XXXX outbreaks in the United States, 1971-2011.

@entity461 @entity1 @entity7014
UNASSIGNED: @entity461 is the leading parasitic aetiology of @entity1 enteric infections in the United States, with an estimated 1  2 million cases occurring annually. To better understand transmission, we analysed data on all @entity7014 outbreaks reported to the Centers for Disease Control and Prevention for 1971-2011. The 242 outbreaks, affecting ~41 000 @entity1 , resulted from waterborne (74  8%), foodborne (15  7%), @entity1 -to- @entity1 (2  5%), and animal contact (1  2%) transmission. Most (74  6%) waterborne outbreaks were associated with drinking water, followed by recreational water (18  2%). Problems with water treatment, untreated groundwater, and distribution systems were identified most often during drinking water-associated outbreak investigations; problems with water treatment declined after the 1980s. Most recreational water-associated outbreaks were linked to treated swimming venues, with pools and wading pools implicated most often. Produce was implicated most often in foodborne outbreaks. Additionally, foods were most commonly prepared in a restaurant and contaminated by a food handler. Lessons learned from examining patterns in outbreaks over time can help prevent future disease. Groundwater and distribution system vulnerabilities, inadequate pool disinfection, fruit and vegetable contamination, and poor food handler hygiene are promising targets for @entity7014 prevention measures.
