Drinking water outbreaks accounted for 3% of all outbreaks, but 15% of all outbreak-related cases.
Norwalk-like viruses: Various transmission routes, including recreational water outbreaks have been documented [ 105].
S. typhi has been identified as the pathogen in drinking water outbreaks [ 37].
Most waterborne disease outbreaks were reported in states bordering the Mississippi River (13, 87%), including all 3 drinking water outbreaks and all 7 recreational water outbreaks associated with lakes or other natural, untreated bodies of water.
The Centers for Disease Control and Prevention CDCC) reported 21 recreational water outbreaks in 2000, more than any single previous year since systematic surveillance began (Lee et al. 2002).
Contaminated groundwater is the most commonly reported source of waterborne disease in the United States, associated with 64% of the drinking water outbreaks between 1989 and 2002.
When the unknown outbreaks were omitted, there was still a statistically significant difference in secondary case rates (p = 0.030), with water outbreaks having a higher rate than food (p = 0.003).
More recently, three highly publicized drinking water outbreaks of E. coli O157 H7 infections (one each in Wyoming, New York, and Canada), have focused increased attention on the safety of drinking water (3, 4 ).
In addition, water outbreaks had lower numbers of primary cases (p < 0.001) and higher secondary cases (p = 0.043) than those where the mode of secondary transmission was person to person in the home.
We have shown that within UK waters, outbreaks of shellfish poisoning are occurring on a regular basis in different regions and affect a diverse range of molluscan shellfish and other marine organisms.
