Shigellosis outbreak associated with swimming.

Makintubee, S; Mallonee, J; Istre, G R

doi:10.2105/ajph.77.2.166

Cited by 29 publications

(7 citation statements)

References 10 publications

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“…4, the average daily exposure would be 2 x 1O-4 and 3 x 10 -4 organisms for the minimum and maximum, with a range of 1.8 x 10 -5 to 1 x 10 -3 organisms (see Tables 6 and 7 for risk ranges and values). Since some cases of outbreaks in literature have occurred at annual local events such as picnics, swimming, and concerts, or at a vacation spot or a cruise (Rosenberg et al, 1976;Black et al, 1978;Makintubee et al, 1987;Spitka et al, 1987;Sorvillo et al, 1988;Reeve et al, 1989;Blostein, 1991;Lee et al, 1991;Lew et al, 1991), it is plausible to assume that exposure may occur only sporadically, e.g. for 7 days out of the year, with the risk on the other days being zero.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of shigellosis in the U.S.: consistency with dose-response information

Crockett

Haas

Fazil

et al. 1996

International Journal of Food Microbiology

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Every year there are estimated 300000 cases of Shigella in the United States (Bennett et al., 1987, Am. J. Prev. Med. 3, 102-114). A beta-Poisson model was fit to human dose-response information on pathogenic Shigella using the Maximum Likelihood Estimation technique (Haas, 1983, Am. J. Epidemiol. 118, 573-582). Pooled and separate data sets for the Shigella species were fit to the beta-Poisson model and 95% confidence limits and regions were calculated. Shigella dysentariae and Shigella jlexneri confidence regions and limits overlapped with each other and with the pooled data set, suggesting that this model can describe Shigella in general. The pooled Shigella model as well as the upper and lower confidence limits of the three data sets showed average exposures based on the estimated U.S. caseload of pathogenic Shigella of 0.01 to 0.014 organisms (confidence limits O.OOl-0.05) for a 7-day per annum period of exposure and ranges from 0.07 to 0.1 organisms (confidence limits 0.006-0.4). for a l-day per annum period of exposure. The plausibility of the pooled dose-response model was then evaluated by comparison with two known cruise ship outbreaks. The pooled model estimated that the two outbreaks studied could have been due to ingestion of 344 (confidence limits 72-915) Shigella cells per meal and 10.5-12 (confidence limits l-44) Shigella cells per glass of water by passengers.

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Section: Discussionmentioning

confidence: 99%

Prevalence of shigellosis in the U.S.: consistency with dose-response information

Crockett

Haas

Fazil

et al. 1996

International Journal of Food Microbiology

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“…This is not unusual in a waterborne outbreak [10,11,16]. Shigella is difficult to culture from water and may require samples of as much as 10 litres [6]. Nevertheless, the proximity of the sewage pipe end to the valley fountain, the run-off of the unprocessed sewage material towards this fountain, the contamination of its water with faecal coliforms, and the control of the outbreak after the isolation of this fountain and chlorination of the village's water supply, are strong indications of a waterborne outbreak.…”

Section: Bacteriologic Findingsmentioning

confidence: 99%

“…Shigellosis is usually transmitted from person to person in households [5,6], however outbreaks due to contaminated food [7][8][9] or water [6,10] are not unusual. We report an outbreak of shigellosis in a Greek village on the island of Crete, which was linked to contaminated drinking water.…”

Section: Introductionmentioning

confidence: 99%

An outbreak of diarrhoeal disease attributed to Shigella sonnei

et al. 1994

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SUMMARYAn outbreak of gastroenteritis occurred in a village on the Island of Crete, with 1479 inhabitants. One hundred and thirty–eight symptomatic patients from 57 different families were examined. Thirty percent of children under 12 years were affected compared with 4% of adolescents and adults (P < 0.0001). Thirty–five out of 105 stool cultures (33%) grew Shigella sonnei. Thirty–four isolates had the same susceptibility pattern and were sensitive to ampicillin, while one was resistant to this antibiotic. Thirty–three isolates had the same plasmid profile. Based on epidemiologic and environmental findings, it was concluded that the transmission of shigellosis was waterborne. Shigella were not isolated from water, but one of the three village springs was found to be contaminated with faecal coliforms. This spring was probably contaminated by sewage material, due to its proximity to a source of untreated sewage effluent. Implementation of environmental and control measures brought the epidemic to an end.

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“…For instance, there were studies indicating that enterovirus-like illnesses (particularly those caused by coxsackieviruses) were swimming-related [5][6][7]. Other studies also provided evidence that swimming in polluted freshwater beaches could be linked with outbreaks of hepatitis A [8], shigellosis [9,10], and Norwalk virus gastroenteritis [11,12].…”

Section: Introductionmentioning

confidence: 99%

Health effects of beach water pollution in Hong Kong

Cheung¹,

Chang²,

Hung³

et al. 1990

Epidemiol. Infect.

131

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Prospective epidemiological studies of beach water pollution were conducted in Hong Kong in the summers of 1986 and 1987. For the main study in 1987, a total of 18741 usable responses were obtained from beachgoers on nine beaches at weekends. The study indicated the overall perceived symptom rates for gastrointestinal, ear, eye, skin, respiratory, fever and total illness were significantly higher for swimmers than non-swimmers; and the swimming-associated symptom rates for gastrointestinal, skin, respiratory and total illness were higher at 'barely acceptable' beaches than at 'relatively unpolluted' ones. Escherichia coli was found to be the best indicator of the health effects associated with swimming in the beaches of Hong Kong. It showed the highest correlation with combined swimming-associated gastroenteritis and skin symptom rates when compared with other microbial indicators. A linear relationship between E. coli and the combined symptom rates was established. Staphylococci were correlated with ear, respiratory and total illness, but could not be used for predicting swimming-associated health risks. They should be used to complement E. coli. The setting of health-related bathing-water quality standards based on such a study is discussed.

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Shigellosis outbreak associated with swimming.

Cited by 29 publications

References 10 publications

Prevalence of shigellosis in the U.S.: consistency with dose-response information

Prevalence of shigellosis in the U.S.: consistency with dose-response information

An outbreak of diarrhoeal disease attributed to Shigella sonnei

Health effects of beach water pollution in Hong Kong

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