The Latin American Cholera Epidemic of the 1990’s: My View from the Inside
By Fred M. Reiff, PE

From 1981 through most of 1995 I was an official in the Pan American Health Organization (PAHO), which is also the Regional Office for the Americas for the World Health Organization.  PeruOne of my major responsibilities was assisting Latin American and Caribbean countries in the prevention and mitigation of waterborne and water related diseases, which inherently included working closely with both health and water agencies to achieve improvements in availability and quality of drinking water, particularly in economically disadvantaged areas.  This experience provided a unique perspective on the prevention and control of waterborne diseases before, during and after the introduction of cholera in Peru in 1991.

Before 1991, cholera—an acute and deadly diarrheal disease—had not been prevalent in the Americas since the early 1900’s.  Between 1991 and 1993, the disease raged throughout Latin American sparing only Uruguay and the Caribbean.  The outbreak claimed almost 9,000 lives and sickened nearly one … READ MORE >>


West Nile Virus: A Seasonal Epidemic in North America
Chris Wiant, MPH, PhD

West Nile Virus Activity by State – United States, 2015 (as of August 11, 2015)
Map courtesy of the US Centers for Disease Control and Prevention

This summer North America is once again experiencing a “seasonal epidemic” of West Nile virus that is expected to last through the fall.  According to the Centers for Disease Control and Prevention (CDC) website, the mosquito-borne virus has been reported in 42 US states as of August 11, 2015.  Fortunately, most people who are infected with the virus show no symptoms; about 20 percent of people infected develop mild symptoms (e.g., headache, body aches, joint pains, vomiting, diarrhea or rash) after three to 14 days.  Less than one percent of those infected become seriously ill (e.g., high fever, muscle weakness, neck stiffness, stupor, and potentially permanent or fatal neurological disease).  There are no medications to treat West Nile virus, nor vaccines to prevent … READ MORE >>


Legionella Outbreak in the Bronx
Stephen A. Hubbs, PE

Cooling towers on building roof tops are believed to be the breeding grounds of bacteria responsible for a summer outbreak of Legionnaires’ Disease in New York City.  The outbreak began on July 10.  As of August 13, twelve deaths and 119 cases of illness have been attributed to the disease, which is caused by Legionella bacteria (see New York City Department of Health and Mental Hygiene website). The current outbreak is the largest in New York City’s history, and is focused in the city’s Bronx borough.  On August 11, The New York Times reported a Rikers Island (New York) inmate had been diagnosed with Legionnaires’ Disease, but that the case is unlikely to be connected to the outbreak in the Bronx.

An Airborne Respiratory Disease

Legionella occurs naturally in water and can grow to very high levels in warm water, according to the US Centers for Disease Control and … READ MORE >>


What to do about Bird (and Other) Droppings in the Swimming Pool
Bob G. Vincent

There’s nothing like a swim in an outdoor pool in beautiful summer weather. As the open air is the domain of nature’s flying creatures, however, the occasional splat of bird droppings in the pool is to be expected. What, if anything, needs to be done about bird droppings in the pool?

According to the US Centers for Disease Control and Prevention (CDC) website, many germs that might be present in bird droppings can infect humans, although few, if any, outbreaks have been associated with bird droppings. Duck and goose droppings are highlighted by CDC as potentially containing E. coli, Salmonella, Campylobacter or Cryptosporidium. Fortunately, in a well-maintained pool most pathogens in bird droppings are killed by chlorine within minutes, according to CDC. Cryptosporidium, a microscopic parasite surrounded by a tough chlorine-resistant outer shell, can be removed by a well-maintained pool filtration system.

Addressing Bird (and Other Types)


Naegleria fowleri Infection: Low Likelihood, High Impact
Ralph Morris, MD, MPH

Number of Case-reports of Primary Amebic Meningoencephalitis Caused by Naegleria fowleri by State of Exposure—US, 1962-20140
Chart courtesy of CDC

A rare but deadly “brain-eating” waterborne amoeba is making US headlines once again this summer in California, Minnesota and Louisiana.  A 21-year old California woman died on June 20 of an infection caused by Naegleria fowleri, according to a news report.  An investigation is ongoing, but the infection may have resulted from her exposure to the amoeba in a natural hot spring.  On July 9, a Naegleria infection killed a 14-year old boy who swam in Minnesota’s Lake Minnewaska, according to Outbreak News TodayAnd Naegleria fowleri’s presence was confirmed in two sampling locations in St. Bernard Parish, and one in Ascension Parish, Louisiana, according to

It is important to note that Naegleria infection cannot be contracted by drinking water contaminated with the organism, … READ MORE >>


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