MMWR Morb Mortal Wkly Rep. 2018 Jun 29;67(25):701-706. doi: 10.15585/mmwr.mm6725a1.
Outbreaks associated with untreated recreational water can be caused by pathogens, toxins, or chemicals in fresh water (e.g., lakes, rivers) or marine water (e.g., ocean). During 2000-2014, public health officials from 35 states and Guam voluntarily reported 140 untreated recreational water-associated outbreaks to CDC. These outbreaks resulted in at least 4,958 cases of disease and two deaths. Among the 95 outbreaks with a confirmed infectious etiology, enteric pathogens caused 80 (84%); 21 (22%) were caused by norovirus, 19 (20%) by Escherichia coli, 14 (15%) by Shigella, and 12 (13%) by Cryptosporidium. Investigations of these 95 outbreaks identified 3,125 cases; 2,704 (87%) were caused by enteric pathogens, including 1,459 (47%) by norovirus, 362 (12%) by Shigella, 314 (10%) by Cryptosporidium, and 155 (5%) by E. coli. Avian schistosomes were identified as the cause in 345 (11%) of the 3,125 cases. The two deaths were in persons affected by a single outbreak (two cases) caused by Naegleria fowleri. Public parks (50 [36%]) and beaches (45 [32%]) were the leading settings associated with the 140 outbreaks. Overall, the majority of outbreaks started during June-August (113 [81%]); 65 (58%) started in July. Swimmers and parents of young swimmers can take steps to minimize the risk for exposure to pathogens, toxins, and chemicals in untreated recreational water by heeding posted advisories closing the beach to swimming; not swimming in discolored, smelly, foamy, or scummy water; not swimming while sick with diarrhea; and limiting water entering the nose when swimming in warm freshwater.
与未经处理的娱乐用水相关的疫情爆发可能是由淡水（如湖泊、河流）或海水（如海洋）中的病原体、毒素或化学物质引起的。在 2000 年至 2014 年期间，来自 35 个州和关岛的公共卫生官员自愿向疾病预防控制中心报告了 140 起未经处理的娱乐用水相关疫情爆发。这些疫情爆发导致至少 4958 例疾病和 2 人死亡。在 95 起具有明确传染性病因的疫情爆发中，肠道病原体导致 80 起（84%）；21 起（22%）由诺如病毒引起，19 起（20%）由大肠杆菌引起，14 起（15%）由志贺氏菌引起，12 起（13%）由隐孢子虫引起。对这 95 起疫情爆发的调查确定了 3125 例病例；2704 例（87%）由肠道病原体引起，其中 1459 例（47%）由诺如病毒引起，362 例（12%）由志贺氏菌引起，314 例（10%）由隐孢子虫引起，155 例（5%）由大肠杆菌引起。在 3125 例病例中，有 345 例（11%）确定为鸟类血吸虫引起。两例死亡是由福氏耐格里变形虫单一疫情爆发（两例）引起的。公园（50 例[36%]）和海滩（45 例[32%]）是与这 140 起疫情爆发相关的主要场所。总体而言，大多数疫情爆发发生在 6 月至 8 月（113 例[81%]）；7 月开始的有 65 例（58%）。游泳者和年幼游泳者的父母可以通过注意张贴的通告，在海滩游泳时关闭游泳；不在变色、发臭、泡沫或浑浊的水中游泳；在腹泻时不游泳；以及在温暖的淡水中游泳时限制水进入鼻子，从而采取措施降低接触未经处理的娱乐用水中的病原体、毒素和化学物质的风险。
