Use of a health information telephone line, Info-Santé CLSC, for the surveillance of waterborne gastroenteritis

Gilbert, Marie-Line; Levallois, Patrick; Rodrı́guez, Manuel J.

doi:10.2166/wh.2006.0019

Cited by 15 publications

(21 citation statements)

References 17 publications

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“…A stronger relationship between turbidity and parasite occurrence was observed in Coghlan Creek, which has lower streamflow discharge than Salmon River. A link between drinking water turbidity and emergency room visits, hospitalizations, and calls to a health information telephone line has previously been shown (29,30). However, many studies have failed to show consistently strong relationships between turbidity and parasite occurrence in raw water supplies (31,32).…”

Section: Discussionmentioning

confidence: 96%

Assessment of Giardia and Cryptosporidium spp. as a Microbial Source Tracking Tool for Surface Water: Application in a Mixed-Use Watershed

Prystajecky

Huck

Schreier

et al. 2014

Appl Environ Microbiol

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Knowledge of host specificity, combined with genomic sequencing of Giardia and Cryptosporidium spp., has demonstrated a microbial source tracking (MST) utility for these common waterborne microbes. To explore the source attribution potential of these pathogens, water samples were collected in a mixed rural-urban watershed in the Township of Langley, in southwestern British Columbia (BC), Canada, over a 2-year period. Cryptosporidium was detected in 63% of surface water samples at concentrations ranging from no positive detection (NPD) to 20,600 oocysts per 100 liters. Giardia was detected in 86% of surface water samples at concentrations ranging from NPD to 3,800 cysts per 100 liters of water. Sequencing at the 18S rRNA locus revealed that 50% of Cryptosporidium samples and 98% of Giardia samples contained species/genotypes (Cryptosporidium) or assemblages (Giardia) that are capable of infecting humans, based on current knowledge of host specificity and taxonomy. Cryptosporidium genotyping data were more promising for source tracking potential, due to the greater number of host-adapted (i.e., narrow-host-range) species/genotypes compared to Giardia, since 98% of Giardia isolates were zoonotic and the potential host could not be predicted. This report highlights the benefits of parasite genomic sequencing to complement Method 1623 (U.S. Environmental Protection Agency) and shows that Cryptosporidium subtyping for MST purposes is superior to the use of Giardia subtyping, based on better detection limits for Cryptosporidium-positive samples than for Giardia-positive samples and on greater host specificity among Cryptosporidium species. These additional tools could be used for risk assessment in public health and watershed management decisions.

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Section: Discussionmentioning

confidence: 96%

Assessment of Giardia and Cryptosporidium spp. as a Microbial Source Tracking Tool for Surface Water: Application in a Mixed-Use Watershed

Prystajecky

Huck

Schreier

et al. 2014

Appl Environ Microbiol

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“…Erogov et al [8] reported a 1–2 day lag effect for self-reported GI symptoms, while Gilbert et al [9] reported positive associations with the daily use of a health information telephone line, 11, 15 and 17 days later. An increase in pediatric GI visits to the emergency department in Philadelphia was observed 4 days after increased turbidity [12], and hospital admissions in the same area were also associated with increased turbidity in the elderly [11] and children [12], with a delayed effect.…”

Section: Discussionmentioning

confidence: 99%

Association between Precipitation Upstream of a Drinking Water Utility and Nurse Advice Calls Relating to Acute Gastrointestinal Illnesses

2013

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BackgroundThe River Göta Älv is a source of fresh-water for the City of Gothenburg (Sweden). We recently identified a clear association between upstream precipitation and indicator bacteria concentrations in the river water outside the intake to the drinking water utility. This study aimed to determine if variation in the incidence of acute gastrointestinal illnesses is associated with upstream precipitation.MethodsWe acquired data, covering 1494 days, on the daily number of telephone calls to the nurse advice line from citizens in Gothenburg living in areas with Göta Älv as a fresh-water supply. We separated calls relating to gastrointestinal illnesses from other medical concerns, and analyzed their association with precipitation using a distributed lag non-linear Poisson regression model, adjusting for seasonal patterns and covariates. We used a 0–21-day lag period for precipitation to account for drinking water delivery times and incubation periods of waterborne pathogens.ResultsThe study period contained 25,659 nurse advice calls relating to gastrointestinal illnesses. Heavy rainfall was associated with increased calls the same day and around 5–6 days later. Consecutive days of wet weather were also found to be associated with an increase in the daily number of gastrointestinal concerns. No associations were identified between precipitation and nurse advice calls relating to other medical concerns.ConclusionAn increase in nurse advice calls relating to gastrointestinal illnesses around 5–6 days after heavy rainfall is consistent with a hypothesis that the cause could be related to drinking water due to insufficient barriers in the drinking water production, suggesting the need for improved drinking water treatment.

