Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Volume 31, Number 8—August 2025

Dispatch

Variance Among Public Health Agencies’ Boil Water Guidance

Megan DorrisComments to Author , Shanna Miko, Jasen M. Kunz, and Vincent R. Hill
Author affiliation: Epidemic Intelligence Service, Atlanta, Georgia, USA (M. Dorris); Centers for Disease Control and Prevention, Atlanta, Georgia (M. Dorris, S. Miko, J. Kunz, V. Hill)

Main Article

Table

Comparison of guidance from 5 public health agencies for study of variance among public health agencies’ boil water guidance*

Agency Target endpoint End point definition Duration at endpoint Elevation adjustment Cooling guidance
CDC drinking water advisories webpage (5)
Full rolling boil
Not defined
1 min
3 min at elevations above 1,981 m (6,500 ft)
Allow boiled water to cool before you use it
Yellow Book (6)
Boiling
Not defined
1 min, if fuel supplies are adequate
No adjustment needed at common terrestrial travel elevations.
Not addressed
EPA (7)
Rolling boil
Not defined
1 min
3 min at elevations 1,524 m (5,000 feet)
Let water cool naturally
Health Canada (8)
Rolling boil
A vigorous boil, where bubbles appear at the center and do not disappear when the water is stirred
1 min
2 min at elevations above 2,000 m (6,562 ft)
The water should then be cooled
Ready.gov (9)
Rolling boil
Not defined
1 min
Not addressed
Let the water cool before drinking
WHO (11) Rolling boil Not defined No additional time after reaching rolling boil No adjustment at high elevation Cool naturally, without the addition of ice

*CDC, US Centers for Disease Control and Prevention; EPA, US Environmental Protection Agency; WHO, World Health Organization.

Main Article

References
  1. State of North Carolina Office of State and Budget Management. Hurricane Helene damage needs assessment: Hurricane Helene recovery recommendations. December 13, 2024. [cited 2024 Dec 11]. https://www.osbm.nc.gov/hurricane-helene-dna/open
  2. Phillis  MAJ, Peterson  B. A week after Helene hit, thousands still without water struggle to find enough [cited 2024 Dec 11]. https://apnews.com/article/hurricane-helene-asheville-north-carolina-water-737bd51b1351315dc28522e36c425f18
  3. Espinosa  MF, Sancho  AN, Mendoza  LM, Mota  CR, Verbyla  ME. Systematic review and meta-analysis of time-temperature pathogen inactivation. Int J Hyg Environ Health. 2020;230:113595. DOIPubMedGoogle Scholar
  4. Centers for Disease Control and Prevention, US Environmental Protection Agency, American Water Works Association, Association of State and Territorial Health Officials, Association of State Drinking Water Administrators, National Environmental Health Association. Drinking water advisory communication toolbox. Updated 2016 [cited 2024 Dec 9] https://www.cdc.gov/water-emergency/media/pdfs/2024/08/dwact-2016.pdf
  5. Centers for Disease Control and Prevention. Drinking water advisories: an overview. [cited 2024 Dec 9]. https://www.cdc.gov/water-emergency/about/drinking-water-advisories-an-overview.html
  6. Backer  H, Hill  V. Water disinfection. 2023. In: CDC Yellow Book 2024: health information for international travel [cited 2024 Dec 9]. https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/water-disinfection
  7. US Environmental Protection Agency. Emergency disinfection of drinking water [cited 2024 Dec 9]. https://www.epa.gov/ground-water-and-drinking-water/emergency-disinfection-drinking-water
  8. Health Canada. Guidance for issuing and rescinding boil water advisories in Canadian drinking water supplies. 2015 [cited 2024 Dec 9]. https://www.canada.ca/en/health-canada/services/publications/healthy-living/guidance-issuing-rescinding-boil-water-advisories-canadian-drinking-water-supplies.html
  9. US Department of Homeland Security. Water [cited 2024 Dec 9]. https://www.ready.gov/water
  10. World Health Organization. Guidelines for drinking-water quality: 4th edition, incorporating the 1st addendum. 2017 [cited 2024 Dec 9]. https://www.who.int/publications/i/item/9789241549950
  11. World Health Organization. Boil water. 2015 [cited 2024 Dec 11]. https://iris.who.int/handle/10665/155821
  12. Sharvelle  S, Ashbolt  N, Clerico  E, Holquist  R, Levernz  H, Olivieri  A. Risk-based framework for the development of public health guidance for decentralized non-potable water systems. Proc Water Environ Fed. 2017;8:3799809. DOIGoogle Scholar

Main Article

Page created: June 24, 2025
Page updated: July 10, 2025
Page reviewed: July 10, 2025
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external