Current
Record
|
New
Record
|
Title
|
The
title has changed from Waterborne
Diseases Outbreak Report
to:
National
Outbreak Reporting System
Waterborne
Disease Transmission
|
Color
|
In
the electronic version,
General
has brown headings. The color theme for all sections of the
revised CDC 52.12 paper form is blue to be consistent with the
original form. Multiple shades of blue clearly identify sections
and subsections. The revised form has been tested for readability
by printing the form in color and in grayscale. Headings use white
or black text and the data entry fields use black text.
|
Logos
|
The
CDC logo has been moved from lower right corner to upper right
corner. The DHHS logo has been added in upper left corner and
replaces the DHHS mailing address.
|
Form
description
|
The
form description was:
This
form should be used to report outbreaks of illness after
consumption or use of water intended for drinking, as well as
outbreaks associated with exposure (ingestion, contact or
inhalation) of recreational water.
The
form description has been reworded, as follows:
This
form is used to report waterborne disease outbreak investigations.
This form has 6 parts, indicated by tabs at the top of each page.
Part 1 asks for the minimum or basic information about the
outbreak investigation. Part 2 asks for epidemiological data and
clinical specimen test results. Parts 3, 4, 5 and 6 collect
information about types of water exposure (treated recreational
water, untreated recreational water, drinking water, and water not
intended for drinking/water of unknown intent). Only 1 of these 4
water exposure parts should be completed for an outbreak
investigation report.“
|
CDC
Use Only Report ID field
|
The
CDC
Use Only field
has been renamed CDC
Report ID
and has been moved from the upper right corner to the upper left
corner (below the DHHS logo) A State
Report ID
field has been added to the right of the CDC
Report ID
field for an ID number that may have been assigned by the
reporting state.
|
1.
Type of Exposure
|
Type
of Exposure
has been renamed Type
of Water Exposure and
has been moved from the beginning of page 1 to the beginning of
the Water-General
tab on page 3. The options have been reordered and additional
options have been provided. Descriptive examples have been
provided for each type of water exposure. Recreational
water
has been divided into two responses: Water
intended for recreational purposes- treated and
Water intended for recreational purposes- untreated.
Drinking
water is
now described as Water
intended for drinking.
Other
has been changed to Water
not intended for drinking or water of unknown intent (WNID/WUI).
|
|
Type
of Exposure-
NEW SECTION:
The
first question on page 1 of the revised form is Primary
Mode of Transmission.
Multiple surveillance systems will share the General
tab in NORS. Each will have its own mode of transmission for
outbreak reporting. State reporters will select Water
on
the CDC 52.12 to identify water as the mode of transmission that
resulted in the outbreak.
Page
2 has a section titled Secondary
Cases
where users can select a secondary mode of transmission and enter
information about illness associated with the secondary mode of
transmission (e.g. an individual who became ill from a water
exposure may then transmit the disease agent to other individuals
via person-to-person contact).
|
2.
Location of Outbreak
|
Location
of Outbreak
has been renamed Geographic
Location
(page 1)
This
section has been expanded so that state reporters can clearly
differentiate between the state and county that reported the
outbreak and any additional states or counties that were also
involved in the outbreak.
For
the reporting state, three additional fields have been added:
Exposure
occurred in multiple states,
Exposure
occurred in a single state, but cases resided in multiple states,
and Other
states:________.
Similarly,
for the reporting county, three additional fields have been added:
Exposure
occurred in multiple counties,
Exposure
occurred in a single county, but cases resided in multiple
counties in the reporting state,
and Other
counties:________.
City
or town
has been changed to City/Town/Place
of exposure. Do
not include proprietary or private facility names
has been added to discourage the entry of unique identifiers of
business establishments.
|
|
Location
of Outbreak-
NEW SECTION:
A
new section titled Geographic
Location has
been included in the Water-General
tab on page 3. The field Percent
of primary cases living in the reporting state:
________% requests the proportion of cases who reside in the
reporting state only.
|
3.
