Beaches: 2013 Shigella Outbreak and Proposed Amendments to Regulations

1. Beaches: 2013 Shigella Outbreak and Proposed Amendments to Regulations Vanessa Curran, Bathing Beaches Coordinator Environmental Toxicology Program Bureau of Environmental Health Massachusetts Department of Public Health

2. Outline • 2013 Shigella Outbreak • Analysis of Historical Data • Proposed Amendments to Regulations • Next Steps • Questions

3. I. Shigella Outbreak

4. Shigella Outbreak (cont.) • Around July 4th, over 130 people got sick after swimming at Spring Lake in Burrillville, RI • Shigellosis – diarrhea, fever, stomach cramps • Transmitted person to person • The RI Dept. of Health believes that fecal contamination of the water occurred on 7/4 • Burrillville abuts the Massachusetts border (Uxbridge and Douglas)

5. ShigellaOutbreak (cont.) 5 miles apart

6. ShigellaOutbreak (cont.) • Swimmers also reported becoming ill after swimming at WallumLake in Douglas (DCR property) which spans MA/RI border – 7 confirmed cases • Webster Lake in Webster – 4 confirmed cases • Falls Pond in North Attleboro – 1 confirmed case

7. ShigellaOutbreak (cont.) • Beaches staff conducted site visits at Wallum and Webster lakes and reviewed beach sampling data • DCR staff increased cleaning of Wallum Lake facilities based on DPH recommendations • Falls Pond was closed (high bacteria) at time of exposure • Also conducted phone interviews with ill beachgoers • Beaches staff coordinated with staff from MDPH’s Division of Epidemiology and Immunization • MDPH epis worked with RI epis and CDC

8. II. Analysis of Historical Data Marine Beaches • 60 communities with marine beaches • Approximately 535 marine beaches with 600 sampling locations • On average, 8,000 samples are collected annually, 5% of which exceed the single sample bacteria standard, which results in posting a beach (no swimming) • MA has the highest number of monitored marine beaches in New England and 3rd highest in U.S.

9. Analysis of Historical Data Freshwater Beaches • 181 communities with freshwater beaches • Approximately 530 freshwater beaches with 575 sampling locations • On average, 7,500 samples are collected annually, 4% of which exceed the single sample bacteria standard

10. Analysis of Historical Data • Exceedancesoccur infrequently (about 5% of marine beach samples and 4% of freshwater beach samples). • Available testing methods require 24 hrs for incubation; results of water samples taken are not available until the next day.

11. Analysis of Historical Data • The vast majority of exceedances are transient (e.g., present one day but not the next day). • This often results in a beach being posted when water quality is good. • 13 years of beach data show that approximately 80% of beach postings occur on days when the water test results are acceptable.

12. III. Proposed Amendments to Beaches Regulations Problem with Current Criteria: • A sample taken on Day 1 has results on Day 2, showing an exceedance. This results in a posting on Day 2. Another sample is taken on Day 2, with results on Day 3 showing no exceedance for the Day 2 sample. • This means that the beach was frequently posted on a day (Day 2) when it was clean.

13. Proposed Amendments to Beaches Regulations Inaccurate postings result in: • Fewer opportunities for recreation. • Increased administrative work for local health officials. • Economic impacts to local communities and beach community businesses.

14. Proposed Amendments to Beaches Regulations Proposed New Criteria: • For beaches with a history of infrequent and transient elevated bacteria levels, a posting will not be required until after two samples collected on consecutive days show elevated bacteria levels. • Other Northeast states similarly require two consecutive days of exceedances before posting (e.g., Connecticut, New Jersey) Plum Island – Newburyport

15. Proposed Amendments to Beaches Regulations • If a sample is not collected on the day following the initial exceedance, then the beach must be posted • A consecutive sample must be collected in order to avoid posting on Day 2 • LBOH can also choose to post after 1 exceedance if desired

16. Proposed Amendments to Beaches Regulations • For beaches with a history of more frequent elevated bacteria levels that remain for more than 24 hours, postings will continue to be required after each instance of elevated bacteria levels. • These are the beaches more likely to have non-transient bacteria contamination Wollaston Beach - Quincy

17. Proposed Amendments to Beaches Regulations • Through a thorough analysis of historical data, MDPH/BEH determined that beaches which experienced • at least one instance of consecutive day exceedances • in at least two of the most recent four beach seasons will still require posting after one single sample exceedance. • Approximately 5% of marine and freshwater beaches statewide fall into this category.

18. Proposed Amendments to Beaches Regulations • These amendments will result in far fewer postings on days that beach waters actually meet water quality standards and provide protection of public health for beaches deemed to present a greater risk.

19. IV. Next Steps • Public Comment Period: 4/11 – 4/28/2014 • Present information on proposed regulatory changes to local health officials at two joint regional MHOA-MDPH/BEH workshops in April • Public Hearing on April 28, 2014 • Review and prepare response to public comments • Return to PHC in May 2014 for final approval • Intention for regulations to take effect in June 2014 for majority of bathing beach season

20. V. Questions?

21. Contact Information • Vanessa Curran, Bathing Beaches Coordinator • Phone – 617.624.5757 • Fax – 617.624.5183 • E-mail – Vanessa.Curran@state.ma.us • Irena Draksic, Bathing Beaches Inspector • Region – Cape & Islands and Buzzard’s Bay Communities • Phone – 508.375.6875 • Fax – 508.375.0140 • E-mail – Irena.Draksic@state.ma.us • Michael Beattie, Bathing Beaches Inspector • Region – All other areas • Phone – 617.624.5757 • Fax – 617.624.5183 • E-mail – Mike.Beattie@state.ma.us