Illness in a community associated with an episode of water contamination with sewage

Fogarty, John E.; Thornton, Liam; Hayes, Christine; Laffoy, Marie; O’Flanagan, D; Devlin, Joe; Corcoran, R

doi:10.1017/s0950268800057952

Cited by 19 publications

(14 citation statements)

References 14 publications

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“…An outbreak can be recognised by: (i) the poor quality of water detected during regular controls; (ii) complaints about water quality; (iii) an incident in the supply and/or sewage water system during maintenance work; and (iv) an increased number of cases of gastroenteritis. In most instances, waterborne outbreaks are suspected when there are already a large number of declared cases [3,12,18,28,38,39]. In the present outbreak, the initial warning was given by a GP who notified officials 5–10 days after the assumed date of onset.…”

Section: Discussionmentioning

confidence: 97%

A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, France, 2000

Gallay

Valk

Cournot³

et al. 2006

Clinical Microbiology and Infection

132

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A large waterborne outbreak of infection that occurred during August 2000 in a local community in France was investigated initially via a rapid survey of visits to local physicians. A retrospective cohort study was then conducted on a random cluster sample of residents. Of 709 residents interviewed, 202 (28.5%) were definite cases (at least three liquid stools/day or vomiting) and 62 (8.7%) were probable cases (less than three liquid stools/day or abdominal pain). Those who had drunk tap water had a three-fold increased risk for illness (95% CI 2.4-4.0). The risk increased with the amount of water consumed (chi-square trend: p < 0.0001). Bacteriological analyses of stools were performed for 35 patients and virological analyses for 24 patients. Campylobacter coli, group A rotavirus and norovirus were detected in 31.5%, 71.0% and 21% of samples, respectively. An extensive environmental investigation concluded that a groundwater source to this community had probably been contaminated by agricultural run-off, and a failure in the chlorination system was identified. This is the first documented waterborne outbreak of infection involving human C. coli infections. A better understanding of the factors influencing campylobacter transmission between hosts is required.

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Section: Discussionmentioning

confidence: 97%

A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, France, 2000

Gallay

Valk

Cournot³

et al. 2006

Clinical Microbiology and Infection

132

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“…Viruses are known to cause a significant portion of waterborne disease, mostly from ingestion of sewage-contaminated water and seafood (10). Until recently, however, virus detection and quantification have relied on cell culture-based approaches that are much too slow to be effective source-tracking tools.…”

mentioning

confidence: 99%

Multitiered Approach Using Quantitative PCR To Track Sources of Fecal Pollution Affecting Santa Monica Bay, California

Noble

Griffith

Fuhrman

et al. 2006

Appl Environ Microbiol

127

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The ubiquity of fecal indicator bacteria such as Escherichia coli and Enterococcus spp. in urban environments makes tracking of fecal contamination extremely challenging. A multitiered approach was used to assess sources of fecal pollution in Ballona Creek, an urban watershed that drains to the Santa Monica Bay (SMB) near Los Angeles, Calif. A mass-based design at six main-stem sites and four major tributaries over a 6-h period was used (i) to assess the flux of Enterococcus spp. and E. coli by using culture-based methods (tier 1); (ii) to assess levels of Enterococcus spp. by using quantitative PCR and to detect and/or quantify additional markers of human fecal contamination, including a human-specific Bacteroides sp. marker and enterovirus, using quantitative reverse transcriptase PCR (tier 2); and (iii) to assess the specific types of enterovirus genomes found via sequence analysis (tier 3). Sources of fecal indicator bacteria were ubiquitous, and concentrations were high, throughout Ballona Creek, with no single tributary dominating fecal inputs. The flux of Enterococcus spp. and E. coli averaged 10 9 to 10 10 cells h ؊1 and was as high at the head of the watershed as at the mouth prior to discharge into the SMB. In addition, a signal for the human-specific Bacteroides marker was consistently detected: 86% of the samples taken over the extent during the study period tested positive. Enteroviruses were quantifiable in 14 of 36 samples (39%), with the highest concentrations at the site furthest upstream (Cochran). These results indicated the power of using multiple approaches to assess and quantify fecal contamination in freshwater conduits to high-use, high-priority recreational swimming areas.The Santa Monica Bay (SMB), California, is home to some of the most popular beaches in the world. It is located adjacent to metropolitan Los Angeles, and more than 50 million beachgoers visit SMB shorelines every year-more than those visiting all other beaches in California combined (38). However, there are serious concerns about beach water quality because of continued exceedances of water quality thresholds based on fecal indicator bacteria such as total coliforms, fecal coliforms, or Escherichia coli and Enterococcus spp., particularly in areas impacted by urban runoff. Thirteen percent of the shoreline mile-days in the SMB exceeded water quality thresholds between 1995 and 2000, with over 50% of these exceedances located near storm drains (37). The public health risk associated with urban runoff has been directly demonstrated through epidemiology studies. Haile et al. (19) demonstrated that swimmers near storm drain discharges in the SMB had a higher likelihood of respiratory and/or gastrointestinal symptoms than swimmers more than 400 m from a storm drain.Despite the impairment of water quality and risks to human health, identification and elimination of the sources of bacteria responsible for the beach warnings remain elusive. The difficulty in identifying and eliminating the sources of bacteria results from thre...

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“…Surface waters in both rural and urban areas are affected by fecal contamination from human and animal sources (14,18). The occurrence of AstVs in water sources (9,29,31,40,51,60) and the occurrence of AstVs in sludge biosolids (10) have been reported, but the clinical significance and epidemiological impact of environmental AstV strains is unknown (60).…”

mentioning

confidence: 99%

Molecular Characterization of Astroviruses by Reverse Transcriptase PCR and Sequence Analysis: Comparison of Clinical and Environmental Isolates from South Africa

Nadan

Walter

Grabow

et al. 2003

Appl Environ Microbiol

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Illness in a community associated with an episode of water contamination with sewage

Cited by 19 publications

References 14 publications

A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, France, 2000

A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, France, 2000

Multitiered Approach Using Quantitative PCR To Track Sources of Fecal Pollution Affecting Santa Monica Bay, California

Molecular Characterization of Astroviruses by Reverse Transcriptase PCR and Sequence Analysis: Comparison of Clinical and Environmental Isolates from South Africa

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