Waterborne Diseases Outbreaks in the Czech Republic, 1995-2005
Authors:
F. Kožíšek 1,2; H. Jeligová 1; A. Dvořáková 3
Authors place of work:
Státní zdravotní ústav Praha, Centrum odborných činností v OPVZ, Odbor hygieny životního prostředí
1; 3. lékařská fakulta UK Praha, Ústav obecné hygieny
2; Státní zdravotní ústav Praha, Centrum laboratorních činností v OPVZ, Odbor chemických a fyzikálních laboratoří
3
Published in the journal:
Epidemiol. Mikrobiol. Imunol. 58, 2009, č. 3, s. 124-131
Summary
Despite considerable advances in drinking water safety assurance and adherence to the public health standards, waterborne diaseases outbreaks have still been observed even in industrialized countries. The study objective was to map such outbreaks in the Czech Republic in 1995-2005.
In this study, an outbreak is the occurrence of more cases of disease than normally expected within a specific place over a given period of time and a waterborne disease is a disease where water is the vehicle or source of infection. The data on waterborne outbreaks was obtained from the EPIDAT database (national infectious diseases reporting system) information provided by epidemiologists of all regional public health authorities and the National Reference Laboratory for Legionella.
In 1995 – 2005, 33 outbreaks with water indicated as the route of transmission were recorded in the Czech Republic. The leading cause was unsafe drinking water (27 outbreaks), mainly from wells (19 outbreaks); nevertheless, the most serious consequences were observed in two outbreaks caused by microbiologically contaminated hot water. Other sources of waterborne infection were mineral water springs, a swimming pool and a brook. The total of reported cases of waterborne diseases was 1655, 356 hospitalisations and ten deaths due to legionellosis were recorded. The highest number of outbreaks (7) as well as the highest number of cases (841) were reported in 1997. Comparison of two five-year periods, i.e. 1996-2000 and 2001-2005, showed a nearly one third decrease in the total of outbreaks and a half reduction in the total of cases in the latter. In view of the limited length of monitoring, it is not possible to say with certainty whether it is a random distribution or an actual trend. Almost two thirds of cases were diagnosed as acute gastroenteritis of probable infectious origin and other frequent waterborne diseases were viral hepatitis A and bacillary dysentery.
When analyzing the described outbreaks, it should be taken into account that only the diagnosed and reported outbreak cases are covered, while the actual number of cases is likely to be underreported. Although no evidence is available that any vast and serious waterborne diseases outbreaks escaped reporting, some small and less serious outbreaks may have occurred unnoticed. In the future, the diagnosis, investigation and evaluation of waterborne diseases outbreaks should be improved, among others by implementing an evidence-based classification system and issuing regular surveys of outbreaks and their causes which would be helpful in preventing failures in other similar water sources.
Key words:
outbreak – waterborne diseases – source of infection – drinking water sources.
Zdroje
1. CDC. Surveillance for Waterborne-Disease Outbreaks – United States, 1993-1994. MMWR, 1996, 45(SS-1), 1-33.
2. Craun, G. F., Frost, F. J., Calderon, R. L., Hilborn E.D. et al. Improving waterborne disease outbreak investigations. Int J Environ. Health Res, 2001, 11 , 229-243.
3. Eisenberg, J.N.S, Bartram, J., Hunter, P.R. A public health perspective for establishing water-related guidelines and standards. In: Fewtrell, L. and Bartram, J. (eds) Water Quality. Guidelines, standards and health: assessment of risk and risk management for water-related infectious disease. P. 229-256. IWA Publishing, WHO and Swedish Institute for Infectious Disease Control, London 2001.
4. Frost, F. J., Braun, G. F., Calderon, R. L. Waterborne disease surveillance. JAWWA, 1996, 88(9), 66-75.
5. Göpfertová, D., Pazdiora, P., Dáňová, J. Epidemiologie infekčních nemocí. Nakladatelství Karolinum, 2002.
6. Helcl, J., Brabcová, A. Epidemie virové hepatitidy typu A vodního původu v ČR. Čs. hygiena, 1990, 35(6), 347-354.
7. Hrudey, S. E., Hrudey, E. J. Safe drinking water. Lessons from recent outbreaks in affluent nations. IWA Publishing, London 2004.
8. Hunter, P.R., Andersson, Y., Von Bonsdorff, C.H. et al. Surveillance and investigation of contamination incidents and waterborne outbreaks. In: Dufour, A., Snozzi, M., Koster, W., Bartram, J., Ronchi, E., Fewtrell, L. (eds.). Assessing microbial safety of drinking water: improving approaches and methods. P. 205-236. IWA Publishing (on behalf of the OECD and the WHO), London 2003.
9. Kožíšek, F., Pumann, P., Javoříková, E., Procházková P. Nemoci a epidemie spojené s koupáním v České republice. Hygiena, 2008, 53(3), 108-109.
10. Miettinen, I. T., Zacheus, O., Pitkänen, T., Kuusi, M. et al. Waterborne outbreaks in Finland. Proceedings of the Symposium on Health-Related Water Microbiology, Swansea, UK 5-9.9.2005, 39-40.
11. Payment, P., Richardson, L., Siemiatycki, J., Dewar, R. et al. A randomized trial to evaluate the risk of gastrointestinal disease due to consumption of drinking water meeting current microbiological standards. Am J Public Health, 1991, 81, 703-708.
12. Pazdiora, P., Morávková, I., Nocarová, D., Velkoborská, M. et al. Vodní epidemie tularémie v Chlumčanech. Epidemiol Mikrobiol Imunol, 2002, 51(1): 23-25.
13. Protokol o vodě a zdraví k Úmluvě o ochraně a využívání hraničních vodních toků a mezinárodních jezer z roku 1992. .
14. Said, B., Wright, F., Nichols, G. L., Reacher, M. et al. Outbreaks of infectious disease associated with private drinking water supplies in England and Wales 1970-2000. Epidemiol Infect, 2003, 130, 469-479.
15. Sattranová, L., Nožička, J. Epidemie “Zátoň”. Zprávy CEM, č. 6/1998, str. 224-226.
16. Schuster, C. J., Ellis, A. G., Robertson, W. J., Charron, D. F. et al. Infectious Disease Outbreaks Related to Drinking Water in Canada, 1974-2001. Can J Public Health, 2005, 96(4), 254-258.
17. Tillett, H. E., Louvois, J., Wall, P. G. Surveillance of outbreaks of waterborne infectious disease: categorizing levels of evidence. Epidemiol Infect, 1998, 120, 37-42.
18. Vlašimská, H., Kolář, J. Zpráva „Zhodnocení rizika vodou přenosných epidemií a parazitóz a z toho vyplývající komunálně hygienická opatření“. KHS Středočeského kraje, 1991.
19. Zítek, K., Beneš, Č. Epidemie povodňové leptospirózy. Zprávy CEM, 1998, 7(4), 160-165.
Štítky
Hygiene and epidemiology Medical virology Clinical microbiologyČlánok vyšiel v časopise
Epidemiology, Microbiology, Immunology
2009 Číslo 3
Najčítanejšie v tomto čísle
- Use of PCR in Diagnosis of Enteroviral Infections
- Apitherapy – the Role of Honey in the Chronic Wound Healing Process
- Waterborne Diseases Outbreaks in the Czech Republic, 1995-2005
- Serological Characteristics of Hantaviruses from Clinical Specimens Analyzed in 1998-2008 in the Department of Virology, Public Health Institute, Ostrava