2013–2014 Recreational Water–associated Outbreak Surveillance Report Supplemental Tables
These tables provide supplemental information not published in Outbreaks Associated with Treated Recreational Water — United States, 2000–2014 (MMWR Weekly) and Outbreaks Associated with Untreated Recreational Water — United States, 2000–2014 (MMWR Weekly).
Table 1. Waterborne Disease Outbreaks* Associated with Treated Recreational Water or Untreated Recreational Water, by Year and Jurisdiction — Waterborne Disease and Outbreak Surveillance System, United States, 2013–2014
Treated Recreational Water
Jurisdiction | Month | Year | Class† | Etiology§ | Predominant Illness¶ | No. Cases | No. Hospitalizations | Venue | Setting |
---|---|---|---|---|---|---|---|---|---|
California | July | 2013 | III | Legionella pneumophila serogroup 1 | ARI | 5 | 4 | Spa | Recreational facility |
California | October | 2014 | IV | Legionella pneumophila serogroup 1 (S) | ARI | 2 | 1 | Spa | Trailer Park |
Colorado | April | 2013 | III | Legionella pneumophila serogroup 1 | ARI | 3 | 0 | Spa | Hotel/Motel/Lodge/Inn |
Colorado | March | 2014 | III | Legionella pneumophila serogroup 1 | ARI | 2 | 2 | Spa | Club (Requires Membership) |
Colorado | August | 2014 | IV | Chemical-Unknown (S) | Eye; Skin | 13 | 0 | Pool | Hotel/Motel/Lodge/Inn |
Florida | April | 2013 | IV | Legionella pneumophila serogroup 1 | ARI | 4 | 3 | Spa | Trailer Park |
Florida | June | 2013 | II | Legionella sp. | ARI | 2 | 2 | Spa | Apartment/Condo |
Florida | September | 2013 | III | Cryptosporidium sp. | AGI | 15 | 2 | Pool | Hotel/Motel/Lodge/Inn |
Florida | June | 2014 | I | Cryptosporidium hominis | AGI | 26 | 0 | Pool | Club (Requires Membership) |
Florida | June | 2014 | II | Cryptosporidium hominis | AGI | 47 | 0 | Pool | Park – Amusement |
Florida | June | 2014 | III | Cryptosporidium sp. | AGI | 19 | 0 | Interactive fountain(s) | Park – Community/Municipal |
Florida | June | 2014 | III | Cryptosporidium sp. | AGI | 4 | 0 | Pool | Club (Requires Membership) |
Florida | July | 2014 | III | Shigella sp. | AGI | 6 | 0 | Interactive fountain(s) | Park – Community/Municipal |
Florida | August | 2014 | IV | Cryptosporidium sp. | AGI | 10 | 0 | Wading pool | Child Care/Daycare Center |
Florida | September | 2014 | III | Cryptosporidium sp. | AGI | 21 | 0 | Temporary water slide | Private Residence |
Georgia | July | 2013 | IV | Cryptosporidium sp. | AGI | 5 | 0 | Pool | Park – Waterpark |
Georgia | August | 2013 | IV | Legionella pneumophila serogroup 1 | ARI | 5 | 3 | Pool, spa | Hotel/Motel/Lodge/Inn |
Georgia | August | 2014 | I | Cryptosporidium hominis IfA12G1 | AGI | 63 | 0 | Pool, wading pool | Club (Requires Membership) |
Georgia | August | 2014 | II | Cryptosporidium spp. | AGI | 18 | 1 | Interactive fountain(s) | Park – Community/Municipal |
Idaho | January | 2013 | I | Mycobacterium abscessus | Skin | 11 | 0 | Wading pool | Club (Requires Membership) |
Illinois | July | 2013 | IV | Cryptosporidium sp. | AGI | 3 | 0 | Pool | Community/Municipality |
Illinois | October | 2013 | III | Legionella pneumophila serogroup 1 | ARI | 2 | 2 | Spa | Club (Requires Membership) |
Illinois | March | 2014 | III | Pseudomonas aeruginosa (S) | AGI; Skin | 2 | 0 | Spa | Hotel/Motel/Lodge/Inn |
Iowa | June | 2013 | II | Cryptosporidium sp. | AGI | 10 | 0 | Wading pool | Park – Community/Municipal |
Iowa | July | 2013 | II | Cryptosporidium sp. | AGI | 5 | 0 | Pool | Park – Community/Municipal |
Iowa | July | 2013 | II | Cryptosporidium sp. | AGI | 8 | 0 | Wading pool | Park – Community/Municipal |
Kansas | February | 2014 | III | Legionella pneumophila serogroup 1 | ARI | 2 | Spa | Hotel/Motel/Lodge/Inn | |
Kentucky | July | 2014 | III | Legionella pneumophila serogroup 1 | ARI | 3 | 2 | Spa | Hospital/Health Care |
