Epidemiology and Infection

A large outbreak of campylobacteriosis associated with a municipal water supply in Finland 1

M. KUUSI a1c1, J. P. NUORTI a1, M.-L. HÄNNINEN a2, M. KOSKELA a3, V. JUSSILA a4, E. KELA a1, I. MIETTINEN a5 and P. RUUTU a1
a1 Department of Infectious Disease Epidemiology, National Public Health Institute, Helsinki, Finland
a2 Department of Food and Environmental Hygiene, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
a3 Department of Microbiology, University Central Hospital of Oulu, Oulu, Finland
a4 Municipal Health Centre of Haukipudas, Haukipudas, Finland
a5 Department of Environmental Health, National Public Health Institute, Kuopio, Finland

Article author query
kuusi m   [PubMed][Google Scholar] 
nuorti jp   [PubMed][Google Scholar] 
hanninen ml   [PubMed][Google Scholar] 
koskela m   [PubMed][Google Scholar] 
jussila v   [PubMed][Google Scholar] 
kela e   [PubMed][Google Scholar] 
miettinen i   [PubMed][Google Scholar] 
ruutu p   [PubMed][Google Scholar] 


In August 1998, an outbreak of campylobacteriosis occurred in one municipality in northern Finland. A 10% random sample of residents (population 15000) was selected through the National Population Registry for a survey conducted by using postal questionnaires. Cases were defined as residents of the municipality with onset of acute gastroenteritis from 1 to 20 August 1998. Of 1167 respondents (response rate 78%), 218 (18·7%) met the case definition. Drinking non-chlorinated municipal tap water was strongly associated with illness (OR 34·4). The estimated total number of ill persons was 2700. Campylobacter jejuni was isolated from stool samples of 45 (61%) out of 74 patients tested. All five isolates tested had indistinguishable PFGE patterns. Water samples were negative for campylobacter and coliforms. Epidemiological and environmental evidence suggested mains repair as the source of contamination. Non-chlorinated ground-water systems may be susceptible to contamination and can cause large outbreaks.

(Accepted December 15 2004)

c1 Department of Infectious Disease Epidemiology, National Public Health Institute, Mannerheimintie 166, 00300 Helsinki, Finland. (Email: markku.kuusi@ktl.fi)


1 Presented in part at the 38th Annual Meeting of the Infectious Disease Society of America (IDSA), New Orleans, 2000.