Tags

Type your tag names separated by a space and hit enter

Surveillance for waterborne-disease outbreaks associated with recreational water--United States, 2001-2002.
MMWR Surveill Summ. 2004 Oct 22; 53(8):1-22.MS

Abstract

PROBLEM/CONDITION

Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have maintained a collaborative surveillance system for collecting and periodically reporting data related to occurrences and causes of waterborne-disease outbreaks (WBDOs) related to drinking water; tabulation of recreational water-associated outbreaks was added to the surveillance system in 1978. This surveillance system is the primary source of data concerning the scope and effects of waterborne disease outbreaks on persons in the United States.

REPORTING PERIOD COVERED

This summary includes data on WBDOs associated with recreational water that occurred during January 2001-December 2002 and on a previously unreported outbreak that occurred during 1998.

DESCRIPTION OF SYSTEM

Public health departments in the states, territories, localities, and the Freely Associated States are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC on a standard form. The surveillance system includes data for outbreaks associated with both drinking water and recreational water; only outbreaks associated with recreational water are reported in this summary.

RESULTS

During 2001-2002, a total of 65 WBDOs associated with recreational water were reported by 23 states. These 65 outbreaks caused illness among an estimated 2,536 persons; 61 persons were hospitalized, eight of whom died. This is the largest number of recreational water-associated outbreaks to occur since reporting began in 1978; the number of recreational water-associated outbreaks has increased significantly during this period (p<0.01). Of these 65 outbreaks, 30 (46.2%) involved gastroenteritis. The etiologic agent was identified in 23 (76.7%) of these 30 outbreaks; 18 (60.0%) of the 30 were associated with swimming or wading pools. Eight (12.3%) of the 65 recreational water-associated disease outbreaks were attributed to single cases of primary amebic meningoencephalitis caused by Naegleria fowleri; all eight cases were fatal and were associated with swimming in a lake (n = seven; 87.5%) or river (n = one; 12.5%). Of the 65 outbreaks, 21 (32.3%) involved dermatitis; 20 (95.2%) of these 21 outbreaks were associated with spas or pools. In addition, one outbreak of Pontiac fever associated with a spa was reported to CDC. Four (6.1%) of the 65 outbreaks involved acute respiratory illness associated with chemical exposure at pools.

INTERPRETATION

The 30 outbreaks involving gastroenteritis comprised the largest proportion of recreational water-associated outbreaks during this reporting period. These outbreaks were associated most frequently with Cryptosporidium (50.0%) in treated water venues and with toxigenic Escherichia coli (25.0%) and norovirus (25.0%) in freshwater venues. The increase in the number of outbreaks since 1993 could reflect improved surveillance and reporting at the local and state level, a true increase in the number of WBDOs, or a combination of these factors.

PUBLIC HEALTH ACTION

CDC uses surveillance data to identify the etiologic agents, types of aquatics venues, water-treatment systems, and deficiencies associated with outbreaks and to evaluate the adequacy of efforts (e.g., regulations and public awareness activities) for providing safe recreational water. Surveillance data are also used to establish public health prevention priorities, which might lead to improved water-quality regulations at the local, state, and federal levels.

Authors+Show Affiliations

Public Health Prevention Service, Epidemiology Program Office, CDC, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15499306

