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A Systematic Review of Waterborne Disease Outbreaks Associated with Small Non-Community Drinking Water Systems in Canada and the United States.

Pons W, Young I, Truong J, Jones-Bitton A, McEwen S, Pintar K, Papadopoulos A - PLoS ONE (2015)

Bottom Line: There was large variation in terminology used to describe SDWSs, and a large number of variables were not reported, including water source and whether water treatment was used (missing in 31% and 66% of reports, respectively).More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs.Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.

View Article: PubMed Central - PubMed

Affiliation: Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada.

ABSTRACT

Background: Reports of outbreaks in Canada and the United States (U.S.) indicate that approximately 50% of all waterborne diseases occur in small non-community drinking water systems (SDWSs). Summarizing these investigations to identify the factors and conditions contributing to outbreaks is needed in order to help prevent future outbreaks.

Objectives: The objectives of this study were to: 1) identify published reports of waterborne disease outbreaks involving SDWSs in Canada and the U.S. since 1970; 2) summarize reported factors contributing to outbreaks, including water system characteristics and events surrounding the outbreaks; and 3) identify terminology used to describe SDWSs in outbreak reports.

Methods: Three electronic databases and grey literature sources were searched for outbreak reports involving SDWSs throughout Canada and the U.S. from 1970 to 2014. Two reviewers independently screened and extracted data related to water system characteristics and outbreak events. The data were analyzed descriptively with 'outbreak' as the unit of analysis.

Results: From a total of 1,995 citations, we identified 50 relevant articles reporting 293 unique outbreaks. Failure of an existing water treatment system (22.7%) and lack of water treatment (20.2%) were the leading causes of waterborne outbreaks in SDWSs. A seasonal trend was observed with 51% of outbreaks occurring in summer months (p<0.001). There was large variation in terminology used to describe SDWSs, and a large number of variables were not reported, including water source and whether water treatment was used (missing in 31% and 66% of reports, respectively).

Conclusions: More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs. Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.

No MeSH data available.


Related in: MedlinePlus

Frequency distribution of etiologic agents in waterborne disease outbreaks in small drinking water systems.Outbreaks reported in Canada and the United States (1970–2014) (n = 293). Other bacteria include: Salmonella spp (n = 6), E.coli O157:H7 (n = 3), Yersinia enterocolitica (n = 3), Streptococcus spp (n = 2), Bacillus cereus (n = 1) and Pseudomonas aeruginosa (n = 1). Other viruses include: Small Round Structured Viruses (SRSV) (n = 1) and Rotavirus (n = 2). Multiple agents included: Campylobacter jejuni and E. coli O157:H7 (n = 2); Campylobacter jejuni and Giardia intestinalis (n = 2); Campylobacter jejuni and Shigella sonnei (n = 1); Campylobacter jejuni and Norovirus (n = 1); and Campylobacter jejuni and Yersinia enterocolitica (n = 1).
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pone.0141646.g003: Frequency distribution of etiologic agents in waterborne disease outbreaks in small drinking water systems.Outbreaks reported in Canada and the United States (1970–2014) (n = 293). Other bacteria include: Salmonella spp (n = 6), E.coli O157:H7 (n = 3), Yersinia enterocolitica (n = 3), Streptococcus spp (n = 2), Bacillus cereus (n = 1) and Pseudomonas aeruginosa (n = 1). Other viruses include: Small Round Structured Viruses (SRSV) (n = 1) and Rotavirus (n = 2). Multiple agents included: Campylobacter jejuni and E. coli O157:H7 (n = 2); Campylobacter jejuni and Giardia intestinalis (n = 2); Campylobacter jejuni and Shigella sonnei (n = 1); Campylobacter jejuni and Norovirus (n = 1); and Campylobacter jejuni and Yersinia enterocolitica (n = 1).

Mentions: Slightly more than half of the outbreaks were of undetermined etiology (161/293; 54.9%). Giardia intestinalis was the most commonly identified agent (42/293; 14.3%), followed by norovirus (29/293; 9.9%) and Campylobacter jejuni (22/293; 7.5%) (Fig 3). Seven outbreaks (2.4%) involved multiple agents (Multiple agents included Campylobacter jejuni and E. coli O157:H7 (n = 2); C. jejuni and G. intestinalis (n = 2); C. jejuni and Shigella sonnei (n = 1); C. jejuni and Norovirus (n = 1); and C. jejuni and Yersinia enterocolitica (n = 1)).


