Abstract
During June 2019, an outbreak of campylobacteriosis occurred in Askøy, an island northwest of Bergen, Norway. According to the publicly available records, over 2000 residents fell ill and 76 were hospitalised, and two deaths were suspected to be associated with Campylobacter infection. By investigating the epidemic pattern and scope, an old caved drinking water holding pool was identified that had been faecally contaminated as indicated by the presence of Escherichia coli (E. coli). Furthermore, Campylobacter bacteria were found at several points in the water distribution system. In the escalated water health crisis, tracking down the infectious source became pivotal for the local municipality in order to take prompt and appropriate action to control the epidemic. A major task was to identify the primary faecal pollution source, which could further assist in tracking down the epidemic origin. Water from the affected pool was analysed using quantitative microbial source tracking (QMST) applying host-specific Bacteroidales 16S rRNA genetic markers. In addition, Campylobacter jejuni, Enterococcus faecalis, Clostridium perfringens and Shiga toxin-producing E. coli were detected. The QMST outcomes revealed that non-human (zoogenic) sources accounted predominantly for faecal pollution. More precisely, 69% of the faecal water contamination originated from horses.
Highlights
Campylobacter is one of four global causative agents of diarrhoeal diseases (WHO, 2018); it has been considered as the most common bacterial pathogen to cause human gastroenteritis, as reported in the USA during 2004–2012, it has caused 1.3 million illnesses annually, 13,240 admissions to hospital and 119 deaths (Geissler et al, 2017)
We report the results of faecal source tracking conducted during the drinking water health crisis targeted in the Askøy municipality in June 2019, which happened to be by far the largest waterborne Campylobacter outbreak in history registered in Norway
The results are reported solely in the original version by the authors who were commissioned by the Askøy municipality to investigate the contaminated water by applying DNA-based markers for quantitative microbial source tracking (QMST) of faecal origin and pollution sources
Summary
Campylobacter is one of four global causative agents of diarrhoeal diseases (WHO, 2018); it has been considered as the most common bacterial pathogen to cause human gastroenteritis, as reported in the USA during 2004–2012, it has caused 1.3 million illnesses annually, 13,240 admissions to hospital and 119 deaths (Geissler et al, 2017). Most well developed and validated genetic markers are derived from Bacteroidales 16S rRNA genes, which exhibit high species distinction between variant hosts (Haramoto and Osada, 2018; Xue and Feng, 2019) Such a host-specific feature enables discriminating primary faecal sources of anthropogenic or zoogenic origins. We report the results of faecal source tracking conducted during the drinking water health crisis targeted in the Askøy municipality in June 2019, which happened to be by far the largest waterborne Campylobacter outbreak in history registered in Norway. The results are reported solely in the original version by the authors who were commissioned by the Askøy municipality to investigate the contaminated water by applying DNA-based markers for quantitative microbial source tracking (QMST) of faecal origin and pollution sources
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