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[ZD04] Outbreaks of waterborne diseases (epidemics)
Impacts

Key message
Neutral

Slovenia reported one to three waterborne outbreaks per year during 2011–2021, except in 2015 and 2017– 2020, when no outbreaks were reported. In these waterborne outbreaks, 3 to 355 cases were reported. In about half of the outbreaks, the causative agent has not been identified, while in others the following causative agents have been confirmed: Cryptosporidium parvum, Escherichia coli, rotavirus, norovirus, Bacillus cereus, Campylobacter jejuni, Salmonella Typhimurium, Francisella tularensis were identified.

This indicator shows the number of received reports of infections of the gastrointestinal tract that can be transmitted via drinking water. The source of infection is microbiological (via faeces) contamination of drinking water; consequently, the indicator is a sign of drinking water quality.

An outbreak attributable to water is the occurrence of a infectious disease transmitted via contaminated drinking water that is greater than would otherwise be expected at a particular time and place and in the number of affected individuals; as well, at least two people will show similar clinical symptoms and an epidemiological picture shows that water is a probable source of infection. Outbreaks are sudden and affect individuals using drinking water from the same source or area. The disease may affect all age groups. Outbreaks are not season-related, although they may be influenced by meteorological conditions (abundant rain, snow melt) and disruptions in the treatment and distribution of drinking water as well as by management of water protection areas and compliance with protection regimes within such areas.

Charts

Figure ZD04-1: Number of waterborne disease outbreaks associated with contaminated drinking water, Slovenia, 2011-2021
Sources:

NIJZ, 2011-2021 (17. 10. 2022)

Show data
Celje[No.] Koper[No.] Kranj[No.] Ljubljana[No.] Maribor[No.] Murska Sobota[No.] Nova Gorica[No.] Novo mesto[No.] Ravne na Koroškem[No.] Total[No.]
2011 0 0 1 1 1 0 0 0 0 3
2012 0 0 0 1 0 0 0 0 0 1
2013 0 0 1 0 0 0 0 0 0 1
2014 0 0 0 1 0 0 0 0 0 1
2015 0 0 0 0 0 0 0 0 0 0
2016 0 0 0 1 0 0 0 0 1 2
2017 0 0 0 0 0 0 0 0 0 0
2018 0 0 0 0 0 0 0 0 0 0
2019 0 0 0 0 0 0 0 0 0 0
2020 0 0 0 0 0 0 0 0 0 0
2021 0 0 0 0 0 0 1 0 0 1
Figure ZD04-2: Number of cases in waterborne disease outbreaks, Slovenia, 2011-2021
Sources:

NIJZ, 2011-2021 (17. 10. 2022)

Show data
Celje[No.] Koper[No.] Kranj[No.] Ljubljana[No.] Maribor[No.] Murska Sobota[No.] Nova Gorica[No.] Novo mesto[No.] Ravne na Koroškem[No.] Total[No.]
2011 0 0 91 152 20 0 0 0 0 263
2012 0 0 0 44 0 0 0 0 0 44
2013 0 0 9 0 0 0 0 0 0 9
2014 0 0 0 5 0 0 0 0 0 5
2015 0 0 0 0 0 0 0 0 0 0
2016 0 0 0 50 0 0 0 0 355 405
2017 0 0 0 0 0 0 0 0 0 0
2018 0 0 0 0 0 0 0 0 0 0
2019 0 0 0 0 0 0 0 0 0 0
2020 0 0 0 0 0 0 0 0 0 0
2021 0 0 0 0 0 0 3 0 0 3
Figure ZD04-3: Percentage of all gastrointestinal illnesses (GI) where etiologic agent was not identified, among all reported GI and percentage of all gastrointestinal illness (GI) where etiologic agent was not identified, among all reported communicable diseases, Slovenia, 2011-2021
Sources:

Computer program SURVIVAL, NIJZ 2011-2021 (17. 10. 2022)

Show data
Percentage of infectious diarrhoea (ICD10: A09, A04.9, A05.9, A08.4) with unconfirmed agent to all reported infectious diarrhoea[%] Percentage of infectious diarrhoea (ICD10: A09, A04.9, A05.9, A08.4) with unconfirmed agent to all reported contagious infectious diarrhoea[%]
2011 69.90 21.40
2012 72.90 20.40
2013 70.30 19.70
2014 70.50 21.90
2015 66 25
2016 63.50 23.30
2017 65 24.70
2018 0 0
2019 0 0
2020 0 0
2021 0 0
Figure ZD04-4: Number of waterborne disease outbreaks in some EU countries, 2008-2013
Sources:

WHO, ENHIS, 2015 (17. 10. 2022)

Show data
2008[No.] 2009[No.] 2010[No.] 2011[No.] 2012[No.] 2013[No.] 2008-2013[No.]
Austria 1 1
Belgium 1 1 2
Denmark 1 2 1 4
Finland 1 1 6 2 2 12
France 3 4 1 8
Greece 1 2 3
Hungary 1 1
Ireland 3 4 1 3 11 2 24
Poland 1 3 4
Slovenia 1 1 3 1 1 7
Spain 2 2 4
Sweden 1 2 5 1 9
United Kingdom 1 1 2
Figure ZD04-5: Number of cases, waterborne outbreaks in some EU countries, 2008-2013
Sources:

ECDC, EFSA  (17. 11. 2022)

Show data
2008[No.] 2009[No.] 2010[No.] 2011[No.] 2012[No.] 2013[No.] 2008-2013[No.]
Austria 2 2
Belgium 3000 64 3064
Denmark 500 800 183 1483
Finland 191 17 78 245 214 745
France 26 45 6 77
Greece 60 631 691
Hunagry 597 597
Ireland 14 8 50 25 54 26 177
Poland 6 67 73
Slovenia 170 52 263 44 9 538
Spain 10 18 28
Sweden 2000 177 13755 20000 35932
United Kingdom 44 39 83

Goals

  • To provide access to safe drinking water and adequate water treatment to all inhabitants of Slovenia.
  • To improve the microbiological quality of drinking water in Slovenia, especially with regard to faecal pollution and particularly in small systems and areas with karst drinking water sources, which are classified as surface drinking water sources from the perspective of public health.
  • It is essential that an overall management strategy is im-plemented in which multiple barriers, including source water protection and appropriate treatment processes, as well as protection during storage and distribution, are used in conjunction with disinfection to prevent or remove microbial contamination.
  • To ensure, early-as-possible detection, information, management and reduction of the number of cases of outbreaks of waterborne acute gastroenterocolitis of unknown etiology;
  • To analyse causes and eliminate mistakes in treatment and management of outbreaks on the basis of experience. In each outbreak, efforts should be made to improve treatment and management methods, which should serve as useful experience in the future.

     

Methodology

Date of data source summarization
Last modified
17.10.2022
Author(s)

Ivanka Gale, MD, spec. hygiene and of public health, Maja Praprotnik, dipl.san.ing., mag. Eva Grilc, MD, spec. of public health, National Institute of Public Heath (NIJZ)