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Increase in outbreaks of gastroenteritis linked to bathing water in Finland in summer 2014
- Ari Kauppinen1 , Haider Al-Hello2 , Outi Zacheus1 , Jaana Kilponen3 , Leena Maunula4 , Sari Huusko5 , Maija Lappalainen6 , Ilkka Miettinen1 , Soile Blomqvist2 , Ruska Rimhanen-Finne5
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View Affiliations Hide AffiliationsAffiliations: 1 National Institute for Health and Welfare, Department of Health Security, Water and Health Unit, Kuopio, Finland 2 National Institute for Health and Welfare, Department of Health Security, Viral Infections Unit, Helsinki, Finland 3 National Supervisory Authority for Welfare and Health, Helsinki, Finland 4 University of Helsinki, Faculty of Veterinary Medicine, Department of Food Hygiene and Environmental Health, Helsinki, Finland 5 National Institute for Health and Welfare, Department of Health Security, Infectious Disease Control Unit, Helsinki, Finland 6 Helsinki University Hospital, Laboratory Services (HUSLAB), Department of Clinical Microbiology, Helsinki, FinlandAri Kauppinenari.kauppinen thl.fi
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Citation style for this article: Kauppinen Ari, Al-Hello Haider, Zacheus Outi, Kilponen Jaana, Maunula Leena, Huusko Sari, Lappalainen Maija, Miettinen Ilkka, Blomqvist Soile, Rimhanen-Finne Ruska. Increase in outbreaks of gastroenteritis linked to bathing water in Finland in summer 2014. Euro Surveill. 2017;22(8):pii=30470. https://doi.org/10.2807/1560-7917.ES.2017.22.8.30470 Received: 26 May 2016; Accepted: 21 Sept 2016
Abstract
An increased number of suspected outbreaks of gastroenteritis linked to bathing water were reported to the Finnish food- and waterborne outbreak (FWO) registry in July and August 2014. The investigation reports were assessed by a national outbreak investigation panel. Eight confirmed outbreaks were identified among the 15 suspected outbreaks linked to bathing water that had been reported to the FWO registry. According to the outbreak investigation reports, 1,453 persons fell ill during these outbreaks. Epidemiological and microbiological data revealed noroviruses as the main causative agents. During the outbreaks, exceptionally warm weather had boosted the use of beaches. Six of eight outbreaks occurred at small lakes; for those, the investigation strongly suggested that the beach users were the source of contamination. In one of those eight outbreaks, an external source of contamination was identified and elevated levels of faecal indicator bacteria (FIB) were noted in water. In the remaining outbreaks, FIB analyses were insufficient to describe the hygienic quality of the water. Restrictions against bathing proved effective in controlling the outbreaks. In spring 2015, the National Institute for Health and Welfare (THL) and the National Supervisory Authority for Welfare and Health (Valvira) published guidelines for outbreak control to prevent bathing water outbreaks.
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