Schuster Corinne J, Ellis Andrea G, Robertson William J, Charron Dominique F, Aramini Jeff J, Marshall Barbara J, Medeiros Diane T
HPRP Project 045032, University of Guelph, ON.
Can J Public Health. 2005 Jul-Aug;96(4):254-8. doi: 10.1007/BF03405157.
Recent public attention on drinking water supplies in the aftermath of waterborne infection outbreaks in Walkerton and North Battleford raises questions about safety. We analyzed information on waterborne outbreaks occurring between 1974 and 2001 in order to identify apparent trends, review the current status of monitoring and reporting, and gain a better understanding of the impact of drinking water quality on public health and disease burden.
Data from outbreak investigations, published and unpublished, were categorized by the type of drinking water provider and were assessed to be definitely, probably or possibly waterborne in nature.
The final data set consisted of 288 outbreaks of disease linked to a drinking water source. There were 99 outbreaks in public water systems, 138 outbreaks in semi-public systems and 51 outbreaks in private systems. The main known causative agents of waterborne disease outbreaks were (in descending frequency of occurrence) Giardia, Campylobacter, Cryptosporidium, Norwalk-like viruses, Salmonella and hepatitis A virus.
We found that severe weather, close proximity to animal populations, treatment system malfunctions, poor maintenance and treatment practices were associated with the reported disease outbreaks resulting from drinking water supplies. However, issues related to the accuracy, co-ordination, compatibility and detail of data exist. A systematic and coordinated national surveillance system for comparison purposes, trend identification and policy development is needed so that future waterborne disease outbreaks can be avoided.
在沃克顿和北贝德福德发生水源性感染疫情后，近期公众对饮用水供应安全高度关注。我们分析了1974年至2001年间发生的水源性疫情信息，以确定明显趋势、审查监测和报告的现状，并更好地了解饮用水质量对公众健康和疾病负担的影响。
已发表和未发表的疫情调查数据按饮用水供应者类型分类，并评估其本质上确定、可能或疑似为水源性。
最终数据集包括288起与饮用水源相关的疾病疫情。公共供水系统中有99起疫情，半公共系统中有138起，私人系统中有51起。水源性疾病疫情的主要已知病原体（按发生频率降序排列）为贾第虫、弯曲杆菌、隐孢子虫、诺如病毒、沙门氏菌和甲型肝炎病毒。
我们发现，恶劣天气、靠近动物群体、处理系统故障、维护不善和处理方法不当与报告的饮用水供应引发的疾病疫情有关。然而，数据的准确性、协调性、兼容性和详细程度存在问题。需要一个系统且协调的国家监测系统，用于比较、确定趋势和制定政策，以便避免未来发生水源性疾病疫情。