Louisiana | June | 2013 | IV | Cryptosporidium sp. | AGI | 141 | 39 | Unreported | Unreported |
Louisiana | July | 2013 | IV | Cryptosporidium sp., Giardia duodenalis | AGI | 3 | 0 | Wading pool | Private Residence |
Louisiana | June | 2014 | IV | Cryptosporidium sp. | AGI | 26 | 1 | Pool, temporary water slide | Unreported |
Louisiana | July | 2014 | IV | Cryptosporidium sp. | AGI | 6 | 0 | Unreported | Unreported |
Louisiana | July | 2014 | IV | Giardia duodenalis | AGI | 3 | 0 | Pool | Unreported |
Louisiana | August | 2014 | IV | Cryptosporidium sp. | AGI | 22 | 0 | Unreported | Unreported |
Maryland | July | 2014 | III | Chlorine gas | ARI | 14 | 7 | Pool | Camp/Cabin Setting |
Michigan | December | 2014 | IV | Chemical-Unknown (S) | Skin | 5 | Pool | Hotel/Motel/Lodge/Inn | |
Minnesota | February | 2013 | III | Pseudomonas aeruginosa (S) | Skin | 3 | 0 | Spa | Hotel/Motel/Lodge/Inn |
Minnesota | August | 2013 | III | Cryptosporidium hominis IaA28R4 | AGI | 10 | 0 | Pool | Community/Municipality |
Minnesota | October | 2013 | III | Chloramines (S) | ARI; Eye | 5 | 0 | Pool, wading pool, spa | Hotel/Motel/Lodge/Inn |
Minnesota | December | 2013 | III | Chemical-Unknown (S) | ARI; Skin | 8 | 0 | Pool | Hotel/Motel/Lodge/Inn |
Minnesota | March | 2014 | III | Chloramines (S) | AGI; ARI; Eye | 8 | 0 | Pool | Hotel/Motel/Lodge/Inn |
Minnesota | March | 2014 | III | Chloramines (S) | ARI | 71 | 0 | Pool | Hotel/Motel/Lodge/Inn |
Minnesota | September | 2014 | II | Cryptosporidium hominis IdA17 | AGI | 3 | 0 | Pool | Recreational facility |
Montana | June | 2013 | IV | Legionella pneumophila serogroup 1 | ARI | 2 | 2 | Unreported | Hotel/Motel/Lodge/Inn |
Montana | August | 2013 | IV | Cryptosporidium sp. | AGI | 18 | Pools | Community/Municipality | |
New York | March | 2014 | III | Chemical-Unknown (S) | ARI; Eye | 75 | 0 | Pool | School/College/University |
North Dakota | July | 2014 | III | Cryptosporidium spp. | AGI | 11 | 1 | Pool | Community/Municipality |
Ohio | April | 2013 | III | Pseudomonas aeruginosa (S) | Skin | 5 | 0 | Pool | Hotel/Motel/Lodge/Inn |
Ohio | April | 2013 | IV | Chemical-Unknown (S) | Skin | 4 | 0 | Spa | Hotel/Motel/Lodge/Inn |
Ohio | June | 2013 | IV | Legionella pneumophila serogroup 1 | ARI | 11 | 1 | Unreported | Private Residence |
Ohio | April | 2014 | III | Pseudomonas aeruginosa (S) | Skin | 2 | Pool, spa | Hotel/Motel/Lodge/Inn | |
Ohio | June | 2014 | III | Chlorine gas | ARI | 16 | 3 | Pool | School/College/University |
Ohio | July | 2014 | IV | Legionella pneumophila serogroup 1 | ARI | 10 | 1 | Spa | Private Residence |
Ohio | August | 2014 | III | Chemical-Unknown (S) | AGI; ARI; Skin | 2 | 0 | Pool | Club (Requires Membership) |
Oklahoma | May | 2013 | IV | Chlorine (S) | Skin | 17 | 0 | Interactive fountain(s) | Park – Unknown |
Pennsylvania | August | 2013 | IV | Cryptosporidium sp. | AGI | 2 | 0 | Interactive fountain(s) | Community/Municipality |
Pennsylvania | June | 2014 | I | Legionella pneumophila serogroup 1 | ARI | 2 | 1 | Spa | Private Residence |
Tennessee | June | 2013 | III | Legionella pneumophila serogroup 1 | ARI | 9 | 8 | Pool, spa | Club (Requires Membership) |
Tennessee | July | 2013 | III | Legionella pneumophila serogroup 1 | ARI | 2 | 2 | Spa | Apartment/Condo |
Tennessee | May | 2014 | I | Salmonella enterica Newport | AGI | 5 | 2 | Interactive fountain(s) | Community/Municipality |
Texas | May | 2014 | IV | Unknown** | AGI | 15 | 2 | Temporary water slide | School/College/University |
Texas | June | 2014 | IV | Cryptosporidium sp. | AGI | 2 | Temporary water slide | Private Residence | |
Virginia | July | 2014 | I | Legionella pneumophila serogroup 1 | ARI | 2 | 2 | Spa | Private Residence |