A Systematic Review of Waterborne Disease Outbreaks Associated with Small Non-Community Drinking Water Systems in Canada and the United States.

Pons W, Young I, Truong J, Jones-Bitton A, McEwen S, Pintar K, Papadopoulos A - PLoS ONE (2015)

Frequency distribution of etiologic agents in waterborne disease outbreaks in small drinking water systems.Outbreaks reported in Canada and the United States (1970–2014) (n = 293). Other bacteria include: Salmonella spp (n = 6), E.coli O157:H7 (n = 3), Yersinia enterocolitica (n = 3), Streptococcus spp (n = 2), Bacillus cereus (n = 1) and Pseudomonas aeruginosa (n = 1). Other viruses include: Small Round Structured Viruses (SRSV) (n = 1) and Rotavirus (n = 2). Multiple agents included: Campylobacter jejuni and E. coli O157:H7 (n = 2); Campylobacter jejuni and Giardia intestinalis (n = 2); Campylobacter jejuni and Shigella sonnei (n = 1); Campylobacter jejuni and Norovirus (n = 1); and Campylobacter jejuni and Yersinia enterocolitica (n = 1).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4625960&req=5

pone.0141646.g003: Frequency distribution of etiologic agents in waterborne disease outbreaks in small drinking water systems.Outbreaks reported in Canada and the United States (1970–2014) (n = 293). Other bacteria include: Salmonella spp (n = 6), E.coli O157:H7 (n = 3), Yersinia enterocolitica (n = 3), Streptococcus spp (n = 2), Bacillus cereus (n = 1) and Pseudomonas aeruginosa (n = 1). Other viruses include: Small Round Structured Viruses (SRSV) (n = 1) and Rotavirus (n = 2). Multiple agents included: Campylobacter jejuni and E. coli O157:H7 (n = 2); Campylobacter jejuni and Giardia intestinalis (n = 2); Campylobacter jejuni and Shigella sonnei (n = 1); Campylobacter jejuni and Norovirus (n = 1); and Campylobacter jejuni and Yersinia enterocolitica (n = 1).
Mentions: Slightly more than half of the outbreaks were of undetermined etiology (161/293; 54.9%). Giardia intestinalis was the most commonly identified agent (42/293; 14.3%), followed by norovirus (29/293; 9.9%) and Campylobacter jejuni (22/293; 7.5%) (Fig 3). Seven outbreaks (2.4%) involved multiple agents (Multiple agents included Campylobacter jejuni and E. coli O157:H7 (n = 2); C. jejuni and G. intestinalis (n = 2); C. jejuni and Shigella sonnei (n = 1); C. jejuni and Norovirus (n = 1); and C. jejuni and Yersinia enterocolitica (n = 1)).

Bottom Line: There was large variation in terminology used to describe SDWSs, and a large number of variables were not reported, including water source and whether water treatment was used (missing in 31% and 66% of reports, respectively).More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs.Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.

View Article: PubMed Central - PubMed

Affiliation: Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada.

ABSTRACT

Background: Reports of outbreaks in Canada and the United States (U.S.) indicate that approximately 50% of all waterborne diseases occur in small non-community drinking water systems (SDWSs). Summarizing these investigations to identify the factors and conditions contributing to outbreaks is needed in order to help prevent future outbreaks.

Objectives: The objectives of this study were to: 1) identify published reports of waterborne disease outbreaks involving SDWSs in Canada and the U.S. since 1970; 2) summarize reported factors contributing to outbreaks, including water system characteristics and events surrounding the outbreaks; and 3) identify terminology used to describe SDWSs in outbreak reports.

Methods: Three electronic databases and grey literature sources were searched for outbreak reports involving SDWSs throughout Canada and the U.S. from 1970 to 2014. Two reviewers independently screened and extracted data related to water system characteristics and outbreak events. The data were analyzed descriptively with 'outbreak' as the unit of analysis.

Results: From a total of 1,995 citations, we identified 50 relevant articles reporting 293 unique outbreaks. Failure of an existing water treatment system (22.7%) and lack of water treatment (20.2%) were the leading causes of waterborne outbreaks in SDWSs. A seasonal trend was observed with 51% of outbreaks occurring in summer months (p<0.001). There was large variation in terminology used to describe SDWSs, and a large number of variables were not reported, including water source and whether water treatment was used (missing in 31% and 66% of reports, respectively).

Conclusions: More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs. Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.

No MeSH data available.


Related in: MedlinePlus