Waterborne Outbreak of Norwalk-Like Virus Gastroenteritis at a Tourist Resort, Italy

Boccia, Delia; Tozzi, Alberto Eugenio; Cotter, Benvon; Rizzo, Caterina; Russo, Teresa; Buttinelli, Gabriele; Caprioli, Alfredo; Marziano, Maria Luisa; Ruggeri, Franco Maria

doi:10.3201/eid0806.010371

Cited by 106 publications

(80 citation statements)

References 16 publications

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“…Microbial infections acquired from contaminated ice are not uncommon and have been reported for Escherichia coli O157 : H7, Legionella pneumophila, Salmonella enteritidis and Norwalk-like virus (Kim & Harrison, 2008;Seo et al, 2006;Boccia et al, 2002;Graman et al, 1997). A significant number of cholera cases are due to consumption of contaminated water rather than personto-person transmission (Schild et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Edible ice in Jakarta, Indonesia, is contaminated with multidrug-resistant Vibrio cholerae with virulence potential

Waturangi

Wennars

Suhartono

et al. 2013

Journal of Medical Microbiology

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Consumption of street food is considered a major health risk in the absence of public-health inspection programmes in Indonesia. It is hypothesized that ice used in street food could be one of the major sources of Vibrio cholerae contamination. This study documented V. cholerae contamination in edible ice from different areas of Jakarta, the capital city of Indonesia, and attempted to characterize the virulence potential of the strains. A selective medium was used to isolate 98 V. cholerae strains and their identity was confirmed using biochemical assays. Serological tests classified the majority (78 %) in the non-O1 serogroup. Multiplex PCR was used to detect the presence of V. cholerae virulence genes, namely ctxA, ompU, tcpA, ace, zot and toxR. The toxR, ctxA, ompU and zot genes were detected in 75, 26, 15 and 1 % of isolates, respectively. The ace and tcpA genes were not detected in any of the isolates. The ctxA gene encoding the cholera toxin subunit A, which has been associated only with clinical strains of O1, here was present in both serogroups. The antibiotic-resistance profile showed that 65, 60, 52, 39, 37, 19 and 3 % of the isolates were resistant to ampicillin, streptomycin, kanamycin, sulfamethoxazole-trimethoprim, erythromycin, tetracycline and ciprofloxacin, respectively. A large proportion of V. cholerae isolates came from west and south Jakarta, and these strains exhibited multidrug resistance to ampicillin, streptomycin, tetracycline, erythromycin, kanamycin and sulfamethoxazole-trimethoprim. Many of these isolates from west and south Jakarta also harboured toxR, encoding a regulator, and ctxA. The presence of multidrug-resistant V. cholerae with virulence genes in edible ice, which could cause a severe outbreak, reflects the poor water quality in Jakarta, and indicates an urgent need for better surveillance and management. INTRODUCTIONIce products are often used in street foods and are consumed by most people, especially in tropical countries such as Indonesia. Microbial infections acquired from contaminated ice are not uncommon and have been reported for Escherichia coli O157 : H7, Legionella pneumophila, Salmonella enteritidis and Norwalk-like virus (Kim & Harrison, 2008;Seo et al., 2006;Boccia et al., 2002;Graman et al., 1997). A significant number of cholera cases are due to consumption of contaminated water rather than personto-person transmission (Schild et al., 2008).The causative agent of cholera is Vibrio cholerae. Although it is a marine organism, it can also be found in fresh-water rivers. There are two V. cholerae serogroups, O1 and non-O1. Members of the O1 group are associated with epidemic cholera, whereas non-O1 members isolated from estuaries are associated with sporadic illness. The presence of virulence genes is usually associated with the O1 group (Sack et al., 2004). However, this scenario has been evolving slowly in recent years, and several studies have reported the presence of virulence genes in non-O1 environmental isolates (Kumar et al., 2008;Jagadeeshan et al., 2009...

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Section: Introductionmentioning

confidence: 99%

Edible ice in Jakarta, Indonesia, is contaminated with multidrug-resistant Vibrio cholerae with virulence potential

Waturangi

Wennars

Suhartono

et al. 2013

Journal of Medical Microbiology

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“…Outbreaks of viral acute gastroenteritis by consumption of contaminated water have been frequently reported in the world, and viruses are known as the etiological agents for the infectious gastroenteritis (Divizia et al 2004). While rotaviruses, astrovirus, and norovirus have been involved in these outbreaks (Hung et al 1984;Boccia et al 2002;Divizia et al 2004;Hoebe et al 2004;Gallay et al 2006;Hewitt et al 2007;Martinelli et al 2007;Maunula et al 2009), routine procedures for monitoring these viruses in water samples had not been drawn up for the water-microbiology screening panel. Sewage water contains much higher numbers of viruses (Meleg et al 2006) and sewage workers frequently exposed to raw sewage were found to be at higher risk of intestinal disease (Rylander 1999;Venczel et al 2003).…”

Section: Introductionmentioning

confidence: 99%

One-year monthly survey of rotavirus, astrovirus and norovirus in three sewage treatment plants in Beijing, China and associated health risk assessment

Zhang

et al. 2011

Water Science and Technology

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“…Human enteric viruses have been recognized as major causes of waterborne out-break which have been reported worldwide in both developed and developing countries [1,2]. Human virus analysis requires advanced technologies and specialists.…”

Section: Introductionmentioning

confidence: 99%

Bacteriophage Removal Efficiency of In-line Coagulation with Ceramic Membrane Filtration

Wattanachira¹,

Rakruam²,

Yanthongyu³

et al. 2017

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Abstract. The main objectives of this study are to evaluate the removal efficiency of bacteriophage Qβ using in-line coagulation with ceramic membrane filtration at different coagulant dosages, ceramic membrane pore sizes and initial bacteriophage Qβ concentrations. Raw water was collected from the Ping River, Chiang Mai, Thailand, and spiked with bacteriophage Qβ to prepare an initial concentration of 8x10 6 PFU/ml. According to the resulted, it was found that the smaller pore sizes membrane yield higher bacteriophage Qβ log removal. However, the use of a ceramic membrane alone could not remove bacteriophage Qβ completely. In-line coagulation combined with ceramic membrane filtration was conducted. The optimal polyaluminum chloride (PACl) doses for the 1.0, 0.5 and 0.1 µm pore size membranes were 2.5, 2.0 and 1.5 mg-Al/L, respectively. Bacteriophage Qβ removal at the optimal PACl dose was more than 6.7 log in all cases. The results of effect of different initial bacteriophage Qβ concentration on the removal efficiency showed that in-line coagulation with ceramic membrane at all pore sizes can completely remove bacteriophage Qβ when the initial concentration was low (5x10 5 PFU/ml). However, the higher initial bacteriophage Qβ concentrations (4x10 6 and 8x10 7 PFU/ml) required a higher PACl dose to obtain effective bacteriophage Qβ removal.

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Waterborne Outbreak of Norwalk-Like Virus Gastroenteritis at a Tourist Resort, Italy

Cited by 106 publications

References 16 publications

Edible ice in Jakarta, Indonesia, is contaminated with multidrug-resistant Vibrio cholerae with virulence potential

Edible ice in Jakarta, Indonesia, is contaminated with multidrug-resistant Vibrio cholerae with virulence potential

One-year monthly survey of rotavirus, astrovirus and norovirus in three sewage treatment plants in Beijing, China and associated health risk assessment

Bacteriophage Removal Efficiency of In-line Coagulation with Ceramic Membrane Filtration

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