Washington | July | 2013 | II | Norovirus | AGI | 11 | 0 | Wading pool | Park – Community/Municipal |
West Virginia | June | 2014 | IV | Legionella pneumophila serogroup 1 | ARI | 4 | 0 | Spa | Hotel/Motel/Lodge/Inn |
Wisconsin | August | 2013 | I | Cryptosporidium hominis IfA12G1 | AGI | 37 | 0 | Pools | Club (Requires Membership); School/College/University |
Wisconsin | October | 2013 | II | Cryptosporidium hominis IfA12G1 | AGI | 2 | 0 | Pool | Resort |
Wisconsin | October | 2013 | III | Chlorine gas | ARI | 24 | 0 | Pool | Resort |
Wisconsin | March | 2014 | I | Norovirus Genogroup II GII_5 | AGI | 23 | 0 | Pool | Resort |
Wisconsin | August | 2014 | I | Cryptosporidium hominis IdA17 | AGI | 3 | 0 | Pool | Hotel/Motel/Lodge/Inn |
Wisconsin | October | 2014 | IV | Cryptosporidium sp. | AGI | 3 | 0 | Pool | Recreational facility |
Untreated Recreational Water
Jurisdiction | Month | Year | Class† | Etiology§ | Predominant Illness¶ | No. Cases | No. Hospitalizations | Venue | Setting |
---|---|---|---|---|---|---|---|---|---|
Idaho | July | 2014 | I | Norovirus Genogroup I GI_3B, GII_4 Sydney (2012), GII_6, | AGI | 97 | 0 | Pond | Beach – Public |
Illinois | July | 2013 | III | Urushiol/Poison Ivy (S) | Skin | 1,341 | Other | Private Outdoor Area | |
Indiana | September | 2013 | IV | Norovirus (S) | AGI | 16 | 0 | River/stream | Public Outdoor Area |
Michigan | June | 2013 | I | Norovirus Genogroup II GII_2 | AGI | 597 | 3 | Other | Public Outdoor Area |
Minnesota | July | 2013 | I | Escherichia coli, Shiga toxin-producing O157:H7 | AGI | 3 | 1 | Lake/Reservoir | Public Outdoor Area |
Minnesota | August | 2013 | II | Norovirus Genogroup II GII_13 | AGI | 10 | 0 | Lake/Reservoir | Beach – Public |
Minnesota | August | 2014 | II | Norovirus Genogroup II GII_7 | AGI | 10 | 0 | Lake/Reservoir | Beach – Public |
Ohio | June | 2014 | III | Leptospira sp. | LEP | 2 | 2 | Lake/Reservoir | Park – State Park |
Oregon | July | 2014 | II | Norovirus Genogroup I GI_1 | AGI | 67 | 0 | Lake/Reservoir | Park – Community/Municipal |
Oregon | July | 2014 | III | Escherichia coli, Shiga toxin-producing O157:H7 | AGI | 3 | 0 | River/stream | Public Outdoor Area |
Rhode Island | July | 2013 | I | Shigella sonnei Subgroup D | AGI | 141 | 19 | Pond | Beach – Public |
South Carolina | June | 2013 | IV | Cryptosporidium sp. | AGI | 5 | 0 | Lake/Reservoir | Beach – Public |
Virginia | June | 2013 | III | Escherichia coli, Shiga toxin-producing O26:NM | AGI | 5 | 0 | Lake/Reservoir | Camp/Cabin Setting |
Washington | July | 2014 | I | Norovirus GII_5 | AGI | 260 | Lake/Reservoir | Park – Community/Municipal | |
Washington | August | 2014 | IV | Norovirus | AGI | 20 | 0 | River/stream | Park – Community/Municipal |
Wisconsin | July | 2013 | II | Escherichia coli, Shiga toxin-producing O145 | AGI | 3 | 0 | Lake/Reservoir | Camp/Cabin Setting |
Previously Unreported
Jurisdiction | Month | Year | Class† | Etiology§ | Predominant Illness¶ | No. Cases | No. Hospitalizations | Venue | Setting |
---|---|---|---|---|---|---|---|---|---|
Colorado | March | 2010 | IV | Unknown (S)** | Skin | 3 | 0 | Pool, wading pool | Recreational facility |
Colorado | January | 2011 | III | Mycobacterium avium complex | ARI | 3 | Spa | Hotel/Motel/Lodge/Inn | |
Colorado | August | 2011 | I | Legionella pneumophila serogroup 1 | ARI | 9 | 8 | Spa | Hotel/Motel/Lodge/Inn |
Michigan | August | 2012 | IV | Chemical-Unknown (S) | ARI; Skin | 2 | 0 | Spa | Hotel/Motel/Lodge/Inn |
Texas | August | 2011 | IV | Cryptosporidium sp. | AGI | 130 | Pools | Unknown; Other |
Abbreviations:
AGI = acute gastrointestinal illness; ARI = acute respiratory illness; Eye = illnesses, conditions, or symptoms related to the eyes; LEP = leptospirosis; Skin = illnesses, conditions, or symptoms related to the skin.
