Over a 5 day period in October 2007 a boil-water notice was served on the majority of Oslo, capital city of Norway, as a result of a combination of bacteriological findings (coliforms, intestinal enterococci, and E. coli), and very low numbers of Cryptosporidium oocysts and Giardia cysts in 10 L water samples taken from the water distribution network. The water source had been regularly monitored for these parasites and generally found to be negative. Over 460,000 residents were affected by the boil-water notice, as were many thousands of businesses.
Despite an extensive outbreak of waterborne giardiasis in Bergen, Norway during 2004/2005, occurrence of parasites in Norwegian drinking water supplies has apparently continued to be considered to be of minimal relevance by Norwegian health authorities. Here we describe the background and occurrence of the episode in Oslo, including the species of Cryptosporidium detected, and use this event, in conjunction with incidents from other countries, as a basis to discuss the following issues: 1) under which circumstances should the occurrence of Cryptosporidium oocysts and Giardia cysts in water supplies trigger the issue of a boil-water notice, and 2) the possibilities and probabilities of post-treatment contamination events in the water distribution network.