Levine W C, Stephenson W T, Craun G F
Division of Bacterial Diseases, Center for Infectious Diseases.
MMWR CDC Surveill Summ. 1990 Mar;39(1):1-13.
From 1986 to 1988, 24 states and Puerto Rico reported 50 outbreaks of illness due to water that people intended to drink, affecting 25,846 persons. The protozoal parasite Giardia lamblia was the agent most commonly implicated in outbreaks, as it has been for the last 10 years; many of these outbreaks were associated with ingestion of chlorinated but unfiltered surface water. Shigella sonnei was the most commonly implicated bacterial pathogen; in outbreaks caused by this pathogen, water supplies were found to be contaminated with human waste. Cryptosporidium contamination of a chlorinated, filtered public water supply caused the largest outbreak during this period, affecting an estimated 13,000 persons. A large multistate outbreak caused by commercially produced ice made from contaminated well water caused illness with Norwalk-like virus among an estimated 5,000 persons. The first reported outbreak of chronic diarrhea of unknown cause associated with drinking untreated well water occurred in 1987. Twenty-six outbreaks due to recreational water use were also reported, including outbreaks of Pseudomonas dermatitis associated with the use of hot tubs or whirlpools, and swimming-associated shigellosis, giardiasis, and viral illness. Although the total number of reported water-related outbreaks has been declining in recent years, the few large outbreaks due to Cryptosporidium, Norwalk-like agent, Shigella sonnei, and Giardia lamblia caused more cases of illness in 1987 than have been reported to the Water-Related Disease Outbreak Surveillance System for any other year since CDC and the Environmental Protection Agency began tabulating these data in 1971.
1986年至1988年期间，24个州和波多黎各报告了50起因人们打算饮用的水而引发的疾病暴发事件，涉及25846人。原生动物寄生虫兰氏贾第鞭毛虫是过去10年中最常与暴发事件相关的病原体；这些暴发事件中有许多与摄入经过氯化处理但未经过滤的地表水有关。宋内志贺菌是最常涉及的细菌性病原体；在由该病原体引起的暴发事件中，发现供水被人类粪便污染。一个经过氯化处理和过滤的公共供水系统受到隐孢子虫污染，导致了这一时期最大规模的暴发事件，估计影响了13000人。一起由受污染井水制成的商业生产冰块引发的多州大规模暴发事件，导致约5000人感染诺如病毒样疾病。1987年首次报告了与饮用未处理井水相关的不明原因慢性腹泻暴发事件。还报告了26起因娱乐用水引发的暴发事件，包括与使用热水浴缸或漩涡浴池相关的假单胞菌性皮炎暴发，以及与游泳相关的志贺菌病、贾第虫病和病毒性疾病。尽管近年来报告的与水相关的暴发事件总数一直在下降，但1987年由隐孢子虫、诺如病毒样病原体、宋内志贺菌和兰氏贾第鞭毛虫引起的少数大规模暴发事件导致的病例数，比自疾病控制与预防中心（CDC）和环境保护局于1971年开始统计这些数据以来，水相关疾病暴发监测系统报告的其他任何一年都要多。
