Tag Archives: Water

Water water everywhere, but is it safe?

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Potable water and the U.S. Centers for Disease Control: two things we take for granted.

CDC reports that during 2013–2014, a total of 42 drinking water–associated outbreaks were reported, resulting in at least 1,006 cases of illness, 124 hospitalizations, and 13 deaths. Legionella was responsible for 57% of outbreaks and 13% of illnesses, and chemicals/toxins and parasites together accounted for 29% of outbreaks and 79% of illnesses. Eight outbreaks caused by parasites resulted in 289 (29%) cases, among which 279 (97%) were caused by Cryptosporidium and 10 (3%) were caused by Giardia duodenalis. Chemicals or toxins were implicated in four outbreaks involving 499 cases, with 13 hospitalizations, including the first outbreaks associated with algal toxins.

To provide information about drinking water–associated waterborne disease outbreaks in the United States in which the first illness occurred in 2013 or 2014 (https://www.cdc.gov/healthywater/surveillance/drinking-surveillance-reports.html), CDC analyzed outbreaks reported to the CDC Waterborne Disease and Outbreak Surveillance System through NORS (https://www.cdc.gov/nors/about.html) as of December 31, 2015. For an event to be defined as a waterborne disease outbreak, two or more cases must be linked epidemiologically by time, location of water exposure, and illness characteristics; and the epidemiologic evidence must implicate water exposure as the probable source of illness. Data requested for each outbreak include 1) the number of cases, hospitalizations, and deaths; 2) the etiologic agent (confirmed or suspected); 3) the implicated water system; 4) the setting of exposure; and 5) relevant epidemiologic and environmental data needed to understand the outbreak occurrences and for determining the deficiency classification.§ One previously unreported outbreak with onset date of first illness in 2012 is presented but is not included in the analysis of outbreaks that occurred during 2013–2014.

Public health officials from 19 states reported 42 outbreaks associated with drinking water during the surveillance period (Table 1) (https://www.cdc.gov/healthywater/surveillance/drinking-water-tables-figures.html).

One outbreak reported during 2013–2014 in an individual system led to 100 estimated illnesses associated with a wedding. The public health challenges highlighted here underscore the need for rapid detection, identification of the cause, and response when drinking water is contaminated by infectious pathogens, chemicals, or toxins to prevent and control waterborne illness and outbreaks.

Two stricken with Giardia in Norway

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Many thanks to our Norwegian correspondent who reports that two people admitted to Haukeland Hospital have been diagnosed with Giardia infection.

“We have two confirmed cases, but it is possibly a third too. It is too early to say anything about the source of infection,” says Surveillance Authority in Bergen municipality Kari Stidal Øystese.

Bergen is sensitive to Giardia outbreaks because in autumn 2004, the drinking water was infected by the Giardia parasite and approximately 5,000 people from Bergen became sick, and many have suffered after-effects for years.

In 2006, a SINTEF report commissioned drainage systems related to the buildings at Knatten, Starefossen and Tarlebøveien, triggered the epidemic. Local authority Torgeir Landvik would blame the dog owners for the fact that thousands of mountain people were infected by Giardia in the fall of 2004. But in 2015, an expert group picked up the dog-kit theory. “Based on available knowledge, Giardia infection from humans is still the most likely cause of the outbreak of disease and long-term strokes,” said the group’s conclusion.

A large community outbreak of waterborne giardiasis- delayed detection in a non-endemic urban area

BMC Public Health, 2006, 6:141,   Karin Nygård, Barbara Schimmer, Øystein Søbstad, Anna Walde, Ingvar Tveit, Nina Langeland, Trygve Hausken and Preben Aavitsland, https://doi.org/10.1186/1471-2458-6-141

https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-6-141

Background

Giardia is not endemic in Norway, and more than 90% of reported cases acquire the infection abroad. In late October 2004, an increase in laboratory confirmed cases of giardiasis was reported in the city of Bergen. An investigation was started to determine the source and extent of the outbreak in order to implement control measures.

Methods

Cases were identified through the laboratory conducting giardia diagnostics in the area. All laboratory-confirmed cases were mapped based on address of residence, and attack rates and relative risks were calculated for each water supply zone. A case control study was conducted among people living in the central area of Bergen using age- and sex matched controls randomly selected from the population register.

Results

The outbreak investigation showed that the outbreak started in late August and peaked in early October. A total of 1300 laboratory-confirmed cases were reported. Data from the Norwegian Prescription Database gave an estimate of 2500 cases treated for giardiasis probably linked to the outbreak. There was a predominance of women aged 20–29 years, with few children or elderly. The risk of infection for persons receiving water from the water supply serving Bergen city centre was significantly higher than for those receiving water from other supplies. Leaking sewage pipes combined with insufficient water treatment was the likely cause of the outbreak.

