Surveillance for waterborne disease outbreaks associated with drinking water and other nonrecreational water - United States, 2009-2010

MMWR Morb Mortal Wkly Rep. 2013 Sep 6;62(35):714-20.


Despite advances in water management and sanitation, waterborne disease outbreaks continue to occur in the United States. CDC collects data on waterborne disease outbreaks submitted from all states and territories through the Waterborne Disease and Outbreak Surveillance System. During 2009-2010, the most recent years for which finalized data are available, 33 drinking water-associated outbreaks were reported, comprising 1,040 cases of illness, 85 hospitalizations, and nine deaths. Legionella accounted for 58% of outbreaks and 7% of illnesses, and Campylobacter accounted for 12% of outbreaks and 78% of illnesses. The most commonly identified outbreak deficiencies in drinking water-associated outbreaks were Legionella in plumbing systems (57.6%), untreated ground water (24.2%), and distribution system deficiencies (12.1%), suggesting that efforts to identify and correct these deficiencies could prevent many outbreaks and illnesses associated with drinking water. In addition to the drinking water outbreaks, 12 outbreaks associated with other nonrecreational water were reported, comprising 234 cases of illness, 51 hospitalizations, and six deaths. Legionella accounted for 58% of these outbreaks, 42% of illnesses, 96% of hospitalizations, and all deaths. Public health, regulatory, and industry professionals can use this information to target prevention efforts against pathogens, infrastructure problems, and water sources associated with waterborne disease outbreaks.

MeSH terms

  • Bacterial Infections / epidemiology*
  • Campylobacter / isolation & purification
  • Disease Outbreaks / statistics & numerical data*
  • Drinking Water / microbiology*
  • Giardia / isolation & purification
  • Humans
  • Legionella / isolation & purification
  • Population Surveillance*
  • United States / epidemiology
  • Water Microbiology*
  • Water Pollutants


  • Drinking Water
  • Water Pollutants