ArticleMMWR. Morbidity and mortality weekly report2020
Outbreaks Associated with Untreated Recreational Water - California, Maine, and Minnesota, 2018-2019.
Article in MMWR. Morbidity and mortality weekly report, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Transkingdom Interactions Between Viruses and Bacteria: Implications for Wastewater Treatment Efficiency.Food and environmental virology · 2026Review
- First Reported Outbreak of Persistent Shiga Toxin-producingOpen forum infectious diseases · 2026Article
- Integrated global assessment ofEco-Environment & Health · 2026Article
- Temporal trends ofFrontiers in public health · 2026Observational
- A multi-tiered approach to assess fecal pollution in an urban watershed: Bacterial and viral indicators and sediment microbial communities.The Science of the total environment · 2024Article
- Clostridium and Cryptosporidium outbreak linked to a splash pad.BMC public health · 2024Article
- Acute Gastroenteritis Outbreak Among Colorado River Rafters and Backpackers in the Grand Canyon, 2022.Wilderness & environmental medicine · 2024Article
- Scenario-based assessment of fecal pathogen sources affecting bathing water quality: novel treatment options to reduce norovirus andFrontiers in microbiology · 2024Article
- Pathogenicity and virulence ofVirulence · 2023Review
- Estimating Waterborne Infectious Disease Burden by Exposure Route, United States, 2014.Emerging infectious diseases · 2023Article
- Persistence of Human Norovirus (GII) in Surface Water: Decay Rate Constants and Inactivation Mechanisms.Environmental science & technology · 2023Article
- Whole-Genome Sequencing and Virulome Analysis of Escherichia coli Isolated from New Zealand Environments of Contrasting Observed Land Use.Applied and environmental microbiology · 2022Article
- A Waterborne Gastroenteritis Outbreak Caused by a GII Norovirus in a Holiday Camp in Catalonia (Spain), 2017.Viruses · 2021Article
- Nationwide Assessment of Water Quality in Rivers across Lebanon by Quantifying Fecal Indicators Densities and Profiling Antibiotic Resistance ofAntibiotics (Basel, Switzerland) · 2021Article
- The European Union One Health 2019 Zoonoses Report.EFSA journal. European Food Safety Authority · 2021Article
- Natural Host-Environmental Media-Human: A New Potential Pathway of COVID-19 Outbreak.Engineering (Beijing, China) · 2020Article
Corrections and comments
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Outbreaks associated with fresh or marine (i.e., untreated) recreational water can be caused by pathogens or chemicals, including toxins. Voluntary reporting of these outbreaks to CDC's National Outbreak Reporting System (NORS) began in 2009. NORS data for 2009-2017 are finalized, and data for 2018-2019 are provisional. During 2009-2019 (as of May 13, 2020), public health officials from 31 states voluntarily reported 119 untreated recreational water-associated outbreaks, resulting at least 5,240 cases; 103 of the outbreaks (87%) started during June-August. Among the 119 outbreaks, 88 (74%) had confirmed etiologies. The leading etiologies were enteric pathogens: norovirus (19 [22%] outbreaks; 1,858 cases); Shiga toxin-producing Escherichia coli (STEC) (19 [22%]; 240), Cryptosporidium (17 [19%]; 237), and Shigella (14 [16%]; 713). This report highlights three examples of outbreaks that occurred during 2018-2019, were caused by leading etiologies (Shigella, norovirus, or STEC), and demonstrate the wide geographic distribution of such outbreaks across the United States. Detection and investigation of untreated recreational water-associated outbreaks are challenging, and the sources of these outbreaks often are not identified. Tools for controlling and preventing transmission of enteric pathogens through untreated recreational water include epidemiologic investigations, regular monitoring of water quality (i.e., testing for fecal indicator bacteria), microbial source tracking, and health policy and communications (e.g., observing beach closure signs and not swimming while ill with diarrhea).
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