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Beyond compliance: environmental health problem solving, interagency collaboration, and risk assessment to prevent waterborne disease outbreaks
  1. Joslyn D Cassady1,
  2. Charles Higgins2,
  3. Hugh M Mainzer3,
  4. Scott A Seys1,
  5. John Sarisky3,
  6. Myfanwy Callahan3,
  7. Karl J Musgrave1
  1. 1Wyoming Department of Health, Cheyenne, Wyoming, USA
  2. 2National Park Service, Washington, DC, USA
  3. 3Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to:
 Dr J Cassady
 Drew University, 36 Madison Avenue, Madison, New Jersey, USA, 07940; jcassady{at}


A systems approach to environmental health problem solving was used to investigate two waterborne norovirus outbreaks in Wyoming and can serve in the development of improved prevention strategies. An interagency collaboration to prevent waterborne disease involving local, state, and federal partners was designed to coordinate response to outbreak investigations. Improved risk assessment and reporting procedures were also integrated to ensure better availability of necessary data. Public health entities should implement sustainable intersectoral interventions to prevent waterborne disease that not only improve regulatory compliance but also have a positive impact on community health outcomes. Collaborative preventive health and water system protection activities should receive priority attention for implementation in state and local jurisdictions.

  • environmental health
  • risk assessment
  • water
  • norovirus

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  • Competing interests/support: the findings and conclusions in this report are those of the authors and do not necessarily represent the official policy or views of the US Department of the Interior (National Park Service) or the US Department of Health and Human Services (Centers for Disease Control and Prevention).

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