Waterborne diseases in the United States PDF
Preview Waterborne diseases in the United States
Waterborne Diseases in the United States Editor Gunther F. Craun Health Effects Research Laboratory U.S. Environmental Protection Agency Cincinnati, Ohio Boca Raton London New York CRC Press, Inc. CRC Press is an imprint of the TayBloor c&a F rRanacist oGnro,u pF, laon rinidfoarma business First published 1986 by CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 Reissued 2018 by CRC Press © 1986 by CRC Press, Inc. CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright. com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging in Publication Data Main entry under title: Waterborne diseases in the United States. Includes bibliographies and index. 1. Waterborne infection—United States. 2. Water quality management—United States. I. Craun, Gunther F. RA642.W3W38 1986 614.4’3 85-9617 ISBN 0-8493-5937-6 A Library of Congress record exists under LC control number: 85009617 Publisher’s Note The publisher has gone to great lengths to ensure the quality of this reprint but points out that some imperfections in the original copies may be apparent. Disclaimer The publisher has made every effort to trace copyright holders and welcomes correspondence from those they have been unable to contact. ISBN 13: 978-1-315-89856-8 (hbk) ISBN 13: 978-1-351-07766-8 (ebk) Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com To Mary, Michael, Matthew, and Emily PREFACE Nostalgia for the "good old days" is a common phenomenon of survivors. This book provides a landmark of the bygone hazardous life of most people in the U.S. or in most of the industrialized world. In the first half of the 20th century, the family of man was an endangered species, not normally listed in legislative protection. Life expectancy at birth was still no more than 50 years. Infant mortality frequently reached or exceeded 50/1000 births. Infectious diseases were rampant. Prevention was still elementary, even though specific causes of transmission were gradually being understood. During that public health gestation period, bases for literal miracles of disease prevention were implemented. The present volume records those experiences from 1920 to 1983 — an heroic accomplishment by Mr. Craun. No small part of the lists of waterborne diseases are the Result of his own continuing identification of epidemic episodes throughout that period. They were the responsible indicators upon which sanitary engineers constructed and operated the myriads of public water supply systems of the U.S. These sophisticated devices repre- sented one of the means by which the war against infectious diseases was largely won in this country and in the developed countries elsewhere. As evidence accumulated throughout the decades as to the means of transmission via water, the management of human wastes and potable waters made tremendous progress in "building out" biological and physical causes of illness and death. The number of waterborne outbreaks still occurring is infinitesimal. They are predominantly in smaller noncommunity systems inadequately disinfected, in most instances by interruption of chlorination. Inci- dentally, chlorine should be noted as perhaps saving more lives throughout the world than any other chemical. The pedestrian rehearsal in the volume conceals this dramatic extension of the lives of people to a present expectancy of some 75 years. The book deserves a high place on the book shelf with Von Clausewitz on the logistics of war and on the detection performances of Sherlock Holmes, James Bond, and Maigret. Their record is no better than that of Craun. All of this does not suggest that vigilance of water quality can now be relaxed. Much too often we get vivid reminders that the familiar salmonellas, dysenteries, and the less familiar giardia are disturbing us. Those who think the task is finished are unaware that the bacterial- viral insults have a strange and long half-life. But what of the future, only briefly noted by Craun? We entered a new and complex world in the last 2 decades. We call it the "Chemical Era". Manmade and natural chemicals total in the millions and thousands of new ones are synthetically produced every year. Too many find their way into the ambient waters of the country and into sources of drinking water. Their actual, potential, and alleged toxicities are known only for a relatively small percentage of the total number. The challenge ahead of us in the water management field is particularly difficult, because the manifestation of insults is 10, 20, and 30 years deferred — some perhaps genetically affecting our great grandchildren. We live in a world of chem- icals, many of which are necessary and salutary for health, safety, and welfare. We wait upon major scientific clarifications. In the meantime, we should follow our past fruitful experience by taking them out of our potable waters as we continue to do with the familiar biological ones. In all of this, we cannot ignore the remaining billions of people in the developing world. They are still the victims of those infectious diseases no longer major threats to us. Their misfortunes are now being multiplied as well by the chemical threats. I close by recalling the wide reminder by the late great public health statesman, Prof. C.E.