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Volume 29, Number 7—July 2023
Research

Estimating Waterborne Infectious Disease Burden by Exposure Route, United States, 2014

Megan E. Gerdes1Comments to Author , Shanna Miko1, Jasen M. Kunz, Elizabeth J. Hannapel, Michele C. Hlavsa, Michael J. Hughes, Matthew J. Stuckey, Louise K. Francois Watkins, Jennifer R. Cope, Jonathan S. Yoder, Vincent R. Hill, and Sarah A. Collier
Author affiliations: Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes); Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)

Main Article

Table 1

Number of cases of selected domestically acquired illnesses from different water sources in study estimating waterborne infectious disease burden by exposure route, United States, 2014*

Disease or syndrome Water exposure route, no. cases (95% CrI)
Recreational water† Drinking water‡ NRND water§
Acute otitis externa 4,430,000 (2,170,000–7,020,000) 126,000 (0–891,000) 111,000 (0–521,000)
Campylobacteriosis 54,900 (0–307,000) 75,400 (40–366,000) 40,900 (0–257,000)
Cryptosporidiosis 211,000 (27,700–718,000) 76,400 (957–362,000) 34,400 (37–177,000)
Giardiasis 204,000 (26,900–552,000) 137,000 (6,070–445,000) 74,100 (41–329,000)
Legionnaires’ disease 1,000 (174–3,810) 5,760 (2,030–9,160) 4,250 (1,360–7,890)
NTM infection 8,630 (0–29,700) 46,400 (17,400–78,200) 13,800 (0–38,200)
Norovirus infection 626,000 (1,930–2,960,000) 604,000 (1,800–2,890,000) 102,000 (2–792,000)
Pseudomonas pneumonia 7,600 (996–16,200) 935 (62–4,750) 7,380 (1,330–15,900)
Pseudomonas septicemia 417 (23–1,940) 929 (25–3,710) 4,410 (481–11,500)
Salmonellosis, nontyphoidal
 14,000 (343–67,500)
 57,700 (3,050–214,000)
 5,320 (72–31,000)
STEC infection
O157 serotype 2,300 (188–9,260) 887 (33–4,220) 163 (0–1,050)
Non-O157 serotype
 5,780 (0–23,600)
 1,360 (0–8,820)
 4,300 (0–18,000)
Shigellosis
 13,200 (667–60,900)
 586 (0–3,920)
 3,450 (71–18,800)
Vibrio spp. infections 33,500 (184–20,300) 342 (2–210) 759 (3–277)
V. alginolyticus 12,300 (3,500–24,900) 93 (0–564) 248 (0–2,330)
V. parahaemolyticus 20,300 (4,950–38,600) 210 (0–1,900) 277 (0–2,490)
V. vulnificus 184 (82–274) 2 (0–18) 3 (0–45)
Other Vibrio spp.
 610 (0–5,050)
 38 (0–270)
 231 (0–1,350)
Total illnesses 5,610,000 (2,970,000–9,000,000) 1,130,000 (255,000–3,540,000) 407,000 (72,800–1,290,000)

*Estimates are rounded to 3 significant figures. CrI, credible interval; NRND, nonrecreational nondrinking; NTM, nontuberculous mycobacteria; STEC, Shiga toxin–producing Escherichia coli.†Recreational water is used for recreational activities, such as swimming, in treated (e.g., pools, hot tubs, and splash pads) or untreated (e.g., lakes, rivers, and oceans) venues (19). ‡Drinking water is used primarily for drinking but can also be used for maintaining hygiene, such as for washing or showering, and can come from public water systems, private wells, or commercially bottled sources (19). §NRND water is used for purposes other than recreation or drinking (e.g., for agriculture, industry, or medical procedures) and can come from backcountry streams or flood waters (19).

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1These first authors contributed equally to this article.

Page created: May 10, 2023
Page updated: June 20, 2023
Page reviewed: June 20, 2023
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