Doctors are reemphasizing the importance of adequate pool and spa sanitation and disinfection for ear health.

Swimming pool otitis — also known as swimmer’s ear — is a painful ear infection of the external or outer ear canal.

It is distinct from otitis media, which is a middle-ear infection that sometimes follows allergies, a cold, sore throat, or respiratory infection.

Swimmer’s ear is frequently caused by the bacteria Pseudomonas aeruginosa and/or Staphylococcus aureus that can proliferate in swimming pools that are not adequately cleaned and disinfected, according to Paola Marchisio, director of the Uosd Pediatrics High Intensity Care Unit of the Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano and associate professor at the University of Milan.

Among the hallmarks of the infection is pain, which may begin as a vague discomfort and then rapidly progress to more intense pain, generally presenting within 48 hours of contact with the bacteria. Other symptoms are itching, decreased hearing, and a sensation of a closed ear, as the outer ear canal swells.

“In otitis externa one feels a very strong pain even if one only touches the auricle, so much so that one cannot even lay one’s head on the pillow to sleep,’ Marchisio said.

In severe cases, patients may experience fever, pain through the face or neck, or swollen lymph nodes in the neck.

It is much more common in children than in adults with a maximum incidence between 5 and 14 years of age, Marchisio said.

Swimmer's ear is usually treated with eardrops. Prompt treatment can help prevent complications and more serious infections, which can become chronic due to resistant bacteria.

Swimmer’s ear can be prevented by adequately sanitizing pools and spas.

According to the Mayo Clinic, it can also be prevented by drying ears after swimming with a towel or hair dryer.

“If you know you don't have a punctured eardrum, you can use homemade preventive eardrops of 1 part white vinegar to 1 part rubbing alcohol. This solution promotes drying and helps prevent the growth of bacteria and fungi. Before and after swimming, pour 1 teaspoon (about 5 milliliters) of the solution into each ear and let it drain back out. Similar over-the-counter solutions might be available at your drugstore,” the Mayo Clinic states on its website at www.mayoclinic.org.