Conclusion

Late detection contributed to the large public health impact of this outbreak. Passive surveillance of laboratory-confirmed cases is not sufficient for timely detection of outbreaks with non-endemic infections.

Hare fever in Norway

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(Something may be lost in translation.)

The veterinary institute has recently diagnosed hare fever (tularemia) with many hares and one dog – all from southern Norway. This indicates that the disease is relatively widespread in this area and people should be aware of it.

Harane with hare fever has been submitted from Agder, northern part of Buskerud and Inner Sogn during the last weeks. Tularemia (harepest) obsessed infection with the bacterium Francisella tularensis.

The bacterium can infect humans and many different animal species. The hare is particularly sensitive to infection and dying usually by blood poisoning few days after he has been infected. Dogs can be infected by catching or by eating smokers. Commonly, they develop transient disease.

Harepest (tularemia) is a disease that can be transmitted from animals to humans. Often it happens via drinking water, for example if dead mice or lem infect wells, streams and other water sources.

The danger of being infected with tularemia or other waterborne disease will always be present. After a lean year, the following year there may be dead animals still infectious. We therefore recommend that you follow the advice and measures for drinking water listed below for safety. It will prevent hare fever and other diseases from drinking water, especially the drinking water that is extracted from wells and other sources in nature.

‘Pathetic’ £450,000 fine because of crypto in UK water supply

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Ed Walker of Blog Preston writes the reason why Prestonians couldn’t drink their water without boiling it for a month has finally been revealed.

United Utilities has been fined after a cryptosporidium outbreak at its Franklaw treatment plants to the north of Preston,

The Drinking Water Inspectorate found the problems came from the Franklaw works using a different reservoir to source water

Rainwater running off agricultural land was able to access an underground water tank at Barnacre.

A ‘planned change in operations’ allowed the entry of the contaminated water into the treatment process.

Traces of cryptosporidium were detected in the water at Franklaw triggering a shut off of supplies for 700,000 people across Lancashire.

Supplies for many were knocked out for a month during the summer of 2015 as engineers worked to fix the issue.

At Preston Crown Court the hearing fined United Utilities £300,000 and additional costs of £150,000 were also agreed. The firm had pleaded guilty to supplying water unfit for human consumption.

United Utilities was criticised for not acting fast enough to issue the boil water warning to households and businesses.

It has since paid out £20million in compensation to customers through reduced water bills.

The fine was branded ‘pathetic’ by Preston MP Mark Hendrick.

NZ campy outbreak cost $21m

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In Aug. 2016, some 5,500 people in a New Zealand town of 14,000 were sickened with Campylobacter linked to the water supply and three died.

Didn’t chlorinate.

Eric Frykberg of RadioNZ reports the NZ Ministry of Health has found Havelock North’s water contamination cost about $21 million – with residents the worst affected.

The campylobacter infection hit the town last August and afflicted more than 5,000 people with illness, filling the hospital and potentially contributing to three deaths.

The investigators measured the next best thing that people could have been doing if they had not been sick. That and the value of direct costs added up to the total figure of $21,029,288.

A report commissioned by the ministry said some 5088 households were affected by the crisis, and the cost to each household was about $2440.

Those costs included the cost of people getting sick and being unable to go to work or school or carry out other tasks.

Some were unable to look after their children, while others had to drive all over town to visit doctors or to get fresh water or other supplies.

They also had to do far more laundry and cleaning.

This left the households to foot a bill of more than $12,420,000 making up the majority of all costs from the crisis.

The report also said not all consequences of the outbreak could be quantified in monetary terms, with personal stress, loss of public faith in the water supply, and “scarring” of the community adding to the societal bill.

The report said about 25 percent of the population of Havelock North was aged over 65 based on the 2013 Census, and the town also had a large number of school aged children.

Hong Kong fairytales: More Vibrio: Suspected food poisoning outbreak in tour group

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The Centre for Health Protection (CHP) of the Department of Health is investigating a suspected outbreak of food poisoning in a tour group, and hence urged the public to maintain good personal, food and environmental hygiene to prevent food-borne diseases.

Because all foodborne illness is caused by poor personal hygiene, and not contaminated product.

Not

The outbreak affected six members of the tour group, comprising two men and four women aged from 44 to 80, who developed abdominal pain, diarrhoea and vomiting 14 to 40 hours after their lunch buffet in a restaurant in a hotel in Macau on August 13 arranged by a travel agent in Hong Kong.

Among them, three sought medical attention in Hong Kong and required no hospitalisation. All affected persons have been in stable condition.

