Going to the beach these days is like taking a dip in an open sewer, according to a new report from the Natural Resources Defense Council.

The NRDC found the nation’s beaches are befouled by raw sewerage and floating debris that is not just seriously gross but a serious health hazard. This is the 19th year that the Washington-based environmental group has published its annual seaside report card, and things aren’t getting any sunnier. For the fourth year in a row, it tallied more than 20,000 closing and advisory days at popular beaches around the country.

Public health officials say swimming with sewage can make you sick and sometimes kill you. The list of waterborne illnesses includes stomach flu, skin rashes, pinkeye, ear, nose and throat problems, dysentery, hepatitis, respiratory ailments and neurological disorders, according to the NRDC. The group’s advice: To minimize risk, don’t go in the water after heavy rains when raw sewerage and polluted storm runoff is often swept out to sea. 

But the report also has a tiny bit of good news: Out of 200 beaches around the country, only about a dozen received top marks based on five water quality and testing measures. We’ve got one of these “five star” beaches within driving distance: Ocean City in Worcester, Maryland.

To read the press release and full report, click here. Here is a USA Today story too.