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SURVEILLANCE FOR DRINKING WATER-ASSOCIATED OUTBREAKS-UNITED STATES, 2001-2002
Citation:
Blackburn, B. G., G. Craun, J. Yoder, S. Lee, R L. Calderon, V. Hill, N. Chen, D. Levy, AND M. Beach. SURVEILLANCE FOR DRINKING WATER-ASSOCIATED OUTBREAKS-UNITED STATES, 2001-2002. MORBIDITY AND MORTALITY WEEKLY REPORT 53(8):23-45, (2004).
Impact/Purpose:
This surveillance system is the primary source of data concerning the scope and effects of waterborne disease outbreaks on persons in the United States
Description:
Problem/Condition: Since 1971, CDC, the U.S. Environmental Protection
Agency (EPA), and the Council of State and Territorial Epidemiologists CSTE) have maintained a collaborative surveillance system for collecting and periodically reporting data related to occurrences and causes of waterborne-disease outbreaks (WBDOs). This surveillance system is the primary source of data concerning the scope and effects of waterborne disease outbreaks on persons in the United States.
Reporting Period Covered: This summary includes data from the period January 2001 u December 2002, as well as three previously unreported outbreaks that occurred in 2000.
Description of the System: The surveillance system includes data for outbreaks associated with drinking water. State, territorial, Freely Associate States, and local public health departments are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC on a standard form.
Results: During 2001 u 2002, a total of 31 outbreaks associated with drinking water were reported by 19 states. These 31 outbreaks caused illness among an estimated 1,020 persons and were linked to seven deaths. The microbe or chemical that caused the outbreak was identified for 24 77.4%) of the 31 outbreaks. Nineteen (79.2%) of the 24 identified outbreaks were associated with pathogens; five (20.8%) were acute chemical poisonings. Five outbreaks were caused by norovirus; protozoa were identified in five outbreaks, and non-Legionella bacteria in three outbreaks. Of the seven outbreaks involving acute gastrointestinal illness of unknown etiology, all were suspected of having an infectious cause. Six drinking water-associated outbreaks of Legionnaires? disease occurred, which were included in this surveillance summary for the first time. Twenty-three (92.0%) of the 25 non-Legionella associated outbreaks were reported in systems that use groundwater sources; nine (39.1%) of these 23 groundwater outbreaks were associated with private, individual wells that are not regulated by EPA.
Interpretation: Drinking water outbreaks decreased compared to the previous reporting period. The number of outbreaks associated with surface water decreased, as only two (8.0% of the total) occurred in 2001