

@article {13916,
	title = {Heavy rainfall and waterborne disease outbreaks: the {Walkerton} example},
	journal = {J Toxicol Environ Health A},
	volume = {67},
	number = {20-22},
	year = {2004},
	pages = {1879{\textendash}1887},
	abstract = {Recent research indicates that excessive rainfall has been a significant contributor to historical waterborne disease outbreaks. The Meteorological Service of Canada, Environment Canada, provided an analysis and testimony to the Walkerton Inquiry on the excessive rainfall events, including an assessment of the historical significance and expected return periods of the rainfall amounts. While the onset of the majority of the Walkerton, Ontario, Escherichia coli O157:H7 and Campylobacter outbreak occurred several days after a heavy rainfall on May 12, the accumulated 5-d rainfall amounts from 8-12 May were particularly significant. These 5-d accumulations could, on average, only be expected once every 60 yr or more in Walkerton and once every 100 yr or so in the heaviest rainfall area to the south of Walkerton. The significant link between excess rainfall and waterborne disease outbreaks, in conjunction with other multiple risk factors, indicates that meteorological and climatological conditions need to be considered by water managers, public health officials, and private citizens as a significant risk factor for water contamination. A system to identify and project the impacts of such challenging or extreme weather conditions on water supply systems could be developed using a combination of weather/climate monitoring information and weather prediction or quantitative precipitation forecast information. The use of weather monitoring and forecast information or a "wellhead alert system" could alert water system and water supply managers on the potential response of their systems to challenging weather conditions and additional requirements to protect health. Similar approaches have recently been used by beach managers in parts of the United States to predict day-to-day water quality for beach advisories.},
	doi = {10.1080/15287390490493475 LQQL5UKQEC87M224 [pii]},
	author = {Auld, H and MacIver, D and Klaassen, J}
}