Date of Outbreak (Date first case became ill)
|
Date
of Outbreak
has been renamed Dates
(page
1). This section contains new fields to help state reporters
better define the start and end of an outbreak using the data
available for a given outbreak. Date
of Outbreak contained
the field Date
first case became ill.
The new fields in the Dates
section are: Date
last case became ill,
Date
of initial exposure
and Date
of last exposure.
Additional information about the Dates
section is described on page 12 of this document with reference to
Date
investigation initiated in
the current 52.12 record.
|
|
Date
of Outbreak- NEW
SECTION:
An
Associated
Events
section has been added to the Water-General
tab
on page 3. Associated
Events
captures additional information about exposure dates that will be
valuable when dates of first and last illness or exposure are not
known. State reporters may answer the following questions to
describe an event (e.g. wedding reception, pool party) and to
provide the time interval for an event with which an outbreak was
considered to have been associated:
Was
exposure associated with a specific event or gathering? (yes, no,
unknown)
If
yes, what type of event or gathering was
involved?_________________________
If
outbreak occurred during a defined event, dates of event:
Start
date: ___/___/____ End date:___/___/____
|
4.
Numbers of: persons exposed, ill, hospitalized and fatalities
(actual and estimated)
|
Numbers
of: persons exposed, ill, hospitalized and fatalities (actual and
estimated)
has been revised. This question is now asked in two sections:
Primary
Cases,
for which count data have historically been collected (page 1) and
Secondary
Cases (page
2), which is summarized above in 1.
Type of Exposure-
NEW SECTION.
The
table Number of Primary Cases requests the following information:
#
Lab-confirmed cases, # Probable cases, # Estimated total primary
ill. The
fields
# Visited Emergency Room and # Visited health care provided
(excluding ER visits) have
been added following #
Died, # Hospitalized.
Actual
and
Estimated
have been replaced with
# Cases and
Total
# of cases for whom info is available.
In
accordance with eFORS, the Primary
Cases
section on page 1 has been revised to contain two additional
tables:
A
table for Sex data requests the percentage of cases who are male
and female with the following fields: Male
and
Female
A
table for Age data (% per age group) has the following fields: <1
year,
1-4
years,
5-9
years,
10-19
years, 20-49 years,
50-74
years,
≥75
years,
Unknown.
The
table Number of Secondary Cases requests the following
information: #
Lab-confirmed cases, # Probable cases, Total # of secondary cases
and
Total
# of cases (Primary+Secondary).
|
|
Information
about the number of people exposed is now requested in Water-
General
under the section Epidemiologic
Data (page
3), which is described for 10a.
Epidemiologic data (current
record) below.
The
first field in this section has been worded as follows: Estimated
total number of persons with primary exposure?_____.
This will provide an approximation (or actual number, if known) of
people who were at risk of becoming ill from the primary mode of
transmission and provides a context for the data reported from an
epidemiological study.
|
5.
History of Exposed Persons (Enter the no. of persons with the
following symptoms):
|
History
of Exposed Persons
historically collected information about individual symptoms and
categories of symptoms at the same time. The two fields that
collected information about the number of interviewed persons were
No.
of Persons Interviewed
and No.
of Interviewed Persons Who Were Ill.
The numbers entered into these two fields frequently referred to
ill persons only. State reporters were not able to indicate if the
number of persons interviewed varied by symptom reported.
History
of Exposed Persons
has been separated into two sections, described below. Respondents
may enter data into one or both sections, depending on the data
available from the outbreak:
Signs
or Symptoms
(General,
page 2) will allow state reporters to enter information about the
number of cases with specific symptoms in the following fields: #
Cases with signs or symptoms and
Total
# of cases for whom info available.
Signs
or Symptoms
provides
valuable information about proportion of cases with a particular
symptom. This is the reporting format currently used in eFORS.
Symptoms
(Water-
General,
page 3) will allow state reporters to enter the total number of
individuals within a category of symptoms (e.g. Gastrointestinal
symptoms/conditions ____,
Respiratory
symptoms/conditions _____).