*n=87, treated water, n=71 untreated water, n=16; Five previously unreported outbreaks associated with treated recreational water occurred during 2010–2012 and are not included in 2013–2014 tables and figures.
† Based on epidemiologic and environmental health data (e.g., water quality data) reported to CDC. For more information, refer to the strength-of-evidence classification table.
§ Etiologies listed are confirmed; however, suspected etiologies denoted with “(S)”. For multiple-etiology outbreaks, etiologies are listed in alphabetical order.
¶ The category of illness reported by 50% of ill respondents. All legionellosis outbreaks were categorized as ARI.
** No data reported.
Table 2. Number of Waterborne Disease Outbreaks Associated with Recreational Water, by Predominant Illness* and Type of Water Exposure — Waterborne Disease and Outbreak Surveillance System, 2013–2014
Recreational Water Outbreaks, by Predominant Illness and Type of Water Exposure
Type of Water Exposure | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Treated Water | Untreated Water | Total | ||||||||||||||
Predominant Illness | Outbreaks | Cases | Hospitalized | Died | Outbreaks | Cases | Hospitalized | Died | Outbreaks | % | Cases | % | Hospitalized | % | Died | % |
AGI | 35 | 606 | 48 | 0 | 14 | 1,237 | 23 | 0 | 49 | 56.3 | 1,843 | 52.0 | 71 | 59.7 | 0 | 0 |
ARI | 22 | 197 | 46 | 4 | 0 | 0 | 0 | 0 | 22 | 25.3 | 197 | 5.6 | 46 | 38.7 | 4 | 100 |
AGI, ARI, and Eye | 1 | 8 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1.1 | 8 | 0.2 | 0 | 0 | 0 | 0 |
AGI, ARI, and Skin | 1 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1.1 | 2 | 0.1 | 0 | 0 | 0 | 0 |
AGI and Skin | 1 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1.1 | 2 | 0.1 | 0 | 0 | 0 | 0 |
ARI and Eye | 2 | 80 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 2.3 | 80 | 2.3 | 0 | 0 | 0 | 0 |
ARI and Skin | 1 | 8 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1.1 | 8 | 0.2 | 0 | 0 | 0 | 0 |
Eye and Skin | 1 | 13 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1.1 | 13 | 0.4 | 0 | 0 | 0 | 0 |
LEP | 0 | 0 | 0 | 0 | 1 | 2 | 2 | 0 | 1 | 1.1 | 2 | 0.1 | 2 | 1.7 | 0 | 0 |
Skin | 7 | 47 | 0 | 0 | 1 | 1,341 | 0 | 0 | 8 | 9.2 | 1,388 | 39.2 | 0 | 0 | 0 | 0 |
Total (%) | 71 (82) | 963 | 94 | 4 (100) | 16(18) | 2,580 | 25 | 0 | 87 | 100 | 3,543 | 100 | 119 | 100 | 4 | 100 |
Abbreviations: AGI = acute gastrointestinal illness; ARI = acute respiratory illness; Eye = illnesses, conditions, or symptoms related to the eyes; LEP = leptospirosis; Skin = illnesses, conditions, or symptoms related to the skin.
*n=87; The category of illness reported by 50% of ill respondents. All legionellosis outbreaks were categorized as ARI.