Surveillance Reports for Recreational Water-associated Disease & Outbreaks

CDC publishes summaries of recreational water-associated waterborne disease outbreaks in the United States based on reports provided by state, local, and territorial health departments. These summaries help public health practitioners better understand the germs, settings, and contributing factors (for example, the filtration system didn’t work) involved in outbreaks linked to recreational water. They also can help identify emerging waterborne disease threats and be used to inform and assess outbreak prevention measures.

Top 5 causes of recreational water outbreaks—United States, 1971–2020

Since 1971, CDC has published data on waterborne disease outbreaks associated with recreational water:

In 2021, CDC published an estimate of the burden and direct healthcare cost of infectious waterborne disease.

Links to historical surveillance reports and appendices are also available below.

Learn more about waterborne disease and outbreak surveillance milestones.

Most Recent Recreational Water–associated Outbreak and Disease Surveillance Data

Hlavsa MC, Aluko SK, Miller AD, Person J, Gerdes ME, Lee S, Laco JP, Hannapel EJ, and Hill VR. Outbreaks Associated with Treated Recreational Water — United States, 2015–2019. MMWR Morb Mortal Wkly Rep 2021;70(20):733–738. DOI:

Reports from 1978 through 2019










* Some of the documents on this page, due to their historical nature, are not able to be provided in an accessible (508-compliant) format. People with disabilities experiencing problems accessing these documents should contact CDC-INFO at, 800-232-4636 or the TTY number at (888) 232-6348 and ask for a 508 Accommodation PR#9342. If emailing please type “508 Accommodation PR#9342” without quotes in the subject line of the email.