Symptoms
summarizes
case count data to present a picture of the illness distribution
for an outbreak. This is the format that has historically been
used to discuss data in WBDOSS reports.
|
6.
Incubation Period
|
Incubation
Period has
been moved to page 2. Mean
incubation period
has been deleted. Minutes
has been added as a time unit option. Unknown
incubation period has
been added as a checkbox field.
|
7.
Duration of Illness
|
Duration
of Illness
has been moved to page 2. Mean
duration of illness
has been deleted. Minutes
has been added as a time unit option. Unknown
duration of illness has
been added as a checkbox field.
|
8.
Specimens Examined from Patients
|
Specimens
Examined from Patients
has been moved to Water-General
(pages 3-4) and renamed Clinical
Specimens - Laboratory Results.
The
first field is worded as follows:
Were
clinical diagnostic specimens taken from persons?’
(responses: yes, no, unknown)
If
yes, from how many persons were specimens taken? ___
|
|
Three
data tables have replaced the single specimen data table for this
section.
The
first table (page 4) expands on Specimen,
a general field in Specimens
Examined from Patients from
the current CDC 52.12 record. More detailed information is
collected using the following new fields: Specimen
Type,
Specimen
Subtype
and Tested
for (e.g.
bacteria, chemicals/toxins, fungi, parasites or viruses).
The
second table replaces No.
Persons
and Findings
in Specimens
Examined from Patients, to
more accurately describe the number of specimens that were tested
and the results for any tests that were conducted. The second
table contains the following fields: Genus/Chemical/Toxin,
Species,
Serotype/Serogroup/Serovar,
Genotype/Subtype,
Confirmed
as Etiology?,
Concentration,
Unit,
Specimen
Type,
Specimen
Subtype,
Test
Type,
Total
# People Tested,
and Total
# People Positive.
A
third data table has been added to capture the results of
laboratory tests that determine the molecular profiles of
microorganisms using standardized, nationally approved tests. The
third table contains the following fields: State
Lab Isolate ID,
Specimen
Profile 1 and
Specimen
Profile 2.
|
9.
Etiology of Outbreak
|
Etiology
of Outbreak
has been incorporated into the second table described in
8.
Specimens Examined from Patients.
State reporters can now indicate that a microorganism or toxin was
the etiologic agent in an outbreak by checking the box Confirmed
as Etiology?
when they enter clinical specimen results for that microorganism
or toxin in the table.
|
10a.
Epidemiologic data
|
Epidemiologic
data
has been moved to Water-General
(page 4). The data table is preceded by three fields. The first
field was discussed in 4.
Numbers of: persons exposed, ill, hospitalized and fatalities
(actual and estimated):
Estimated
total number of persons with primary exposure?_____.
The
remaining two fields divide the statement from a checkbox at the
bottom of the current data table into two elements. The original
field was written as follows: No
data were collected from comparisons groups to estimate risk but
water was the only common source shared by persons who were ill.
The
revisions divide this statement into: Were
data collected from comparison groups to estimate risk?
(responses: yes, no, unknown) and
If
No or Unknown, was water the only common source shared by persons
who were ill? (responses: yes, no, unknown)
|
|
The
data table for Epidemiologic
data
has been revised.
Total
now precedes the fields that fall under the headings Number of
Persons Exposed and Number of Persons Not Exposed in the current
CDC 52.12 record. The two fields named Total
have
been renamed Total
# Exposed (A)
and Total
# Not Exposed,
respectively. Exposed-
Not Ill
and Not
Exposed- Not Ill
have been deleted. Attack
Rate
has been added. Odds
Ratio/Risk Ratio has
been separated into two fields: Odds
Ratio
and Risk
Ratio.
