Surface Water Supplies and Health

Rivers, streams, lakes, and reservoirs have long been important sources of drinking water. In the past, these sources were often heavily contaminated by sewage discharges and, unfortunately, were also important in the transmission of communicable diseases such as typhoid and cholera. With improvements in sewage disposal practices, development and protection of water sources, and water treatment, outbreaks of waterborne disease are less frequently reported, and drinking water becomes a less important route of transmission of communicable disease. In the United States, the incidence of waterborne disease is low but waterborne outbreaks continue to occur. Outbreak statistics are reported in this article, and information is presented on the causes of these outbreaks, especially in surface water systems.