2013-2014 Drinking Water-associated Outbreak Surveillance Report: Supplemental Tables

These tables provide supplemental information not published in Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water — United States, 2013–2014 (MMWR Weekly).

Table 1. Waterborne Disease Outbreaks Associated with Drinking Water (N=42) State/Jurisdiction and Month of First Case Onset — Waterborne Disease and Outbreak Surveillance System, United States, 2013-2014

Abbreviations: L. pneumophila = Legionella pneumophila; AGI = acute gastrointestinal illness; ARI = acute respiratory illness; Neuro = neurologic illnesses, conditions, or symptoms (e.g., meningitis); S = suspected

* Etiologies listed are confirmed, unless indicated as suspected. For multiple-etiology outbreaks, etiologies are listed in alphabetical order.

† The category of illness reported by ≥50% of ill respondents. All legionellosis outbreaks were categorized as ARI.

§ Value was set to “missing” in reports where zero hospitalizations were reported and the number of persons for whom information was available was also zero or instances where reports are missing hospitalization data.

¶ Value was set to “missing” in reports where zero deaths were reported and the number of persons for whom information was available was also zero or instances where reports are missing data on associated deaths.

** Community and noncommunity water systems are public water systems that have ≥15 service connections or serve an average of ≥25 residents for ≥60 days/year. A community water system serves year-round residents of a community, subdivision, or mobile home park. A noncommunity water system serves an institution, industry, camp, park, hotel, or business and can be nontransient or transient. Nontransient systems serve ≥25 of the same persons for ≥6 months of the year but not year-round (e.g., factories and schools) whereas transient systems provide water to places in which persons do not remain for long periods of time (e.g., restaurants, highway rest stations, and parks). Individual water systems are small systems not owned or operated by a water utility that have <15 connections or serve <25 persons.

††Classification of all reported Giardia cases has changed from Giardia intestinalis to Giardia duodenalis to align with laboratory standards.

§§ Setting is listed as other as implicated facility houses both independent living and assisted living facilities.

¶¶ This count was not included in the analysis of the current report. This outbreak occurred in 2012 and was not reported in the previous drinking water outbreak report.

*** Patients’ methemoglobin levels ranged from 1.6%–32.3%. Water was determined to be the source rather than food as all cases had direct exposure to water. Of the 14 cases, 5 used the water to make oatmeal or cream of wheat.

††† This report includes both community and hospital-associated cases (27/45 patients reported healthcare/hospital exposure).

§§§ This is the first drinking water-associated outbreak of this etiology reported to NORS.

¶¶¶ Microcystin was detected in finished water sampled from a community water system; levels exceeded state thresholds and resulted in a ‘Do not drink’ advisory.

**** Cryptosporidium was detected in water samples but not in any clinical specimens.

†††† This system was registered as a community system as a result of the outbreak investigation.

§§§§ Illnesses were associated with exposure to 4-methylcyclohexanemethanol following a documented industrial spill into water supplying a public water system. However, individual levels of exposure could not be quantified in clinical specimens. Propylene glycol phenyl (PPH) ether was also present in the spill at low concentrations.

¶¶¶¶ Strength-of-evidence class determined on the basis of epidemiologic, clinical laboratory, and environmental data (e.g., water quality data) provided to CDC. For more information, see Strength-of-Evidence Classification for Waterborne Disease & Outbreaks.

***** Deficiency classification assigned to all outbreaks associated with drinking water. For more information, see Deficiency Classification for Drinking Water and Other, Non-recreational Waterborne Disease Outbreaks.

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Table 2. Number of Waterborne Disease Outbreaks, by Etiology Group — Waterborne Disease and Outbreak Surveillance System, United States, 2013-2014.

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Table 3a. Number of Waterborne Disease Outbreaks, Community Water Systems — Waterborne Disease and Outbreak Surveillance System, United States, 2013-2014.

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Table 3b. Number of Waterborne Disease Outbreaks, Non-community Water Systems — Waterborne Disease and Outbreak Surveillance System, United States, 2013-2014.

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Table 3c. Number of Waterborne Disease Outbreaks, Commercially-bottled Water — Waterborne Disease and Outbreak Surveillance System, United States, 2013-2014.

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Table 3d. Number of Waterborne Disease Outbreaks, Private Water Systems — Waterborne Disease and Outbreak Surveillance System, United States, 2013-2014.

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