An evaluation of waterborne disease surveillance in the European Union

Surveillance systems to inform controls for waterborne disease (WBD) are important for the protection of public health. Member States of the European Union (EU) will soon be required to implement Directives and the Protocol on Water and Health for controlling WBD. The investigation reported here considers the consistency of surveillance systems across the EU. Eleven EU member states participated in a survey to determine the nature and range of practices used for monitoring WBD. Some WBD are notifiable in most countries surveyed, others are notifiable only in one country. Non-notifiable WBD are routinely monitored in five countries. Surveillance schemes are inconsistent, and the variable mandatory reporting among the Member States allows many WBD cases to remain unidentified. Nine replying countries had no legal definition for WBD outbreak. No country requires the reporting of anti-diarrhea medication sales for detecting outbreaks.