Gastroenteritis Outbreaks after Contamination of Water Supply Systems: Public Health Response Gaps and Challenges, Greece, 2004–2023

Theologia Sideroglou, Anthi Chrysostomou, Lida Politi, Leonidas Georgalis and Kassiani Mellou ()
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Theologia Sideroglou: Department of Foodborne and Waterborne Diseases, Directorate of Surveillance and Prevention of Infectious Diseases, National Public Health Organization, 15123 Athens, Greece
Anthi Chrysostomou: Department of Foodborne and Waterborne Diseases, Directorate of Surveillance and Prevention of Infectious Diseases, National Public Health Organization, 15123 Athens, Greece
Lida Politi: Department of Microbial Resistance and Infections in Health Care Settings, Directorate of Surveillance and Prevention of Infectious Diseases, National Public Health Organization, 15123 Athens, Greece
Leonidas Georgalis: Department of Foodborne and Waterborne Diseases, Directorate of Surveillance and Prevention of Infectious Diseases, National Public Health Organization, 15123 Athens, Greece
Kassiani Mellou: Directorate of Surveillance and Prevention of Infectious Diseases, National Public Health Organization, 15123 Athens, Greece

IJERPH, 2024, vol. 21, issue 6, 1-11

Abstract: Background: waterborne disease outbreaks (WGDOs) following the contamination of drinking water remain a public health concern. Methods: The current study aims to assess the occurrence and identify gaps in the notification and investigation of WGDOs in Greece. Data for 2004–2023 were retrieved and summarized. Results: Thirty-five outbreaks with 6128 recorded cases were identified. The median time from the date of onset in the first cases to reporting was 7 days (range: 1–26 days). Authorities were informed by health care services in thirty (85.7%) outbreaks and by the media in five (14.3%). The investigation methods used varied. An analytical study was conducted in nine (25.7%) outbreaks and the testing of clinical samples in twenty-seven (77.1%). In three (11.1%) outbreaks, clinical samples were simultaneously tested for multiple bacteria, viruses, and parasites. Water samples were collected in nineteen (54.3%) outbreaks (in three after chlorination) with a mean time lag of 5 days (range: 1–20 days) from the first cases. A pathogen in clinical samples was identified in 20 (57.1%) outbreaks and, in 1 (6.25%), the same microorganism was isolated in both clinical and water samples. Conclusions: delays in reporting and the heterogeneity of investigations depict that the surveillance of WGDOs and response practices should be strengthened, and operational procedures should be standardised.

Keywords: investigation; gastroenteritis outbreak; surveillance; waterborne; public health; Greece (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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