The 1993 Cryptosporidium illness outbreak in Milwaukee, Wisconsin and the more
recent E. coli tragedy in Walkerton, Canada underline the need for water utilities to
establish and maintain effective partnerships with local public health and emergency
planning agencies. In San Antonio, Texas local water utilities working with their Local
Emergency Planning Committee (LEPC) were able to participate in a simulated
waterborne illness outbreak and tabletop exercise with local public health professionals
and regulatory agency officials.
This paper reports how a simulated disease outbreak, "Don't Drink the Water", was
designed as a training exercise to introduce water and reuse water operators to basic
epidemiological techniques used by public health officials in the investigation of a
suspected waterborne illness outbreak. Working in teams, participants were provided
information on individuals experiencing symptoms of a waterborne illness. Each team
included water operators, public health sanitarians and regulatory agency professionals.
Participants used data from patient histories to construct an epidemiological curve to
approximate the time of exposure and to identify the most likely source of the illness as a
picnic. Using basic epidemiological techniques to calculate specific food and beverage
attack rates, it was possible to eliminate contaminated water as the cause of the illness
and to identify shrimp consumed during a picnic as the probable source.