Water-borne Disease Outbreaks in Canadian Small Drinking Water Systems

Information about Canadian drinking water systems and past water-borne disease outbreaks is incomplete and non-standardized. Standard definitions and coordinated surveillance systems for water-borne disease outbreaks would help inform policy and practice. A relatively high proportion of past water-borne disease outbreaks in Canada are estimated to have occurred in small drinking water systems serving populations of 5,000 people or less. Water-borne disease outbreaks in small drinking water systems are often the result of a combination of water system failures; contributing factors often include a lack of source water protection and inadequate drinking water treatment. Analyses suggest small drinking water systems face challenges associated with infrastructure, technology, and financial constraints. Investments in drinking water systems and operator training have the potential to reduce the burden of water-borne disease in Canada.