In its review of the events, the Health Board wrote, that on Thursday 4 May, a large water mains pipe burst in Kuressaare during the process of replacing a sewage pipe on Kalevi tänav. As a result of the incident, there was a risk that drinking water in Kuressaare had become contaminated.

"No water samples were taken after the pipes were repaired and the incident was not reported to the Health Board, even though it is mandatory to report these kinds of incidents," the Health Board wrote.

Kadri Juhkam, head of the Health Board's western regional department, said that the water operator had acknowledged the error and was continuing to cooperate in order to fully to resolve the crisis.

To assess what happened in Kuressaare and prevent similar incidents occurring in the future, the Health Board has now launched a national supervision procedure.

Leena Albrecht, head of the Health Board's environmental health department, added, that if the board had been informed in time, and mandatory water samples taken following the initial incident, the local population would have been informed of the contamination risk at least 48 hours earlier.

"The obligation to ensure the water quality comes from the Water Act. In the case of an emergency like this, it is paramount that water samples are taken immediately after the accident, as there is no other way to be sure of the quality. The water accident in and of  itself is sufficient to suspect that there may be contamination," said Albrecht.

Two days later, the first patients arrived at Kuressaare Hospital complaining of abdominal pain, diarrhea and nausea.

The next day, on May 7, the Kuressaare Hospital informed the Health Board. After interviewing five of the people affected, the board then contacted Kuressaare Veevärk AS, the company responsible for providing the town's water.

Kadri Juhkam, head of the Health Board's western regional department, said that during the board's interview with Kuressaare Veevaärk, the water operator had initial assessed that there was no possibility of local drinking water having become contaminated due to the accident.

However, the board remained skeptical, asking Mihkel Laidna, head of Kuressaare Hospital's emergency department (EMO), to post on social media warning people against drinking the water. The Health Board itself posted a similar message a few hours later. A short EE-ALARM alert was also sent out.

According to the Health Board, Kuressaare Veevärk also lacked both a risk assessment and contingency plan required to continue its provision of its vital service in the event of the town's drinking water becoming contaminated.

On Monday, May 8, Kuressaare Veevärk began conducting preventive measures including cleaning and chlorinating the water as well as draining it from the mains and replacing it with uncontaminated water. Eight points located in different areas of the town, from which daily water samples were taken, were also agreed upon.

The Health Board wrote that, in the days that followed, Kuressaare Veevärk AS also involved experts from Rapla Vee and Tallinn University of Technology (TalTech) to help resolve the issue.

"The most controversial issue was whether regional differences in water consumption could be allowed. The water quality requirements were adhered to, according to which the permitted level of E. coli is zero. It was therefore decided to send a clear message that until traces of E. coli had disappeared completely from the water supply, the consumption of water could not be allowed."

On May 22, the work of the crisis team was considered to be complete, after the third consecutive negative laboratory test was received, confirming the purity of the drinking water in the town's main water supply. Isolated traces of E. coli may still have been found in pipes inside properties, with residents therefore repeatedly urged to drain household water systems. The same request was also made to businesses, with particular attention paid to those dealing with food businesses, which were expected to take additional water samples as a self-monitoring measure.

Health Board spokesperson Imre Kaas, said that dealing with this kind of an emergency is usually the responsibility of local authorities. However, in this case, the Health Board had been forced to take the lead.

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