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Environ Health Perspect. 2001 May; 109(Suppl 2): 211–221.
PMCID: PMC1240668
Research Article

Climate variability and change in the United States: potential impacts on water- and foodborne diseases caused by microbiologic agents.


Exposure to waterborne and foodborne pathogens can occur via drinking water (associated with fecal contamination), seafood (due to natural microbial hazards, toxins, or wastewater disposal) or fresh produce (irrigated or processed with contaminated water). Weather influences the transport and dissemination of these microbial agents via rainfall and runoff and the survival and/or growth through such factors as temperature. Federal and state laws and regulatory programs protect much of the U.S. population from waterborne disease; however, if climate variability increases, current and future deficiencies in areas such as watershed protection, infrastructure, and storm drainage systems will probably increase the risk of contamination events. Knowledge about transport processes and the fate of microbial pollutants associated with rainfall and snowmelt is key to predicting risks from a change in weather variability. Although recent studies identified links between climate variability and occurrence of microbial agents in water, the relationships need further quantification in the context of other stresses. In the marine environment as well, there are few studies that adequately address the potential health effects of climate variability in combination with other stresses such as overfishing, introduced species, and rise in sea level. Advances in monitoring are necessary to enhance early-warning and prevention capabilities. Application of existing technologies, such as molecular fingerprinting to track contaminant sources or satellite remote sensing to detect coastal algal blooms, could be expanded. This assessment recommends incorporating a range of future scenarios of improvement plans for current deficiencies in the public health infrastructure to achieve more realistic risk assessments.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Koopman JS, Longini IM., Jr The ecological effects of individual exposures and nonlinear disease dynamics in populations. Am J Public Health. 1994 May;84(5):836–842. [PMC free article] [PubMed]
  • Gerba CP, Rose JB, Haas CN. Sensitive populations: who is at the greatest risk? Int J Food Microbiol. 1996 Jun;30(1-2):113–123. [PubMed]
  • Feachem R, Garelick H, Slade J. Enteroviruses in the environment. Trop Dis Bull. 1981 Mar;78(3):185–230. [PubMed]
  • Levy DA, Bens MS, Craun GF, Calderon RL, Herwaldt BL. Surveillance for waterborne-disease outbreaks--United States, 1995-1996. MMWR CDC Surveill Summ. 1998 Dec 11;47(5):1–34. [PubMed]
  • Ford TE. Microbiological safety of drinking water: United States and global perspectives. Environ Health Perspect. 1999 Feb;107 (Suppl 1):191–206. [PMC free article] [PubMed]
  • Hoxie NJ, Davis JP, Vergeront JM, Nashold RD, Blair KA. Cryptosporidiosis-associated mortality following a massive waterborne outbreak in Milwaukee, Wisconsin. Am J Public Health. 1997 Dec;87(12):2032–2035. [PMC free article] [PubMed]
