A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, France, 2000
|Author(s)||Gallay A1, De Valk H1, Cournot M2, Ladeuil B4, Hemery C2, Castor C1, Bon F3, Megraud F5, Le Cann Pierre6, Desenclos Jc1|
|Affiliation(s)||1 : Inst Veille Sanitaire, F-94415 St Maurice, France.
2 : Cellule Interreg Epidemiol Intervent Sud Ouest, Toulouse, France.
3 : CHU Dijon, Ctr Natl Reference Virus Enter, Dijon, France.
4 : Direct Dept Agr Foret Lot, Cahors, France.
5 : CHU Pellegrin Bordeaux, Ctr Natl Reference Campylobacters & Helicobacters, Bordeaux, France.
6 : IFREMER, F-44311 Nantes 3, France.
|Source||Clinical Microbiology and Infection (1198-743X) (Blackwell science), 2006-06 , Vol. 12 , N. 6 , P. 561-570|
|WOS© Times Cited||93|
|Keyword(s)||Waterborne outbreak, Rotavirus, Norovirus, Gastroenteritis, Epidemiology, Campylobacter coli|
|Abstract||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.|