A large community outbreak of gastroenteritis associated with consumption of drinking water contaminated by river water, Belgium, 2010

Abstract

SUMMARYOn 6 December 2010 a fire in Hemiksem, Belgium, was extinguished by the fire brigade with both river water and tap water. Local physicians were asked to report all cases of gastroenteritis. We conducted a retrospective cohort study among 1000 randomly selected households. We performed a statistical and geospatial analysis. Human stool samples, tap water and river water were tested for pathogens. Of the 1185 persons living in the 528 responding households, 222 (18·7%) reported symptoms of gastroenteritis during the time period 6–13 December. Drinking tap water was significantly associated with an increased risk for gastroenteritis (relative risk 3·67, 95% confidence interval 2·86–4·70) as was place of residence. Campylobacter sp. (2/56), norovirus GI and GII (11/56), rotavirus (1/56) and Giardia lamblia (3/56) were detected in stool samples. Tap water samples tested positive for faecal indicator bacteria and protozoa. The results support the hypothesis that a point-source contamination of the tap water with river water was the cause of the multi-pathogen waterborne outbreak.

Psychological comorbidity increases the risk for postinfectious IBS partly by enhanced susceptibility to develop infectious gastroenteritis

“…An epidemic outbreak of IGE occurred in Hemiksem and Schelle (Belgium) between 6 and 9 December 2010 by contamination of the municipal tap water with local creek water as reported by the Local Health Authority 24. Although not officially established, the contamination was most likely caused by a misconnection of hoses by fireman during fire extinction.…”

“…In December 2010, two small villages in Belgium (Hemiksem and Schelle) suffered from a large community-wide multipathogen outbreak of gastroenteritis due to contamination of the tap water with water from a small creek 24. At least 18 000 local residents were exposed to this contaminated water supply 24.…”

“…At least 18 000 local residents were exposed to this contaminated water supply 24. In the present study, we aimed (1) to explore the potential relationship between psychological factors, the immune response in the acute infectious phase and the risk to develop IGE and/or PI-IBS; and (2) to study in depth the potential role of persistent immune activation in those patients who developed PI-IBS.…”

Rotavirus and Astrovirus

“…Outbreaks associated with RVA, resulting from contamination of waters by sewage, have been reported in several countries such as Albania, Belgium, Canada, China, Finland, France, Greece, Italy, Russia, Sweden, Turkey, and United States of America (USA) (Lycke et al, 1978;Hopkins et al, 1984;Hung et al, 1984;Solodovnikov et al, 1989;Ansari et al, 1991;Kukkula et al, 1997;Borchardt et al, 2004;Divizia et al, 2004;Gallay et al, 2006;Martinelli et al, 2007;Rasanen et al, 2010;Koroglu et al, 2011;Mellou et al, 2014;Braeye et al, 2015). Data on the occurrence of RVA in environmental samples has been generated mostly by studies carried out in developing countries, where RVA still have significant morbidity when compared to developed ones.…”

Eco-Epidemiology and Control of Waterborne Gastroenteritis: A Review

“…Traditionally chlorine dioxide was not commonly used for drinking water disinfection, but recently it has been used because of trihalomethane production coupled with chlorine disinfection. Emitted UV radiations by a low-pressure mercury lamp are used to inactivate bacteria and other microbes because it is biocidal between 180-320 nm of wavelength [61].…”