  • Mac Kenzie WR, Hoxie NJ, Proctor ME, Gradus MS, Blair KA, Peterson DE, Kazmierczak JJ, Addiss DG, Fox KR, Rose JB, et al. A massive outbreak in Milwaukee of cryptosporidium infection transmitted through the public water supply. N Engl J Med. 1994 Jul 21;331(3):161–167. [PubMed]
  • Koopman JS, Longini IM., Jr The ecological effects of individual exposures and nonlinear disease dynamics in populations. Am J Public Health. 1994 May;84(5):836–842. [PMC free article] [PubMed]
  • Smith HV, Rose JB. Waterborne cryptosporidiosis: current status. Parasitol Today. 1998 Jan;14(1):14–22. [PubMed]
  • Rose JB. Environmental ecology of Cryptosporidium and public health implications. Annu Rev Public Health. 1997;18:135–161. [PubMed]
  • Goldstein ST, Juranek DD, Ravenholt O, Hightower AW, Martin DG, Mesnik JL, Griffiths SD, Bryant AJ, Reich RR, Herwaldt BL. Cryptosporidiosis: an outbreak associated with drinking water despite state-of-the-art water treatment. Ann Intern Med. 1996 Mar 1;124(5):459–468. [PubMed]
  • Wuhib T, Silva TM, Newman RD, Garcia LS, Pereira ML, Chaves CS, Wahlquist SP, Bryan RT, Guerrant RL, Sousa A de Q, et al. Cryptosporidial and microsporidial infections in human immunodeficiency virus-infected patients in northeastern Brazil. J Infect Dis. 1994 Aug;170(2):494–497. [PubMed]
  • Weniger BG, Blaser MJ, Gedrose J, Lippy EC, Juranek DD. An outbreak of waterborne giardiasis associated with heavy water runoff due to warm weather and volcanic ashfall. Am J Public Health. 1983 Aug;73(8):868–872. [PMC free article] [PubMed]
  • LeChevallier MW, Norton WD, Lee RG. Occurrence of Giardia and Cryptosporidium spp. in surface water supplies. Appl Environ Microbiol. 1991 Sep;57(9):2610–2616. [PMC free article] [PubMed]
  • Helms CM, Massanari RM, Zeitler R, Streed S, Gilchrist MJ, Hall N, Hausler WJ, Jr, Sywassink J, Johnson W, Wintermeyer L, et al. Legionnaires' disease associated with a hospital water system: a cluster of 24 nosocomial cases. Ann Intern Med. 1983 Aug;99(2):172–178. [PubMed]
  • Parker BC, Ford MA, Gruft H, Falkinham JO., 3rd Epidemiology of infection by nontuberculous mycobacteria. IV. Preferential aerosolization of Mycobacterium intracellulare from natural waters. Am Rev Respir Dis. 1983 Oct;128(4):652–656. [PubMed]
  • Dufour AP. Bacterial indicators of recreational water quality. Can J Public Health. 1984 Jan-Feb;75(1):49–56. [PubMed]
  • Coye MJ, Goldoft M. Microbiological contamination of the ocean, and human health. N J Med. 1989 Jul;86(7):533–538. [PubMed]
  • Garrett ES, dos Santos CL, Jahncke ML. Public, animal, and environmental health implications of aquaculture. Emerg Infect Dis. 1997 Oct-Dec;3(4):453–457. [PMC free article] [PubMed]
  • Prüss A. Review of epidemiological studies on health effects from exposure to recreational water. Int J Epidemiol. 1998 Feb;27(1):1–9. [PubMed]
  • Haile RW, Witte JS, Gold M, Cressey R, McGee C, Millikan RC, Glasser A, Harawa N, Ervin C, Harmon P, et al. The health effects of swimming in ocean water contaminated by storm drain runoff. Epidemiology. 1999 Jul;10(4):355–363. [PubMed]
  • Sykora JL, Keleti G, Martinez AJ. Occurrence and pathogenicity of Naegleria fowleri in artificially heated waters. Appl Environ Microbiol. 1983 Mar;45(3):974–979. [PMC free article] [PubMed]
