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 I. 2013 Shigella Outbreak II. Analysis of Historical Data III. Proposed Amendments to Regulations IV. Next Steps V. Questions

3. I. Shigella Outbreak

4. Shigella Outbreak (cont.) Around July 4 th, 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. Shigella Outbreak (cont.) 5 miles apart

6. Shigella Outbreak (cont.) Swimmers also reported becoming ill after swimming at Wallum Lake 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. Shigella Outbreak (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 3 rd 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  Exceedances occur 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