Similarly, p-Value
or Confidence Interval
has been separated into p-Value
and 95%
Confidence Interval.
|
|
Two
attack rate fields have been added below the epidemiologic data
table to differentiate between reporting state residents and
non-residents. The fields are: Attack
rate for residents of reporting state: ______%
and Attack
rate for non-residents of reporting state: _______%.
|
|
Epidemiologic
data- NEW SECTION
Additional
information about the epidemiological methods, as well as other
methods (e.g. environmental methods) used have been added in a
checklist on page 1 under Investigation
Methods.
Important methods for the Epidemiologic
data
section in this list are: Interviews
only of ill persons,
Case-control
study
and Cohort
study.
|
10b.
Comments
|
Comments
for epidemiologic data and methods has been moved directly after
Investigation
Methods (page
1). Additional comments may be added under Remarks
on page 2.
|
11.
Water Supply Characteristics
|
Water
Supply Characteristics
combined questions for drinking water and recreational water.
State reporters also used this section to provide information
about outbreaks that involved other types of water exposure.
To
simplify the reporting process, the content from this section has
been reorganized. Water
Supply Characteristics
does not appear in one shared location on the revised form. The
fields have instead been included for each type of water exposure,
where appropriate. Fields have been added to capture details that
were previously reported in the margins of the paper form.
The
changes to Water
Supply Characteristics
are detailed in 11a, 11b, and 11c below.
|
|
Water
Supply Characteristics-
NEW
SECTION:
Traceback
has been added to General
on
page 2 . This section contains the following fields: Please
check if traceback conducted;
Source
name;
Source
type;
Location
of source (State, Country);
and Comments.
Traceback
will only be used to provide the water source for waterborne
disease outbreaks involving bottled water. This information may be
shared with the Food and Drug Administration (FDA). Traceback
is
shared with the foodborne disease surveillance team and will be
used more often by state reporters completing CDC 52.13.
|
|
Water
Supply Characteristics-
NEW
SECTION:
Intent
for Use
has been added to Water
Not Intended For Drinking/Water of Unknown Intent
at the beginning of page 13. This section provides information
about water supply characteristics for water that is not
recreational water or drinking water.
The
Intent
for Use
section is worded as follows:
What
was the intended use for the implicated water (check
all that apply)
__Cooling/Air
Conditions (e.g., cooling tower, swamp cooler)
__Mister
(e.g., produce in grocery store, public cooling system)
__Ornamental
(e.g., a decorative non-interactive fountain intended for public
display and not designed for swimming or recreational use)
__Industrial/Occupational
(e.g., steam cleaner)
__Agricultural
Irrigation
__Waste
water
__Other
(specify):__________
__Unknown
|
11a.
Type of Drinking Water Supply
|
Type
of Drinking Water Supply
has been moved to Drinking
Water
on page 9. A table titled Drinking Water Vehicle Description
contains the field Water
Type for
state reporters to record EPA-regulated water supplies (e.g.
community system) and FDA-regulated water supplies (bottled water)
that are listed in Type
of Drinking Water Supply.
Subcategories
of these drinking water supplies (e.g. school, restaurant, hotel)
are now included in the Setting
of Exposure
field described in further detail below (11b.
Water Source or Setting).
An additional field for Public
Water System EPA ID Number
has been added to the table so that respondents can directly
associate a public water system with existing EPA records.
|
11b.
Water Source or Setting
|
Water
Source or Setting
has been expanded into two-three fields, dependent on the type of
water exposure.
Water
Type
refers to the source of the water in Recreational
Water-Treated
(page 5), Recreational
Water-Untreated
(page 7) and Water
Not Intended for Drinking/Water of Unknown Intent
(page 13).
In
Drinking
Water,
the source of water will be collected on page 9 in the fields
Water
Source
and Water
Source Description.
In
Recreational
Water-Treated,
Water Subtype
follows Water
Type
on page 5. This field will detail whether the water source was
indoor, outdoor or unknown.
In
Recreational
Water-Untreated,
If Spring or Hot Spring, Water Subtype follows
Water
Type
on page 7. This field will detail whether the water source was
indoor, outdoor or unknown.
