An outbreak of Escherichia coli 0157 and campylobacteriosisassociated with contamination of a drinking water supply

Stream water into which treated sewage discharged contaminated the public water supply of a Fife village with a population of about 1100. Of 765 residents and workers who reported illness 711 had gastrointestinal symptoms and 633 were defined as cases. Mains water analysis revealed high faecal coliform counts. An outbreak of Campylobacter and E coli 0157 infection was bacteriologically confirmed in eight and six people respectively. Two of the latter developed haemolytic uraemic syndrome. All affected individuals made full recoveries. Human normal immunoglobulin was offered to those aged between six months and 40 years of age and 618 individuals were immunised. Salivary tests four months after the incident confirmed that no Hepatitis A outbreak had occurred. In a follow-up questionnaire residents generally expressed happiness with the medical response to the incident although many reported that they still had worries. The two major medical issues which emerged from this outbreak were the importance of effective communications and the appropriateness of offering post-exposure human normal immunoglobulin.