Large waterborne epidemic in Pirkanmaa, Finland 2007. Study on disease burden, health consequences and health-economic costs
Abstract
(online publication)A large drinking water-associated epidemic took place in the town of Nokia, Southern Finland in November-December 2007.Water became heavily contaminated with treated waste water at the town's waste water plant.A valve connecting waste water and household water lines had been opened during plant maintenance and accidentally left open for two days, allowing large amounts of waste water to flow into the distribution network.During the following weeks the Nokia health centre encountered a rush of patients with gastroenteritis, a total of 1222 visits being reported for the outbreak period, 28 November to 31 December 2007.Altogether 204 referrals to Tampere University Hospital were made, of which 71% involved children.Clinical stool samples revealed seven pathogens, six of which were also detected in water samples.This diversity reflects the mechanism and the magnitude of the contamination.Campylobacter, norovirus and Giardia were considered the main pathogens.A population-based questionnaire study was conducted to assess the burden of gastroenteritis and joint symptoms within 8 weeks from exposure.Based on technical data and modelling, the town was divided into two areas: contaminated and uncontaminated.One thousand residents from both areas were picked from the population register to form two study groups, contaminated and uncontaminated group.The control group constituted 1 000 inhabitants of another municipality located in the same city area.In comparison…
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