Water Preparedness and Response: Developing Water, Sanitation, and Hygiene-Related Public Health Tools for Response to Natural Disasters, Emergencies, and Outbreaks

Key Objectives: The goal of this roundtable is to develop WASH-related guidance for state/local health departments to respond to complex WASH emergencies, which are often caused by emerging pathogens, chemicals, toxins, natural disasters (e.g., floods, hurricanes), or aging infrastructure. Additionally, it will develop a plan to integrate the public health preparedness planning and response with the overall emergency response framework in these emergency events. Brief Summary:  Complex emergencies and outbreaks associated with drinking water, sanitation, and hygiene (WASH) trigger emergency responses because of their potential for causing community-wide outbreaks and disruption. Often these responses are not based on applicable public health planning or exercises and lack appropriate response tools or timely and credible public health messaging. This presentation will discuss recent water-related emergencies that presented preparedness and communication challenges for state and local public health agencies. Recent events include: South Carolina (2015): Extensive flooding caused widespread drinking water advisories. Healthcare facilities were closed because they were unable to operate safely; Columbus OH, (2015)  Nitrate contamination of public drinking water triggered a ‘Do Not Drink’ advisory; unclear guidance was provided on water use for healthcare facilities and food service; Bridger Pipeline Oil Spill, MT, (2015): Oil contamination of river and water system led to ‘Do Not Use’ order for entire city; Charleston, WV, (2014)—Toxic chemical contamination of the  Elk River and contamination of drinking water led to  ‘Do Not Use’ order;  guidance was needed on flushing contaminated water from homes and businesses; Toledo, OH, (2014)—Harmful algal bloom toxin contamination of municipal finished drinking water led to ‘Do Not Use’ order, causing extensive community disruption; Baker City, OR, (2013)—Cryptosporidiumin drinking water led to ‘Boil Water’ advisory for >1 month and challenges with hygiene and drinking water availability; St. Bernard Parish Louisiana, (2013, 2011, 2015)—Naegleria fowleri(‘brain-eating’ ameba) in drinking water system; deaths from exposure to tap water; water safe to drink but not for other uses--communication challenges during remediation. Participants will discuss available WASH-related preparedness and response tools including the newly revised Drinking Water Advisory Communication Toolkit and Emergency Water Supply Planning Guide for Hospitals and Healthcare Facilities. Discussion of these complex events will identify additional tools and resources that are needed for preparedness and response. This will assist with the process of developing accessible and timely tools that can be used to protect the health of community members in the event of a WASH-related emergency or disease outbreak.