your pool must have been quite warm (as you indicated) since normally that bacteria proliferates much more in hot tubs than in pools (it is found in pools, but not in as large quantities). If you were using test strips, they are practically useless.

    The advice in this thread is sound. 1) Get a proper test kit (the TFTestkits TF-100 or the Taylor K-2006), 2) If the CYA level in your pool is high, say higher than 50 ppm, do a partial drain/refill to lower it, 3) SLAM the pool by raising and maintaining a shock level of FC appropriate to the CYA level, 4) put your pool toys, life jackets, and other items you had in the pool when you were swimming into the pool while you are SLAMing it or wipe them outside the pool with a dilute bleach solution (quite dilute so that you don't bleach out the fabric -- no more than 1/4 teaspoon of bleach in 2 gallons of water).

    Can you give us a history of what chemicals you added to the pool since you first filled it with water? You have an Intex saltwater system so something is amiss. Perhaps you never added any Cyanuric Acid (CYA aka stabilizer or conditioner) to the water so the saltwater system wasn't able to keep up during the day because the UV in sunlight would break down the chlorine faster than the saltwater system could generate chlorine. Or if you were regularly shocking or adding Dichlor, then the CYA could be too high. Let us know what you've added so we can better figure out what happened.
    16,000 gallon outdoor in-ground 16'x32' plaster pool; Pentair Intelliflo VF pump; Pentair IntelliTouch i9+3s control system; Jandy CL-340 square foot cartridge filter
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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Thank you for your help!! We really really appreciate it!

    Yes, after a trip to our doctor and the ER, Hot Tub Rash is what we all have as well as my daughter now has swimmers ear which is caused by this bacteria.

    We did order the TF-100 and it will be here soon. My husband tested the water last night with the test strips that we currently have and he said that the chlorine is purple or all the way high and everything else is showing in the lowest color. I am sorry, that is all the info he would give me and when the tests come I will be able to get better information. I also know that after we discovered the rash he went out to the pool and turned on the chlorine boost...

    When we opened the pool we did put the CYA in a floater with a sock around it. We had the saltwater system on a 6 hour on 6 hour off rotation. We also have a sand filter. We have backwashed the pool a couple of times. Do we need to take out the sand and out new in because of the bacteria? We have not added anything else to the pool. I do know that the chlorine was showing the highest color for several days and my husband told me that he turned off the saltwater system and took out the CYA floater. It is my guess that this is what happened in combination with the hot temperatures.

    How do we SLAM the pool since it is a saltwater system? What do we put in it? What about the chlorine boost cycle on the system?

    Edit to add that we will take a sample of the water to a pool supply store to see the test results.

    Thank you again for you help!!!
    AG Vinyl Intex Easy Set 15' x 48" 3,736 Gallon with Intex 1600 GPH Saltwater System & Sand Filter Pump Set

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    SLAMming a saltwater pool is the same as a non-saltwater pool. There's no need to change the sand, chlorine will take care of that. The boost function won't be able to raise the chlorine high enough and will just shorten the life of the cell. Once you get your test kit, you will SLAM using bleach or liquid chlorine.
    John
    7 year old ~13,500 gal 24' AGP with 1.5 hp Proline pump, 150 sqft Pleatco cartridge, filled with well water with pH of about 4.5.
    Wanda the Whale pool vacuum, home made heater, Taylor K-2006
    Cloudy Pool? 1) Order test kit. 2) Follow SLAM
    New to TFPC? Read Pool School a few times, then post questions. PoolMath will help with chemical additions.

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    From a PM (such questions should be posted on the forum):

    Well, we woke up this morning to the pool being completely empty except about a foot of water. It was on slightly uneven ground. I knew it and complained to my husband when he filled it that it would be an issue. He didn't seem to think so. The pool is the intex brand and the easy set model. The wall just let go and the water went over the side.

    My question to you is... since he never got the chlorine to slam it is the bacteria now all over my yard? It flooded all over my children's swing set. Can it live on that stuff?

    How about the inside of my salt water system and filtration unit? I was planning on the slam process cleaning those out of any bacteria. If we leave it off will this be a problem for next season?