The stool specimen of one patient tested positive for Vibrio parahaemolyticus upon laboratory testing.

 

Dozens of guests at Ibiza hotel struck down by gastroenteritis amid fears dirty rainwater seeped into water tanks

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One of my fondest childhood memories was the rain barrels my grandparents used to collect water.

I have no idea why, other than a foreshadowing of somewhat of a career in microbiology, but the memories remain vivid.

Now we live in Australia, which has 10 years of drought followed by a 1-in-500-year downpour, so we have these bloody big rain water collection tanks that look nothing like my grandparents.’

Around 50 guests at an Ibiza hotel popular with British holidaymakers have fallen ill with suspected gastroenteritis.

A pregnant woman needed hospital treatment and doctors were made available for 49 other guests following the outbreak at the four-star Hotel Algarb in Playa d’en Bossa,

A probe is now underway to establish the cause, although it has been initially linked to rainwater from midweek storms on the island filtering into hotel water tanks and ending up being used to make ice.

The mum-to-be who was hospitalised with “light gastroenteritis” has now been discharged.

14 sick, 4 with HUS from E. coli in Calif. lake

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An E. coli-contaminated lake in Nevada County, Calif., linked to the illnesses of 14 people will remain closed until at least Aug. 23, county officials announced Wednesday.

Hannah Knowles of the Sacramento Bee reports authorities closed all of Lake Wildwood’s public beaches last week after water testing confirmed reports linking E. coli infections to the lake’s Main Beach, also called Commodore Park. The county also advised against any swimming in the lake.

As of Wednesday, 14 people – 11 children and three adults – are believed to have contracted E. coli after visiting the Main Beach and, in many cases, ingesting lake water, according to the Nevada County Public Health Department. Lab results so far confirm 11 of those 14 cases are connected to the lake’s bacteria.

By Tuesday, nine people had been hospitalized in connection with the outbreak, county Public Health Coordinator Patti Carter said. Six had been discharged by Wednesday evening.

Four sickened children developed a serious condition called hemolytic uremic syndrome, which can lead to potentially fatal kidney failure and anemia.

Careful with that Italian water fountain: An entire orchestra is rushed to hospital

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Norman Lebrecht of Slippedisc reports all 80 members of the European Spirit of Youth Orchestra were rushed to the Santa Chiara Emergency Room in Trento, Italy, suffering from dehydration after an outbreak of vomiting and diarrhea.

About 20 young musicians received prolonged treatment and two were detained in hospital overnight.

The problem was traced to a picturesque fountain in the small town of Belluno, where the orchestra had stopped for a drink of water. Officials say this was due to current repairs to the aqueduct.

The orchestra aims to continue its tour with conductor Igor Coretti-Kuret.

 

Things rarely happen until they do: 4136 sick from Norovirus in bottled water, Spain, 2016

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In April 2016, an outbreak of gastrointestinal illness (4,136 cases) occurred in Catalonia, Spain. We detected high levels of norovirus genotypes I and II in office water coolers associated with the outbreak. Infectious viral tiiter estimates were 33–49 genome copies/L for genotype I and 327–660 genome copies/L for genotype II.

During April 11–25, 2016, a total of 4,136 cases of gastroenteritis were reported by the Public Health Agency of Catalonia (ASPCAT; Figure, panel A). A case-patient was defined as an exposed person who had vomiting or diarrhea (3 or more loose stools within 24 hours) and >2 of the following: nausea, abdominal pain, or fever (≥37.8°C). Six patients required hospitalization.

The epidemiologic investigation conducted by the ASPCAT pointed toward an association of the outbreak with drinking bottled spring water from office water coolers; the water had been bottled at a source in Andorra (M. Jané-Checa and A. Martínez-Mateo, Public Health Agency of Catalonia, pers. comm., 2016 Sep 1). Compared with other modes of transmission such as food or person to person, norovirus outbreaks associated with drinking water are rare in developed countries. On April 15, 2016, as a precautionary measure, the company producing the bottled water recalled >6,150 containers of water of suspected quality that had already been distributed to 925 companies. The water complied with all requirements of the European Commission directive on the exploitation and marketing of natural mineral waters, but these requirements do not include any virologic determination.

Norovirus in bottled water associated with gastroenteritis outbreak, Spain, 2016

Emerging Infectious Diseases, Volume 23, Number 9—September 2017

Albert Blanco, Susana Guix, Noemí Fuster, Cristina Fuentes, Rosa Bartolomé, Thais Cornejo, Rosa Maria Pintó, and Albert Bosch

https://wwwnc.cdc.gov/eid/article/23/9/16-1489_article