  • Tyndall RL, Ironside KS, Metler PL, Tan EL, Hazen TC, Fliermans CB. Effect of thermal additions on the density and distribution of thermophilic amoebae and pathogenic Naegleria fowleri in a newly created cooling lake. Appl Environ Microbiol. 1989 Mar;55(3):722–732. [PMC free article] [PubMed]
  • Kilvington S, Beeching J. Identification and epidemiological typing of Naegleria fowleri with DNA probes. Appl Environ Microbiol. 1995 Jun;61(6):2071–2078. [PMC free article] [PubMed]
  • Mathers WD, Sutphin JE, Lane JA, Folberg R. Correlation between surface water contamination with amoeba and the onset of symptoms and diagnosis of amoeba-like keratitis. Br J Ophthalmol. 1998 Oct;82(10):1143–1146. [PMC free article] [PubMed]
  • Cabelli VJ, Dufour AP, McCabe LJ, Levin MA. Swimming-associated gastroenteritis and water quality. Am J Epidemiol. 1982 Apr;115(4):606–616. [PubMed]
  • Epstein PR. Algal blooms in the spread and persistence of cholera. Biosystems. 1993;31(2-3):209–221. [PubMed]
  • Colwell RR, Kaper J, Joseph SW. Vibrio cholerae, Vibrio parahaemolyticus, and other vibrios: occurrence and distribution in Chesapeake Bay. Science. 1977 Oct 28;198(4315):394–396. [PubMed]
  • Dumler JS, Osterhout GJ, Spangler JG, Dick JD. Vibrio cholerae non-serogroup O1 cystitis. J Clin Microbiol. 1989 Aug;27(8):1898–1899. [PMC free article] [PubMed]
  • Opal SM, Saxon JR. Intracranial infection by Vibrio alginolyticus following injury in salt water. J Clin Microbiol. 1986 Feb;23(2):373–374. [PMC free article] [PubMed]
  • Clark RB, Spector H, Friedman DM, Oldrati KJ, Young CL, Nelson SC. Osteomyelitis and synovitis produced by Mycobacterium marinum in a fisherman. J Clin Microbiol. 1990 Nov;28(11):2570–2572. [PMC free article] [PubMed]
  • Matsiota-Bernard P, Nauciel C. Vibrio alginolyticus wound infection after exposure to sea water in an air crash. Eur J Clin Microbiol Infect Dis. 1993 Jun;12(6):474–475. [PubMed]
  • Roland FP. Leg gangrene and endotoxin shock due to vibrio parahaemolyticus--an infection acquired in New England coastal waters. N Engl J Med. 1970 Jun 4;282(23):1306–1306. [PubMed]
  • Johnston JM, Becker SF, McFarland LM. Vibrio vulnificus. Man and the sea. JAMA. 1985 May 17;253(19):2850–2853. [PubMed]
  • Klontz KC, Lieb S, Schreiber M, Janowski HT, Baldy LM, Gunn RA. Syndromes of Vibrio vulnificus infections. Clinical and epidemiologic features in Florida cases, 1981-1987. Ann Intern Med. 1988 Aug 15;109(4):318–323. [PubMed]
  • Tison DL, Kelly MT. Vibrio vulnificus endometritis. J Clin Microbiol. 1984 Aug;20(2):185–186. [PMC free article] [PubMed]
  • Burke WA, Jones BE. Cutaneous infections of the coast. N C Med J. 1987 Sep;48(9):421–424. [PubMed]
  • Solomon AE, Stoughton RB. Dermatitis from purified sea algae toxin (debromoaplysiatoxin). Arch Dermatol. 1978 Sep;114(9):1333–1335. [PubMed]
  • Izumi AK, Moore RE. Seaweed (Lyngbya majuscula) dermatitis. Clin Dermatol. 1987 Jul-Sep;5(3):92–100. [PubMed]
  • Freudenthal AR, Joseph PR. Seabather's eruption. N Engl J Med. 1993 Aug 19;329(8):542–544. [PubMed]
  • Tomchik RS, Russell MT, Szmant AM, Black NA. Clinical perspectives on seabather's eruption, also known as 'sea lice'. JAMA. 1993 Apr 7;269(13):1669–1672. [PubMed]
  • Ubillos SS, Vuong D, Sinnott JT, Sakalosky PE. Seabather's eruption. South Med J. 1995 Nov;88(11):1163–1165. [PubMed]
