• Child Health
• Communicable Diseases
• Epidemiology
• Gastroenterology
• Infectious Disease Medicine

We have fond memories of spending our family summers playing in British rivers. However, the Environmental Agency (EA) highlights alarmingly frequent and prolonged discharges of untreated sewage into our rivers, through storm overflow spills1—averaging 825 spills each day, totalling nearly 1.8 million hours over 2022. Concerns must be raised whether all of these releases are necessary, and why none of our rivers now meet legal water quality standards.

Clean water and sanitation is one of the most important modern public health interventions. As human excrement contains over 50 pathogens,2 the accidental ingestion of contaminated water can allow faeco-oral transmission of pathogens including Escherichia coli, Enterococcus and Norovirus. Indeed, studies3 have demonstrated increased odds of gastroenteritis ailments (OR 1.29) and other illnesses such as otitis externa, folliculitis and pneumonia (OR 1.86) in those with recreational exposure from wild swimming, compared with …