– We must expect that some people will develop long-term ailments after being infected by Campylobacter bacteria present in drinking water

Researchers from NORCE, the University of Bergen and Haukeland University Hospital acted quickly while the outbreak of disease in Askøy was still in progress.

Sist oppdatert: Sep 6, 2019
Published Jul 2, 2019
Campylobacter illfoto m wensaas
Campylobacter bacteria, illustration based on scans made with a scanning electron microscope. To the right, NORCE researcher and GP Knut-Arne Wensaas. (Illustration by Alissa Eckert, with contributions from CDC/James Archer)

They are now studying the outbreak, thanks to previous years of experience regarding research based on contaminated drinking water.

In a new health survey, the course of disease and after-effects are being charted, following infection from drinking water from Kleppe waterworks at Askøy in Hordaland.

Before charting is complete, researchers cannot say anything certain about what people from Askøy can expect regarding ailments associated with the Campylobacter infection.

“But we must expect that some people will develop long-term ailments, even though it is difficult to say anything about the scope. We hope and believe that the health surveys we perform will reveal the type of ailments that arise and that this can contribute to better and more purposeful treatment and management”, says senior researcher and doctor Knut-Arne Wensaas at the Research Unit for General Practice in Bergen (RUGP Bergen) in NORCE.

Large amounts of data

Askøy municipality has sent text messages (SMS) to 16,000 people, asking them to complete the researchers’ web-based survey.

Within just a few days, researchers had received around 2000 responses, and they will eventually possess a large and valuable data set that will take time to analyse.

“In addition to investigating the acute situation here and now, we will gain an overview of the use of medication and other illnesses of those affected. We hope to reveal all the factors that are of importance regarding the course of disease, as well as later complications and after-effects”, says Wensaas.

A control group that has not been infected with Campylobacter, has been given the same questions so that researchers can compare the results.

Many inhabitants of the island municipality situated outside Bergen were affected by the contaminated drinking water. The outbreak of infection began just before Thursday the 6th June 2019, when more people than normal came to Askøy casualty clinic with gastrointestinal symptoms.

The municipality estimated that during the weeks that followed, several thousand people were struck with diarrhoea, high fevers and vomiting of varying severity, after drinking water that came from an elevated water reservoir associated with Kleppe waterworks.

Two fatalities have also been linked to the Campylobacter outbreak.

– A very dramatic and severe outbreak

Professor and doctor Guri Rørtveit at the University of Bergen is the project manager. She also holds an additional post at RUGP in NORCE. Rørtveit says that it will be important both for researchers, and not least the inhabitants of Askøy, to gain good knowledge regarding the consequences of this outbreak, and to document it all.

“Subsequently, one will then find it much easier to determine whether a symptom that occurs may be related to the Campylobacter infection that affected people at that time. It has been a very dramatic and severe outbreak for the inhabitants of Askøy, and it is important to research this outbreak”, says Rørtveit.

NORCE researcher Wensaas is pleased that the research communities discussed the problem at an early stage, and combined their efforts so they could start quickly on charting the course of the illness.

“The fact that we could quickly organize the research regarding the outbreak at Askøy, is of course very valuable. We managed this thanks to great cooperation between the institutions and a lot of research experience that was gained after many were infected by the giardia lamblia parasite found in the Svartediket drinking water spring in Bergen during the autumn of 2004”, says Wensaas.

At least 2500 people became ill with diarrhoea and abdominal pains at the time. Several follow-up studies have shown that many have struggled with stomach problems and fatigue in the years that followed. The research that has taken place in Bergen has provided a number of answers that can help to understand the long-term consequences of Giardia infections.

New and important knowledge

Wensaas and the other researchers involved in the Askøy survey, now hope to gain a lot of new and important knowledge about Campylobacter after-effects.

Some people have also been asked to take blood tests and stool samples, and the plan is to provide the participants with follow-up in the form of new surveys, 3, 6 and 12 months after the outbreak of the disease.

The project team includes NORCE, UiB and Haukeland University Hospital, as well as Askøy municipality. The project is based on close and quality cooperation between the three research institutions over several years.

The drinking water scandal at Askøy

Symptoms were first observed at Askøy casualty clinic on Wednesday the 5th of June 2019. Several patients sought medical attention due to high fever, abdominal pain, vomiting and diarrhoea. On Friday the 7th, high concentrations of E-coli bacteria were detected in the water at Øvre Kleppe. 18 patients that receive their water supply from this source were admitted to Haukland University Hospital with gastrointestinal symptoms, according to NTB.

Seriously ill after drinking water from Askøy