Due to ongoing microbiological analyses, the health authority is unable to provide definitive results on Monday.

The situation in Kuressaare began to worsen on Saturday, Mari-Anne Harma, acting director of the Health Board (Terviseamet), said. "There were 20 patients by Sunday evening and eight people were referred to the ambulance today," she said.

"The disease is treatable; the acute phase lasts 12 hours," Härma explained, adding that "the elderly and young children are the most at risk."

Härma said that the epidemic may have been caused by Thursday's water accident in Kuressaare, which may have contaminated drinking water with sewage. When sewage contaminates drinking water, the proliferation of viruses and bacteria is typical. "Yesterday, the first samples arrived at the laboratory; we cannot speak of widespread contamination but initial laboratory results indicate the presence of E. coli bacteria. However, we cannot rule out the possibility of other water-borne viral infections," Harma said.

The Health Board does not yet have definitive information on when the water in Kuressaare will once again be safe to drink. "It is uncertain how long Kuressaare Veevarg will need to clean the water conduit but it will likely take several days.

Before the public water supply has been declared safe by the health authority, only boiled water and bottled water should be consumed, Härma said.

PTA: Food business operators need to stop operations

Jaana Oona, a senior specialist at the Agriculture and Food Board (PTA), said that there are also numerous food producers in the area and the board is requesting an emergency halt to all food processing if no other water source can be found.

Oona said, "Otherwise, the disease will be transmitted through food."

Liis Lepik, the deputy mayor of Saaremaa, said that Kuressaare Veevark has begun chlorinating the water pipelines. However, there is a dearth of drinking water on the island.

"Bottled water has run out in both large and small stores; we are in contact with Coop to ensure that people have access to water supply. Tomorrow we will deliver a second shipment of safe water to educational institutions," she said.

Kuressaare Hospital is coping well. Lepik said, "We are awaiting the official test results before deciding how to provide water to people."

It is unclear at this time if Kuressaare Veevark, the company that repaired the water damage on Thursday, conducted the necessary analyses prior to restoring the water connection. "There are indications that the necessary samples were not collected," Härma said.

Lepik added that this is one of the factors that the municipality is monitoring the outbreak. "When the crisis becomes less severe we will begin to study its primary causes," she said.

In the city of Kuressaare a massive outbreak of diarrhea, vomiting and abdominal pain began on Saturday at noon. The outbreak is constrained to the city of Kuressaare.

On Sunday, the health department was aware of several dozen hospital admissions of which 12 required treatment. The elderly and infants are the most at risk from the contamination.

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