In
Recreational
Water-Treated
(page 5), Recreational
Water-Untreated
(page 7), Drinking
Water
(page 9) and
Water Not Intended for Drinking/Water of Unknown Intent
(page 13), the table that will collect data for Water
Source or Setting
has an additional field titled Setting
of Exposure.
This field will collect descriptive data about the outbreak
setting, such as: camp; hospital; membership club.
|
|
Fill
Water Type
has been added in the third row of the Recreational Water Vehicle
Description table for Recreational
Water-Treated
(page 5). This variable will collect supplemental water source
data that was not asked previously in Water
Source or Setting.
|
11c.
Water Treatment Provided
|
Water
Treatment Provided
has been included in Recreational
Water-Treated
(page 5), Drinking
Water
(page 9) and Water
Not Intended for Drinking/Water of Unknown Intent (page
13). The variables and options have been tailored to each type of
water exposure and new variables, listed below, have been created
to capture treatment subtypes that were already listed on the CDC
52.12 form.
In
Recreational
Water-Treated
(page 5), the Recreational Water Vehicle Description table
contains the following fields: Usual
Water Treatment Provided at Venue,
Venue
Treatment Subtype,
Chlorination
Subtype,
If
Public Water Was Used to Fill, Usual Water Treatment Provided for
Fill Water Before Coming to the Venue
and
If Public Water Was Used to Fill, Fill Water Treatment Subtype.
In
Drinking
Water
(page 9), the Drinking Water Vehicle Description table contains
the following fields:
Usual Water Treatment Provided
and Water
Treatment Subtype.
In
Water
Not Intended for Drinking/Water of Unknown Intent (page
13), the Water Description table contains the following fields:
Usual
Water Treatment Provided
and Water
Treatment Subtype.
|
12.
Factors Contributing to Drinking Water Contamination
|
Factors
Contributing to Drinking Water Contamination
has been moved to pages 10 and 11 The factors are listed under
Factors
Contributing to Drinking Water Contamination and/or Increased
Exposure to Contaminated Drinking Water.
|
12a.
Contamination at the water source
|
Contamination
at the water source
has been moved to page 10. Checklist options have been expanded.
The following field has been placed before the checklist:
Did
a problem with the source water (i.e. ground water or surface
water) contribute to the disease or outbreak? (responses: yes, no,
unknown)
|
12b.
Water treatment deficiencies
|
Water
treatment deficiencies
has been moved to page 11. Checklist options have been expanded.
The following field has been placed before the checklist:
Did
a problem with the water treatment prior to entry into a house or
building contribute to the disease or outbreak?
(responses:
yes, no, unknown)
|
12c.
Contamination in the water distribution system or home plumbing
|
Contamination
in the water distribution system or home plumbing
has been moved to page 11 and divided into two checklists.
Checklist options have been expanded for both lists.
Checklist
1 addresses distribution system factors, and includes storage
factors.
Checklist
2 addresses home plumbing, as well as other factors not under the
jurisdiction of a water utility or factors at the point of use.
|
|
Contamination
in the water distribution system or home plumbing-
Checklist 1 (page 11) is preceded by the following field:
Did
a problem with the distribution system contribute to the disease
or outbreak?
(responses:
yes, no, unknown) (Note: For a community water system, the
distribution system refers to the pipes and storage infrastructure
under the jurisdiction of the water utility prior to the water
meter (or property line if the system is not metered). For
noncommunity and nonpublic water systems, the distribution system
refers to the pipes and storage infrastructure prior to to entry
into a building or house).
|
|
Contamination
in the water distribution system or home plumbing-
Checklist 2 (page 11) is preceded by the following statement:
Did
a problem occur after the water meter or outside the jurisdiction
of a water utility that contributed to the disease or outbreak?
(e.g., in a service line leading to a house/building, in the
plumbing inside a house/building, during shipping/hauling, during
storage other than in the distribution system, at the point of
use, involving commercially-bottled water)? (responses: yes, no,
unknown).
|
12d.
