A Hydric Outbreak in a Municipal Drinking – Water Supply in Kruja, Albania

Dritan Ulqinaku; Oltiana Petri; Erjona Abazaj; Rovena Daja

doi:10.3889/oamjms.2022.8827

Authors

Dritan Ulqinaku Department of Infection Disease and Epidemiology, Institute of Public Health, Tirana, Albania
Oltiana Petri Department of Infection Disease and Epidemiology, Institute of Public Health, Tirana, Albania
Erjona Abazaj Department of Infection Disease and Epidemiology, Institute of Public Health, Tirana, Albania https://orcid.org/0000-0003-2386-4605
Rovena Daja Department of Infection Disease and Epidemiology, Institute of Public Health, Tirana, Albania

DOI:

https://doi.org/10.3889/oamjms.2022.8827

Keywords:

Contaminated drinking water, Kruja, Epidemiologic data, Albania

Abstract

BACKGROUND: Contaminated drinking water causes extensive outbreaks of illness because of the large number of people served by water supply facility.

AIM: The present study describes a community epidemic outbreak of infection with multiple pathogens in Kruja city, Albania, in October 2021.

METHODS: This descriptive study presents a case of epidemic outbreak caused by the hydric system in the inhabitants of the Kruja city from October 23, 2021 to October 29, 2021. A standard questionnaire was used for interview that addressed clinical symptoms, food consumption, and environmental exposures. Clinical specimens were cultured using standard microbiological methods for bacterial and viral pathogens. During 6 days of epidemy, 690 patients were treated to the emergency room of Kruje hospital.

RESULTS: Day 3 presented the highest number of patients 39.1% (270/690) and the last day of epidemy presented the lowest number of patients 1.4% (10/690). Abdominal pain continuing with vomiting was more frequently clinical sign among patients. The most affected age group is 15–44 years old, which is also the most active age group. Salmonella Gr. B and Norovirus G2 were the results taken from the examination of stool samples. Analysis of a water sample resulted in Enterococcus faecalis contamination.

CONCLUSION: Problems with drinking water are still present in our country. The latest outbreak shows the special care and importance of safe storage and distribution of drinking water. Investments in water supply as well as rigorous monitoring of drinking water should be an absolute priority of both public health and local government employees.

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References

Kauppinen A, Pitkänen T, Al-Hello H, Maunula L, Hokajärvi AM, Rimhanen-Finne R, et al. Two drinking water outbreaks caused by wastewater intrusion including sapovirus in Finland. Int J Environ Res Public Health. 2019;16(22):4376. https://doi.org/10.3390/ijerph16224376 PMid:31717479 DOI: https://doi.org/10.3390/ijerph16224376

Funari E, Kistemann T, Herbst S, Rechenburg A. Technical Guidance on Water-related Disease Surveillance. Copenhagen: WHO Regional Office for Europe; 2011. Available from: http://www.euro.who.int/en/publications/abstracts/technical-guidance-onwater-related-disease-surveillance-2011. [Last accessed on 2021 May 25].

Dufour A, Snozzi M, Koster W, Bartram J, Ronchi E, Fewtrell L. Assessing Microbial Safety of Drinking Water: Improving Approaches and Methods. London: IWA Publishing; 2003. Available from: https://www.who.int/water_sanitation_health/publications/9241546301/en. [Last accessed on 2021 May 25].

World Health Organization. Water Safety in Distribution Systems. Geneva: World Health Organization; 2014. Available from: https://www.who.int/water_sanitation_health/publications/water-safety-in-distribution-system/en. [Last accessed on 2021 May 25].

Gallay A, De Valk H, Cournot M, Ladeuil B, Hemery C, Castor C, et al. A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, France, 2000. Clin Microbiol Infect. 2006;12(6):561-70. https://doi.org/10.1111/j.1469-0691.2006.01441.x PMid:16700706 DOI: https://doi.org/10.1111/j.1469-0691.2006.01441.x

Mellou K, Katsioulis A, Potamiti-Komi M, Pournaras S, Kyritsi M, Katsiaflaka A, et al. A large waterborne gastroenteritis outbreak in central Greece, March 2012: Challenges for the investigation and management. Epidemiol Infect. 2014;142(1):40-50. https://doi.org/10.1017/S0950268813000939 PMid:23632123 DOI: https://doi.org/10.1017/S0950268813000939

World Health Organization. Guidelines for Drinking Water Quality. 4th ed. Geneva: World Health Organization; 2011. Available from: https://www.who.int/water_sanitation_health/publications/2011/dwq_guidelines/en. [Last accessed on 2021 May 25].

Kramer MH, Herwaldt BL, Craun GF, Calderon RL, Ju-ranek DD. Surveillance for waterborne-disease outbreaks--United States, 1993-94. MMWR CDC Surveill Summ. 1996;45(1):1-33. PMid:8600346

Hedberg C, Osterholm M. Outbreaks of food-borne and water borne viral gastroenteritis. Clin Microbiol Rev. 1993;6(3):199-210. https://doi.org/10.1128/CMR.6.3.199 PMid:8395330 DOI: https://doi.org/10.1128/CMR.6.3.199

Jungsun P, Seok JK, Soojin K, Eunkyung S, Kyung-Hwan OH, Yonghoon K, et al. A waterborne outbreak of multiple diarrhoeagenic Escherichia coli infections associated with drinking water at a school camp. Int J Infect Dis. 2018;66:45-50. https://doi.org/10.1016/j.ijid.2017.09.021 PMid:29031605 DOI: https://doi.org/10.1016/j.ijid.2017.09.021

Humphrey T, O’Brien S, Madsen M. Campylobacters as zoonotic pathogens: A food production perspective. Int J Food Microbiol. 2007;117(3):237-57. https://doi.org/10.1016/j.ijfoodmicro.2007.01.006 PMid:17368847 DOI: https://doi.org/10.1016/j.ijfoodmicro.2007.01.006

Wallender EK, Ailes EC, Yoder JS, Roberts VA, Brunkard JM. Contributing factors to disease outbreaks associated with untreated groundwater. Ground Water. 2014;52(6):886-97. https://doi.org/10.1111/gwat.12121 PMid:24116713 DOI: https://doi.org/10.1111/gwat.12121

Braeye TK, Schrijver K, De Wollants E, Van Ranst M, Verhaegen J. A large community outbreak of gastroenteritis associated with consumption of drinking water contaminated by river water, Belgium, 2010. Epidemiol Infect. 2015;143(4):711-9. https://doi.org/10.1017/s0950268814001629 PMid:25062494 DOI: https://doi.org/10.1017/S0950268814001629

Riera-Montes M, Brus Sjolander K, Allestam G, Hallin E, Hedlund KO, Lofdahl M. Waterborne norovirus outbreak in a municipal drinking-water supply in Sweden. Epidemiol Infect. 2011;139(12):1928-35. https://doi.org/10.1017/S0950268810003146 PMid:21251349 DOI: https://doi.org/10.1017/S0950268810003146

Doron S, Gorbach SL. Bacterial infections: Overview. Int Encyclop Public Health. 2008:273-82. https://doi.org/10.1016/B978-012373960-5.00596-7 DOI: https://doi.org/10.1016/B978-012373960-5.00596-7