Surveillance Reports for Recreational Water-associated Disease & Outbreaks
CDC publishes summaries of recreational water-associated waterborne disease outbreaks in the United States based on reports provided by state, local, and territorial health departments. These summaries help public health practitioners better understand the germs, settings, and contributing factors (for example, the filtration system didn’t work) involved in outbreaks linked to recreational water. They also can help identify emerging waterborne disease threats and be used to inform and assess outbreak prevention measures.
Explore waterborne disease outbreak data on CDC’s National Outbreak Reporting System (NORS) Dashboard.
Since 1971, CDC has published data on waterborne disease outbreaks associated with recreational water:
- 2015 forward: Reports are published on CDC’s Summary Reports of Waterborne Outbreaks page.
- 2009–2014: Reports were published in the MMWR Weekly with supplemental content posted below.
- 1971–2008: Reports were published as MMWR Surveillance Summaries.
In 2021, CDC published an estimate of the burden and direct healthcare cost of infectious waterborne disease.
Links to historical surveillance reports and appendices are also available below.
Learn more about waterborne disease and outbreak surveillance milestones.
Most Recent Recreational Water–associated Outbreak and Disease Surveillance Data
Hlavsa MC, Aluko SK, Miller AD, Person J, Gerdes ME, Lee S, Laco JP, Hannapel EJ, and Hill VR. Outbreaks Associated with Treated Recreational Water — United States, 2015–2019. MMWR Morb Mortal Wkly Rep 2021;70(20):733–738. DOI: http://dx.doi.org/10.15585/mmwr.mm7020a1.
Reports from 1978 through 2019
2015-2019
- Hlavsa MC, Aluko SK, Miller AD, Person J, Gerdes ME, Lee S, Laco JP, Hannapel EJ, and Hill VR. Outbreaks Associated with Treated Recreational Water — United States, 2015–2019. MMWR Morb Mortal Wkly Rep 2021;70(20):733–738. DOI: http://dx.doi.org/10.15585/mmwr.mm7020a1.
2015
- CDC. Waterborne Disease and Outbreak Surveillance System (WBDOSS) Summary Report, United States, 2015. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC, 2022.
2000-2014
- Hlavsa MC, Cikesh BL, Roberts VA, et al. Outbreaks Associated with Treated Recreational Water — United States, 2000–2014. MMWR Morb Mortal Wkly Rep 2018;67:547–551. DOI: http://dx.doi.org/10.15585/mmwr.mm6719a3
- Graciaa DS, Cope JR, Roberts VA, et al. Outbreaks Associated with Untreated Recreational Water — United States, 2000–2014. MMWR Morb Mortal Wkly Rep 2018;67:701–706. DOI: http://dx.doi.org/10.15585/mmwr.mm6725a1
- Strength-of-Evidence Classification for Waterborne Disease & Outbreaks
- 2013–2014 Supplemental Data Tables
- 2013–2014 Supplemental Figures
2011-2012
- Hlavsa MC, Roberts VA, Kahler AM, et al. Outbreaks of Illness Associated with Recreational Water — United States, 2011–2012. MMWR Morb Mortal Wkly Rep 2015;64(24):668–672.
2009-2010
- Hlavsa MC, Roberts VA, Kahler AM, et al. Recreational Water–Associated Disease Outbreaks — United States, 2009–2010. MMWR Morb Mortal Wkly Rep 2014;63(01):6–10.
2007-2008
- Hlavsa MC, Roberts VA, Anderson AR, et al. Surveillance for Waterborne Disease Outbreaks and Other Health Events Associated with Recreational Water — United States, 2007–2008 [PDF – 80 pages]. MMWR Morb Mortal Wkly Rep 2011;60(12):1–75.
2005-2006
- Yoder JS, Hlavsa MC, Craun GF, et al. Surveillance for Waterborne Disease and Outbreaks Associated with Recreational Water Use and Other Aquatic Facility-Associated Health Events — United States, 2005–2006. MMWR Morb Mortal Wkly Rep 2008;57(09):1–29.
2003-2004
- Dziuban EJ, Liang JL, Craun GF, et al. Surveillance for Waterborne Disease and Outbreaks Associated with Recreational Water — United States, 2003–2004 [PDF – 68 pages]. MMWR Morb Mortal Wkly Rep 2006;55(12):1–31.
2001-2002
- Yoder JS, Blackburn BG, Craun GF, et al. Surveillance for Waterborne-Disease Outbreaks Associated with Recreational Water — United States, 2001–2002 [PDF – 48 pages]. MMWR Morb Mortal Wkly Rep 2004;53(8):1–22.
1999-2000
- Surveillance for Waterborne-Disease Outbreaks — United States, 1999–2000 (MMWR, 2002)
- Surveillance for Waterborne-Disease Outbreaks — United States, 1999–2000 [PDF – 52 pages]
1997-1998
- Surveillance for Waterborne-Disease Outbreaks — United States, 1997–1998 (MMWR, 2000)
- Surveillance for Waterborne-Disease Outbreaks — United States, 1997–1998 [PDF – 44 pages]
1995-1996
- Surveillance for Waterborne-Disease Outbreaks — United States, 1995-1996 (MMWR, 1998)
- Surveillance for Waterborne-Disease Outbreaks — United States, 1995-1996 [PDF – 80 pages]
1993-1994
- Surveillance for Waterborne-Disease Outbreaks — United States, 1993-1994 (MMWR, 1996)
- Surveillance for Waterborne-Disease Outbreaks — United States, 1993-1994 [PDF – 40 pages]
1991-1992
1989-1990
1986-1988
1985
1984
1983
1982
1981
1980
* Some of the documents on this page, due to their historical nature, are not able to be provided in an accessible (508-compliant) format. People with disabilities experiencing problems accessing these documents should contact CDC-INFO at CDC-INFO@cdc.gov, 800-232-4636 or the TTY number at (888) 232-6348 and ask for a 508 Accommodation PR#9342. If emailing please type “508 Accommodation PR#9342” without quotes in the subject line of the email.