title: The importance of waterborne disease outbreak surveillance in the United States.
abstract: Analyses of the causes of disease outbreaks associated with contaminated  drinking water in the United States have helped inform prevention efforts at the  national, state, and local levels. This article describes the changing nature  of disease outbreaks in public water systems during 1971-2008 and discusses the  importance of a collaborative waterborne outbreak surveillance system established  in 1971. Increasing reports of outbreaks throughout the early 1980s emphasized that  microbial contaminants remained a health-risk challenge for suppliers of drinking water.  Outbreak investigations identified the responsible etiologic agents and deficiencies  in the treatment and distribution of drinking water, especially the high risk  associated with unfiltered surface water systems. Surveillance information was important in establishing an effective research program that guided government  regulations and industry actions to improve drinking water quality.  Recent surveillance statistics suggest that prevention efforts based on these research findings have been effective in reducing outbreak  risks especially for surface water systems.
authors.affiliation: Gunther F Craun & Associates, Staunton, VA 24401, USA. gcraun@verizon.net
authors.forename: Gunther Franz
authors.initials: GF
authors.lastname: Craun
mesh_terms: D000818:Animals; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D060766:Drinking Water / Q000382:microbiology; D006801:Humans; D062486:Public Health Surveillance; D013551:Swimming Pools; D014481:United States / Q000453:epidemiology; D014871:Water Microbiology; D014881:Water Supply / Q000032:analysis / Q000331:legislation & jurisprudence*
chemical_list: D060766:Drinking Water