Magnitude & Burden of Waterborne Disease in the U.S.

Although the U.S. has one of the safest drinking water systems in the world, there are an estimated 4-32 million cases of acute gastrointestinal illness (AGI) per year from public drinking water systems 1,2. This estimate does not include waterborne illness from non-public drinking water systems (for example, private wells), recreational water, or water for other uses (for example, irrigation, medical uses, or building water systems.) The frequency of disease from all water exposures is likely higher, but the overall prevalence of waterborne illness in the U.S. is unknown. It is important to understand the full scope of waterborne illness in the U.S. so that researchers and public health agencies can assess the public health risk of illness due to contaminated water, advocate for resources, and develop preventive measures.

Developing a Comprehensive Waterborne Disease Burden Estimate

CDC is working to estimate illnesses, hospitalizations, deaths, and healthcare costs for various types of waterborne diseases in the U.S. To better guide these efforts, CDC and partners are working to develop a comprehensive estimate of waterborne disease in the U.S.

The new estimate will provide numbers of people in the U.S. who:

  • Get sick from waterborne diseases
  • Are hospitalized with waterborne diseases
  • Die of waterborne diseases

The new estimate will also include illnesses from all types of waterborne diseases. Waterborne illness can cause a variety of health conditions, including:

  • Gastrointestinal illness (for example, upset stomach, diarrhea, or vomiting)
  • Respiratory illness (for example, coughing, difficulty breathing, or pneumonia)
  • Eye, ear, or skin infections (for example, Swimmer’s Ear or Hot Tub Rash)
  • Wound infections

This comprehensive burden estimate will provide a better understanding of the top waterborne pathogens driving illness and healthcare costs in the U.S. and will serve as a tool to help public health and water representatives focus resources toward developing effective and cost-efficient disease prevention strategies.

To learn more about estimating the magnitude and burden of waterborne disease, visit the following pages:

Contact Us

If you would like to learn more about our work to develop a comprehensive waterborne disease burden estimate, share resources, or make suggestions, contact us at

  1. Colford JM, Roy S, Beach MJ, Hightower A, Shaw SE, Wade TJ. A review of household drinking water intervention trials and an approach to the estimation of endemic waterborne gastroenteritis in the United States.External J Water Health. 2006; 4 Suppl 2: 71-88.
  2. Messner M, Shaw S, Regli S, Rotert K, Blank V, Soller J. An approach for developing a national estimate of waterborne disease due to drinking water and a national estimate model application.External J Water Health. 2006;4(Suppl 2):201-40.