Other Reasons/contributing factors for contamination of water
(e.g. Corrosive water)
|
Other
Reasons/contributing factors for contamination of water (e.g.
Corrosive water) has
been replaced with Remarks
on
page 12.
In
addition, each checklist for the questions described in 12a-12c
includes the option Other,
specify:________.
|
13.
Route of Entry for Recreational Exposure
|
Route
of Entry for Recreational Exposure
has been moved to Water-General
on page 3 and renamed Route
of Entry.
The section will apply to all types of water exposure instead of
just recreational water exposures.
Accidental
ingestion
and intentional
ingestion
have been combined into a single field called Ingestion.
The distinction between accidental and intentional ingestion can
be difficult to make and does not add substantial value within the
current reporting system.
|
14.
Factors Contributing to Recreational Water Contamination
|
Factors
Contributing to Recreational Water Contamination
has been moved to page 6 in Recreational
Water-Treated
and page 8 in Recreational
Water-Untreated.
Recreational
Water-Treated:
The factors are listed in the section titled: Factors
Contributing to Recreational Water Contamination and/or Increased
Exposure in Treated Venues.
Factors Contributing to Recreational Water Contamination and/or
Increased Exposure in Untreated Venues.
Recreational
Water-Untreated:
The factors are listed in the section titled: Factors
Contributing to Recreational Water Contamination and/or Increased
Exposure in Untreated Venues.
|
14a.
Fresh or marine water
|
Fresh
or marine water
has been moved to page 6. Checklist options have been expanded.
The
checklist has been ordered and grouped in the following
categories, which are indicated through shading and text on the
revised form: People, Facility Design, Maintenance and Policy and
Management. Options for Other,
specify:_________
and Unknown
have
also been included.
|
14b.
Filtered and/or disinfected swimming venues
|
Filtered
and/or disinfected swimming venues
has been moved to page 8. Checklist options have been expanded.
The
checklist has been ordered and grouped in the following
categories, which are indicated through shading and text on the
revised form: People, Swim Area Design, Water Quality and Policy
and Management. Options for Other,
specify:_________
and Unknown
have
also been included.
|
15.
Water specimens examined
|
Water
specimens examined
was designed to collect data about water quality and provide
information about pathogens/agents in water samples. It has been
expanded and included in Recreational
Water-Treated
(pages 5-6), Recreational
Water-Untreated
(page 7), Drinking
Water
(pages 9-10) and
Water Not Intended for Drinking/Water of Unknown Intent
(pages 13-14). Additional information about the changes are
summarized below and then discussed in further detail for each of
the four types of water exposure.
Water
Quality- NEW SECTION
Additional fields will assess water
quality, and the impact of policy and management on water quality.
These fields have been written as questions, and will be
particularly helpful when no water samples were collected or
analyzed during the outbreak. Water quality questions have been
included in Recreational
Water-Treated
(page 5), Recreational
Water-Untreated
(page 7) and Drinking
Water
(page 9). These questions precede the sections about laboratory
data and pathogen/agent results.
The
three water quality sections have been titled:
Recreational
Water Quality
Recreational
Water Quality
Drinking
Water Quality
Laboratory
Section
Laboratory
sections have been standardized so that data will be reported
consistently across all sections; however, some fields are not in
all laboratory sections because they do not apply to all types of
water exposure (e.g. Untreated recreational venues do not use
disinfectants; therefore a field for disinfectant level
measurements would not be relevant).
The
four laboratory sections have been titled:
Laboratory
Section- Recreational Water Samples from Treated Venues
Laboratory
Section- Recreational Water Samples from Untreated Venues
Laboratory
Section- Drinking Water
Laboratory
Section
The
laboratory sections begin by asking if water was tested and
contain two-three tables, depending on the type of water exposure.
Table
one is the Results table. This table has been included in all
laboratory sections. Table one contains five vertical columns for
individual water samples. All Results tables have the following
fields: Source
of Sample, Additional Description of Source of Sample,
Date,
Volume
Tested (Unit, Number)
and Temperature
(Unit, Number).
