BACKGROUND: A cross-border gastroenteritis outbreak at a scouting camp was associated with drinking water from a farmer's well. OBJECTIVES: A retrospective cohort study was performed to identify size and source of the outbreak, as well as other characteristics. STUDY DESIGN: Epidemiological investigation included standardized questionnaires about sex, age, risk exposures, illness and family members. Stool and water (100mL) samples were analyzed for bacteria, viruses and parasites. RESULTS: Questionnaires were returned by 84 scouts (response rate 82%), mean age of 13 years. The primary attack rate was 85% (diarrhoea and/or vomiting). Drinking water was the strongest independent risk factor showing a dose-response effect with 50%, 75%, 75%, 93% and 96% case prevalence for 0, 1, 2-3, 4-5 and >5 glasses consumed, respectively. Norovirus (GI.2 Southampton and GII.7 Leeds) was detected in 51 stool specimens (75%) from ill scouts. Water analysis showed fecal contamination, but no norovirus. The secondary attack rate was 20%. CONCLUSIONS: This remarkable outbreak was caused by a point-source infection with two genogroups of noroviruses most likely transmitted by drinking water from a well. Finding a dose-response relationship was striking. Specific measures to reduce the risk of waterborne diseases, outbreak investigation and a good international public health network are important.
BACKGROUND: A cross-border gastroenteritis outbreak at a scouting camp was associated with drinking water from a farmer's well. OBJECTIVES: A retrospective cohort study was performed to identify size and source of the outbreak, as well as other characteristics. STUDY DESIGN: Epidemiological investigation included standardized questionnaires about sex, age, risk exposures, illness and family members. Stool and water (100mL) samples were analyzed for bacteria, viruses and parasites. RESULTS: Questionnaires were returned by 84 scouts (response rate 82%), mean age of 13 years. The primary attack rate was 85% (diarrhoea and/or vomiting). Drinking water was the strongest independent risk factor showing a dose-response effect with 50%, 75%, 75%, 93% and 96% case prevalence for 0, 1, 2-3, 4-5 and >5 glasses consumed, respectively. Norovirus (GI.2 Southampton and GII.7 Leeds) was detected in 51 stool specimens (75%) from ill scouts. Water analysis showed fecal contamination, but no norovirus. The secondary attack rate was 20%. CONCLUSIONS: This remarkable outbreak was caused by a point-source infection with two genogroups of noroviruses most likely transmitted by drinking water from a well. Finding a dose-response relationship was striking. Specific measures to reduce the risk of waterborne diseases, outbreak investigation and a good international public health network are important.
Authors: Anna Carratalà; Marta Rusiñol; Jesús Rodriguez-Manzano; Laura Guerrero-Latorre; Regina Sommer; Rosina Girones Journal: Food Environ Virol Date: 2013-08-17 Impact factor: 2.778
Authors: Katri Jalava; Hanna Rintala; Jukka Ollgren; Leena Maunula; Vicente Gomez-Alvarez; Joana Revez; Marja Palander; Jenni Antikainen; Ari Kauppinen; Pia Räsänen; Sallamaari Siponen; Outi Nyholm; Aino Kyyhkynen; Sirpa Hakkarainen; Juhani Merentie; Martti Pärnänen; Raisa Loginov; Hodon Ryu; Markku Kuusi; Anja Siitonen; Ilkka Miettinen; Jorge W Santo Domingo; Marja-Liisa Hänninen; Tarja Pitkänen Journal: PLoS One Date: 2014-08-22 Impact factor: 3.240
Authors: Anita K Kambhampati; Zachary A Marsh; Michele C Hlavsa; Virginia A Roberts; Antonio R Vieira; Jonathan S Yoder; Aron J Hall Journal: J Pediatric Infect Dis Soc Date: 2019-11-06 Impact factor: 3.164