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Abstract：
BACKGROUND: waterborne disease outbreaks (WGDOs) following the contamination of drinking water remain a public health concern.
METHODS: The current study aims to assess the occurrence and identify gaps in the notification and investigation of WGDOs in Greece. Data for 2004-2023 were retrieved and summarized.
RESULTS: Thirty-five outbreaks with 6128 recorded cases were identified. The median time from the date of onset in the first cases to reporting was 7 days (range: 1-26 days). Authorities were informed by health care services in thirty (85.7%) outbreaks and by the media in five (14.3%). The investigation methods used varied. An analytical study was conducted in nine (25.7%) outbreaks and the testing of clinical samples in twenty-seven (77.1%). In three (11.1%) outbreaks, clinical samples were simultaneously tested for multiple bacteria, viruses, and parasites. Water samples were collected in nineteen (54.3%) outbreaks (in three after chlorination) with a mean time lag of 5 days (range: 1-20 days) from the first cases. A pathogen in clinical samples was identified in 20 (57.1%) outbreaks and, in 1 (6.25%), the same microorganism was isolated in both clinical and water samples.
CONCLUSIONS: delays in reporting and the heterogeneity of investigations depict that the surveillance of WGDOs and response practices should be strengthened, and operational procedures should be standardised.
METHODS: The current study aims to assess the occurrence and identify gaps in the notification and investigation of WGDOs in Greece. Data for 2004-2023 were retrieved and summarized.
RESULTS: Thirty-five outbreaks with 6128 recorded cases were identified. The median time from the date of onset in the first cases to reporting was 7 days (range: 1-26 days). Authorities were informed by health care services in thirty (85.7%) outbreaks and by the media in five (14.3%). The investigation methods used varied. An analytical study was conducted in nine (25.7%) outbreaks and the testing of clinical samples in twenty-seven (77.1%). In three (11.1%) outbreaks, clinical samples were simultaneously tested for multiple bacteria, viruses, and parasites. Water samples were collected in nineteen (54.3%) outbreaks (in three after chlorination) with a mean time lag of 5 days (range: 1-20 days) from the first cases. A pathogen in clinical samples was identified in 20 (57.1%) outbreaks and, in 1 (6.25%), the same microorganism was isolated in both clinical and water samples.
CONCLUSIONS: delays in reporting and the heterogeneity of investigations depict that the surveillance of WGDOs and response practices should be strengthened, and operational procedures should be standardised.
摘要：
背景：饮用水污染后的水传播疾病暴发（WGDO）仍然是公共卫生问题。
方法：本研究旨在评估希腊WGDO的通知和调查中的发生情况并确定差距。检索并总结了2004-2023年的数据。
结果：确定了35次暴发，记录了6128例病例。从第一批病例的发病日期到报告的中位时间为7天（范围：1-26天）。当局在30起(85.7%)疫情中得到了医疗保健服务的通知，在5起(14.3%)病例中得到了媒体的通知。使用的调查方法多种多样。对9次(25.7%)疫情进行了分析研究，对27次(77.1%)的临床样本进行了检测。在三次(11.1%)疫情中，临床样本同时检测多种细菌，病毒,和寄生虫。在19次（54.3％）暴发（氯化后3次）中收集了水样，平均时滞为5天（范围：1-20天）。在20例(57.1%)疫情中发现了临床样本中的病原体，在1（6.25%）中，在临床和水样中均分离出相同的微生物。
结论：报告的延迟和调查的异质性表明，应加强对WGDO和应对措施的监测，和操作程序应该标准化。
方法：本研究旨在评估希腊WGDO的通知和调查中的发生情况并确定差距。检索并总结了2004-2023年的数据。
结果：确定了35次暴发，记录了6128例病例。从第一批病例的发病日期到报告的中位时间为7天（范围：1-26天）。当局在30起(85.7%)疫情中得到了医疗保健服务的通知，在5起(14.3%)病例中得到了媒体的通知。使用的调查方法多种多样。对9次(25.7%)疫情进行了分析研究，对27次(77.1%)的临床样本进行了检测。在三次(11.1%)疫情中，临床样本同时检测多种细菌，病毒,和寄生虫。在19次（54.3％）暴发（氯化后3次）中收集了水样，平均时滞为5天（范围：1-20天）。在20例(57.1%)疫情中发现了临床样本中的病原体，在1（6.25%）中，在临床和水样中均分离出相同的微生物。
结论：报告的延迟和调查的异质性表明，应加强对WGDO和应对措施的监测，和操作程序应该标准化。
