The characterization of waterborne-disease outbreaks.

The occurrence of waterborne-disease outbreaks from piped drinking-water supplies indicates the limitations of current systems for achieving their control. Problems associated with the early identification of outbreaks delay the implementation of control measures. The identification of such outbreaks is complicated by the confusion between drinking waterborne diseases and other routes of transmission, such as food and recreational water. The detection and description of waterborne outbreaks is based largely on surveillance and laboratory systems, which can be specific but are often delayed. In this study, we identified a number of characteristics that are common features of waterborne-disease outbreaks. We review their occurrence in well-documented outbreaks and evaluate their use in the early detection and recognition of waterborne disease.