    Edit to add... my husband just told me that he will level the ground under the pool with sand and refill it. Can he effectively clean the inside of the pool by wiping it down while there is no water in it? If he refills it, should he slam it as soon as it is full to clean the pool walls and the system?
    The Pseudeomonas aeurginosa is very common in the environment and normally is not a problem because it is limited in number so your immune system fights it off. The reason it can become a problem in pools and spas is that it can proliferate to much larger numbers in the water if not properly disinfected. Your child's swing when it dries out will kill most of the bacteria and the UV from sunlight will likely kill it as well.

    The inside of your saltwater chlorine generator gets water flow through it even when powered off so will get cleaned during the SLAM process.
    16,000 gallon outdoor in-ground 16'x32' plaster pool; Pentair Intelliflo VF pump; Pentair IntelliTouch i9+3s control system; Jandy CL-340 square foot cartridge filter
    12 Fafco solar panels; Purex Triton PowerMax 250 natural gas heater (200,000 BTU/hr output); automatic electric pool safety cover; 4-wheel pressure-side "The Pool Cleaner"

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Thank you so much for your help! So sorry about that!

    So we do not need to physically wipe down the inside of the pool at this point? Or should it be brushed after we add new water and slam it?

    If we decide to dry the pool out and not refill it this year, I am guessing that the sun will kill off the remaining bacteria left on the pool walls. I am just concerned that my husband will come in contact with the nasty stuff again. Sorry to re-ask the same questions again.. but want to double check that if we winterize the sand and saltwater system that we will not need to worry about any bacteria left behind for next year.

    Thank you everyone for helping us so much!!!!!

    Thank you!
    AG Vinyl Intex Easy Set 15' x 48" 3,736 Gallon with Intex 1600 GPH Saltwater System & Sand Filter Pump Set

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    If the pool walls feel at all slimy, then go ahead and wipe them down with a dilute bleach solution. If they are slimy, then there may be biofilms and those will be more resistant even with the SLAM process. If the walls are squeaky clean, then no need for the extra wipe down.

    Even if you dry out the pool, if the walls are slimy I'd still wipe them down. Be sure to wear gloves.

    As for the sand filter, you should check it to make sure there isn't channeling or clumping of the sand as that could also indicate biofilms. If you see issues there, then there are biofilm removal products such as Ahh-Some® and AquaFinesse™.
    16,000 gallon outdoor in-ground 16'x32' plaster pool; Pentair Intelliflo VF pump; Pentair IntelliTouch i9+3s control system; Jandy CL-340 square foot cartridge filter
    12 Fafco solar panels; Purex Triton PowerMax 250 natural gas heater (200,000 BTU/hr output); automatic electric pool safety cover; 4-wheel pressure-side "The Pool Cleaner"

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    Richard320's Avatar
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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Quote Originally Posted by rach_osu
    Thank you for your help!! We really really appreciate it!

    Yes, after a trip to our doctor and the ER, Hot Tub Rash is what we all have as well as my daughter now has swimmers ear which is caused by this bacteria.

    We did order the TF-100 and it will be here soon.
    I'm going to bookmark this thread so I can post this the next time someone argues against spending the dough for a proper test kit because it's just a kiddie pool.

    Tell me, if you don't mind, how the price of the test kit stacks up against the cost/copay of the doctor visit?
    16K freeform gunite with spa; Pentair 4000 DE filter; Century Whisperflow 1 HP; Pentair Minimax heater.
    Troublefree does not mean Maintenancefree. It's like brushing your teeth: You can spend a couple minutes a day and pennies a week or go to the dentist once a year and spend several thousand dollars.
    A pool is like a pet - you have to feed it every day, even the days you don't want to play with it!

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Quote Originally Posted by Richard320
    Quote Originally Posted by rach_osu
    Thank you for your help!! We really really appreciate it!

    Yes, after a trip to our doctor and the ER, Hot Tub Rash is what we all have as well as my daughter now has swimmers ear which is caused by this bacteria.

    We did order the TF-100 and it will be here soon.
    I'm going to bookmark this thread so I can post this the next time someone argues against spending the dough for a proper test kit because it's just a kiddie pool.

    Tell me, if you don't mind, how the price of the test kit stacks up against the cost/copay of the doctor visit?
    I find that comment not very nice! I am a mother of 4 small children and watching them suffer was definitely not part of the plans when we put together our pool and test kits. We have a 15 x 48 size pool with the intex 1600 sand /saltwater system and by no means did we think it was a kiddie pool. Unfortunately my laid back husband did not educate himself enough to really understand the pool chemistry. It has been a very hard lesson for all of us and we have all shed many many tears over this entire situation.

