Nygård Karin, Gondrosen Bjørn, Lund Vidar
Divisjon for smittevern, Nasjonalt folkehelseinstitutt, Postboks 4404 Nydalen, 0403 Oslo.
Tidsskr Nor Laegeforen. 2003 Dec 4;123(23):3410-3.
The drinking water in Norway has traditionally been considered being of good quality. However, outbreaks related to drinking water are reported every year. We review waterborne outbreaks in Norway over the last 15 years, and describe the aetiology of and contributory factors in these outbreaks.
We compiled data on waterborne outbreaks reported to the Norwegian Institute of Public Health and Norwegian Food Control Authority during 1988-2002. We included all events in which two or more people fell ill and water was the suspected source of infection.
Over the 15-year period. 72 outbreaks were reported, affecting a total of 10 616 persons. Campylobacter was the cause in 26% (19/72) of the outbreaks, norovirus in 18% (13/72). The causative organism was unknown in 46% (33/72). The water came from public waterworks in 32 of the 54 outbreaks for which this information was available (59%); from a private supply in the remaining 22. For 62% (16/26) of the outbreaks related to waterworks, the water was not disinfected before distribution. None of the private water supplies were disinfected. Over the last five years, there were more outbreaks related to private supplies.
The most important contributory factor to waterborne outbreaks in Norway is contamination of the raw water combined with missing or faulty disinfecting procedures. To prevent future outbreaks, a continuous upgrading of small and private water supplies is needed. Reporting of outbreaks is important for the implementation of targeted and effective preventive measures.
挪威的饮用水传统上被认为质量良好。然而，每年都有与饮用水相关的疫情报告。我们回顾了挪威过去15年的水源性疫情，并描述了这些疫情的病因和促成因素。
我们收集了1988 - 2002年期间向挪威公共卫生研究所和挪威食品控制局报告的水源性疫情数据。我们纳入了所有有两人或两人以上患病且水被怀疑为感染源的事件。
在这15年期间，共报告了72起疫情，总计影响10616人。弯曲杆菌是26%（19/72）疫情的病因，诺如病毒是18%（13/72）疫情的病因。46%（33/72）的疫情致病生物未知。在可获得此信息的54起疫情中，有32起（59%）的水来自公共供水厂；其余22起来自私人供水。在与供水厂相关的疫情中，62%（16/26）的水在分发前未进行消毒。所有私人供水均未消毒。在过去五年中，与私人供水相关的疫情更多。
挪威水源性疫情的最重要促成因素是原水受到污染以及消毒程序缺失或存在缺陷。为防止未来发生疫情，需要持续升级小型和私人供水系统。报告疫情对于实施有针对性和有效的预防措施很重要。
