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Outbreaks Associated with Untreated Recreational Water — California, Maine, and Minnesota, 2018–2019
Citation:
Vanden Esschert, K., S. Combes, E. Smith, T. Robinson, M. Mattioli, E. Hilborn, V. Roberts, A. Yu, K. Lamba, G. Arzaga, M. Zahn, Z. Marsh, S. Combes, E. Smith, T. Robinson, S. Gretsch, J. Laco, M. Wikswo, D. Tack, Tim Wade, AND M. Hlavsa. Outbreaks Associated with Untreated Recreational Water — California, Maine, and Minnesota, 2018–2019. MORBIDITY AND MORTALITY WEEKLY REPORT. U.S. Department of Health and Human Services, Washington, DC, 69(25):781-783, (2020). https://doi.org/10.15585/mmwr.mm6925a3
Impact/Purpose:
During 2018 - 2019, CDC's Natioanl Outbreak Reporting system received notice of 98 waterborne disease outbreaks (WBDO) associated with exposure to untreated surface waters. Three infectious etiologies were responsible for the largest number of outbreaks and cases: norovirus, Shigella spp, and Shiga-toxin producing E. coli. This report describes outbreaks associated with these pathogens in three states: California Maine and Minnesota. This qualitative WBDO information is useful to the Office of Water to understand emerging trends and occurrences of waterborne pathogens in the US.
Description:
Outbreaks associated with fresh or marine (i.e., untreated) recreational water can be caused by pathogens, toxins, or other chemical agents. Public health officials voluntarily report these outbreaks to CDC’s National Outbreak Reporting System (NORS). Reporting to NORS began in 2009; 2017 is the last year for which NORS data have been finalized. Public health officials from 30 states voluntarily reported 98 untreated recreational water–associated outbreaks, which started during 2009–2017 and resulted in at least 4,765 cases. Most of these outbreaks started during June–August (82 [84%]). Enteric pathogens were the leading confirmed outbreak etiologies: Norovirus (17 [17%] outbreaks, 1,753 cases), Shiga toxin–producing Escherichia coli (STEC) (15 [15%] outbreaks, 144 cases), Cryptosporidium (13 [13%], 147 cases), and Shigella (12 [12%] outbreaks, 777 cases). This report highlights three untreated recreational water–associated outbreaks caused by Shigella, norovirus, or STEC during 2018 or 2019. This report also highlights how microbial water quality testing, environmental investigations, microbial source tracking, and health policy and communication can be tools for preventing transmission of enteric pathogens through untreated recreational water.
URLs/Downloads:
DOI: Outbreaks Associated with Untreated Recreational Water — California, Maine, and Minnesota, 2018–2019