Written by a team of international experts, this third edition designed to guide public health personnel or teams in any country that investigates reports of alleged waterborne illnesses. The manual is based on epidemiologic principles and investigative techniques that have been found effective in determining causal factors of disease incidence. The guidelines are presented in the sequence usually followed during investigations and are organized so that an investigator can easily find the information needed in any phase of an investigation. The book services as a guide to: • Develop a waterborne disease surveillance and emergency operations program • Handle illness alerts and water-related complaints that may be related to illness • Interview ill persons, those at risk, and controls • Develop a case definition • Transport water specimens and clinical specimens • Trace sources of contamination • Identify factors responsible for contamination, survival of pathogenic microorganisms or toxic substances, and/or propagation of pathogens • Collate and interpret collected data • Report information about the outbreak This edition has been extensively updated. A section has been added on water not intended for drinking as a source of illness. The chapter on “collection and analysis of data” has been significantly expanded to explain how data is collected and used to suggest possible vehicles, routes, and agents. The book is designed to improve the quality of investigation of outbreaks and disease surveillance. The International Association for Food Protection is a non-profit association of food safety professionals. Dedicated to the life-long educational needs of its Members, IAFP provides Members with an information network through its two scientific journals (Food Protection Trends and Journal of Food Protection), its educational Annual Meeting, international meetings and symposia along with international interaction between food safety professionals.

Procedures to Investigate Foodborne Illness is designed to guide public health personnel or teams in any country that investigates reports of alleged foodborne illnesses. The manual is based on epidemiologic principles and investigative techniques that have been found effective in determining causal factors of disease incidence. The guidelines are presented in the sequence usually followed during investigations and are organized so that an investigator can easily find the information needed in any phase of an investigation. Included are descriptions of the following procedures: Plan, prepare, investigate and respond to intentional contamination of food Handle illness alerts and food-related complaints that may be related to illness Interview ill persons, those at risk, and controls Develop a case definition Collect and ship specimens and food samples Conduct hazard analysis (environmental assessments) at sites where foods responsible for outbreaks were produced, processed, or prepared Trace sources of contamination Identify factors responsible for contamination, survival of pathogenic microorganisms or toxic substances, and/or propagation of pathogens Collate and interpret collected data Report information about the outbreak This edition also contains extensively updated and more user-friendly keys to assist investigators in identifying the contributing factors that may lead to the contamination, proliferation or survival of agents of foodborne disease.

As the human population grows-tripling in the past century while, simultaneously, quadrupling its demand for water-Earth's finite freshwater supplies are increasingly strained, and also increasingly contaminated by domestic, agricultural, and industrial wastes. Today, approximately one-third of the world's population lives in areas with scarce water resources. Nearly one billion people currently lack access to an adequate water supply, and more than twice as many lack access to basic sanitation services. It is projected that by 2025 water scarcity will affect nearly two-thirds of all people on the planet. Recognizing that water availability, water quality, and sanitation are fundamental issues underlying infectious disease emergence and spread, the Institute of Medicine held a two-day public workshop, summarized in this volume. Through invited presentations and discussions, participants explored global and local connections between water, sanitation, and health; the spectrum of water-related disease transmission processes as they inform intervention design; lessons learned from water-related disease outbreaks; vulnerabilities in water and sanitation infrastructure in both industrialized and developing countries; and opportunities to improve water and sanitation infrastructure so as to reduce the risk of water-related infectious disease.

Legionnaires' disease, a pneumonia caused by the Legionella bacterium, is the leading cause of reported waterborne disease outbreaks in the United States. Legionella occur naturally in water from many different environmental sources, but grow rapidly in the warm, stagnant conditions that can be found in engineered water systems such as cooling towers, building plumbing, and hot tubs. Humans are primarily exposed to Legionella through inhalation of contaminated aerosols into the respiratory system. Legionnaires' disease can be fatal, with between 3 and 33 percent of Legionella infections leading to death, and studies show the incidence of Legionnaires' disease in the United States increased five-fold from 2000 to 2017. Management of Legionella in Water Systems reviews the state of science on Legionella contamination of water systems, specifically the ecology and diagnosis. This report explores the process of transmission via water systems, quantification, prevention and control, and policy and training issues that affect the incidence of Legionnaires' disease. It also analyzes existing knowledge gaps and recommends research priorities moving forward.

"These guidelines have been written for public health practitioners, food and health inspectors, district and national medical officers, laboratory personnel and others who may undertake or participate in the investigation and control of foodborne disease outbreaks."--P. 4 of cover.