Surveillance Webinar: Public Health and Waterborne Illness-Surveillance Webinar: Public Health and Waterborne Illness Recording

Video Transcription

Video Summary

Dr. Sharon Balter, Director of the Division of Communicable Disease Control and Prevention at Los Angeles County Department of Public Health, delivered a comprehensive lecture on surveillance systems and environmental health focusing on waterborne diseases and water system safety. She traced the historical development of water systems in the U.S., highlighting public health milestones such as chlorination, the Safe Drinking Water Act, and modern regulations enforced primarily at the state level. Dr. Balter explained conventional water treatment processes and challenges like chlorine-resistant pathogens (e.g., Cryptosporidium, Legionella) and the need for maintaining disinfectant residuals throughout the distribution system.<br /><br />She emphasized the complexity of detecting waterborne outbreaks due to factors like non-reportable pathogens and lag in disease reporting. Using case studies such as the 1993 Milwaukee cryptosporidiosis outbreak and the 2015 South Bronx Legionnaires’ disease outbreak, she illustrated effective public health responses involving syndromic surveillance, epidemiologic investigations, and environmental testing. Dr. Balter discussed emerging surveillance tools like wastewater monitoring, which, while promising for tracking viral outbreaks and some community infections (e.g., hepatitis A), requires further study for practical use and privacy considerations.<br /><br />The lecture also addressed non-infectious water risks, focusing on chemical contaminants such as lead and PFAS. The Flint, Michigan water crisis was presented as a sober example of regulatory failure leading to lead poisoning and secondary Legionella outbreaks. Dr. Balter concluded by highlighting the necessity of close collaboration between public health officials and water system operators, the importance of multiple surveillance methodologies, and vigilance toward community concerns to protect public health. The session ended with Q&A addressing wastewater surveillance developments, climate change impacts on waterborne illnesses, and approaches to detecting case clusters.

Keywords

waterborne diseases

water system safety

chlorination

Safe Drinking Water Act

Cryptosporidium

Legionella

syndromic surveillance

wastewater monitoring

lead contamination

PFAS