Waterborne illness information for healthcare and public health professionals

Information about disease reporting, Massachusetts regulations related to drinking and recreational water, and guidance on implementing regulations.

Disease reporting, isolation, and quarantine

• Many waterborne illnesses are reportable to public health authorities. Please review regulations related to disease reporting, isolation, and quarantine.
• Suspected outbreaks, defined as two or more people from different households with similar illness who were exposed to a common water source before symptom onset, should be reported promptly to the local board of health or the DPH Division of Epidemiology [phone].
• The Guide to Surveillance, Reporting and Control assists local boards of health with specific surveillance, response, and reporting responsibilities for infectious diseases reportable to the Massachusetts Department of Public Health.

Disease-specific fact sheets

You can view fact sheets about diseases that can be spread by swallowing contaminated water or being exposed to contaminated recreational water.

• Cryptosporidiosis
• Giardia
• Noroviruses
• Shiga Toxin Producing Escherichia coli
• Shigella
• Vibrio parahaemolyticus

Drinking water

• Drinking Water Health & Safety
• Drinking Water Information for Boards of Health
• Regulations regarding drinking water
  • 310 CMR 22: The Massachusetts Drinking Water Regulations

Recreational water

• Clinical Testing and Diagnosis for Illnesses Caused by Harmful Algal Blooms | CDC
• Beach Water Quality
• Swimming pool sanitation: regulation, forms, advisories and more
• Regulations regarding recreational water
  • 105 CMR 435.00: State sanitary code chapter V: Sanitary standards for swimming pools
  • 105 CMR 445.00: State sanitary code chapter VII: Minimum standards for bathing beaches
  • 105 CMR 430.00: Minimum standards for recreational camps for children: State sanitary code chapter IV
• Beach testing guidelines for marine and freshwater beaches

Additional resources

Waterborne Disease Outbreak Investigation Toolkit | Water, Sanitation, and Hygiene (WASH)-related Emergencies and Outbreaks | CDC