Identifying water contamination from syndromic surveillance signals


The EPA Water Security initiative contamination warning system (CWS) detection strategy involves the use of multiple monitoring and surveillance components for timely detection of drinking water contamination in the distribution system. The public health surveillance (PHS) component of the contamination warning system involves the analysis of health-related data to identify disease events that may stem from drinking water contamination. Public health data include hospital admission reports, infectious disease surveillance, emergency medical service reports, 911 calls and poison control center (PCC) calls. Automated analysis of these data streams results in alerts, which are investigated by health department epidemiologists. A comprehensive operational strategy was developed to describe the processes and procedures involved in the the initial investigation and validation of a PHS alert. The operational strategy established specific roles and responsibilities, and detailed procedural flow descriptions. The procedural flow concluded with the determination of whether or not an alert generated from surveillance of public health data streams is indicative of a possible water contamination incident.


To develop standard operating procedures (SOPs) to identify or rule out possible water contamination as a cause for a syndromic surveillance alarm.

Primary Topic Areas: 
Original Publication Year: 
Event/Publication Date: 
December, 2010

June 27, 2019

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National Syndromic
Surveillance Program

The National Syndromic Surveillance Program (NSSP) is a collaboration among states and public health jurisdictions that contribute data to the BioSense Platform, public health practitioners who use local syndromic surveillance systems, Center for Disease Control and Prevention programs, other federal agencies, partner organizations, hospitals, healthcare professionals, and academic institutions.

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