title: Faecal contamination of a municipal drinking water distribution system in association with Campylobacter jejuni infections.
abstract: After heavy rains Campylobacter jejuni together with high counts of Escherichia coli, other coliforms and intestinal enterococci were detected from drinking water of a municipal distribution system in eastern Finland in August 2004. Three patients with a positive C. jejuni finding, who had drunk the contaminated water, were identified and interviewed. The pulsed-field gel electrophoresis (PFGE) genotypes from the patient samples were identical to some of the genotypes isolated from the water of the suspected contamination source. In addition, repetitive DNA element analysis (rep-PCR) revealed identical patterns of E. coli and other coliform isolates along the distribution line. Further on-site technical investigations revealed that one of the two rainwater gutters on the roof of the water storage tower had been in an incorrect position and rainwater had flushed a large amount of faecal material from wild birds into the drinking water. The findings required close co-operation between civil authorities, and application of cultivation and genotyping techniques strongly suggested that the municipal drinking water was the source of the infections. The faecal contamination associated with failures in cleaning and technical management stress the importance of instructions for waterworks personnel to perform maintenance work properly.
authors.affiliation: Department of Environmental Health, National Public Health Institute (KTL), Laboratory of Environmental Microbiology, P.O. Box 95, FI-70701 Kuopio, Finland. Tarja.Pitkanen@ktl.fi
authors.forename: Tarja
authors.initials: T
authors.lastname: Pitkänen
authors.forename: Ilkka T
authors.initials: IT
authors.lastname: Miettinen
authors.forename: Ulla-Maija
authors.initials: UM
authors.lastname: Nakari
authors.forename: Johanna
authors.initials: J
authors.lastname: Takkinen
authors.forename: Kalle
authors.initials: K
authors.lastname: Nieminen
authors.forename: Anja
authors.initials: A
authors.lastname: Siitonen
authors.forename: Markku
authors.initials: M
authors.lastname: Kuusi
authors.forename: Arja
authors.initials: A
authors.lastname: Holopainen
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Hänninen
mesh_terms: D002169:Campylobacter Infections / Q000453:epidemiology*; D016123:Campylobacter jejuni / Q000302:isolation & purification*; D002947:Cities / Q000453:epidemiology; D004326:Drinking; D005243:Feces / Q000382:microbiology*; D005387:Finland / Q000453:epidemiology; D005618:Fresh Water / Q000382:microbiology*; D006801:Humans; D007407:Interviews as Topic; D014871:Water Microbiology