Health officials are urgently warning against swimming in disease-ridden lakes as more than two dozen young people fall ill in Virginia

Americans are being warned to be careful while swimming in lakes this summer – after several children suffered kidney failure after swimming in fresh water.

The patients became ill days after playing in Lake Anna, Virginia, over Memorial Day weekend, with symptoms including diarrhea, dehydration and stomach cramps.

A total of twenty people – mainly children – have become ill after swimming in the lake, while a number have also been hospitalized. No deaths have been reported.

Tests show that many of the patients are infected with E.coli, a bacteria that can contaminate lakes and rivers, usually when sewage is dumped into them.

However, officials are testing for other bugs, including the deadly brain-eating amoeba Naegleria fowleri – which kills more than 97 percent of those it infects.

Amoebae appear to be becoming more common in freshwater as warmer weather warms lakes and streams.

Families who have lost loved ones to the amoeba are raising awareness about the organism this year, including the mother of 10-year-old Lily Avant – who died in 2019 after contracting the disease from a local river.

Most people contract E.coli from eating foods such as salad, which may have been sprayed with water contaminated with the bacteria.

But it is also possible to catch the bacteria from lakes and rivers if someone swallows contaminated water. Three to five percent of patients die from the disease.

Fifteen-year-old Ava Inglett was among those hospitalized during the Virginia E.coli outbreak.

Her mother Judy told her local news her daughter became ill a few days after attending a boating weekend at the lake before being rushed to hospital.

She has now had at least four rounds of dialysis and three blood transfusions as she battles the infection.

“She’s going through all these things that I never in a million years would have imagined my daughter would have to deal with,” Mrs Inglett said.

“There’s something in the water that’s making all these kids sick.”

She added: ‘I want people to know and think twice before they let their child swim in that water because I would hate for anyone else to go through what my daughter went through.’

The lake, about 70 miles south of Washington DC, is popular with families and for boating activities, as well as swimming and kayaking. About 3 million visitors enjoy days at the lake every year.

Virginia Department of Health officials revealed the spike in illnesses in an alert and said they were testing the water to determine the cause.

All patients are also interviewed to ensure the E.coli did not come from food, a common way people become infected.

Ten of the patients have been confirmed to be infected with E.coli.

Health Director Dr Olugbenga Obasanjo said: “As we head to pools, lakes and beaches to enjoy the warmer weather and spend time with our families, it is important to remember to take precautions to prevent illness.

‘Showering before and after swimming, washing your hands before eating and making sure you don’t drink the lake water are some ways to stay healthy this summer.

‘Even if you have diarrhea, it is important not to swim.’

He added: ‘Children may need additional monitoring and reminders to follow these precautions.’

E.coli often enters lakes through leaks from sewage pipes or animal feces, as well as through runoff from storm drains.

Swimmers can then become infected if they accidentally swallow contaminated water or handle food after swimming without washing their hands.

The bacteria can survive the stomach acid and travel to the small intestine, where they cause an infection that causes the typical gastrointestinal symptoms.

But they also release toxins in the intestines that can enter the bloodstream and destroy red blood cells.

The waste from destroyed cells can then build up in the kidneys, preventing them from filtering the blood properly, causing kidney failure.

Doctors treat the condition through dialysis – which filters the blood when the kidneys cannot do so – giving the kidneys time to heal.

To treat an E.coli infection, doctors prescribe antibiotics, such as ciprofloxacin and azithromycin, which kill the bacteria.

About three to five percent of patients who contract E.coli die from the disease, the World Health Organization says.

It is especially dangerous for children under five years old, adults over 65 years old, and anyone with a weakened immune system.