Safe Drinking WaterDrinking water provides an efficient source for the spread of gastrointestinal microbial pathogens capable of causing serious human disease. The massive death toll and burden of disease worldwide caused by unsafe drinking water is a compelling reason to value the privilege of having safe drinking water delivered to individual homes. On rare occasions, that privilege has been undermined in affluent nations by waterborne disease outbreaks traced to the water supply. Using the rich and detailed perspectives offered by the evidence and reports from the Canadian public inquiries into the Walkerton (2000) and North Battleford (2001) outbreaks to develop templates for understanding their key dimensions, over 60 waterborne outbreaks from 15 affluent countries over the past 30 years are explored as individual case studies. Recurring themes and patterns are revealed and the critical human dimensions are highlighted suggesting insights for more effective and more individualized preventive strategies, personnel training, management, and regulatory control. Safe Drinking Water aims to raise understanding and awareness of those factors that have most commonly contributed to or caused drinking-water-transmitted disease outbreaks - essentially a case-history analysis within the multi-barrier framework. It contains detailed analysis of the failures underlying drinking-water-transmitted disease epidemics that have been documented in the open literature, by public inquiry, in investigation reports, in surveillance databases and other reliable information sources. The book adopts a theme of 'converting hindsight into foresight', to inform drinking-water and health professionals including operators, managers, engineers, chemists and microbiologists, regulators, as well as undergraduates and graduates at specialty level. Key Features: Contains details and perspectives of major outbreaks not widely known or understood beyond those directly involved in the investigations. Technical and scientific background associated with case studies is offered in an accessible summary form. Does not require specialist training or experience to comprehend the details of the numerous outbreaks reviewed. By providing a broad-spectrum review using a consistent approach, several key recurring themes are revealed that offer insights for developing localized, tailor-made prevention strategies. |
Contents
21 HISTORICAL BACKGROUND | 6 |
22 MAJOR CLASSES OF WATERBORNE PATHOGENS | 20 |
23 SPECIFIC PATHOGENS RELEVANT TO OUTBREAK CASE STUDIES | 25 |
24 INDICATOR AND SURROGATE ORGANISMS | 42 |
25 SUMMARY OF PATHOGENS | 45 |
31 INTRODUCTION TO WATER QUALITY | 50 |
32 SOURCE WATER PROTECTION | 55 |
33 CONVENTIONAL WATER TREATMENT PROCESSES | 56 |
454 Creston Erickson BC Canada | 210 |
455 Nursery School Kindergarten | 213 |
456 The Isle of Thanet Region Kent England | 215 |
4564 Direct Causes of the Outbreak | 216 |
457 Naas County Kildare Ireland | 217 |
4574 Direct Causes of the Outbreak | 219 |
458 Uggelose Denmark | 220 |
4584 Direct Causes of the Outbreak | 221 |
Colloids remain in suspension because they are too small to settle at a significant rate As well an individual colloid typically has a charged surface that... | 58 |
34 ADVANCED WATER TREATMENT PROCESSES | 73 |
35 WATER DISTRIBUTION AND STORAGE | 76 |
36 RISK MANAGEMENT FOR SAFE DRINKING WATER | 78 |
41 INTRODUCTION | 81 |
42 WALKERTON ONTARIO CANADA | 95 |
4231 Introduction | 97 |
4 | 123 |
432 Richmond Heights Florida USA | 125 |
433 Rome New York USA | 128 |
4335 Commentary | 129 |
434 Crater Lake Oregon USA | 130 |
4345 Commentary | 131 |
435 Camas Washington USA | 132 |
4354 Direct Causes of the Outbreak | 133 |
436 Berlin New Hampshire USA | 134 |
4364 Direct Causes of the Outbreak | 136 |
437 Bennington Vermont USA | 137 |
438 Bradford Pennsylvania USA | 139 |
44 OUTBREAKS IN THE 1980s | 142 |
443 Red Lodge Montana USA | 144 |
444 Bramham Yorkshire England | 147 |
4445 Commentary | 149 |
445 Rome Georgia USA | 150 |
4454 Direct Causes of the Outbreak | 151 |
446 Grums and Vålberg Vårmland Sweden | 152 |
447 EagleVail Colorado USA | 155 |
4473 Outbreak Experience March 1981 | 156 |
4474 Direct Causes of the Outbreak | 157 |
448 Mjövik Karlskrona Blekinge Sweden | 158 |
4484 Direct Causes of the Outbreak | 160 |
4485 Commentary | 161 |
4494 Direct Causes of the Outbreak | 163 |
