Utah parents, read this before you let your kids play in the sprinklers this summer

Last July, there was an E. coli outbreak in Utah.

I don’t know about you, but E. coli is one of those things that I tend to glaze over when it’s mentioned in the news. The rhythms of the story are so familiar by now: There’s some lettuce or some restaurant at the center of an outbreak, some people get sick, the health authorities intervene, and things go back to normal. It’s just ... predictable.

But last week, the Centers for Disease Control and Prevention released a report about the Utah outbreak in their Morbidity and Mortality Weekly Report — a roundup of interesting, but bad health things happening in the U.S. Much of what we learned about COVID outbreaks came in the MMWR, for example.

This report fell outside of the usual story on E. coli. Instead of ending in a neatly tied-up bow, this report points to some ongoing risks that I think a lot of Utahns will want to know about.

In particular: Utah’s unique water supply system provides a bit of a danger. Let me explain.

What happened in Utah

Last summer, between July 22-27, six kids in Lehi tested positive for E. coli. That’s unusual, obviously, so they tested the E. coli strains the children had, and found they were exactly the same. In other words, their disease was coming from the same source.

But as Utah Department of Health experts interviewed the kids’ parents, there wasn’t much in common among the kids. They hadn’t eaten at the same restaurant, nor even eaten the same meals. The only thing in common that they had was they had all played outside in the water recently. But of course they had. They’re kids.

Still, that’s what health officials had to go on. So they tested water samples from where the kids had played — backyards and parks in particular. At five of those sites, they found E. coli.

Then, they tested two of Lehi’s water reservoirs and found E. coli at one of them.

The Utah County Health Department issued a news release about the outbreak on Aug. 4; Lehi sent out a release on Aug. 19 affirming E. coli had been found. Officials also mailed a notice to residents on Aug. 28. On Aug. 31, the final case of the outbreak was detected.

In all, 13 kids were diagnosed with E. coli infection. The children were between 1 and 15 years old. The average age was 4. Five of them had played with hose water from Lehi, five with inflatable lawn water toys and water tables. Two remembered drinking the water from the hose, one just ran through sprinklers.

Seven of them were hospitalized, and two of them had “hemolytic uremic syndrome,” which results in smaller blood vessels in children, a change in color in skin tone, and, frequently, kidney failure. It’s something that happens relatively often in kids, especially, who are infected with E. coli.

But that’s not all: While there were 13 confirmed cases, experts estimate that there are 26.1 undiagnosed cases of E. coli infection in people for every one diagnosed. So we can estimate that there were about 340 people, likely mostly children, who got sick last summer due to E. coli in Lehi.

Secondary water systems

So what allowed this to happen? Well, Lehi, like a lot of Utah cities, has a two-pronged watering system. Within homes, the “primary” drinking water system is used — the water that gets sent through treatment plans to make safe for human consumption. And for outdoors, “secondary” water is used. That’s, as the CDC calls it, “untreated, pressurized, municipal irrigation water” — water that flows down from the mountains, hangs out in reservoirs, and then gets sent to backyards. It’s clear that the E. coli traveled through this latter system.

I spent most of my adolescence in Riverton, which has this two-pronged system. I’ll be honest, I thought this was a pretty ubiquitous setup, at least in the suburbs.

But it turns out that these secondary water systems in which the water is untreated but still delivered to homes are extremely uncommon outside of Utah. It’s common for farms and the like nationwide, but the fact that Utah municipalities are sending untreated water to residential suburb homes, even to be used in the outdoors, was a surprise to many at the CDC. It just doesn’t happen in most other places.

Which Utah municipalities have secondary water systems? Here’s the map.

Among the cities with secondary water are West Jordan, South Jordan, Riverton, Herriman, Bluffdale, Alpine, Lehi, Pleasant Grove, American Fork, Springville, Spanish Fork, Payson, Grantsville, Stansbury, Park City, Midway, Bountiful, Farmington, Kaysville, Syracuse, Clinton, Roy, North Ogden, and many more. Like I said, check the map.

While it’s unusual outside of Utah, I have to say — most of the time, secondary water seems to me to be a pretty sensical system, at least in my opinion. Because most water used in residential areas is outside, keeping lawns green, not treating that water saves a lot of money, time, and effort for cities. It saves tens of millions in water treatment costs. And it makes sense for these suburbs that were so recently mostly agricultural to simply convert those irrigation systems to lawn-watering systems.

What should we do?

But every once in a while, an outbreak like this is going to happen as a result. UDOH officials couldn’t pinpoint how many of these had happened before, but indicated that this mechanism would explain multiple untraceable past outbreaks in Utah.

E. coli outbreaks usually happen due to, well, poop. To figure out where the E. coli came from, UDOH tested the backyards, parks, and reservoirs in Lehi for traces of different kinds of feces — avian, ruminant (cows, sheep, deer, etc.), and human.

Could you perhaps separate the excrement contaminated by E. coli away from the water sources? Unfortunately, the places that tested positive for E. coli mostly tested negative for feces — with one exception. They all tested positive for bird poop.

That’s the most difficult one to avoid, of course. Birds, nonstop, are flying over all manner of things and pooping in or on them. If a bird picks up an E. coli infection, well, it’s easy to imagine how that can spread across hundreds of kids in a community just as soon as it makes a deposit in the water supply.

The CDC, then, made some recommendations to municipalities with secondary water. One logical one: covering secondary water reservoirs to make it more difficult for bird waste to end up in them.

Their biggest focus, though, was just about making sure the public knows that secondary water is not wholly safe when people, and especially kids are involved. They recommended more prominent labeling of secondary water systems at public sites, distributing conspicuous signage for homeowners to use in their yards, and color coding spigots.

In 2022, the Utah Legislature passed a law requiring that all secondary water systems be metered by 2030. I wonder if a similar law could pass next session to implement some of these recommendations.

I think doing so would be especially important given Utah’s population growth. We’re adding tens of thousands of residents per year from out of state — and especially to Lehi! The vast majority of them will not have encountered secondary water systems before.

That doesn’t mean that we should get rid of secondary water in communities. But it does mean a good ol’ public information campaign is in order to avoid hundreds of kids getting sick on a regular basis in their own backyards.

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