The importance of waterborne disease outbreak surveillance in the United States

Abstract

Abstract. Analyses of the causes of disease outbreaks associated with contaminated drinking water in the United States have helped inform prevention efforts at the national, state, and local levels. This article describes the changing nature of disease outbreaks in public water systems during and discusses the importance of a collaborative waterborne outbreak surveillance system established in 1971. Increasing reports of outbreaks throughout the early 1980s emphasized that microbial contaminants remained a health-risk challenge for suppliers of drinking water. Outbreak investigations identified the responsible etiologic agents and deficiencies in the treatment and distribution of drinking water, especially the high risk associated with unfiltered surface water systems. Surveillance information was important in establishing an effective research program that guided government regulations and industry actions to improve drinking water quality. Recent surveillance statistics suggest that prevention efforts based on these research findings have been effective in reducing outbreak risks especially for surface water systems.Key words: drinking waters, epidemiology, surveillance systems.Riassunto (L'importanza della sorveglianza delle epidemie delle patologie trasmesse con le acque negli Stati Uniti). L'analisi delle cause delle epidemie di malattie associate con l'acqua potabile contaminata negli Stati Uniti ha contribuito ad indirizzare le misure di prevenzione a livello nazionale, di stato e locale. Questo articolo descrive i cambiamenti nella natura delle epidemie di malattie nei sistemi idrici pubblici fra il 1971 e il 2008 e discute l'importanza del sistema di sorveglianza delle epidemie associate all'acqua stabilito nel 1971, in un contesto di collaborazione. Un crescente numero di notifiche sulle epidemie attraverso i primi anni 80 aveva sottolineato l'importanza dei microrganismi patogeni nelle acque potabili. Le indagini sulle epidemie hanno permesso di identificare gli agenti eziologici responsabili e le deficienze nei trattamenti e nella distribuzione delle acque potabili, specialmente il rischio elevato associato con sistemi che utilizzavano acque superficiali non filtrate. Le informazioni derivanti dalla sorveglianza sono state importanti per stabilire programmi efficaci di ricerca per indirizzare i regolamenti governativi e le azioni industriali allo scopo di migliorare la qualità delle acque potabili. Statistiche recenti sui dati della sorveglianza suggeriscono che le azioni di prevenzione basate sui risultati di queste ricerche sono state efficaci nel ridurre i rischi di epidemie nei sistemi idrici pubblici.Parole chiave: acque potabili, epidemiologia, sistemi di sorveglianza.

Upscaling Transport of Bacillus subtilis Endospores and Coliphage phiX174 in Heterogeneous Porous Media from the Column to the Field Scale

“…Disease outbreaks due to contaminated groundwater are, therefore, of great concern. − In the last few decades, multiple disease outbreaks across the U.S. and Europe have been shown to have had their origin in contaminated groundwater, but it is difficult to identify specific risks due to a substantial lack of data. − It can be assumed that many cases of water-associated infections go undocumented in developing countries as well as in affluent nations . Furthermore, while health risks associated with surface water contamination have been decreasing since the end of last century, this is not the case for groundwater …”

“…7 Furthermore, while health risks associated with surface water contamination have been decreasing since the end of last century, this is not the case for groundwater. 8 One economically advantageous treatment option to reduce the concentration of pathogens in groundwater is to ensure sufficient transport times through the porous media in question. In order to determine the pathogen removal rates in an aquifer, tracer tests with surrogate organisms are often performed; 9,10 however, field tracer tests may require special permits and are time-consuming, expensive, and site-specific.…”

Prevalence and Characterization of Legionella pneumophila and Related Species from Water-Based Recreational Sites

“…In a study conducted in Chicago, United States, 41 out of 160 samples were positive for Legionella from 12 of 36 recreational centers. 25 North Carolina recently faced an outbreak of LD among the people who attended the NC Mountain State Fair held in 2019. The investigation found that the outbreak of LD was caused by exposure to Legionella in aerosolized water from a hot tub that was kept for display during the fair.…”

“…2 Since the prevalence of infections caused by the genus Legionella is high in developed countries, strict surveillance systems are in place to monitor and control any outbreaks. 25,26 The exact incidence of legionellosis worldwide is unknown because of differences in national policies in reporting such cases and due to the inadequacy of knowledge pertaining to isolation and identification of the organism.…”

Flow Cytometry and Fecal Indicator Bacteria Analyses for Fingerprinting Microbial Pollution in Karst Aquifer Systems

“…Many incidences of waterborne diseases can be associated with contamination of surface water and groundwater due to failing on‐site domestic wastewater treatment systems (DWTSs), spreading of agricultural fecal matter (i.e., manure) and other farming activities in rural and less urbanized areas (Fetter, 2001 ; WHO, 2003 ). Despite a decrease in recent decades in waterborne disease outbreak risks related to municipal water supply sources, no corresponding decrease in disease outbreak risks for untreated or inadequately treated groundwater has been observed on the basis of outbreak reports (Craun, 2012 ). Hence, microbial pathogenic contamination of aquifers remains an ongoing, globally important, water quality problem (Ashbolt, 2004 ; Nguyen et al., 2016 ).…”