Protecting and maintaining water distributions systems is crucial to ensuring high quality drinking water. Distribution systems-consisting of pipes, pumps, valves, storage tanks, reservoirs, meters, fittings, and other hydraulic appurtenances-carry drinking water from a centralized treatment plant or well supplies to consumers' taps. Spanning almost 1 million miles in the United States, distribution systems represent the vast majority of physical infrastructure for water supplies, and thus constitute the primary management challenge from both an operational and public health standpoint. Recent data on waterborne disease outbreaks suggest that distribution systems remain a source of contamination that has yet to be fully addressed. This report evaluates approaches for risk characterization and recent data, and it identifies a variety of strategies that could be considered to reduce the risks posed by water-quality deteriorating events in distribution systems. Particular attention is given to backflow events via cross connections, the potential for contamination of the distribution system during construction and repair activities, maintenance of storage facilities, and the role of premise plumbing in public health risk. The report also identifies advances in detection, monitoring and modeling, analytical methods, and research and development opportunities that will enable the water supply industry to further reduce risks associated with drinking water distribution systems.

What happens to "orphan" diseases that aren't big enough profit centers for the pharmaceutical industry or get caught in the web of government funding and academic research? Augie Nieto found out in the spring of 2005: At forty-seven years old he was diagnosed with ALS. Devastated, Augie struggled with depression and attempted suicide. When he awoke from a coma, with friends and family surrounding him, his sense of faith and mission were renewed. Fast-forward one year: Augie and his wife, Lynne, were profiled as "Real Heroes" on the Today show. Their determination to beat the disease had already led to major overhauls in the way ALS research was conducted. In partnership with the Muscular Dystrophy Association, Augie had set up a foundation and lab to coordinate and oversee ALS research and testing across the globe. By centralizing operations and championing an entrepreneurial approach to medical research, Augie and his team accomplished remarkable results in less than two years. Part inspiration, part business innovation, Augie's Quest illustrates how one person can make a meaningful difference. Praise for Augie Nieto: George H. W. Bush, former U.S. president: "Your contributions to the fitness industry are well known, and your dedication an inspiration." Lance Armstrong, seven-time "Le Tour de France" champion: "I think it says a lot about Augie, the fact that everybody came together regardless of whether or not it's for competing gyms or competing companies that make equipment. They all say, this is one of our own; this is a guy who's committed his life to our industry and has been dealt a serious blow. We're going to be there for him, we're going to say, we're here for you and we're part of the Quest." Arnold Schwarzenegger, governor of California: "Your success has been incredible. But you are so much more than just a successful businessman. You are the greatest husband, a great father, and a terrific friend. So,