    We have decided to begin to winterize the pool and put it away for the season. I absolutely can not thank the people of this forum enough for helping us through this. We appreciate it so much!! I know next spring when we get everything back out that we will be here again reading and learning from everyone.
    AG Vinyl Intex Easy Set 15' x 48" 3,736 Gallon with Intex 1600 GPH Saltwater System & Sand Filter Pump Set

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    Richard320's Avatar
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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Quote Originally Posted by rach_osu

    I find that comment not very nice! I am a mother of 4 small children and watching them suffer was definitely not part of the plans when we put together our pool and test kits. We have a 15 x 48 size pool with the intex 1600 sand /saltwater system and by no means did we think it was a kiddie pool. Unfortunately my laid back husband did not educate himself enough to really understand the pool chemistry. It has been a very hard lesson for all of us and we have all shed many many tears over this entire situation.

    We have decided to begin to winterize the pool and put it away for the season. I absolutely can not thank the people of this forum enough for helping us through this. We appreciate it so much!! I know next spring when we get everything back out that we will be here again reading and learning from everyone.
    Sorry if you took it the wrong way, but it was not a dig at you personally. Many people show up here with problem pools and balk at spending the money on a test kit because the pool store tests for free and the kit is almost as much as they paid for the pool. But this thread points out the risk of that, and I intend to refer to it the next time that argument comes up again. You have added to the collective store of knowledge here. Sometimes the horror stories illustrate things best.
    16K freeform gunite with spa; Pentair 4000 DE filter; Century Whisperflow 1 HP; Pentair Minimax heater.
    Troublefree does not mean Maintenancefree. It's like brushing your teeth: You can spend a couple minutes a day and pennies a week or go to the dentist once a year and spend several thousand dollars.
    A pool is like a pet - you have to feed it every day, even the days you don't want to play with it!

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Below is a link to a Clorox Service Bulletin PDF document. Page 4 of this document describes Clorox's recommended steps to treat Pseudomonas Aeruginosa using Clorox regular bleach.

    [center:122s7dea]http://www.clorox.com/pdf/5813-100_s...-bulletins.pdf[/center:122s7dea]

    In short, here's what it says:

    "For hospital -and/or- healthcare disinfection -or- To kill Pseudomonas aeruginosa: [First] Clean surface by removing gross filth (loose dirt, debris,food materials, etc.) Use 1/2 cup of This Product in 1 gallon of water. -or- Prepare a 2400 ppm available chlorine solutions. [Use chlorine test stripsto determine exact available chlorine concentration -or- verify the appropriate available chlorine concentration is achieved.] Thoroughly wet surface with the solution and allow it to remain in contact with the surface for 10 minutes. Rinse with clean water and dry."


    This document has all kinds of useful information in it. I hope it helps.

    Dave
    21,000 gal IG - Pebble Sheen Blue Granite - raised spa w/spillway – 3 sheer decents
    Pentair: Easytouch 8 – Intelliflo VS filter pump – Intellichlor IC-40 SWG – Screenlogic 2
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    Polaris 280 vacuum – Built April 2013 – Full Sun

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    Re: Treating Pseudomonas Aeruginosa (hot tub rash) in a pool

    Quote Originally Posted by df21084
    Below is a link to a Clorox Service Bulletin PDF document. Page 4 of this document describes Clorox's recommended steps to treat Pseudomonas Aeruginosa using Clorox regular bleach.

    [center:tt4r9li2]http://www.clorox.com/pdf/5813-100_s...-bulletins.pdf[/center:tt4r9li2]

    In short, here's what it says:

    "For hospital -and/or- healthcare disinfection -or- To kill Pseudomonas aeruginosa: [First] Clean surface by removing gross filth (loose dirt, debris,food materials, etc.) Use 1/2 cup of This Product in 1 gallon of water. -or- Prepare a 2400 ppm available chlorine solutions. [Use chlorine test stripsto determine exact available chlorine concentration -or- verify the appropriate available chlorine concentration is achieved.] Thoroughly wet surface with the solution and allow it to remain in contact with the surface for 10 minutes. Rinse with clean water and dry."


    This document has all kinds of useful information in it. I hope it helps.

    Dave
    Thank you SO MUCH Dave!!! I really really appreciate the information!!
    AG Vinyl Intex Easy Set 15' x 48" 3,736 Gallon with Intex 1600 GPH Saltwater System & Sand Filter Pump Set

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