Outbreak of acute gastroenteritis due to a washwater-contaminated water supply, Switzerland, 2008

An operating error in a sewage treatment plant led to severe drinking water contamination in a well-defined district of a suburban municipality of Zurich, Switzerland. Despite the alert issued to the local population on the same day advising people not to consume the contaminated water, cases of acute gastroenteric diseases were subsequently observed. Considerable faecal contamination was detected the day after the incident in water samples taken up to 500 m from the sewage plant. In a retrospective epidemiological study involving 240 persons living in the affected area, 126 cases of acute gastrointestinal illness were documented. The epidemic curve revealed a peak incidence two days after the event. Stool samples from 11 of 20 patients were positive for noroviruses or Campylobacter jejuni. Although these microorganisms were not detected in the contaminated water, the subsequently conducted case-control study among the surveyed population showed that consumption of contaminated drinking water was associated with gastrointestinal illness (odds ratio 29.1; 95% confidence interval: 9.8-86.4; p 0.001). The study also revealed the very probable time period of infection. We present the dimension and chronology of this outbreak and discuss the reasons for its localised and temporary spread.