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[ Recorded presentation ] Recorded presentation

Public health partnerships and disease surveillance with a large water utility: Waterborne disease surveillance by Massachusetts Water Resources Authority with state and city health departments

Joshua Das, MS, Planning, Massachusetts Water Resources Authority, Charlestown Navy Yard, 100 First Avenue, Boston, MA 02130, 617-788-4668, Joshua.Das@mwra.state.ma.us, Barbara Bolstorff, MPH, Bureau of Communicable Disease Control, Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130, and Justin Pendarvis, MPH, Communicable Disease Control Division, Boston Public Health Commission, 1010 Massachusetts Ave, 2nd Floor, Boston, MA 02118.

Since 2000, the Massachusetts Water Resources Authority (MWRA), water supplier for 2.2 million residents in eastern Massachusetts, has collaborated with the Massachusetts Department of Public Health (MDPH) and the Boston Public Health Commission (BPHC) on a surveillance system that monitors several possible predictors of gastrointestinal illness potentially related to drinking water. The system consists of: enhanced passive surveillance for selected waterborne pathogens (cryptosporidium and giardia) reported from clinical laboratories, daily tracking of rates of gastrointestinal syndromes within a local health management organization, weekly tracking at sentinel sites, monitoring daily sales of anti-diarrheal medications and pediatric electrolytes from select companies, and syndromic surveillance (with subsequent local public health investigation) at all Boston hospitals that selects for gastrointestinal illness related chief complaints.

Since the start of the surveillance system, no drinking-water related outbreaks involving the municipal water system were identified. Using retrospective comparative analysis that included all of Massachusetts, there was no evidence of change in the relative rates of giardiasis in the MWRA service area after a treatment change in 1998 when chlorination was increased. Differences in rates of water-borne illness, before and after the recent change from chlorination to ozonation, are being evaluated.

The process of starting the surveillance system and monthly meetings has increased contact and formed a strong relationship between MWRA, MDPH, and BPHC. This partnership has promoted a greater understanding of the water supply by the public health partners and has allowed MWRA to gain more knowledge about levels of disease in the service area.

Learning Objectives: Learning Objectives