Table
two is the Water Quality table. This table has been included in
all laboratory sections except Laboratory
Section- Recreational Water Samples from Treated Venues.
Table two contains the following fields: Sample
Number,
Type,
Concentration
and Unit.
Table
three is the Microbiology or Chemical/Toxin Analysis table. This
table has been included in all laboratory sections. Table three
contains the following fields: Sample
Number,
Genus/Chemical/Toxin,
Species,
Serotype/Serogroup/Serovar,
Genotype/Subtype,
PFGE
Pattern,
Test
Results Positive?,
Concentration,
Unit,
Test
Type
and Test
Method.
|
|
Recreational
Water-Treated
Recreational
Water Quality
is on page 5.
The
added questions are:
Did
the venue meet state or local recreational water quality
regulations? (responses: yes, no, unknown, not applicable) (if No,
explain)
and Was
there a pool operator on the payroll with state-approved training
or certification? (responses: yes, no, unknown, not applicable).
Laboratory
Section- Recreational Water Samples from Treated Venues
is on pages 5-6.
The
first field is: Was
water from treated recreational water venues tested? (responses:
yes, no, unknown)
Table
1 contains the additional fields Residual/Free
Disinfectant Level (Number, Unit),
Combined
Disinfectant Level (Number, Unit)
and pH.
Table
2 is not included in this section. Table 3 is on page 6.
|
|
Recreational
Water-Untreated
Recreational
Water Quality is
on page 7.
The
added questions are:
Did
the venue meet state or local recreational water quality
regulations? (responses: yes, no, unknown, not applicable) (if No,
explain)
and Did
the venue meet Environmental Protection Agency (EPA) recreational
water quality standards?
(responses:
yes, no, unknown).
Laboratory
Section- Recreational Water Samples from Untreated Venues is
on page 7.
The
first field is: Was
water from untreated recreational water venues tested? (responses:
yes, no, unknown)
Table
1 is on page 7.
Table
2 and Table 3 are on page 7.
|
|
Drinking
Water
Drinking
Water Quality
is on page 9.
The
added questions are:
Did
the drinking water system have any monitoring violations in the 1
month prior to the outbreak? (responses: yes, no, unknown, not
applicable) (if Yes, explain);
Did
the drinking water system have any maximum contaminant level (MCL)
violations in the 1 month prior to the outbreak?(responses: yes,
no, unknown, not applicable) (if Yes, explain);
and Did
the drinking water system have any violations in the 12 months
prior to the outbreak? (responses: yes, no, unknown, not
applicable) (if Yes, explain).
Laboratory
Section- Drinking Water
The
first field is: Was
drinking water tested? (responses: yes, no, unknown)
Table
1 contains the additional fields Residual/Free
Disinfectant Level (Number, Unit),
pH
and Turbidity.
Table
2 and Table 3 are on page 10.
|
|
Water
Not Intended for Drinking/Water of Unknown Intent
Water
Quality- There is no section for water quality questions. Water
samples for these types of exposure are not likely to have a
single set of regulations or standards by which water quality
would be assessed. For this reason, standard questions were not
developed and the section was omitted.
Laboratory
Section
The
first field is: Was
the implicated water tested? (responses: yes, no, unknown)
Table
1 contains the additional fields Residual/Free
Disinfectant Level (Number, Unit),
Turbidity
and pH.
Table
2 is on page 13. Table 3 is on page 14.
|
16.
Remarks
|
Remarks
is included at the bottom of page 2 in General.
The following note has been added:
Briefly
describe important aspects of the outbreak not covered above.
Please indicate if any adverse outcomes occurred in special
populations (e.g. pregnant women, immunocompromised persons).
|
|
Additional
comments may be added in Remarks
at
the end of Recreational
Water-Treated
(page 6), Recreational
Water-Untreated
(page 8), Drinking
Water
(page 12) and
Water Not Intended for Drinking/Water of Unknown Intent
(page 14).
|
Person
to contact for information about water quality or water system
|
The
contact information for Person
to contact for information about water quality or water system
is at the bottom of page 2 in General;
however, Person
to contact for information about water quality or water system
has been combined with
Person completing the form and
renamed Reporting
Agency.
