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An investigation of a waterborne outbreak caused by microbiological contamination of the drinking water supply system Background: An outbreak of acute gastroenteritis occurred in March and April 2010 in the town of Mengeš where drinking tap water was contaminated, affecting an area with 3000 residents. The aim was to assess the extent of the outbreak, identify the etiological agents and test the hypothesis that drinking unboiled water from the distribution system was the vehicle for the outbreak, and if necessary to initiate appropriate control measures. Methods: A retrospective cohort study including 160 randomly selected households (20% of the affected residents) was conducted. A case was a resident of Mengeš developing either diarrhoea, vomiting or abdominal pain. Results: The overall attack rate was 31.3%. The epidemic curve showed a clear peak in the number of cases suggesting a common point source exposure. Residents who consumed unboiled tap water were 4.8 times (95% CI 0.7-32.7) more likely to become ill than the non-exposed. Drinking unboiled water, brushing teeth and eating raw fruit and vegetables washed with unboiled tap water was associated with gastroenteritis (RR 3.1 (CI 95% 1.5-6.5), 3.1 (CI 95% 1.2-8.1) and 2.3 (CI 95% 1.2-4.3)). There was a dose-response relationship between the volume of unboiled tap water drunk and the attack rate among the residents. Norovirus and Rotavirus were detected in the water samples, as well as in stool samples from the cases. Conclusion: The results suggest that the vehicle of transmission was contaminated drinking water. Residents of affected area were advised to temporarily boil tap water. Because of continuous problems with water from the distribution system, building a new one from other water sources was considered. Preiskava Hidričnega Izbruha, Povzročenega z Mikrobiološko Kontaminacijo Pitne Vode Uvod: V marcu in aprilu 2010 je v Mengšu na območju s 3.000 prebivalci zaradi kontaminacije pitne vode prišlo do izbruha akutnega gastroenteritisa. Cilj naše preiskave je bil oceniti obseg izbruha, identificirati povzročitelje in preveriti hipotezo, da je bila pot prenosa v izbruhu pitje neprekuhane vode iz vodovoda, ter če bi bilo potrebno, predlagati ustrezne ukrepe. Metode: Izvedena je bila retrospektivna kohortna raziskava, v katero je bilo vključenih 160 naključno izbranih gospodinjstev (z 20 % prebivalcev s prizadetega področja). Primer je bil prebivalec Mengša, ki se mu je pojavila driska, bruhanje ali bolečine v trebuhu. Rezultati: Celotna stopnja zbolevanja je bila 31,3-odstotna. Na epidemijski krivulji je bilo vidno jasno kopičenje števila primerov, kar je nakazovalo izpostavljenost skupnemu viru okužbe. Prebivalci, ki so uživali neprekuhano vodo iz pipe, so imeli 4,8-krat (95% IZ: 0,7-32,7) večjo verjetnost, da zbolijo, kot neizpostavljeni. Pitje neprekuhane vode iz pipe, umivanje zob in uživanje surovega sadja in zelenjave, oprane z neprekuhano vodo iz pipe, je bilo povezano z gastroenteritisom (RR 3,1 (95%; IZ: 1,5-6,5), 3,1 (95% IZ: 1,2-8,1) in 2,3 (95% IZ: 1,2-4,3)). Ugotovljena je bila povezava med količino popite neprekuhane vode iz pipe in stopnjo zbolevanja med prebivalci. Norovirusi in rotavirusi so bili odkriti v vzorcih pitne vode in tudi v vzorcih blata zbolelih. Zaključek: Naši rezultati kažejo, da je bila pot prenosa kontaminirana pitna voda. Prebivalcem prizadetega območja je bilo svetovano začasno prekuhavanje pitne vode. Zaradi stalnih problemov z vodo iz vodovoda se je začela obravnavati gradnja novega iz drugih vodnih virov.