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The EPA Water Security initiative contamination warning system detection strategy involves the use of multiple monitoring and surveillance components for timely detection of drinking water contamination in the distribution system. The public health surveillance (PHS) component of the contamination warning system involves the analysis of health-related data to identify disease events that may stem from drinking water contamination. Public health data include hospital admission reports, infectious disease surveillance, emergency medical service reports, 911 calls and poison control center calls. Automated analysis of these data streams results in alerts, which are investigated by health department epidemiologists. A comprehensive operational strategy was developed to describe the processes and procedures involved in the the initial investigation and validation of a PHS alert. The operational strategy established specific roles and responsibilities, and detailed procedural flow descriptions. The procedural flow concluded with the determination of whether or not an alert generated from surveillance of public health data streams is indicative of a possible water contamination incident.

 

Objective

To develop standard operating procedures to identify or rule out possible water contamination as a cause for a syndromic surveillance alarm.

Referenced File
Submitted by hparton on

Many studies evaluate the timeliness and accuracy of outbreak detection algorithms used in syndromic surveillance. Of greater interest, however, is defining the outcome associated with improved detection. In case of a waterborne cryptosporidiosis outbreak, public health interventions are aimed exclusively at preventing new infections, and not at medical treatment of infected individuals. The effectiveness of these interventions in reducing morbidity and mortality will depend on their timeliness, the level of compliance, and the duration of exposure to pathogen. In this work, we use simulation modeling to examine several scenarios of issuing a boil-water advisory (BWA) as a response to outbreak detection through syndromic surveillance, and quantify the possible benefits of earlier interventions.

Objective

To quantitatively assess the benefit of issuing a boil-water advisory for preventing morbidity and mortality from a waterborne outbreak of cryptosporidiosis.

Referenced File
Submitted by uysz on

Cyanotoxins are unregulated, emerging contaminants that have been associated with adverse health effects, including gastroenteritis, when consumed at high levels1,2. In May and June of 2018 cyanotoxins were detected in the public drinking water system for Salem, OR at levels above Environmental Protection Agency (EPA) health advisory levels for sensitive groups3. Sensitive groups were defined as children under 6, elderly adults, pregnant women, nursing mothers, people with compromised immune systems, people receiving dialysis, people with pre-existing liver conditions, and pets. Several health advisories were issued, and there was substantial media coverage of the event. The Oregon Health Authority (OHA) organized an Incident Management Team (IMT), which coordinated activities with other state and local agencies. Oregon ESSENCE staff used syndromic surveillance to monitor the population for health effects and healthcare seeking behavior.

Objective: Examine healthcare seeking behavior in a population exposed to low levels of cyanotoxins in the public drinking water supply and quantify how publicity of the event may have affected perceptions of risk in the affected population.

Submitted by elamb on
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