What are waterborne disease outbreaks?
Waterborne disease outbreaks (WBDO) can be categorized by etiologic agent (the organism making people sick), type of water use (drinking, recreational, other), routes of entry (ingestion, inhalation, intranasal, or skin contact) and means of water contamination.
WBD agents may cause gastrointestinal, skin, respiratory or systemic illness. Symptoms may include abdominal cramps, vomiting, diarrhea, hives, rashes, irritated eyes, sore throat, pneumonia, or systemic illness.
Purpose of Reporting and Monitoring
- To detect WBDOs that can be controlled with appropriate public health measures (boil or bottled water advisory, pool closure).
- To confirm the type of WBDO, thereby guiding treatment and control measures to prevent further exposures and additional cases of illness.
- To assess whether implemented control measures are effective in stopping further transmission.
- To expand current understanding of the transmission, pathogenesis, and community impact of illness caused by WBD agents.
- To identify new WBD agents, hazards, or gaps in the water safety system.
Responding and Reporting
What actions can health facilities take?
In most instances, consult with state/local environmental and public health staff, who can provide situation specific guidance and assist an owner/operator in treating water and cleaning the facility as needed. With guidance from environmental health staff, immediate control measures could include (but are not limited to) the following:
- Drinking water: Issuing a boil or bottled water advisory, recalling a commercial product like bottled water
- Recreational water: Closing a facility or beach, posting warning signs at a lake, super-chlorinating pool water, backwashing the filter, draining the water, sanitizing the bathrooms or other likely-contaminated areas, cleaning the entire facility, and refilling the water and treating the water as required or feasible (for treated water facilities)
- Any water source: Issuing a press release to advise citizens who may develop illness
How to report the event?
- Water systems and local public health departments: Report known or suspected WBDO to CDPHE immediately upon receiving a report of a known or suspected outbreak. CDPHE will review the situation with you and assist if there is agreement that an investigation is needed.
- Health care facilities: Immediately notify your local health jurisdiction of outbreaks or suspected outbreaks.
- Per statute 6 CCR 1009-1, appendix A: "Outbreaks - known or suspected of all types - including those transmitted from food, water, person-to-person, and related to a healthcare setting."
Who to contact at the department?
- Contact the department’s 24-hr emergency line: 1-877-518-5608.
- Call as soon as possible but no later than 10 a.m. of the day following the incident.
- CDPHE Communicable Diseases
- 303-692-2700
- 303-370-9395 (after hours only)
- CDPHE Toxicology Line
- ToxCall 303-692-2606, cdphe_toxcall@state.co.us
- ToxCall is a good resource if toxic algae is suspected
Additional details including what information to include when you report an incident and what to expect after reporting can be found here.
➽ Chelsea Cotton Source Water & Emerging Contaminant Engineer
