Contaminated water caused the first outbreak of giardiasis in Finland, 2007: A descriptive study

Abstract

The severe sewage contamination of a drinking water distribution network affected inhabitants in the town of Nokia, Finland in November 2007–February 2008. One of the pathogens found in patient and environmental samples was Giardia, which for the first time was detected as the causal agent of an outbreak in Finland. To describe the existence and the importance of Giardia infections related to this outbreak, we described characteristics of the giardiasis cases and calculated the incidence of giardiasis as well as the frequency of positive Giardia tests both before and during the outbreak. Persons reported to the Finnish Infectious Disease Registry (FIDR) with Giardia infections were interviewed. The number of persons tested for Giardia was obtained from the Centre for Laboratory Medicine at the Tampere University Hospital. The investigations provided strong evidence that Giardia infections in Nokia resulted from the contaminated water. The proportion of persons testing positive for Giardia and the incidence of giardiasis multiplied during the outbreak. To improve outbreak management, national guidelines on testing environmental samples for Giardia should be developed, and further resources should be allocated to both clinical and environmental laboratories that perform parasitological analyses.

Acknowledgements

We thank the following persons for their assistance in the investigation: Pia Sainio for conducting the telephone interviews, and Outi Lepistö, Markku Mäkiranta and Sami Kallioinen for the water, wastewater and biofilm sampling. Funding was provided by the National Institute for Health and Welfare and Helsinki University Central Hospital Research Funds.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.