4410 Greenville Florida USA | 165 |
4411 Braun Station Texas USA | 168 |
44114 Direct Causes of the Outbreak | 169 |
4412 Alsvåg Norway | 170 |
44124 Direct Causes of the Outbreak | 171 |
4413 Orangeville Ontario Canada | 172 |
44134 Direct Causes of the Outbreak | 173 |
4414 Pittsfield Massachusetts USA | 174 |
4415 Penticton BC Canada | 177 |
4416 Sälen Dalarna Sweden | 181 |
4417 Carrollton Georgia USA | 183 |
4418 Sunbury Diggers Rest and Bulla | 186 |
44185 Commentary | 188 |
4419 Boden Sweden | 189 |
44194 Direct Causes of the Outbreak | 190 |
4420 SaltcoatsStevenston Ayrshire Scotland MarchApril 1988 | 191 |
4421 Skjervøy Norway | 194 |
44215 Commentary | 195 |
44224 Direct Causes of the Outbreak | 196 |
4423 Oakcreek Canyon Sedona | 199 |
45 OUTBREAKS IN THE 1990s | 202 |
4524 Direct Causes of the Outbreak | 204 |
453 Moama New South Wales Australia | 207 |
4585 Commentary | 222 |
4510 Bradford West Yorkshire England | 226 |
4511 Warrington Cheshire England | 228 |
45114 Direct Causes of the Outbreak | 230 |
4512 KitchenerWaterloo Ontario Canada | 231 |
45125 Commentary | 233 |
4513 Milwaukee Wisconsin USA | 234 |
4514 Gideon Missouri USA | 248 |
45144 Direct Causes of the Outbreak | 250 |
4515 Noormarkku Finland | 253 |
45154 Direct Causes of the Outbreak | 254 |
4516 Temagami Ontario Canada | 255 |
4517 Victoria BC Canada | 258 |
4518 Village in Fife Scotland | 263 |
45184 Direct Causes of the Outbreak | 264 |
4519 Yukon Territory Canada | 265 |
4520 South Devon Torbay and District England | 268 |
4521 Klarup North Jutland Denmark | 273 |
45214 Direct Causes of the Outbreak | 275 |
4522 Cranbrook BC Canada | 276 |
45224 Direct Causes of the Outbreak | 277 |
45225 Commentary | 278 |
4523 Ogose Town Saitama Prefecture | 279 |
4524 Strömsund Jämtland Sweden | 282 |
4525 NW London and W Hertfordshire North Thames England February 1997 | 285 |
45254 Direct Causes of the Outbreak | 286 |
4526 Resort Hotel Bermuda | 287 |
4527 Heinävesi Finland March 1998 | 290 |
4528 Alpine Wyoming USA | 292 |
45285 Commentary | 293 |
4529 Brushy Creek Williamson County | 294 |
4530 La Neuveville Bern Canton | 297 |
4531 Washington County Fair New York USA | 300 |
46 OUTBREAKS IN THE 21ST CENTURY | 305 |
463 Belfast Northern Ireland | 307 |
4634 Direct Causes of the Outbreak | 310 |
4644 Direct Causes of the Outbreak | 313 |
465 Asikkala Finland August 2000 August 2001 and OctoberNovember 2001 | 314 |
466 North Battleford Saskatchewan Canada | 316 |
467 Boarding School Hawkes Bay | 341 |
468 CampConference Centre Stockholm County | 345 |
469 Transtrand County of Dalarna Sweden | 347 |
47 A WATERBORNE OUTBREAK OF BAD NEWS SYDNEY AUSTRALIA | 351 |
48 A WATERBORNE OUTBREAK BY ANY OTHER NAME? EDMONTON ALBERTA CANADA | 369 |
482 The Edmonton Drinking Water System | 370 |
51 SUMMARIES OF OUTBREAKS AVAILABLE IN THE LITERATURE | 381 |
52 RECURRING THEMES | 394 |
53 ROUTINE MICROBIAL SAFETY OF DRINKING WATER | 421 |
61 INTRODUCTION | 424 |
62 CHALLENGES | 426 |
63 LIMITATIONS | 427 |
64 ELEMENTS OF PREVENTION | 428 |
Hazard identification and preventive measures | 438 |
66 THE PUBLIC AND SAFE DRINKING WATER | 445 |
Common terms and phrases
American Water April attack rate bacteria boil water advisory Campylobacter chloramines chlorine chlorine residual cholera coagulation coli coliforms confirmed consumers Craun Creek cryptosporidiosis Cryptosporidium oocysts Cryptosporidium parvum Date of onset detected diarrhea Direct Causes disinfection distribution system drinking water quality drinking water safety drinking water supply Drinking Water System Eagle-Vail Edmonton effluent epidemiologic estimated evidence failure fever Figure filter filtration gastroenteritis Giardia lamblia giardiasis groundwater Health Unit Hrudey human identified illness infection investigation jejuni laboratory laboratory-confirmed lamblia located microbial Milwaukee monitoring North Battleford occurred Ontario oocysts operators Outbreak Experience outbreak of cryptosporidiosis parvum pathogens problems public health raw water reported reservoir residents responsible revealed risk river safe drinking water sewage sewer source water Stan Koebel stool samples surface water survey Sydney Water symptoms tank Temagami treated water turbidity U.S. EPA upstream virus Walkerton Inquiry water samples water treatment plant Water Works Association waterborne disease waterborne outbreaks