According to the study, it showing that data determing 32 outbreaks of hepatitis A associating with drinking water were identifying during 1971 to 2017; and all occurring before 2010, according to research issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality. The researchers identifying 32 outbreaks that resulting in 857 cases; all occurring before 2010.
Untreated ground water correlated with 72% 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.
Hepatitis A virus (HAV) is an RNA virus primarily transmitting via the fecal-oral route and; in rare cases, causes liver failure and death in infected persons. Although drinking water associated hepatitis A outbreaks in the United States are rarely reporting; HAV was the most commonly reported etiology for outbreaks associated with untreated ground water during 1971–2008; and HAV can remain infectious in water for months.
Outbreaks of hepatitis A
The only contaminating drinking water systems to cause the last four reporting hepatitis A outbreaks during 1995 to 2009 were individual water systems; which are not requiring to meet national drinking water standards. During 2009 to 2017, no waterborne outbreaks were reporting. Public health education about the risks associated with drinking untreating ground water from individual systems; as well as relevant safety measures; is needing to prevent future drinking water-associating hepatitis A outbreaks.
This report analyzes drinking water associating hepatitis A outbreaks; reporting to the Waterborne Disease and Outbreak Surveillance System during 1971–2017. During that period, 32 outbreaks resulting in 857 cases were reporting; all before 2010. Untreating ground water was associating with 23 (72%) outbreak; resulting in 585 (68.3%) reporting cases.
Reporting outbreak significantly decreasing after introduction of Advisory Committee on Immunization Practices (ACIP) hepatitis A vaccination recommendations and U.S. Environmental Protection Agency’s (USEPA) public ground water system regulations. No waterborne outbreak were reporting during 2009–2017. Water testing and treatment are important considerations to protect persons who use these unregulated systems from HAV infection.
A community water system serves year round residents of a community, subdivision; or mobile home park. A noncommunity water system serves an institution, industry, camp, park, hotel, or business. Individual water systems are small systems (e.g., private wells and springs) not owning or operating by a water utility that have fewer than 15 connections or serve fewer than 25 persons. The number of outbreak before and after public health interventions were comparing; chi-squared tests were used to identify significant (p-value<0.05) differences.