Norovirus Outbreak Associated With a Natural Lake Used for Recreation — Oregon, 2014

Amy Zlot, MPH; Maayan Simckes, MPH; Jennifer Vines, MD; Laura Reynolds, MPH; Amy Sullivan PhD; Magdalena Kendall Scott, MPH; J. Michael McLuckie; Dan Kromer, MPA; Vincent R. Hill, PhD; Jonathan S. Yoder, MPH; Michele C. Hlavsa, MPH


Morbidity and Mortality Weekly Report. 2015;64(18):485-490. 

In This Article

Environmental Health Investigation

Blue Lake, just south of the Columbia River, is a natural lake, about 25 feet (7.6 m) at its deepest, but about half of the lake, including the swimming area, is 10 feet (3.0 m) deep or less. The beach area itself is a small area, approximately 300 feet long by 30 feet wide (91.4 m by 9.1 m). The water along the beach is shallow. Bubblers were installed in the swimming area to circulate water from the center of the lake into the swimming area. Before the outbreak, the bubblers were in operation and were working as designed. The lake is monitored for fecal contamination twice-weekly during May–September. MCHS was notified of a high E. coli result from the shallow swimming area at Blue Lake on July 16. The E. coli count was 304, above the safety threshold of 235. A follow-up sample, collected on July 17, did not violate Oregon water quality standards. Samples collected from July 14 were also below the threshold and considered safe, as were samples leading up to the outbreak. The laboratory does not conduct species identification tests. The positive test is a general indicator of fecal contamination, of which an animal or human could be the source. Because the timing of the fecal coliform elevation occurred after the outbreak, this spike in fecal contamination was determined to be unrelated to the norovirus outbreak. Blue Lake Regional Park is on a sewage system versus a septic tank system. Multnomah County Environmental Health conducted an evaluation of the park after notification of illness and did not find any signs of failure of the sewage system. Blue Lake uses well water for watering the large land area, but uses a public water source for drinking water and for their facilities.

Blue Lake proactively closed the beach to swimming, paddleboat, and fishing activities from Monday, July 14 until Wednesday, July 23; however, the picnic grounds and splash pad remained open during this period. On July 23, MCHD and the Oregon Public Health Division sampled lake water by pumping approximately 90 L from different areas of the swimming area through each of two hollow-fiber ultrafilters.[1] Two samples (100 mL each) were also collected for E. coli testing. Ultrafilter samples were sent to CDC, which reported on July 30 that the samples had negative results for norovirus using real-time reverse transcription-PCR testing.[2] E. coli concentrations in the tested samples were below state and federal ambient water quality standards.