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Waterborne disease outbreaks, 1986-1988
W C Levine1, W T Stephenson, G F Craun
1Division of Bacterial Diseases, Center for Infectious Diseases.
Summary
Waterborne illnesses from drinking water outbreaks remain a concern, with Giardia lamblia and Shigella sonnei frequently implicated. Large outbreaks, including Cryptosporidium and Norwalk-like viruses, highlight risks even in treated water supplies.
Area of Science:
- Public Health
- Environmental Health
- Epidemiology
Background:
- Waterborne disease outbreaks pose significant public health risks.
- Surveillance data from 1986-1988 indicate continued challenges in ensuring safe drinking water.
- Recreational water use also contributes to illness outbreaks.
Purpose of the Study:
- To analyze trends and common agents in drinking waterborne disease outbreaks.
- To identify specific water sources and contamination pathways.
- To assess the impact of large-scale outbreaks on overall reported illness.
Main Methods:
- Analysis of reported waterborne disease outbreaks from 24 states and Puerto Rico (1986-1988).
- Identification of causative agents, including protozoa, bacteria, and viruses.
- Categorization of outbreaks by water type (drinking, recreational) and source.
Main Results:
- 50 drinking water outbreaks affected 25,846 people; Giardia lamblia was most common.
- Shigella sonnei outbreaks linked to human waste contamination.
- Cryptosporidium caused the largest outbreak (13,000 people); Norwalk-like virus outbreak affected 5,000.
- First reported outbreak of chronic diarrhea from untreated well water in 1987.
- 26 recreational water outbreaks included Pseudomonas dermatitis and various infections.
Conclusions:
- Despite declining trends, large outbreaks significantly impact annual case numbers.
- Contamination of both treated and untreated water sources remains a critical issue.
- Continued vigilance and improved water treatment/source protection are essential for preventing waterborne illnesses.