Two Drinking Water Outbreaks Caused by Wastewater Intrusion Including Sapovirus in Finland.

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2019
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Abstract
Drinking water outbreaks occur worldwide and may be caused by several factors, including raw water contamination, treatment deficiencies, and distribution network failure. This study describes two drinking water outbreaks in Finland in 2016 (outbreak I) and 2018 (outbreak II). Both outbreaks caused approximately 450 illness cases and were due to drinking water pipe breakage and subsequent wastewater intrusion into the distribution system. In both outbreaks, the sapovirus was found in patient samples as the main causative agent. In addition, adenoviruses and (outbreak I), and noroviruses, astroviruses, enterotoxigenic and enterohemorragic (ETEC and EHEC, respectively) and (outbreak II) were detected in patient samples. Water samples were analyzed for the selected pathogens largely based on the results of patient samples. In addition, traditional fecal indicator bacteria and host-specific microbial source tracking (MST) markers (GenBac3 and HF183) were analyzed from water. In drinking water, sapovirus and enteropathogenic (EPEC) were found in outbreak II. The MST markers proved useful in the detection of contamination and to ensure the success of contaminant removal from the water distribution system. As mitigation actions, boil water advisory, alternative drinking water sources and chlorination were organized to restrict the outbreaks and to clean the contaminated distribution network. This study highlights the emerging role of sapoviruses as a waterborne pathogen and warrants the need for testing of multiple viruses during outbreak investigation.
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kauppinen2019twointernational Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Kauppinen, Ari;Pitkänen, Tarja;Al-Hello, Haider;Maunula, Leena;Hokajärvi, Anna-Maria;Rimhanen-Finne, Ruska;Miettinen, Ilkka T;
Journal International journal of environmental research and public health
Year 2019
DOI
E4376
URL
Keywords
contamination wastewater enteric viruses fecal indicators drinking water microbial source tracking dientamoeba fragilis sapovirus waterborne outbreak

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