Citation

Yoder, Jonathan S., et al. "Surveillance for Waterborne-disease Outbreaks Associated With Recreational water--United States, 2001-2002." Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C. : 2002), vol. 53, no. 8, 2004, pp. 1-22.
Yoder JS, Blackburn BG, Craun GF, et al. Surveillance for waterborne-disease outbreaks associated with recreational water--United States, 2001-2002. MMWR Surveill Summ. 2004;53(8):1-22.
Yoder, J. S., Blackburn, B. G., Craun, G. F., Hill, V., Levy, D. A., Chen, N., Lee, S. H., Calderon, R. L., & Beach, M. J. (2004). Surveillance for waterborne-disease outbreaks associated with recreational water--United States, 2001-2002. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C. : 2002), 53(8), 1-22.
Yoder JS, et al. Surveillance for Waterborne-disease Outbreaks Associated With Recreational water--United States, 2001-2002. MMWR Surveill Summ. 2004 Oct 22;53(8):1-22. PubMed PMID: 15499306.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surveillance for waterborne-disease outbreaks associated with recreational water--United States, 2001-2002. AU - Yoder,Jonathan S, AU - Blackburn,Brian G, AU - Craun,Gunther F, AU - Hill,Vincent, AU - Levy,Deborah A, AU - Chen,Nora, AU - Lee,Sherline H, AU - Calderon,Rebecca L, AU - Beach,Michael J, PY - 2004/10/23/pubmed PY - 2004/10/27/medline PY - 2004/10/23/entrez SP - 1 EP - 22 JF - Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) JO - MMWR Surveill Summ VL - 53 IS - 8 N2 - PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have maintained a collaborative surveillance system for collecting and periodically reporting data related to occurrences and causes of waterborne-disease outbreaks (WBDOs) related to drinking water; tabulation of recreational water-associated outbreaks was added to the surveillance system in 1978. This surveillance system is the primary source of data concerning the scope and effects of waterborne disease outbreaks on persons in the United States. REPORTING PERIOD COVERED: This summary includes data on WBDOs associated with recreational water that occurred during January 2001-December 2002 and on a previously unreported outbreak that occurred during 1998. DESCRIPTION OF SYSTEM: Public health departments in the states, territories, localities, and the Freely Associated States are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC on a standard form. The surveillance system includes data for outbreaks associated with both drinking water and recreational water; only outbreaks associated with recreational water are reported in this summary. RESULTS: During 2001-2002, a total of 65 WBDOs associated with recreational water were reported by 23 states. These 65 outbreaks caused illness among an estimated 2,536 persons; 61 persons were hospitalized, eight of whom died. This is the largest number of recreational water-associated outbreaks to occur since reporting began in 1978; the number of recreational water-associated outbreaks has increased significantly during this period (p<0.01). Of these 65 outbreaks, 30 (46.2%) involved gastroenteritis. The etiologic agent was identified in 23 (76.7%) of these 30 outbreaks; 18 (60.0%) of the 30 were associated with swimming or wading pools. Eight (12.3%) of the 65 recreational water-associated disease outbreaks were attributed to single cases of primary amebic meningoencephalitis caused by Naegleria fowleri; all eight cases were fatal and were associated with swimming in a lake (n = seven; 87.5%) or river (n = one; 12.5%). Of the 65 outbreaks, 21 (32.3%) involved dermatitis; 20 (95.2%) of these 21 outbreaks were associated with spas or pools. In addition, one outbreak of Pontiac fever associated with a spa was reported to CDC. Four (6.1%) of the 65 outbreaks involved acute respiratory illness associated with chemical exposure at pools. INTERPRETATION: The 30 outbreaks involving gastroenteritis comprised the largest proportion of recreational water-associated outbreaks during this reporting period. These outbreaks were associated most frequently with Cryptosporidium (50.0%) in treated water venues and with toxigenic Escherichia coli (25.0%) and norovirus (25.0%) in freshwater venues. The increase in the number of outbreaks since 1993 could reflect improved surveillance and reporting at the local and state level, a true increase in the number of WBDOs, or a combination of these factors. PUBLIC HEALTH ACTION: CDC uses surveillance data to identify the etiologic agents, types of aquatics venues, water-treatment systems, and deficiencies associated with outbreaks and to evaluate the adequacy of efforts (e.g., regulations and public awareness activities) for providing safe recreational water. Surveillance data are also used to establish public health prevention priorities, which might lead to improved water-quality regulations at the local, state, and federal levels. SN - 1545-8636 UR - https://www.unboundmedicine.com/medline/citation/15499306/Surveillance_for_waterborne_disease_outbreaks_associated_with_recreational_water__United_States_2001_2002_ L2 - https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5308a1.htm DB - PRIME DP - Unbound Medicine ER -