A waterborne outbreak of small round structured virus, 
campylobacter and shigella co-infections in La Neuveville, 
Switzerland, 1998

Maurer, A. M.; Stürchler, D

doi:10.1017/s0950268899004495

Cited by 70 publications

(49 citation statements)

References 17 publications

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“…To our knowledge, this is the first report describing the involvement of more than one enteric pathogen in an outbreak setting in India. Involvement of more than one pathogen during outbreaks has been reported elsewhere and was usually attributed to gross contamination of food or drinking water (9,18). However in this study, the concurrent incidence of two different enteric pathogens, V. cholerae and ETEC, in a single patient was not encountered.…”

Section: Discussionmentioning

confidence: 52%

Concomitant Infection of Enterotoxigenic Escherichia coli in an Outbreak of Cholera Caused by Vibrio cholerae O1 and O139 in Ahmedabad, India

Chakraborty

Deokule²,

Garg

et al. 2001

J Clin Microbiol

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In Ahmedabad, a major city in the state of Gujarat, India, an outbreak of acute secretory diarrhea caused by Vibrio cholerae O1 Ogawa El Tor, V. cholerae O139, and multiple serotypes of enterotoxigenic Escherichia coli (ETEC) occurred in January 2000. All of the representative V. cholerae O1 and O139 isolates examined harbored the ctxA gene (encoding the A subunit of cholera toxin) and the El Tor variant of the tcpA gene (encoding toxin-coregulated pilus). ETEC isolates of different serotypes were positive for the elt gene, encoding heat-labile enterotoxin. To further understand the molecular characteristics of the pathogens, representative isolates were examined by ribotyping and pulsed-field gel electrophoresis (PFGE). Ribotyping showed that the isolates of V. cholerae O1 Ogawa exhibited a pattern identical to that of the prevailing clone of O1 in areas where cholera is endemic in India, and all of the O139 isolates were identical to the BII clone of V. cholerae O139. PFGE of the representative O1 Ogawa isolates exhibited an identical pattern, comparable to the H pattern of the new clone of O1 reported in Calcutta, India. PFGE analysis of the V. cholerae O139 isolates showed identical patterns, but these differed from the PFGE patterns of O139 isolates reported during 1992 to 1997 in Calcutta. ETEC isolates showed genetic heterogeneity among isolates belonging to the same serotype, although the identical PFGE pattern was also observed among ETEC isolates of different serotypes. Antibiograms of the isolates were unusual, because all of the O139 isolates were resistant to nalidixic acid. Likewise, all of the E. coli isolates showed resistance to ciprofloxacin, norfloxacin, and nalidixic acid. This is a unique outbreak, and we believe that it is the first in which V. cholerae and ETEC were concomitantly involved.Acute diarrheal diseases have been recognized as one of the major causes of morbidity and mortality in developing and underdeveloped countries. The common pathogens associated with diarrhea in developing countries are diarrheagenic Escherichia coli, Vibrio cholerae, Salmonella spp., and Shigella spp., etc. Cholera is caused by toxigenic strains of V. cholerae belonging to the O1 or O139 serogroup, which have the potential to cause epidemics (4, 25). It is estimated that tens of thousands of people in the world are affected every year due to cholera outbreaks and epidemics. Outbreaks of cholera are generally due to lack of sanitation or contamination of drinking water (28, 30). The etiologic agent, enterotoxigenic E. coli (ETEC), causes nearly 400 million diarrheal episodes and 700,000 deaths annually among children less than 5 years old (15). The present investigation highlights an association of three pathogens associated with a large outbreak of diarrhea in a metropolitan city of Gujarat state, India. MATERIALS AND METHODSDescription of the outbreak. From 1 to 17 January 2000, a total of 809 patients reported to three different hospitals, namely, I. D. Hospital, V. S. General Hospital, and L. G. Hospita...

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Section: Discussionmentioning

confidence: 52%

Concomitant Infection of Enterotoxigenic Escherichia coli in an Outbreak of Cholera Caused by Vibrio cholerae O1 and O139 in Ahmedabad, India

Chakraborty

Deokule²,

Garg

et al. 2001

J Clin Microbiol

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“…Numerous outbreaks of norovirus-associated gastroenteritis originating from contaminated drinking or recreational water have been ascribed to various causes (4,6,21,29,34,37,40). Contamination of drinking water by sewage through pump failure or blockage of a sewage system has been previously described (6,34).…”

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confidence: 99%

Presence of Noroviruses and Other Enteric Viruses in Sewage and Surface Waters in The Netherlands

Lodder

Husman

2005

Appl Environ Microbiol

341

201

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Since virus concentrations in drinking waters are generally below the detection limit, the infectious risk from drinking water consumption requires assessment from the virus concentrations in source waters and removal efficiency of treatment processes. In this study, we estimated from reverse transcription-PCR on 10-fold serially diluted RNA that noroviruses, the most prevalent waterborne gastroenteritis agents, were present at 4 (0.2 to 38) to 4,900 (303 to 4.6 ؋ 10 4 ) PCR-detectable units (PDU) per liter of river water (ranges are given in parentheses). These virus concentrations are still high compared with 896 to 7,499 PDU/liter of treated sewage and 5,111 to 850,000 PDU/liter in raw sewage. Sequencing analyses designated human norovirus GGII.4 Lordsdale as the most prevalent strain in the sampling period 1998 to 1999 in both sewage and surface waters. Other GGII strains were also very abundant, indicating that the majority of the virus contamination was derived from urban sewage, although very divergent strains and one animal strain were also detected in the surface and sewage waters. Rotaviruses were also detected in two large rivers (the Maas and the Waal) at 57 to 5,386 PDU/liter. The high virus concentrations determined by PCR may in part be explained by the detection of virus RNA instead of infectious particles. Indeed, reoviruses and enteroviruses that can be cultured were present at much lower levels, of 0.3 to 1 and 2 to 10 PFU/liter, respectively. Assuming 1% of the noroviruses and rotaviruses to be infectious, a much higher disease burden than for other viruses can be expected, not only because of the higher levels but also because of these viruses' higher infectivity and attack rates.

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“…Despite the decline, outbreaks, especially those associated with untreated groundwater, continue to occur (3,4,5,10,14,17,20). About 10% of waterborne outbreaks in the United States are reported to be caused by viruses.…”

mentioning

confidence: 99%

A Multiplex Reverse Transcription-PCR Method for Detection of Human Enteric Viruses in Groundwater

Fout

Martinson

Moyer

et al. 2003

Appl Environ Microbiol

147

111

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A waterborne outbreak of small round structured virus, campylobacter and shigella co-infections in La Neuveville, Switzerland, 1998

Cited by 70 publications

References 17 publications

Concomitant Infection of Enterotoxigenic Escherichia coli in an Outbreak of Cholera Caused by Vibrio cholerae O1 and O139 in Ahmedabad, India

Concomitant Infection of Enterotoxigenic Escherichia coli in an Outbreak of Cholera Caused by Vibrio cholerae O1 and O139 in Ahmedabad, India

Presence of Noroviruses and Other Enteric Viruses in Sewage and Surface Waters in The Netherlands

A Multiplex Reverse Transcription-PCR Method for Detection of Human Enteric Viruses in Groundwater

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