2013-2014 Outbreaks Associated with Environmental & Undetermined Exposures to Water Surveillance Report: Supplemental Tables

These tables provide supplemental information not published in Waterborne Disease Outbreaks Associated With Environmental and Undetermined Exposures to Water – United States, 2013-2014 (MMWR Weekly).

Table. Waterborne disease outbreaks associated with environmental and undetermined exposures to water* (n = 28), by state or jurisdiction and month of first case onset — Waterborne Disease and Outbreak Surveillance System, United States, 2013–2014

Environmental Exposures to Water

Exposure state/ Jurisdiction Month Year Class*** Etiology† Predominant illness§ No. cases No. hospitalizations¶ No. deaths** Deficiency†† Water source Setting
Colorado October 2014 III Giardia duodenalis AGI 9 0 0 12 River/Stream Park
Illinois January 2013 III Pseudomonas aeruginosa Skin 30 7 0 12 Other†† Store/Shop
Illinois September 2013 III Giardia duodenalis AGI 69 0 0 12 River/Stream Park
Michigan October 2014 III Giardia duodenalis AGI 6 0 0 12 Sewage Private Residence
Minnesota December 2013 IV Legionella pneumophila serogroup 1 ARI 2 2 0 5b Fountain – Ornamental Casino
Minnesota July 2014 III Giardia duodenalis AGI 6 0 0 12 River/Stream Public Outdoor Area
New Mexico July 2013 III Giardia duodenalis AGI 3 0 0 12 River/Stream Camp/Cabin Setting
New York October 2013 III Giardia duodenalis AGI 5 0 0 12 Spring Other§§
Ohio June 2013 III Legionella pneumophila serogroup 1 ARI 39 32 6 5c Cooling Tower Hospital/Health Care
Ohio July 2013 I Legionella pneumophila serogroup 1 ARI 3 2 1 5b Cooling Tower Factory/Industrial Facility
Ohio August 2014 III Legionella pneumophila serogroup 1 ARI 22 8 0 5b Evaporative Condenser/ Air Conditioner Church/Place of Worship
Pennsylvania July 2013 III Legionella pneumophila serogroup 1 ARI 6 3 0 5b Cooling Tower Prison/Jail (Juvenile/Adult)
Pennsylvania August 2013 III Legionella pneumophila serogroup 1 ARI 15 15 2 5b Cooling Tower;             Fountain – Ornamental Hospital/Health Care
Utah October 2014 IV Giardia duodenalis AGI 4 0 0 12 River/Stream Backcountry
Virginia May 2013 IV Unknown AGI 7 0 0 99c Lake/Reservoir/ Impoundment Public Outdoor Area

Undetermined Exposures to Water

Exposure state/ Jurisdiction Month Year Class*** Etiology† Predominant illness§ No. cases No. hospitalizations¶ No. deaths** Deficiency††† Water source Setting
Alabama September 2013 IV Legionella pneumophila serogroup 1 ARI 19 14 5 5c Unknown Long Term Care Facility
California January 2014 IV Legionella pneumophila serogroup 1 ARI 2 2 0 5c Unknown Hotel/Motel/Lodge/Inn
California April 2014 IV Legionella pneumophila serogroup 2-14 ARI 2 2 1 5c Unknown Assisted Living Facility
Kentucky June 2014 IV Legionella pneumophila serogroup 1 ARI 6 2 0 5c Unknown Long Term Care Facility
Montana July 2014 IV Cryptosporidium sp. AGI 11 0 0 99d Unknown NR***
New York May 2014 IV Legionella pneumophila serogroup 1 ARI 2 2 0 5c Unknown NR***
Ohio July 2009¶¶ IV Legionella pneumophila serogroup 1 ARI 9 6 0 5c Unknown Long Term Care Facility
Ohio July 2013 IV Legionella pneumophila serogroup 1 ARI 2 2 0 5c Unknown Indoor Workplace/Office
Ohio March 2014 IV Legionella pneumophila serogroup 1 ARI 4 2 1 5c Unknown Long Term Care Facility
Ohio April 2014 IV Legionella pneumophila serogroup 1 ARI 4 2 1 5c Unknown Long Term Care Facility
Ohio October 2014 IV Legionella pneumophila serogroup 1 ARI 2 2 0 5c Unknown Hospital/Health Care
Pennsylvania January 2014 IV Legionella pneumophila serogroup 1 ARI 6 6 0 5c Unknown Assisted Living Facility
Texas April 2013 IV Legionella pneumophila serogroup 1 ARI 3 3 0 5c Unknown Prison/Jail (Juvenile/Adult)

Abbreviations: AGI = acute gastrointestinal illness; ARI = acute respiratory illness; Skin = illnesses, conditions, or symptoms related to the skin; NR = not reported.

* The environmental exposure to water category includes outbreaks not associated with exposure to drinking water systems (i.e., public, private or bottled water) or recreational water venues (e.g., swimming pools, lakes). The undetermined exposure to water category includes outbreaks where a single water exposure (i.e. treated or untreated recreational water, drinking water, or environmental exposures) could not be determined based on available evidence.

† Etiologies listed are confirmed, unless indicated “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 people for whom information was available was also zero.

** Value was set to “missing” in reports where zero deaths were reported and the number of people for whom information was available was also zero.

†† This outbreak was associated with a water storage container used in a tattoo and piercing shop.

§§ This outbreak setting was associated with a spring on a private property in a rural area.

¶¶ This outbreak from 2009 was not included in previous NORS reports. Data from this outbreak are presented in this table but not included in the analysis and discussion.

*** 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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