WEDNESDAY, Jan. 28, 2004 (HealthDayNews) -- Anyone who's ever watched a youngster splashing around in the bath, filling and dumping water out of bath toys, knows that kids love to play in the water.
But the same toys that bring so much laughter may also be inviting germs to hang out in your tub.
In a letter in the Jan. 29 issue of the New England Journal of Medicine, Dr. Neil Smalheiser, assistant professor in psychiatry from the University of Illinois at Chicago, points out that water toys used in the bathtub or in wading pools may be an unrecognized source of infections.
Smalheiser says his neighbor's toddler daughter had a diarrheal illness caused by the single-celled parasite Giardia lamblia. Giardia is the most common non-bacterial cause of diarrhea in North America, according to the U.S. Food and Drug Administration.
While Smalheiser doesn't know if the little girl's doctors ever pinpointed the exact cause of her illness, he says she had swallowed several gulps of water from a bath toy floating in an outdoor wading pool before getting sick.
"I noticed that this was something that looked like it could be a risk and no one had ever really paid attention to it," says Smalheiser. "[Bath toys] could be a problem, or they might not be," he says adding that it would be worth finding out if there is a risk from these ubiquitous toys.
After a search of medical literature, it appears that only two studies have addressed children's bath toys. One, appearing in the January 1999 issue of the Pediatric Infectious Disease Journal found a drug-resistant strain of Pseudomonas aeruginosa was transmitted to patients in a pediatric oncology ward through bath toys used by multiple children.
The other study, done in 1976 and published in the German journal Central Sheet for Bacteriology, found bath toys could harbor as many as 4 million germs on their surfaces.
Philip Tierno, director of clinical microbiology at New York University Medical Center, says infections from bath toys are "probably more widespread than we realize." He says toys in general pose an infection risk when kids pass them back and forth.
"Eighty percent of all infectious disease is transmitted by either direct or indirect touch," says Tierno, author of the book The Secret Life of Germs: Observations and Lessons from a Microbe Hunter.
Jennifer Brown, a pediatric nurse at Children's Memorial Hospital in Chicago, says bath toys probably do contribute to some gastrointestinal illnesses, but says you don't need to deny your children bath toys altogether.
"Look for something like a cup or a bucket," she advises. "Something without seams or holes where water can go inside. Something that's easy to clean that you can dry thoroughly."
Tierno also says you don't have to forbid bath toys. "You don't have to live in a bubble, but be prudent and wise in the way your child handles toys."
He says all toys should be washed after play, especially when other kids come over and play with toys. He recommends washing them with soap and water, then rinsing them with peroxide or white vinegar, and then rinsing them once more with water.
The little girl who prompted Smalheiser's letter had swallowed water from a wading pool, which can also be a source of infection. "Wading pools are bad news," Tierno says.
He says that germs from adults and children collect in wading pools, and the low levels of chlorine in these pools aren't enough to kill bacteria and parasites.
"It's just not a good idea to bring a fillable toy into a wading pool," says Tierno, who suggests a floating toy instead.
More information
To learn more about Giardia lamblia, read the U.S. Food and Drug Administration's Bad Bug Book. To learn more about how infections are spread, go the Mayo Clinic.
