Unintentional drinking-water contamination events of unknown origin: surrogate for terrorism preparedness.

Drinking-water is a direct conduit to many human receptors. An intentional attack (e.g. terrorism) on drinking-water systems can shock and disrupt elements of national infrastructures. We report on an unintentional drinking-water contamination event that occurred in Tel Aviv, Israel in July, 2001. Initially of unknown origin, this event involved risk management strategies used by the Ministry of Health for abating a potential public health crisis as might be envisaged of water contamination due to terrorism. In an abrupt event of unknown origin, public health officials need to be responsible for the same level of preparedness and risk communication. This is emphasized by comparison of management strategies between the Tel Aviv event and one of dire consequences that occurred in Camelford, England in 1988. From the onset of the Tel Aviv incident, the public health strategy was to employ the precautionary principle by warning residents of the affected region to not drink tap water, even if boiled. This strategy was in contrast to an earlier crisis that occurred in Camelford, England in 1988. An outcome of this event was heightened awareness that a water crisis can occur in peacetime and not only in association with terrorism. No matter how minor the contamination event or short-term the disruption of delivery of safe drinking-water, psychological, medical and public health impact could be significant.