Public Health Approaches to Preventing Outbreaks of Gastrointestinal Infection Linked to Karst Systems

Abstract

Outbreaks of gastrointestinal illness have occurred following the contamination of karst systems used as drinking water sources. Outbreaks have been caused by the flow of fecal pollution from humans and livestock into karst aquifers and wells. These outbreaks have resulted in thousands of cases of illness and dozens of hospitalizations. Collaborations between hydrogeologists and public health specialists should be promoted in order to reduce the likelihood and severity of such outbreaks in the future. Public health agencies utilize a variety of measures designed to reduce the risk of illness among swimmers at beaches. These measures might be modified and applied to karst aquifers that are used as sources of untreated drinking water. In this chapter, the process for prioritizing beaches for water quality monitoring, the use of rapid bacterial detection methods, and public health notification processes are described. Microbial source-tracking methods used as a research tool at beaches could help identify and mitigate the human, livestock, and wildlife sources of fecal microbes that pollute karst aquifers, particularly after heavy precipitation. Other opportunities for collaboration include the participation of hydrogeologists in the investigation of disease outbreaks, the education of public health personnel about the site selection and maintenance of domestic wells, and in joint analyses of health data in relation to weather and hydrogeology data.