Surveillance for Waterborne Disease and Outbreaks Associated with Recreational Water, United States, 2003-2004 and Surveillance for Waterborne Disease and Outbreaks Associated with Drinking Water and Water Not Intended for Drinking, United States, 200

摘要

During 1920-1970, statistical data regarding waterborne disease and outbreaks (WBDOs) in the United States were collected by different researchers and federal agencies (1). Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists (CSTE) have collaboratively maintained the Waterborne Disease and Outbreak Surveillance System (WBDOSS), a surveillance system that tracks the occurrences and causes of WBDOs associated with drinking water (211). In 1978, WBDOs associated with recreational water were added to the surveillance system. The types of outbreaks and diseases included in the surveillance summaries have expanded multiple times. Outbreaks of Pontiac fever (PF) were added in 1989 (9), outbreaks of Legionnaires disease were added in 2001 (2), and single cases of Vibrio illness associated with recreational water but not limited to preexisting wounds have been added in this report. WBDOs associated with drinking water and water not intended for drinking are presented in a separate report (12). WBDO surveillance activities are intended to (1) characterize the epidemiology of WBDOs; (2) identify changing trends in the etiologic agents and other risk factors associated with WBDOs; (3) identify major deficiencies in providing safe recreational water; (4) encourage public health personnel to detect and investigate WBDOs; and (5) foster collaboration among local, state, federal, and international agencies on initiatives to prevent waterborne disease. Data obtained through the WBDOSS are useful for identifying major deficiencies in providing safe recreational water, influencing research priorities, supporting public health recommendations, and encouraging improved waterquality policies and regulations. However, the WBDOs summarized in this report represent only a portion of the illness associated with water exposure. The surveillance information described in this report does not include endemic waterborne disease risks, although studies to measure the levels of endemic illness associated with recreational water use are needed. Reliable estimates of the number of unrecognized WBDOs are not available.