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Outbreaks of waterborne infectious intestinal disease in England and Wales, 1992–2003

Published online by Cambridge University Press:  11 May 2006

A. SMITH
Affiliation:
Health Protection Agency, Centre for Infections London, UK
M. REACHER
Affiliation:
Health Protection Agency, Centre for Infections London, UK
W. SMERDON
Affiliation:
Health Protection Agency, Centre for Infections London, UK
G. K. ADAK
Affiliation:
Health Protection Agency, Centre for Infections London, UK
G. NICHOLS
Affiliation:
Health Protection Agency, Centre for Infections London, UK
R. M. CHALMERS
Affiliation:
Cryptosporidium Reference Unit, NPHS Microbiology Swansea, Singleton Hospital, Sketty, Swansea, UK
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Abstract

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We reviewed the epidemiological and microbiological characteristics of 89 reported outbreaks of waterborne infectious intestinal disease affecting 4321 people in England and Wales over the period 1992–2003. Public water supplies were implicated in 24 outbreaks (27%), private water supplies in 25 (28%), swimming pools in 35 (39%) and other sources in five outbreaks (6%). Cryptosporidium was implicated in 69% of outbreaks, Campylobacter sp. in 14%, Giardia in 2%, E. coli O157 in 3% and Astrovirus in 1%. From 2000, there was a consistent decline in the number of outbreaks of waterborne disease associated with public water supplies. The incidence rate of outbreaks in recipients of private water supplies may be as high as 35 times the rate in those receiving public water supplies (1830 vs. 53 per million population). Private water suppliers need to be aware of the importance of adequate treatment and the prevention of faecal contamination of storage water. Swimming-pool operators need to ensure chlorination and in particular adequate filtration measures are in place.

Type
Review Article
Copyright
2006 Cambridge University Press