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Outbreaks Associated with Treated Recreational Water - United States, 2015-2019.
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- Author(s): Hlavsa MC; Aluko SK; Miller AD; Person J; Gerdes ME; Lee S; Laco JP; Hannapel EJ; Hill VR
- Source:
MMWR. Morbidity and mortality weekly report [MMWR Morb Mortal Wkly Rep] 2021 May 21; Vol. 70 (20), pp. 733-738. Date of Electronic Publication: 2021 May 21.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: U.S. Centers for Disease Control Country of Publication: United States NLM ID: 7802429 Publication Model: Electronic Cited Medium: Internet ISSN: 1545-861X (Electronic) Linking ISSN: 01492195 NLM ISO Abbreviation: MMWR Morb Mortal Wkly Rep Subsets: MEDLINE
- Publication Information: Publication: Atlanta, GA : U.S. Centers for Disease Control
Original Publication: [Atlanta] U. S. Dept. of Health, Education, and Welfare, Public Health Service, Center for Disease Control. - Subject Terms: Recreation*; Communicable Diseases/*epidemiology ; Disease Outbreaks/*statistics & numerical data ; Water Purification/*statistics & numerical data; Baths/adverse effects ; Communicable Diseases/etiology ; Cryptosporidium/isolation & purification ; Health Resorts/statistics & numerical data ; Humans ; Legionella/isolation & purification ; Swimming Pools/statistics & numerical data ; United States/epidemiology ; Water Microbiology
- Abstract: Outbreaks associated with treated recreational water can be caused by pathogens or chemicals in aquatic venues such as pools, hot tubs, water playgrounds, or other artificially constructed structures that are intended for recreational or therapeutic purposes. For the pseriod 2015-2019, public health officials from 36 states and the District of Columbia (DC) voluntarily reported 208 outbreaks associated with treated recreational water. Almost all (199; 96%) of the outbreaks were associated with public (nonbackyard) pools, hot tubs, or water playgrounds. These outbreaks resulted in at least 3,646 cases of illness, 286 hospitalizations, and 13 deaths. Among the 155 (75%) outbreaks with a confirmed infectious etiology, 76 (49%) were caused by Cryptosporidium (which causes cryptosporidiosis, a gastrointestinal illness) and 65 (42%) by Legionella (which causes Legionnaires' disease, a severe pneumonia, and Pontiac fever, a milder illness with flu-like symptoms). Cryptosporidium accounted for 2,492 (84%) of 2,953 cases resulting from the 155 outbreaks with a confirmed etiology. All 13 deaths occurred in persons affected by a Legionnaires' disease outbreak. Among the 208 outbreaks, 71 (34%) were associated with a hotel (i.e., hotel, motel, lodge, or inn) or a resort, and 107 (51%) started during June-August. Implementing recommendations in CDC's Model Aquatic Health Code (MAHC) (1) can help prevent outbreaks associated with treated recreational water in public aquatic venues.
Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed. - References: Water Res. 2002 Sep;36(16):4053-63. (PMID: 12405414)
MMWR Morb Mortal Wkly Rep. 2016 Jun 10;65(22):576-84. (PMID: 27281485)
Environ Sci Technol. 2015 Jun 16;49(12):7348-55. (PMID: 26042636)
J Water Health. 2008 Dec;6(4):513-20. (PMID: 18401116)
J Environ Health. 2010 Nov;73(4):8-14. (PMID: 21133310)
Trends Parasitol. 2005 Feb;21(2):81-7. (PMID: 15664531) - Publication Date: Date Created: 20210520 Date Completed: 20210521 Latest Revision: 20210528
- Publication Date: 20240104
- Accession Number: PMC8136425
- Accession Number: 10.15585/mmwr.mm7020a1
- Accession Number: 34014907
- Source:
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