Waterborne Illness


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    The Nebraska Department of Health and Human Services (DHHS) monitors waterborne illness cases and outbreaks across the state of Nebraska through the use of a public health surveillance system.

    DHHS collaborates with many partners such as hospitals, clinics, laboratories, local, state, and federal partners to detect, investigate, control, and report waterborne disease cases and outbreaks.

    What is a waterborne illness?

    Waterborne illness is primarily caused by swallowing contaminated recreational or drinking water. Many waterborne pathogens can also be acquired by consuming contaminated food or beverages, from contact with animals or their environment, through person-to-person spread or breathing in contaminated water droplets.

    Symptoms of Waterborne Illness

    The incubation period (the time between exposure to the pathogen and onset of symptoms) may begin within hours after being exposed or may begin days later. Common symptoms of waterborne illness are:

    • Diarrhea
    • Vomiting
    • Nausea
    • Stomach cramps
    • Fever
    • Skin, ear, or eye problems
    • Cough and or shortness of breath 

    Causes of Waterborne Illness

    Who is at risk of a waterborne illness?

    Everyone is at risk of getting a waterborne illness. However, some people are at a greater risk of becoming seriously ill or even dying from a waterborne illness:

    • Infants
    • Young children
    • Pregnant women and their unborn babies
    • Older adults
    • People with chronic disease and/or weakened immune systems

    What can you do to protect yourself from waterborne illness?

    • Stay out of the water if you have diarrhea.
    • Shower before you get in the water.
    • Don't pee or poop in the water.
    • Do not drink water from untreated or unknown sources.
    • Ensure building owners and managers maintain building water systems.

    Other Resources

    Frequently Asked Questions

    If I am experiencing illness, should I still go to work?

    No. If you are experiencing diarrhea, vomiting, or have a fever, you should not work. You should be symptom free for at least 24 hours before returning to work. Working while sick increases the risk of spreading illness to others.

    How do I report a waterborne illness?

    1. Report your illness to your Local Public Health Department or Nebraska DHHS Office of Epidemiology (402) 471-2937. Reporting illnesses helps identify potential waterborne illness outbreaks.
    2. Seek medical care if symptoms continue or are severe (such as bloody diarrhea, excessive nausea and vomiting, or a fever).

    What is a waterborne illness outbreak?

    A waterborne disease outbreak occurs when two or more people get the same illness from the same contaminated water (i.e. swimming pool, lake, or drinking water system).

    What settings can waterborne illness outbreaks occur?

    Waterborne illness outbreaks can occur in a variety of settings including: water parks, interactive fountains, water play areas, splash pads, hot tubs, lakes, rivers, springs, ponds, streams, oceans, and public or individual water systems.

    Who investigates waterborne illness outbreaks?

    Waterborne illness outbreaks require a team effort between the public, local health departments, DHHS, NDEE, physicians, hospitals, laboratories, and regulatory agencies.

    How is a waterborne illness outbreak investigated?

    There are many steps involved in a waterborne outbreak investigation.

    1. Detect a possible outbreak through public health surveillance.
    2. Define and find cases.
    3. Generate a hypotheses through interviews.
    4. Test hypotheses using epidemiology, clinical data, and environmental investigation.
    5. Identify source of outbreak.
    6. Control outbreak through remediation and outreach.
    7. Decide outbreak is over.
    8. Prevent future outbreaks through summarizing, interpreting, and reporting findings.

    Who do I contact if I have concerns about my drinking water?

    Please contact Nebraska Department of Environmental and Energy (NDEE) at (402) 471-2186 and request to speak with the State Drinking Water Program.

    Where can I find current health alerts for Nebraska lakes and beaches?

    Nebraska Department of Environmental and Energy (NDEE) conducts weekly sampling for Harmful Algal Blooms (HABs), also known as toxic blue-green algae, and E. coli bacteria at 51 public recreational lakes (54 sites in all) across Nebraska from May 1st through September 30th. Samples are typically collected on Monday and posted on the web site on each Friday. View sampling results.

    Who do I contact if I have concerns about the quality of water in a public lake/beach?

    Please contact NDEE's Surface Water Unit at (402) 471-0096, or (402) 471-2186, or e-mail NDEQ.BeachWatch@Nebraska.gov.
    Office of Epidemiology
    Division of Public Health/ Department of Health & Human Services
    Phone Number
    (402) 471-2937
    Fax Number
    (402) 471-3601
    Mailing Address
    DHHS, Office of Epidemiology
    P.O. Box 95026, Lincoln, Nebraska 68509-5026