Outbreaks Associated with Ingesting Water from Freshwater Sources in Outdoor Settings-United States, 2000-2022

Area of Science:

• Environmental Health
• Infectious Diseases
• Public Health Surveillance

Background:

• Freshwater sources can harbor pathogens, posing risks if ingested without adequate treatment.
• Waterborne illnesses can result from consuming contaminated drinking or recreational water.

Purpose of the Study:

• To analyze outbreaks linked to ingesting insufficiently treated freshwater in outdoor settings.
• To identify pathogens, water sources, and demographic factors associated with these outbreaks.

Main Methods:

• Analysis of data from the Waterborne Disease and Outbreak Surveillance System (WBDOSS) from 2000-2022.
• Focus on outbreaks involving ingestion of freshwater in outdoor environments.

Main Results:

• 32 outbreaks reported across 16 jurisdictions, causing 437 illnesses and 4 hospitalizations.
• Giardia (69%) and Campylobacter (28%) were the primary pathogens; rivers/streams were the most common source (75%).
• Half of outbreaks involved no water treatment; exposure occurred in recreational areas, with peak illness in ages 10-19.

Conclusions:

• Outbreaks from untreated freshwater are preventable through potable water use or proper treatment.
• Public health initiatives should emphasize safe water practices, hygiene, and treatment for outdoor enthusiasts.
• Healthcare providers should inquire about freshwater exposure in patients with gastrointestinal symptoms.