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Outbreaks Associated with Treated Recreational Water - United States, 2000-2014
MMWR. Morbidity and Mortality Weekly Report
|May 18, 2018
Summary
Recreational water outbreaks from 2000-2014 caused over 27,000 illnesses and eight deaths, primarily from Cryptosporidium and Legionella. Hotels were the leading outbreak setting, highlighting the need for improved water safety measures.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Environmental Health
Background:
- Outbreaks linked to treated recreational water venues like pools and spas pose significant public health risks.
- Pathogens and chemicals in water can cause illness, with notable examples including Cryptosporidium, Legionella, and Pseudomonas.
Purpose of the Study:
- To analyze the epidemiology of outbreaks associated with treated recreational water in the United States from 2000 to 2014.
- To identify common pathogens, settings, and temporal trends associated with these outbreaks.
Main Methods:
- Retrospective analysis of outbreak data reported by public health officials across 46 states and Puerto Rico.
- Categorization of outbreaks by causative agent (infectious or chemical), specific pathogen, venue type, and temporal occurrence.
Main Results:
- 493 outbreaks reported, resulting in at least 27,219 cases and eight deaths.
- Cryptosporidium was the leading cause of infectious outbreaks (58%), followed by Legionella (16%) and Pseudomonas (13%).
- Hotels were the most frequent setting (32%), and outbreaks peaked in summer months.
Conclusions:
- Outbreaks in treated recreational water remain a substantial public health concern, with chlorine-resistant pathogens emerging as key etiological agents.
- Findings underscore the importance of implementing and adhering to guidelines like the CDC's Model Aquatic Health Code to prevent future outbreaks.
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