Waterborne disease in the United States, 1991 and 1992

Abstract

Although outbreaks of waterborne disease are probably underrecognized and underreported, the reported data are helpful in identifying water treatment deficiencies as well as in characterizing the epidemiology of waterborne disease.For 1991 and 1992, 17 states and territories reported 34 outbreaks of disease associated with drinking water, which affected an estimated 17,464 people. A protozoal parasite (Giardia lamblia or Cryptosporidium) was identified as the etiologic agent for seven of the eleven outbreaks for which an agent was determined; the remaining four were due to hepatitis A, Shigella sonnei, or chemicals. A lack of treatment or inadequate treatment accounted for the majority of outbreaks, and most (76 percent) were associated with well water. In addition, eight states reported eleven outbreaks of gastroenteritis associated with unintentional ingestion of recreational water. Six of these outbreaks were caused by Giardia or Cryptosporidium. Ongoing for 22 years, this national surveillance of waterborne disease helps to identify deficiencies in water systems and the etiologic agents associated with outbreaks.