Outbreaks Associated with Untreated Recreational Water - California, Maine, and Minnesota, 2018–2019

• Published in: MMWR. Morbidity and Mortality Weekly Report Vol. 69; no. 25; pp. 781 - 783
• Main Authors: Esschert, Kayla L Vanden, Mattioli, Mia C, Hilborn, Elizabeth D, Roberts, Virginia A, Yu, Alexander T, Lamba, Katherine, Arzaga, Gena, Zahn, Matthew, Marsh, Zachary, Combes, Stephen M, Smith, Emer S, Robinson, Trisha J, Gretsch, Stephanie R, Laco, Joseph P, Wikswo, Mary E, Miller, Allison D, Tack, Danielle M, Wade, Timothy J, Hlavsa, Michele C
• Format: Report
• Language: English
• Published: Atlanta U.S. Center for Disease Control 26-06-2020
• Subjects: Age; Bacteria; Diarrhea; E coli; Environmental monitoring; Epidemics; Epidemiology; Etiology; Fecal coliforms; Feces; Genomes; Geographical distribution; Health care; Health policy; Illnesses; Lakes; Microorganisms; Outbreaks; Pathogens; Pollution monitoring; Public access; Public health; Recreation; Rivers; Shigellosis; Social networks; Swimming; Toxins; Water quality; United States > US; Maine; Minnesota; California
• ISSN: 0149-2195; 1545-861X

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. 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 US. 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).