The
fields for Reporting
Agency
are: Agency
name,
Contact
name,
Phone
no.,
E-mail,
Contact
title
and Fax
no.
|
Person
completing the form
|
The
contact information for Person
completing the form
is at the bottom of page 2 in General;
however, Person
completing the form has
been combined with
Person to contact for information about water quality or water
system
and renamed Reporting
Agency.
The
fields for Reporting
Agency
are: Agency
name,
Contact
name,
Phone
no.,
E-mail,
Contact
title
and Fax
no.
|
Date
investigation initiated
|
Date
investigation initiated
provided information about the timeliness of the response to the
outbreak. It has been deleted and is captured in Dates
on page 1 in General.
The two fields that will capture information about the timeliness
of the response are Date
of report to CDC (other than this form)
and Date
of notification to State/Territory or Local/Tribal Health
Authorities.
|
Note
(Epidemic and laboratory assistance)
|
The
note was:
Epidemic
and laboratory assistance for the investigation of a waterborne
outbreak is available upon request by the State Health Department
to the Centers for Disease Control and Prevention. To improve
national surveillance of outbreaks of waterborne diseases, please
send a copy of this report, your internal report, and the
questionnaire used in the epidemiologic investigation (if
available) to:
The
note has been reworded as follows:
Epidemic
and laboratory assistance for the investigation of a waterborne
disease outbreak is available upon request by the State Health
Department to the Centers for Disease Control and Prevention.
Please enter this report into the National Outbreak Reporting
System (NORS). State/Local reports and questionnaires can also be
attached to the report in the electronic system. Communications
and requests for epidemic and laboratory assistance may be
directed to:
|
Contact
information
|
The
contact information was:
Centers
for Disease Control and Prevention, Division of Parasitic
Diseases, Attention: Waterborne Disease Coordinator, 4770 Buford
Highway, NE, Mailstop F-22, Atlanta, GA, 30341-3724
The
contact information has been reworded as follows:
Waterborne
Disease and Surveillance Coordinator, Division of Parasitic
Diseases, National Center for Zoonotic, Vector-Borne, and Enteric
Diseases, Coordinating Center for Infectious Diseases, CDC 4770
Buford Highway, NE, MS F-22, Atlanta, GA, 30341-3724 or (770)
488-7775.
|
|
|
New
section # 1- Supplement to questions 11, 12, 14
|
General-
Environmental Health Specialists Network
Environmental
Health Specialists Network
has been added on page 2. This section is an extension of
questions 11, 12 and 14, which ask for information about
environmental factors involved in waterborne disease outbreaks.
The EHS-Net
Evaluation ID will
enable a state reporter to link an outbreak report to an
environmental evaluation conducted by state members of the
federally-funded Environmental Health Specialists Network program.
|
New
section # 2
|
General-
Recall
Recall
is on page 2. This section contains the following fields: Please
check if any food or bottled water product was recalled;
Type
of item recalled;
and Comments.
Recall
will only be used in waterborne disease outbreaks involving
bottled water. This information may be shared with the Food and
Drug Administration (FDA). Recall
is
shared with the foodborne disease surveillance team and will be
used more often by state reporters completing CDC 52.13.
|
New
section # 3- Extension of questions 12, 14
|
Water
Not Intended For Drinking/Water of Unknown Intent-
Factors
Contributing to Contamination and/or Increased Exposure to
Contaminated Water
Factors
Contributing to Contamination and/or Increased Exposure to
Contaminated Water
is a checklist of factors on page 14. This checklist was created
by examining past outbreak reports. The checklist is an extension
of questions 12 and 14. It has been designed to capture similar
information about water not intended for drinking/water of unknown
intent.
|