Outbreaks of Illness Associated with Recreational Water, United States

 Michele C. Hlavsa, MPH1; Virginia A. Roberts, MSPH1; Amy M. Kahler, MS1; Elizabeth D. Hilborn, DVM2; Taryn R. Mecher, MPH1,3; Michael J. Beach, PhD1; Timothy J. Wade, PhD2; Jonathan S. Yoder, MPH1 (Author affiliations at end of text) Outbreaks of Illness Associated with Recreational Water — United States, 2011–2012  MMWR, June 26, 2015, Vol. 64,  No. 24, page 668

Summary: What is already known on this topic? Treated and untreated recreational water–associated outbreaks occur throughout the United States and their incidence has been increasing in recent years. CDC collects data on waterborne outbreaks electronically submitted by the 50 states, the District of Columbia, U.S. territories, and Freely Associated States to CDC’s Waterborne Disease and Outbreak Surveillance System via the National Outbreak Reporting System.

What is added by this report? For 2011–2012, a total of 90 recreational water–associated outbreaks were reported to CDC, resulting in at least 1,788 cases, 95 hospitalizations, and one death. Cryptosporidium caused over half of the outbreaks associated with treated recreational water venues (e.g., pools). Escherichia coli O157:H7 and O111 caused one third of outbreaks associated with untreated recreational water (e.g., lakes).

What are the implications for public health practice? Guidance, such as the Model Aquatic Health Code (MAHC), to prevent and control recreational water–associated outbreaks can be optimized when informed by national outbreak and laboratory (e.g., molecular typing of Cryptosporidium) data.

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