A Waterborne Outbreak of Gastroenteritis with Multiple Etiologies among Resort Island Visitors and Residents: Ohio, 2004

O’Reilly, Ciara E.; Bowen, Anna; Perez, Nytzia; Sarisky, John; Shepherd, Craig A.; Miller, Mark D.; Hubbard, Brian; Herring, Michael E.; Buchanan, Sharunda; Fitzgerald, Collette; Hill, Vincent R.; Arrowood, Michael J.; Xiao, Lihua; Hoekstra, Robert M.; Mintz, Eric D.; Lynch, Michael

doi:10.1086/511043

Cited by 121 publications

(77 citation statements)

References 13 publications

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“…Nevertheless, even in countries with no hygiene problems, outbreaks occur due to insufficient water networks. In countries with uncompleted infrastructure, this kind of outbreaks are frequent (O'Reilly et al, 2007;Kanungo et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

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Epidemiological characteristics and molecular typing ofSalmonella entericaserovar Typhi during a waterborne outbreak in Eastern Anatolia

Bayram¹,

Güdücüoğlu²,

Otlu³

et al. 2011

Annals of Tropical Medicine & Parasitology

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In this study, we aimed to study the molecular and epidemiological characteristics of Salmonella enterica serovar Typhi (S. typhi) outbreak in Eastern Anatolia.Six hundred and thirty-seven patients from the same county with clinical diagnosis of typhoid fever were investigated with conventional methods from stool, urine and blood specimens. Antibiotic susceptibility tests and identifications were performed for positive specimens. Clonal relationships between the isolates were investigated using pulsed field gel electrophoresis (PFGE) method. A questionnaire was completed for the water consumption habits of patients.Of 91 culture positive specimens, 76 were blood, 13 were stool and 2 were urine. The isolates were resistant to ampicillin, ampicillin/sulbactam, chloramphenicol, cefuroxime, amikacin, gentamicin and trimethoprim-sulfamethoxazole. Although there was a single band difference in some isolates, PFGE results indicated that this was an outbreak caused by single strain according to the Tenover criteria.This outbreak thought to be associated with the consumption of tap water contaminated with sewage represents a breakdown of the basic public health and civil engineering infrastructure. Appropriate public health measures should be taken in order to avoid such outbreaks in the future.

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Section: Discussionmentioning

confidence: 99%

“…Typhoid fever is an acute febrile disease caused by Salmonella enterica serovar typhi (S. typhi) and may be food and waterborne (O'Reilly et al, 2007;Bhunia et al, 2009). Its incubation period varies between 3 days and 1 month.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological characteristics and molecular typing ofSalmonella entericaserovar Typhi during a waterborne outbreak in Eastern Anatolia

Bayram¹,

Güdücüoğlu²,

Otlu³

et al. 2011

Annals of Tropical Medicine & Parasitology

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“…Despite wealthy economies and access to proven drinking water-treatment technologies, significant outbreaks of waterborne intestinal disease still occur in the occidental world [2][3][4]. Waterborne disease outbreaks often involve acute gastroenteritis [5].…”

Section: Introductionmentioning

confidence: 99%

Massive outbreak of viral gastroenteritis associated with consumption of municipal drinking water in a European capital city

Werber

Laušević²,

Mugoša³

et al. 2009

Epidemiol. Infect.

