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Two Drinking Water Outbreaks Caused by Wastewater Intrusion Including Sapovirus in Finland

Author

Listed:
  • Ari Kauppinen

    (Department of Health Security, Expert Microbiology Unit, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland)

  • Tarja Pitkänen

    (Department of Health Security, Expert Microbiology Unit, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland)

  • Haider Al-Hello

    (Department of Health Security, Expert Microbiology Unit, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland)

  • Leena Maunula

    (Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland)

  • Anna-Maria Hokajärvi

    (Department of Health Security, Expert Microbiology Unit, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland)

  • Ruska Rimhanen-Finne

    (Department of Health Security, Infectious Diseases Control and Vaccinations Unit, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland)

  • Ilkka T. Miettinen

    (Department of Health Security, Expert Microbiology Unit, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland)

Abstract

Drinking water outbreaks occur worldwide and may be caused by several factors, including raw water contamination, treatment deficiencies, and distribution network failure. This study describes two drinking water outbreaks in Finland in 2016 (outbreak I) and 2018 (outbreak II). Both outbreaks caused approximately 450 illness cases and were due to drinking water pipe breakage and subsequent wastewater intrusion into the distribution system. In both outbreaks, the sapovirus was found in patient samples as the main causative agent. In addition, adenoviruses and Dientamoeba fragilis (outbreak I), and noroviruses, astroviruses, enterotoxigenic and enterohemorragic Escherichia coli (ETEC and EHEC, respectively) and Plesiomonas shigelloides (outbreak II) were detected in patient samples. Water samples were analyzed for the selected pathogens largely based on the results of patient samples. In addition, traditional fecal indicator bacteria and host-specific microbial source tracking (MST) markers (GenBac3 and HF183) were analyzed from water. In drinking water, sapovirus and enteropathogenic E. coli (EPEC) were found in outbreak II. The MST markers proved useful in the detection of contamination and to ensure the success of contaminant removal from the water distribution system. As mitigation actions, boil water advisory, alternative drinking water sources and chlorination were organized to restrict the outbreaks and to clean the contaminated distribution network. This study highlights the emerging role of sapoviruses as a waterborne pathogen and warrants the need for testing of multiple viruses during outbreak investigation.

Suggested Citation

  • Ari Kauppinen & Tarja Pitkänen & Haider Al-Hello & Leena Maunula & Anna-Maria Hokajärvi & Ruska Rimhanen-Finne & Ilkka T. Miettinen, 2019. "Two Drinking Water Outbreaks Caused by Wastewater Intrusion Including Sapovirus in Finland," IJERPH, MDPI, vol. 16(22), pages 1-14, November.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:22:p:4376-:d:285230
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    References listed on IDEAS

    as
    1. Curriero, F.C. & Patz, J.A. & Rose, J.B. & Lele, S., 2001. "The association between extreme precipitation and waterborne disease outbreaks in the United States, 1948-1994," American Journal of Public Health, American Public Health Association, vol. 91(8), pages 1194-1199.
    2. Apostolos Vantarakis & Kassiani Μellou & Georgia Spala & Petros Kokkinos & Yiannis Alamanos, 2011. "A Gastroenteritis Outbreak Caused by Noroviruses in Greece," IJERPH, MDPI, vol. 8(8), pages 1-11, August.
    3. Gerba, C.P. & Goyal, S.M. & LaBelle, R.L. & Bodgan, G.F., 1979. "Failure of indicator bacteria to reflect the occurrence of enteroviruses in marine waters," American Journal of Public Health, American Public Health Association, vol. 69(11), pages 1116-1119.
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    Cited by:

    1. Liesbeth Claassen & Julia Hartmann & Susanne Wuijts, 2021. "How to Address Consumers’ Concerns and Information Needs about Emerging Chemical and Microbial Contaminants in Drinking Water; The Case of GenX in The Netherlands," IJERPH, MDPI, vol. 18(20), pages 1-17, October.
    2. Lida Politi & Kassiani Mellou & Anthi Chrysostomou & Georgia Mandilara & Ioanna Spiliopoulou & Antonia Theofilou & Michalis Polemis & Kyriaki Tryfinopoulou & Theologia Sideroglou, 2024. "A Community Waterborne Salmonella Bovismorbificans Outbreak in Greece," IJERPH, MDPI, vol. 21(2), pages 1-14, February.
    3. Lisa Paruch, 2022. "Molecular Diagnostic Tools Applied for Assessing Microbial Water Quality," IJERPH, MDPI, vol. 19(9), pages 1-21, April.

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