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In the twenty-first century, it's relatively rare, at least in the developed world, for anyone to bathe in water that has fecal matter floating in it. We don't share toilet paper. We don't have to worry about developing gangrene if we bathe with an open wound.
However there are problems in personal hygiene that perpetuate other diseases even in the modern era. Here are some problem areas with easy fixes.
- Demodex infections. Everyone has at least a few of the tiny mites known as Demodex lodged on their facial skin. These almost-microscopic eight-legged creatures feed on excess skin oils and bacteria. In many (although not all) people who have acne rosacea, however, Demodex numbers build up and cause allergic reactions which are seen as acne-like breakouts. It's important (1) for people with acne rosacea to use fresh towels and wash cloths every day, so they do reinfect themselves with Demodex and (2) for other members of the household not to use the wash linens used by someone who has rosacea.
- Doggy do. The canine members of our families don't wipe up after they relieve themselves. For that reason, it's not a great idea for dogs to share bath water, swimming pool water, or hot tub water. Tapeworms in dogs can be transmitted to humans if water is swallowed, and hookworms in dogs can be transmitted to humans by contact.
- Swimmer's itch (known as "stinging water" in parts of Europe) is a parasitic infection of the skin with a form of schistosomiasis, which gets into water from bird droppings. Don't swim in lakes or rivers where birds congregate. Don't swim in a pool where there are large numbers of birds.
- Head lice infect about 20 percent of elementary school children. They are much more common in girls than in boys, due to the usual length of girls' hair. Lice can spread to anyone in the family who uses the same combs, the same towels, the same bed linens, or the same pillows. It's important not to share.
- Legionnaires' disease (legionella) is a bacterial infection that tends to accumulate in stagnant water. It's rare, although not unknown, for the infection to grow in hot tubs and shared physical therapy baths. If you share water for treating a sports injury, make sure that the therapist keeps the tub clean and uses appropriate disinfectants.
- Giardiasis, a particularly unpleasant long-term form of diarrhea also known as "purple burps," is spread by cysts from feces that find their way into water. It's a major hazard of bathing in "pristine" mountain streams (when you don't know who has bathed in them before you) and using any water in an area where people don't wash their hands after bowel movement. The only solution is not to drink or bathe in contaminated water.