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“…Although all variables were not tested beyond a 15-day time lag in France and 1-month time lag in Spain, multiple windows of potential significance (Table 5) and sensitivity test results suggest variable rates of secondary contagion and/or the presence of multiple pathogens or pathogen types, such as viruses, bacteria, and protozoa (Aramini et al, 2000; David et al, 2014; Egorov et al, 2003; Gilbert et al, 2006). Selecting the one or two most significant time lags could thus underestimate impact relative to including a larger range (e.g., up to 30 days) that captures all primary and secondary cases (Aramini et al, 2000; Beaudeau, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…Time series studies have been used to interpret risks related to drinking water in the US, Canada, France, Sweden, Russia, and other high-income locations (Aramini et al, 2000; Beaudeau et al, 2014a, 2014b, 2012; Carlton et al, 2014; Egorov et al, 2003; Gilbert et al, 2006; Tinker et al, 2010; Tornevi and Forsberg, 2016; Zhou et al, 2013). This approach offers a means to characterize the relationship between surrogates for pathogen transmission in drinking water and commonly measured health outcomes, such as diarrheal disease.…”

Section: Introductionmentioning

confidence: 99%

Time series study of weather, water quality, and acute gastroenteritis at Water Safety Plan implementation sites in France and Spain

Setty

Enault

Loret

et al. 2018

International Journal of Hygiene and Environmental Health

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Water Safety Plans (WSPs), recommended by the World Health Organization since 2004, can help drinking water suppliers to proactively identify potential risks and implement preventive barriers that improve safety. Few studies have investigated long-term impacts of WSPs, such as changes in drinking water quality or public health; however, some evidence from high-income countries associates WSP implementation with a reduction in diarrheal disease. To validate the previously observed linkages between WSPs and health outcomes, this time series study examined site-specific relationships between water-related exposures and acute gastroenteritis rates at three locations in France and Spain, including the role of WSP status. Relationships between control or exposure variables and health outcomes were tested using Poisson regression within generalized additive models. Controls included suspected temporal trends in disease reporting. Exposures included temperature, precipitation, raw water quality, and finished water quality (e.g., turbidity, free chlorine). In France, daily acute gastroenteritis cases were tracked using prescription reimbursements; Spanish data aggregated monthly acute gastroenteritis hospital visits. The models identified several significant relationships between indicators of exposure and acute gastroenteritis. Lag times of 6–9 days (including transit time) were most relevant for hydrological indicators (related to precipitation, runoff, and flow) at the two French sites, indicative of viral pathogens. Flush events (defined as surface runoff after a two-week antecedent dry period) linked to nonpoint source pollution were associated with a 10% increase in acute gastroenteritis rates at one location supplied by surface water. Acute gastroenteritis rates were positively associated with elevated turbidity average or maximum values in finished water at locations supplied by both surface and groundwater, by about 4% per 1-NTU increase in the two-week moving average of daily maxima or about 10% per 0.1 NTU increase in the prior month’s average value. In some cases, risk appeared to be mitigated by WSP-related treatment interventions. Our results suggest drinking water exposure is associated with some potentially preventable gastrointestinal illness risk in high-income regions.

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Use of a health information telephone line, Info-Santé CLSC, for the surveillance of waterborne gastroenteritis

Cited by 15 publications

References 17 publications

Assessment of Giardia and Cryptosporidium spp. as a Microbial Source Tracking Tool for Surface Water: Application in a Mixed-Use Watershed

Assessment of Giardia and Cryptosporidium spp. as a Microbial Source Tracking Tool for Surface Water: Application in a Mixed-Use Watershed

Association between Precipitation Upstream of a Drinking Water Utility and Nurse Advice Calls Relating to Acute Gastrointestinal Illnesses

Time series study of weather, water quality, and acute gastroenteritis at Water Safety Plan implementation sites in France and Spain

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