E. coli and Salmonella are typically foodborne bacteria, but contaminated water is far from an infrequent cause of severe gastrointestinal disease.  In fact, when a system becomes contaminated, a more perfect method of distributing disease on a wide basis is hard to imagine.  Nonetheless, there are always those who do not appear to care much.  According to its press release: 

The Missouri Department of Natural Resources has identified 23 drinking water systems in Missouri that have chronically failed to complete drinking water testing required by the department to ensure a safe water supply.

The systems listed have at least three major monitoring violations in a 12-month period, with the most recent violations occurring in the third quarter of 2011. While failing to monitor does not necessarily mean the water is unsafe, routine testing by a facility is a crucial part of maintaining a safe water supply.

The violators are, by county and distribution system, as follows:

  • Barry — Jenkins Kwik Stop.
  • Benton — Hidden Valley Mobile Home Park, Last Chance Restaurant and Lounge, Sun Valley Subdivision, TT Campground.
  • Camden — Nantucket Bay.
  • Dallas — Fraternal Order of Eagles 4010.
  • Greene — Expressway Stop.
  • Hickory — Shadow Lake Golf Course.
  • Jefferson — Walker Hill Mobile Home Park.
  • Maries — Moreland’s Catfish Patch and Steak House.
  • Miller — Camp Bagnell Campground.
  • Montgomery — Danville Sinclair.
  • Morgan Mallard Bay.
  • Pettis — Budget Host Super 7 Motel.
  • Polk — Valley View Acres.
  • St. Louis — Whispering Oaks Health Care.
  • Stone — Cedar Haven Resort, Cross Roads Store.
  • Taney — East Fork Subdivision, GDM Investment Project, Savannah Place Third Addition.
  • Webster — Eagle Stop.

Here are a few examples where dilapidated infrastructure, or pure negligence, caused thousands of ordinary folks to become ill.  Some even died.

Alamosa Water Salmonella Outbreak, 442 ill and 1 dead:  An outbreak of gastroenteritis due to Salmonella Typhimurium occurred among residents of the City of Alamosa, Colorado. The investigation showed that there was no common food source among the ill. The majority of the ill lived within the city limits. There were several infants among the ill who had consumed only formula mixed with tap water. Laboratory results detected Salmonella Typhimurium in the municipal water. Tests of the non-chlorinated artesian well, which fed the water supply, showed no contamination. Tests of water from the distribution lines were contaminated. Residents were ordered to use bottled water until the water system was flushed. A leaky, in-ground, water storage tank was blamed for the contamination; it was known to have been a problem since 1997. Giardia and Cryptosporidium were also found in the city’s water, but were not linked to any reported illnesses.

Walkerton Water E. coli O157:H7 Outbreak, 2,300 ill, 7 dead:  In 200, the small, rural community of Walkerton, Ontario, Canada fell victim to a devastating outbreak of waterborne disease that caused seven deaths and more than 2,300 illnesses. A result of cattle manure washing into a shallow water supply well, the 2000 outbreak revealed serious flaws in the municipality’s drinking water system and raised concerns about the management of public water sources across Canada. Walkerton’s water system managers recently pleaded guilty to criminal charges, closing five years worth of investigation. However, many factors contributed to the Walkerton tragedy, highlighting the need for constant vigilance and multiple layers of protection to ensure safe community water supplies.

The government of Ontario established an independent “Commission of Inquiry” to document events surrounding the Walkerton outbreak and to suggest preemptive reforms for other water systems in the province. The inquiry, conducted by Justice Dennis O’Connor, led to scrutiny of Walkerton water system operators and, eventually, to criminal charges for their roles in the outbreak. Justice O’Connor’s report concluded that for years, Walkerton operators had failed to use adequate doses of chlorine, failed to test chlorine residual levels daily as required, and falsified log entries and annual reports. During the period of contamination beginning May 12, operators failed to check residual levels for a period of several days, allowing unchlorinated water to enter the distribution system. In their recently concluded trial, Walkerton utilities manager Stan Koebel and his brother Frank pleaded guilty to a charge of “common nuisance” for failing to monitor and treat the town’s water supply properly. As part of a plea bargain, prosecutors dropped more serious charges of breach of trust and falsifying documents.

White Water Water Park E. coli Outbreak:  In June of 1998, Georgia health officials were notified that a number of children had become ill with E. coli O157:H7 infections and were hospitalized in Atlanta-area hospitals. Public health investigators interviewed victims’ families and learned that all had become ill after visiting the White Water Water Park. The Georgia Department of Health eliminated other possible sources of exposure, such as contaminated food, and determined that contact with and ingestion of pool water infected most of the primary cases.

Twenty-six culture-confirmed E. coli cases were identified, and while health officials hypothesized that the outbreak was considerably larger, the outbreak size was never known due to under-reporting of illnesses. Forty percent of children under five years of age with recognized E. coli infections were diagnosed with hemolytic uremic syndrome.

Cases appeared on four different days, and all cases occurred within a period of eight days. The largest number of infections took place on June 12, and the second-largest number of infections occurred on June 17, which led health officials to believe the E. coli was re-introduced to the park environment on June 17. The PFGE pattern, or “genetic fingerprint” of the strain of bacteria isolated from ill individuals was indistinguishable between visitors to the park on June 11 and 12 and June 17.

Investigators considered three potential causes of contamination in their outbreak analysis: repeat contamination of the park by an E. coli-infected person, persistence of bacteria in pool water overnight due to low chlorine levels, or persistence of bacteria in the pool environment but not in the water. Low chlorine levels in the suspect pools were detected on all days of exposure, and it was never determined whether one of the pools had chlorine in it at the time when the exposures occurred.