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Waterborne illnesses. There are potable water illnesses and recreational water illnesses, and we'll be discussing both of these.Waterborne outbreak agents. There are bacterial agents, viral agents, parasitic agents, and chemical agents which cause waterborne illness.Routes of transmission. Waterborne illnesses can be caused by ingestion or consuming water, by dermal contact, which is contact of the water with skin or mucous membranes, or by inhalation, which is by breathing in a mist or aerosolized water particles.Bacterial pathogens. We will be discussing each one of these pathogens in detail: E. coli O157:H7, Salmonella, Salmonella typhi, Shigella, Campylobacter, Vibrio cholerae, Pseudomonas, and others. Escherichia coli. There are several pathogenic strains of Escherichia coli, which are classified under enterovirulent E. coli. They are enterohemorrhagic, enteroinvasive, enterotoxigenic, enteropathogenic, and enteroaggregative.Escherichia coli O157:H7, the basics. It's a bacteria. It causes diarrheal illness, and it's classified as an enterohemorrhagic E. coli. In its most severe form, it can cause hemorrhagic colitis. The reservoir for this bacteria are cattle, deer, goats, and sheep. Humans can also be a reservoir. It is typically associated with contaminated food and water. E. coli O157:H7 prevention. Prevention strategies for this pathogen include source protection, halogenation of water, or boiling water for one minute. Salmonella species, the basics. It's a bacteria. It causes diarrheal illness known as salmonellosis. Humans and animals are the reservoir, and it's typically associated with contaminated food and water.Salmonella Prevention strategies for this pathogen include source protection, halogenation of water, and also boiling water for one minute. Salmonella typhi, the basics. It's a bacteria. It causes diarrheal illness, also known as typhoid fever. And humans are the reservoir for this pathogen. Salmonella typhi, prevention. Prevention strategies for this pathogen include source protection, halogenation of water, and boiling water for one minute.Shigella species, the basics. It's a bacteria. It causes diarrheal illness known as shigellosis. Humans and primates are the reservoir for this pathogen. Shigella species, in the United States­­ two­thirds of the shigellosis in the U.S. is caused by Shigella sonnei, and the remaining one­third is caused by Shigella flexnieri. In developing countries, Shigella dysenteriae is the primary cause of illness associated with this pathogen. Shigella species, prevention. Prevention strategies for this pathogen include source protection, halogenation of water, and boiling water for one minute.Campylobacter, the basics. It's a bacteria. It causes diarrheal illness. And Campylobacter is primarily associated with poultry, animals, and humans. Campylobacter, prevention. Prevention strategies for this pathogen include source protection, halogenation of water, and boiling water for one minute.Vibrio cholerae, the basics. It's a bacteria. It causes diarrheal illness, also known as cholera. It is typically associated with aquatic environments, shellstocks, and human. Vibrio cholerae has also been associated with ship ballast water, and there will be a discussion later on in this presentation of an outbreak associated with ship ballast water. Vibrio cholerae, prevention. Prevention strategies for this pathogen include source protection, halogenation of water, and boiling water for one minute.Legionella, the basics. It's a bacteria. It causes a respiratory illness known as legionellosis. There are two illnesses associated with legionellosis: the first, Legionnaire's disease, which causes a severe pneumonia, and the second, Pontiac fever, which is a nonpneumonia illness; it's typically an influenza­like illness, and it's less severe. Legionella is naturally found in water, both natural and artificial water sources. Legionella, prevention. Maintaining hot water systems at or above 50 degrees Centigrade and cold water below 20 degrees Centigrade can prevent or control the proliferation of Legionella in water systems. Hot water in tanks should be maintained between 71 and 77 degrees Centigrade. Proper recreational water system maintenance and disinfection can prevent the proliferation of Legionella in recreational water systems. It is important to prevent water stagnation. This can be accomplished by eliminating dead ends in distribution systems and in recreational water systems. Additionally, preventing biofilm development is important to control this particular pathogen in water systems.Pseudomonas, the basics. It's a bacteria. It is caused by dermal contact with water. It can cause dermatitis, which is an inflammation of the skin, or it can cause otitis, which is an infection of the ear. Pseudomonas is typically associated with soil and water. Pseudomonas, prevention. Proper maintenance and disinfection of recreational water systems is important in preventing Pseudomonas.Viral pathogens. We will be discussing Hepatitis A and Norovirus in this presentation.Hepatitis A, the basics. It's a virus. It causes inflammation of the liver. And the reservoir for Hepatitis A virus is humans. Hepatitis A, prevention. Prevention strategies for this pathogen include source protection and adequate disinfection. Fecal matter can protect Hepatitis A virus from chlorine. Additionally, Hepatitis A virus is resistant to combined chlorines, so it is important to have an adequate free chlorine residual.Norovirus, the basics. It's a virus. It causes diarrheal illness. And humans are the reservoir for this virus. Norovirus, prevention. Prevention strategies for this pathogen include source protection.Parasitic pathogens. During this presentation, we will be discussing Cryptosporidium, Giardia, and Schistosomatidae.Cryptosporidium, the basics. It's a parasite. It causes diarrheal illness known as crytpsporidiosis. It is typically associated with animals and humans, and it can be acquired through consuming fecally contaminated food, contact with fecally contaminated soil and water. Cryptosporidium, prevention. Prevention strategies for this pathogen include source protection. A CT value of 9,600 is required when dealing with fecally accidents. CT equals a concentration, in parts per million, while time equals a contact time in minutes. Cryptosporidium can also be prevented or eliminated by boiling water for one minute. Filtration with an "absolute" pore size of one micron or smaller can eliminate Cryptosporidium. And reverse osmosis is known to be effective as well.Giardia, the basics. It is a parasite. It causes diarrheal illness known as giardiasis. It is typically associated with water. It is the most common pathogen in waterborne outbreaks. It can also be found in soil and food. And humans and animals are the reservoir for this pathogen. Giardia, prevention. Prevention strategies for this pathogen include source protection; filtration, coagulation, and halogenation of drinking water.Schistosomatidae, the basics. It is a parasite. It is acquired through dermal contact, cercarial dermatitis. It is commonly known as swimmer's itch. The reservoir for this pathogen are aquatic snails and birds. Schistosomatidae, prevention. Prevention strategies for this pathogen include eliminating snails with a molluscicide or interrupting the life cycle of the parasite by treating birds with an antihelmetic drug. Chemical illnesses.Chemical illnesses associated with potable water and recreational water are too numerous to itemize. They are typically associated with cross­-connections and run­-off. Some chemical contamination can occur naturally.[ Cited: CDC Page on cdc.gov ]