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SUMMARYOn 24 August 2008, an outbreak alert regarding cases of acute gastroenteritis in Podgorica triggered investigations to guide control measures. From 23 August to 7 September, 1699 cases were reported in Podgorica (population 136 000) and we estimated the total size of the outbreak to be 10 000-15 000 corresponding to an attack rate of y10 %. We conducted an age-and neighbourhood-matched case-control study, microbiologically analysed faecal and municipal water samples and assessed the water distribution system. All cases (83/83) and 90 % (89/90) of controls drank unboiled chlorinated municipal water [matched odds ratio (mOR) 11 . 2, 95 % confidence interval (CI), 1 . 6-O]. Consumption of bottled water was inversely associated with illness (mOR 0 . 3, 95 % CI 0 . 1-0 . 8). Analyses of faecal samples identified six norovirus genotypes (21/38 samples) and occasionally other viruses. Multiple defects in the water distribution system were noted. These results suggest that the outbreak was caused by faecally contaminated municipal water. It is unusual to have such a large outbreak in a European city especially when the municipal water supply is chlorinated. Therefore, it is important to establish effective multiple-barrier water-treatment systems whenever possible, but even with an established chlorinated supply, sustained vigilance is central to public health.

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“…Noroviruses are the second most common cause of viral gastroenteritis next to rotaviruses worldwide (38). In recent years, a number of these enteric viruses have been the etiological agents of several waterborne outbreaks (1,2,10,14,21,29,32).…”

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confidence: 99%

Use of Propidium Monoazide in Reverse Transcriptase PCR To Distinguish between Infectious and Noninfectious Enteric Viruses in Water Samples

Parshionikar

Laseke

Fout

2010

Appl Environ Microbiol

202

136

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Human enteric viruses can be present in untreated and inadequately treated drinking water. Molecular methods, such as the reverse transcriptase PCR (RT-PCR), can detect viral genomes in a few hours, but they cannot distinguish between infectious and noninfectious viruses. Since only infectious viruses are a public health concern, methods that not only are rapid but also provide information on the infectivity of viruses are of interest. The intercalating dye propidium monoazide (PMA) has been used for distinguishing between viable and nonviable bacteria with DNA genomes, but it has not been used to distinguish between infectious and noninfectious enteric viruses with RNA genomes. In this study, PMA in conjunction with RT-PCR (PMA-RT-PCR) was used to determine the infectivity of enteric RNA viruses in water. Coxsackievirus, poliovirus, echovirus, and Norwalk virus were rendered noninfectious or inactivated by treatment with heat (72°C, 37°C, and 19°C) or hypochlorite. Infectious or native and noninfectious or inactivated viruses were treated with PMA. This was followed by RNA extraction and RT-PCR or quantitative RT-PCR (qRT-PCR) analysis. The PMA-RT-PCR results indicated that PMA treatment did not interfere with detection of infectious or native viruses but prevented detection of noninfectious or inactivated viruses that were rendered noninfectious or inactivatedby treatment at 72°C and 37°C and by hypochlorite treatment. However, PMA-RT-PCR was unable to prevent detection of enteroviruses that were rendered noninfectious by treatment at 19°C. After PMA treatment poliovirus that was rendered noninfectious by treatment at 37°C was undetectable by qRT-PCR, but PMA treatment did not affect detection of Norwalk virus. PMA-RT-PCR was also shown to be effective for detecting infectious poliovirus in the presence of noninfectious virus and in an environmental matrix. We concluded that PMA can be used to differentiate between potentially infectious and noninfectious viruses under the conditions defined above.

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A Waterborne Outbreak of Gastroenteritis with Multiple Etiologies among Resort Island Visitors and Residents: Ohio, 2004

Abstract: The combined epidemiological and environmental investigation indicated that sewage-contaminated ground water was the likely source of this large outbreak. Long-term changes to the island's water supply and sewage management infrastructure are needed.

Cited by 121 publications

References 13 publications

Epidemiological characteristics and molecular typing ofSalmonella entericaserovar Typhi during a waterborne outbreak in Eastern Anatolia

Epidemiological characteristics and molecular typing ofSalmonella entericaserovar Typhi during a waterborne outbreak in Eastern Anatolia

Massive outbreak of viral gastroenteritis associated with consumption of municipal drinking water in a European capital city

Use of Propidium Monoazide in Reverse Transcriptase PCR To Distinguish between Infectious and Noninfectious Enteric Viruses in Water Samples

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