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Water-related Technical Assistance and Outbreak Response

When people and communities in the U.S. and internationally are concerned about the safety of their drinking and recreational waters, they contact Health Studies Branch for answers and action. HSB conducts rapid epidemiologic investigations in response to outbreaks that may be associated with exposure to water contaminated with non-infectious agents (e.g., chemicals, toxins, heavy metals). Our subject matter experts also provide technical assistance and consultation to state, local, other federal, and international public health agencies.

Environmental conditions greatly influence the relation between water and human health. Challenges to the healthfulness of U.S. water include (1) pathogens resistant to standard water treatment methods, (2) chemical and biological contaminants, (3) aging or inadequate water system infrastructure, and (4) emergency- or disaster-related events. During 1999–2000, 25 states reported 39 drinking water-related outbreaks that caused 2,068 cases of illnesses and 2 deaths. Of the 22 outbreaks for which a cause was identified, 20 were associated with pathogens (parasites, bacteria, or viruses) and 2 were associated with chemical poisonings (nitrate and sodium hydroxide) (MMWR November 22, 2002;51[SS08]:1–28). There are concerns that some substances in water, such as disinfection byproducts and toxins released by marine algae, are associated with health effects. For examples of how HSB has helped state and local public health authorities in the past, please click here.