We considered the following health endpoints consistent with those we previously reported [6 (link),7 (link)].
"Gastrointestinal illness" (GI illness) was defined as any of the following: (1) diarrhea (three or more loose stools in a 24-hour period); (2) vomiting; (3) nausea and stomachache; (4) nausea or stomachache, and interference with regular activities (missed regular activities as a result of the illness).
"Upper respiratory illness" (URI) was defined as any 2 of the following: sore throat, cough, runny nose, cold, or fever.
"Rash" was defined as a rash or itchy skin.
"Eye irritations" were defined as either eye infection or watery eye.
"Earache" was defined as earache, ear infection, or runny ears.
Diarrhea was also considered as a stand alone outcome because it is a commonly used definition of gastroenteritis in population-based surveillance [12 (link),13 (link)].
Participants ill within 3 days before their beach visit were excluded from analysis of the health outcome related to their baseline symptoms.
Diarrhea was also considered as a stand alone outcome because it is a commonly used definition of gastroenteritis in population-based surveillance [12 (link),13 (link)].
Participants ill within 3 days before their beach visit were excluded from analysis of the health outcome related to their baseline symptoms.
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