Outbreak of acute gastroenteritis caused by contamination of drinking water in a factory, the Basque Country

Abstract

On 18 September 2013, the Gipuzkoa Epidemiology Unit was notified of an outbreak of acute gastroenteritis (AGE) among employees at a domestic appliance factory. The first signs of the outbreak had emerged at the end of June and at the time of the notification 30 workers were on sick leave for gastroenteritis. Some employees had had more than one episode and the main symptoms were diarrhoea and vomiting. An investigation began to identify the causative agent, assess exposure and determine the route of transmission. Data collected by a questionnaire identified 302 episodes of AGE among 238 people affected between June and September 2013. The source of water consumed was found to be a risk factor associated with the appearance of symptoms both in the crude and the adjusted analysis: odds ratio 1.8 (0.8-4.2) and 6.4 (4.2-9.8), respectively. Microbiological analysis of stool samples and of water confirmed the presence of norovirus and rotavirus. The environmental study detected a connection between an industrial use water system and drinking water at the factory. It was concluded that the outbreak was caused by mixed viral infections, due to contamination of drinking water.

Summary of Excreted and Waterborne Viruses

“…Water and food are the main vehicles for transmission of viruses that replicate in the gastrointestinal tract causing the wide spectrum of diseases described in Table 2. Contaminated drinking water is an important cause of gastrointestinal disease (Altzibar et al, 2015;Braeye et al, 2015;Craun et al, 2010;Kauppinen et al, 2017). The burden of water-borne diseases directly related to viruses, was estimated at 136 outbreaks in Europe during 2000 and 2007 (39% of all diarrhea cases due to unsafe water) and at 64 outbreaks in the U.…”

A waterborne norovirus gastroenteritis outbreak in a school, eastern China

“…Approximately 14% of norovirus-gastroenteritis outbreaks were estimated to be foodborne [6]. Waterborne norovirus outbreaks accounted for 1·5% [7], and have also been reported in different countries [8–10], including China [11, 12]. Moreover, waterborne outbreaks were reported to be significantly associated with GI strains [13].…”

Akut gastroenterit salgınının mikrobiyolojik değerlendirmesi

“…Consumption of food or drinking water contaminated with feces is one of the leading causes of gastrointestinal disorders. Regarding to the reports from many countries, it is reported that mainly drinking water is the source of gastrointestinal outbreaks 8,9 . Many infectious agents including primarily Norovirus and Rotavirus may cause AGE either sporadically or epidemically 9 .…”

“…Regarding to the reports from many countries, it is reported that mainly drinking water is the source of gastrointestinal outbreaks 8,9 . Many infectious agents including primarily Norovirus and Rotavirus may cause AGE either sporadically or epidemically 9 . In this study, application of 440 patients to emergency service with complaints of nausea, vomiting, abdominal pain and diarrhea within two weeks of September 2015 in Şırnak city was considered as outbreak and investigations were done to determine the causing agents.…”