Fourteen waterborne epidemics occurred in Finland during 1998-1999. About 7,300 illness cases were registered in these outbreaks. All except one of the waterborne epidemics were associated with undisinfected groundwaters. An equal number of waterborne epidemics occurred in public and private water systems, but most cases of illness occurred in public water systems. The three largest epidemics comprised 6,700 illness cases. Insufficient purification treatment unable to remove Norwalk-like viruses caused the only waterborne epidemic in a surface water plant. The main reasons for groundwater outbreaks were floods and surface runoffs which contaminated water. Norwalk-like viruses caused eight and Campylobacter three of the outbreaks. In two cases the epidemic ceased by the exhaustion of susceptible persons in the exposed community but in most cases it was terminated by changing the water source, boiling the drinking water, and starting chlorination.
Small round structured viruses (SRSVs - for example, calici-, astro-, and entero-viruses) are the commonest causes of outbreaks of non-bacterial gastroenteritis worldwide. Transmission of SRSVs by water and by various foods – including salads, bakery prod
In April 1988, an outbreak of gastroenteritis occurred among employees in a large company in Helsinki, Finland. A retrospective cohort study, using a self-administered questionnaire, was carried out to ascertain the cause and extent of the outbreak. To meet the case definition, employees had to have had diarrhoea and/or vomiting since 2 April, 1998. A subanalysis was made in the biggest office, consisting of 360 employees, of whom 204 (57%) completed the questionnaire. Of these 108 (53%) met the case definition. Employees who had eaten raspberry dressing were more likely to meet the case definition than those who had not (Attack Rate (AR) 65% versus AR 18% Relative Risk, (RR) 3.7, 95%, Confidence Intervals (CI) 2.0-6.7). Four stool specimens obtained from affected kitchen staff who had all eaten the raspberry dressing and who had all become ill simultaneously with the employees were positive by polymerase chain reaction (PCR) for calicivirus. The data suggest that the primary source of the outbreak was imported frozen raspberries contaminated by calicivirus.
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