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Milwaukee Disease Outbreak, 1993

The 1993 Milwaukee Cryptosporidiosis outbreak was a major waterborne disease outbreak caused by Cryptosporidium in the Milwaukee, Wisconsin water supply. Over 400,000 residents became ill after the Howard Avenue Water Purification Plant became contaminated with Cryptosporidium, likely from cattle or snowmelt runoff. Symptoms included diarrhea, abdominal cramps, fever and vomiting. Tragically, 104 deaths were attributed to the outbreak, mostly among elderly and immunocompromised individuals. Changes were subsequently made to water treatment and monitoring to prevent future outbreaks.

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70 views8 pages

Milwaukee Disease Outbreak, 1993

The 1993 Milwaukee Cryptosporidiosis outbreak was a major waterborne disease outbreak caused by Cryptosporidium in the Milwaukee, Wisconsin water supply. Over 400,000 residents became ill after the Howard Avenue Water Purification Plant became contaminated with Cryptosporidium, likely from cattle or snowmelt runoff. Symptoms included diarrhea, abdominal cramps, fever and vomiting. Tragically, 104 deaths were attributed to the outbreak, mostly among elderly and immunocompromised individuals. Changes were subsequently made to water treatment and monitoring to prevent future outbreaks.

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MILWAUKEE

DISEASE
OUTBREAK, 1993

BY : JANHAVI KIRAN PATIL


INTRODUCTION
The 1993 Milwaukee
Cryptosporidiosis outbreak' was a
significant distribution of the
Cryptosporidium protozoan in
Milwaukee, Wisconsin, and the
largest waterborne disease outbreak
in documented United States
history.
CAUSES OF OUTBREAK
● The Howard Avenue Water Purification Plant was
contaminated ,and treated water showed turbidity levels well
above normal.
● The root cause of epidemic was never officially identified .
● Initial it was suspected to be caused by Cattle genotype due to
runoff from pastures
● It was also thought that melting ice and snowmelt carrying
CRYPTOSPORIDIUM may have entered the water treatment
plant .
EFFECTS

● There was more than a 100-fold increase in the rate of


isolation of cryptosporidium.
● Watery diarrhea (in 93 percent),
● Abdominal cramps (in 84 percent),
● Fever (in 57 percent)
● Vomiting (in 48 percent)
SEVERITY

● Over the span of approximately two weeks, 403000 of an


estimated 1.61 million residents in the Milwaukee area
became ill.
● Atleast 104 deaths have been attributed to this outbreak,
mostly among the elderly and immune compromised
people, such as AIDS patients.
MITIGATION MEASURES TAKEN

● Application of technical advances to monitor water safety and


minimize the amount of inadequately filtered water to the
public.
● Consistent application of stringent water quality standards.
● Testing of source and finished water for Cryptosporidium.
PRESENT SCENARIO
● Today , the turbidity of filtered plant is measured constantly inside
the plants.
● Tests have not detected a single Cryptosporidium oocyst in filtered
water from the water treatment plant since 1999.
● They also put alarms on the filters to enable automatic shutdown if
turbidity reached a threshold level, and they set and achieved the goal
of maintaining turbidity at a very low level
● These efforts resulted in continuous production by the MWW of
high-quality treated water with mean turbidities of 0.01 NTU .
CONCLUSION
● The 1993 Milwaukee cryptosporidiosis outbreak was the largest
documented waterborne disease outbreak in the United States.
● Cryptosporidium oocysts in untreated water from Lake Michigan
that entered the plant were inadequately removed by the
coagulation and filtration process at the Milwaukee southern
water treatment plant.
● Water quality standards were inadequate to prevent this outbreak.
There was a lack of laboratory testing for Cryptosporidium,
which delayed recognition of the microbial etiology of the
outbreak.

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