  • Mead PS, Slutsker L, Griffin PM, Tauxe RV. Food-related illness and death in the united states reply to dr. hedberg. Emerg Infect Dis. 1999 Nov;5(6):841–842. [PMC free article] [PubMed]
  • Motarjemi Y, Käferstein FK. Global estimation of foodborne diseases. World Health Stat Q. 1997;50(1-2):5–11. [PubMed]
  • Riley LW, Remis RS, Helgerson SD, McGee HB, Wells JG, Davis BR, Hebert RJ, Olcott ES, Johnson LM, Hargrett NT, et al. Hemorrhagic colitis associated with a rare Escherichia coli serotype. N Engl J Med. 1983 Mar 24;308(12):681–685. [PubMed]
  • Tauxe RV. Emerging foodborne diseases: an evolving public health challenge. Emerg Infect Dis. 1997 Oct-Dec;3(4):425–434. [PMC free article] [PubMed]
  • Lipp EK, Rose JB. The role of seafood in foodborne diseases in the United States of America. Rev Sci Tech. 1997 Aug;16(2):620–640. [PubMed]
  • Colwell RR. Global climate and infectious disease: the cholera paradigm. Science. 1996 Dec 20;274(5295):2025–2031. [PubMed]
  • Shapiro RL, Altekruse S, Hutwagner L, Bishop R, Hammond R, Wilson S, Ray B, Thompson S, Tauxe RV, Griffin PM. The role of Gulf Coast oysters harvested in warmer months in Vibrio vulnificus infections in the United States, 1988-1996. Vibrio Working Group. J Infect Dis. 1998 Sep;178(3):752–759. [PubMed]
  • Le Guyader F, Neill FH, Estes MK, Monroe SS, Ando T, Atmar RL. Detection and analysis of a small round-structured virus strain in oysters implicated in an outbreak of acute gastroenteritis. Appl Environ Microbiol. 1996 Nov;62(11):4268–4272. [PMC free article] [PubMed]
  • Luthi TM, Wall PG, Evans HS, Adak GK, Caul EO. Outbreaks of foodborne viral gastroenteritis in England and Wales: 1992 to 1994. Commun Dis Rep CDR Rev. 1996 Sep 13;6(10):R131–R136. [PubMed]
  • McDonnell S, Kirkland KB, Hlady WG, Aristeguieta C, Hopkins RS, Monroe SS, Glass RI. Failure of cooking to prevent shellfish-associated viral gastroenteritis. Arch Intern Med. 1997 Jan 13;157(1):111–116. [PubMed]
  • Birch C, Gust I. Sewage pollution of marine waters: the risks of viral infection. Med J Aust. 1989 Dec 4;151(11-12):609–610. [PubMed]
  • Seyfried PL, Brown NE, Cherwinsky CL, Jenkins GD, Cotter DA, Winner JM, Tobin RS. Impact of sewage treatment plants on surface waters. Can J Public Health. 1984 Jan-Feb;75(1):25–31. [PubMed]
  • Rose JB, Slifko TR. Giardia, Cryptosporidium, and Cyclospora and their impact on foods: a review. J Food Prot. 1999 Sep;62(9):1059–1070. [PubMed]
  • Ortega YR, Sterling CR, Gilman RH, Cama VA, Díaz F. Cyclospora species--a new protozoan pathogen of humans. N Engl J Med. 1993 May 6;328(18):1308–1312. [PubMed]
  • Herwaldt BL, Ackers ML. An outbreak in 1996 of cyclosporiasis associated with imported raspberries. The Cyclospora Working Group. N Engl J Med. 1997 May 29;336(22):1548–1556. [PubMed]
  • Mills AR, Passmore R. Pelagic paralysis. Lancet. 1988 Jan 23;1(8578):161–164. [PubMed]
  • Eastaugh J, Shepherd S. Infectious and toxic syndromes from fish and shellfish consumption. A review. Arch Intern Med. 1989 Aug;149(8):1735–1740. [PubMed]
  • Baden DG, Melinek R, Sechet V, Trainer VL, Schultz DR, Rein KS, Tomas CR, Delgado J, Hale L. Modified immunoassays for polyether toxins: implications of biological matrixes, metabolic states, and epitope recognition. J AOAC Int. 1995 Mar-Apr;78(2):499–508. [PubMed]
