1971 to 2017 Saw 32 Drinking Water Hepatitis A Outbreaks

Thirty-two outbreaks of hepatitis A associated with drinking water were identified during 1971 to 2017, and all occurred before 2010, according to research published in the issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Catherine E. Barrett, Ph.D., from the CDC in Atlanta, and colleagues analyzed drinking water-associated hepatitis A outbreaks reported to the Waterborne Disease and Outbreak Surveillance System during 1971 to 2017.

The researchers identified 32 outbreaks that resulted in 857 cases; all occurred before 2010. Untreated ground water correlated with 72 percent of outbreaks, resulting in 68.3 percent of reported cases. After the introduction of Advisory Committee on Immunization Practices hepatitis A vaccination recommendations and the U.S. Environmental Protection Agency public ground water system regulations, there was a significant decrease in reported outbreaks. The only contaminated drinking water systems to cause the last four reported hepatitis A outbreaks during 1995 to 2009 were individual water systems, which are not required to meet national drinking water standards. During 2009 to 2017, no waterborne outbreaks were reported.

"Public health education about the risks associated with drinking untreated ground water from individual systems, as well as relevant safety measures (i.e., water testing, water treatment, and vaccination), is needed to prevent future drinking water-associated hepatitis A outbreaks," the authors write.

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