TABLE 6.

Recommendations to prevent waterborne disease and improve surveillance

Recommendation
Continued focus on water system operations, management, water quality, and effective regulations to sustain gains made in the provision of safe drinking water
Greater attention to address and prevent waterborne disease transmission in unregulated drinking water systems
Greater attention to address and reduce the risk for outbreaks in groundwater systems
Improved understanding of the biology, ecology, and inactivation of Legionella in biofilm and premise plumbing
Improved recognition and focus on premise plumbing and point-of-use issues
Additional efforts to reduce the risk of outbreaks associated with drinking water distribution systems
Improved prevention efforts in residential and recreational settings (e.g., campgrounds and parks) to reduce waterborne disease outbreaks
Research to better characterize the burden of waterborne disease in the United States so that prevention actions can be prioritized and interventions to reduce waterborne disease can be developed
Additional resources for outbreak detection and investigation of waterborne disease and outbreaks—including epidemiologic, environmental, and laboratory support—at local, state, territorial, and national levels