-A. Winslow. He emphasized that our world is a battlefield, not a nursery. Abel Wolman September 1984 THE EDITOR Gunther F. Craun* has served in various capacities over the past 20 years as an envi- ronmental engineer and epidemiologist with the U.S. Public Health Service and U.S. En- vironmental Protection Agency (EPA). Since 1970 he has been associated with the drinking water and health research activities of the EPA. In addition to infectious waterborne diseases, his current research interests include relationships between drinking water contaminants and cardiovascular disease and cancer. He received his education in civil engineering (B.S.) and sanitary engineering (M.S.) at Virginia Polytechnic Institute, Blacksburg, Va. and public health (M.P.H.) and epidemiology (S.M.) at Harvard University, Cambridge, Mass. He has authored and coauthored numerous articles in the international scientific, public health, and engineering literature. The American Water Works Association and the New England Water Works Association have recognized Mr. Craun for his work on waterborne disease outbreaks and trace metals in the drinking water of the Boston metropolitan area. The EPA awarded Mr. Craun a meritorious performance citation for his participation in the Community Water Supply Study, which identified deficiencies in the public water supplies of the Nation. He is registered as a professional engineer in the Commonwealth of Virginia and is a member of the American Water Works Association Committee on the Status of Waterborne Disease Outbreaks in the U.S. and Canada (chairman, 1977 to 1982) and the International Association of Milk, Food, and Environmental Sanitarians Committee on Communicable Diseases Affecting Man. He served as liasion representative to the Safe Drinking Water Committee of the National Research Council from 1974 to 1977 and as a member of the World Health Organization Working Group of Sodium, Chloride, and Conductivity in Drink- ing Water in 1978. He has also served as a member of the Water Pollution Control Federation Research Committee and the International Association on Water Pollution Research Study Group on Water Virology. Mr. Craun is currently Coordinator of the Environmental Epidemiology Program in the Health Effects Research Laboratory of the EPA, Cincinnati. In his present capacity, he works with a number of other governmental agencies, including the National Cancer Institute, Bethesda, Md. and Oak Ridge National Laboratory, Oak Ridge, Tenn. on epidemiological studies of drinking water contaminants. He is also involved in projects with the National Academy of Sciences, Washington, D.C. and the Center for Environmental Epidemiology, University of Pittsburgh, Pittsburgh, Pa. to identify new research areas and methodologies for environmental epidemiology. This book was edited by Gunther F. Craun in his private capacity. No official support or endorsement by the Environmental Protection Agency or any other agency of the Federal Government is intended or should be inferred. CONTRIBUTORS Frank L. Bryan John C. Hoff Food Microbiologist Research Microbiologist Food Safety Consultation and Training Drinking Water Research Division Tucker, Georgia U.S. Environmental Protection Agency Cincinnati, Ohio Gunther F. Craun Epidemiologist and Sanitary Engineer Peter C. Karalekas, Jr. Health Effects Research Laboratory Sanitary Engineer U.S. Environmental Protection Agency Water Supply Branch Cincinnati, Ohio U.S. Environmental Protection Agency Boston, Massachusetts Alfred P. Dufour Chief, Bacteriology Group Edwin C. Lippy Health Effect Research Laboratory Sanitary Engineer U.S. Environmental Protection Agency Health Effects Research Laboratory Cincinnati, Ohio U.S. Environmental Protection Agency Cincinnati, Ohio T. H. Ericksen Microbiologist Gary S. Logsdon Health Effects Research Laboratory Research Sanitary Engineer U.S. Environmental Protection Agency Drinking Water Research Division Cincinnati, Ohio U.S. Environmental Protection Agency Cincinnati, Ohio Jeffrey R. Harris Medical Epidemiologist Enteric Diseases Branch Floyd B. Taylor Division of Bacterial Diseases Executive Director Centers for Disease Control New England Water Works Association Atlanta, Georgia Dedham, Massachusetts Abel Wolman Professor Emeritus Department of Sanitary Engineering and Water Resources The Johns Hopkins University Baltimore, Maryland TABLE OF CONTENTS SECTION I: WATERBORNE DISEASES Chapter 1 Introduction 3 Gunther F. Craun Chapter 2 Clinical and Epidemiological Characteristics of Common Infectious Diseases and Chemical Poisonings Caused by Ingestion of Contaminated Drinking Water 11 Jeffrey R. Harris Chapter 3 Diseases Caused by Water Contact 23 Alfred P. Dufour Chapter 4 Chemical Drinking Water Contaminants and Disease 43 Gunther F. Craun SECTION II: WATERBORNE OUTBREAK STATISTICS Chapter 5 Statistics of Waterborne Outbreaks in the U.S. (1920—1980) 73 Gunther F. Craun Chapter 6 Recent Statistics of Waterborne Disease Outbreaks (1981—1983) 161 Gunther F. Craun SECTION III: INVESTIGATION OF WATERBORNE OUTBREAKS Chapter 7 Epidemiologic Procedures for Investigation of Waterborne Disease Outbreaks 171 Frank L. Bryan Chapter 8 Methods to Identify Waterborne Pathogens and Indicator Organisms 195 T. H. Ericksen and Alfred P. Dufour Chapter 9 Engineering Aspects of Waterborne Outbreak Investigation 215 Edwin C. Lippy SECTION IV: PREVENTION OF WATERBORNE OUTBREAKS Chapter 10 Regulations and Surveillance 233 Peter C. Karalekas, Jr. and Floyd B. Taylor Chapter 11 Barriers to the Transmission of Waterborne Disease 255 Gary S* Logsdon and John C. Hoff Epilogue 275 Gunther F. Craun Index 279 Section I: Waterborne Diseases
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