Changes occurring on the Colville River have implications for safe travel, subsistence, food security, and drinking water safety related to species that can carry waterborne pathogens. Continued river monitoring is encouraged including break-up, freeze-up, water level, temperature, turbidity, among others. Installation of stream gauges and participation in River Watch programs, and broadcasting river conditions, low water, slide areas and poor ice condition are encouraged. The Local Environmental Observer (LEO) Network can help share observation about new events and connect managers with technical resources to address questions about environmental change. Clinical staff should be aware of potential for new types of environmental change related illness such as giardia.