Waterborne outbreaks in the Nordic countries, 1998 to 2012
B Guzman-Herrador1, A Carlander, S Ethelberg
1Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Summary
Waterborne disease outbreaks in Nordic countries were most common in summer, often caused by viruses and Campylobacter. Parasites, though rare, caused the largest outbreaks, emphasizing the need for water safety vigilance.
Area of Science:
- Environmental microbiology
- Public health surveillance
- Waterborne disease epidemiology
Background:
- Waterborne disease outbreaks pose a significant public health risk, necessitating robust surveillance systems.
- Understanding the epidemiology of these outbreaks is crucial for effective prevention and control strategies.
Purpose of the Study:
- To analyze the trends, causes, and sources of waterborne disease outbreaks in Denmark, Finland, Norway, and Sweden between 1998 and 2012.
- To identify key pathogens and water sources associated with these outbreaks.
- To assess the impact of outbreak size and inform public health interventions.
Main Methods:
- Retrospective analysis of national outbreak surveillance data from 1998 to 2012 (Sweden until 2011).
- Data included outbreak notification, affected individuals, seasonality, pathogens, water sources, and outbreak size.
- Statistical analysis to determine frequencies, proportions, and associations.
Main Results:
- A total of 175 waterborne outbreaks affected 85,995 individuals over the study period.
- Viruses (Caliciviridae) and Campylobacter were the most frequent causes (41% and 29%, respectively).
- Parasitic outbreaks (Giardia, Cryptosporidium), though fewer, caused the largest individual outbreaks (up to 53,000 people).
- Groundwater was the most common source (76%), and single-household supplies were frequently implicated (76%).
- Large-scale outbreaks (>1,000 people) occurred in 6% of cases.
Conclusions:
- Waterborne disease outbreaks are a recurring issue in Nordic countries, with seasonal peaks in summer.
- While common pathogens like viruses and Campylobacter dominate, parasites represent a significant risk for large-scale outbreaks.
- Effective water management, treatment, and surveillance are essential to mitigate the impact of both common and large-scale waterborne disease events.
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