  • Grattan LM, Oldach D, Perl TM, Lowitt MH, Matuszak DL, Dickson C, Parrott C, Shoemaker RC, Kauffman CL, Wasserman MP, et al. Learning and memory difficulties after environmental exposure to waterways containing toxin-producing Pfiesteria or Pfiesteria-like dinoflagellates. Lancet. 1998 Aug 15;352(9127):532–539. [PubMed]
  • Cariton JT, Geller JB. Ecological roulette: the global transport of nonindigenous marine organisms. Science. 1993 Jul 2;261(5117):78–82. [PubMed]
  • Asai S, Krzanowski JJ, Anderson WH, Martin DF, Polson JB, Lockey RF, Bukantz SC, Szentivanyi A. Effects of toxin of red tide, Ptychodiscus brevis, on canine tracheal smooth muscle: a possible new asthma-triggering mechanism. J Allergy Clin Immunol. 1982 May;69(5):418–428. [PubMed]
  • Anderson DM. Red tides. Sci Am. 1994 Aug;271(2):62–68. [PubMed]
  • Huq A, Colwell RR, Rahman R, Ali A, Chowdhury MA, Parveen S, Sack DA, Russek-Cohen E. Detection of Vibrio cholerae O1 in the aquatic environment by fluorescent-monoclonal antibody and culture methods. Appl Environ Microbiol. 1990 Aug;56(8):2370–2373. [PMC free article] [PubMed]
  • Islam MS, Drasar BS, Bradley DJ. Long-term persistence of toxigenic Vibrio cholerae 01 in the mucilaginous sheath of a blue-green alga, Anabaena variabilis. J Trop Med Hyg. 1990 Apr;93(2):133–139. [PubMed]
  • Ezzell C. It came from the deep. Sci Am. 1999 Jun;280(6):22–24. [PubMed]
  • Nau JY. Second HIV receptor? Lancet. 1993 Oct 30;342(8879):1108–1108. [PubMed]
  • Lobitz B, Beck L, Huq A, Wood B, Fuchs G, Faruque AS, Colwell R. Climate and infectious disease: use of remote sensing for detection of Vibrio cholerae by indirect measurement. Proc Natl Acad Sci U S A. 2000 Feb 15;97(4):1438–1443. [PMC free article] [PubMed]
  • Pascual M, Rodó X, Ellner SP, Colwell R, Bouma MJ. Cholera dynamics and El Niño-Southern Oscillation. Science. 2000 Sep 8;289(5485):1766–1769. [PubMed]
  • Speelmon EC, Checkley W, Gilman RH, Patz J, Calderon M, Manga S. Cholera incidence and El Niño-related higher ambient temperature. JAMA. 2000 Jun 21;283(23):3072–3074. [PubMed]
  • Checkley W, Epstein LD, Gilman RH, Figueroa D, Cama RI, Patz JA, Black RE. Effect of El Niño and ambient temperature on hospital admissions for diarrhoeal diseases in Peruvian children. Lancet. 2000 Feb 5;355(9202):442–450. [PubMed]
  • Smith HV, Paton CA, Mitambo MM, Girdwood RW. Sporulation of Cyclospora sp. oocysts. Appl Environ Microbiol. 1997 Apr;63(4):1631–1632. [PMC free article] [PubMed]
  • Madico G, McDonald J, Gilman RH, Cabrera L, Sterling CR. Epidemiology and treatment of Cyclospora cayetanensis infection in Peruvian children. Clin Infect Dis. 1997 May;24(5):977–981. [PubMed]
  • Motes ML, DePaola A, Cook DW, Veazey JE, Hunsucker JC, Garthright WE, Blodgett RJ, Chirtel SJ. Influence of water temperature and salinity on Vibrio vulnificus in Northern Gulf and Atlantic Coast oysters (Crassostrea virginica). Appl Environ Microbiol. 1998 Apr;64(4):1459–1465. [PMC free article] [PubMed]
  • Steiner TS, Thielman NM, Guerrant RL. Protozoal agents: what are the dangers for the public water supply? Annu Rev Med. 1997;48:329–340. [PubMed]

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