An Epidemic of Gastroenteritis Traced to a Contaminated Public Water Supply

Abstract

Between January 1 and March 15, 1974, approximately 1200 cases of acute gastrointestinal illness occurred in Richmond Heights, Florida, a residential community of 6500 in south Dade County. Over one-third of all families in the area had at least one member affected. The findings of 10 culture-proven cases of shigellosis among those who became ill and clinical signs and symptoms in the others suggest that most of the other cases that were not cultured may have been shigellosis also. Epidemiologic investigation showed that consumption of tap water was associated with illness in the initial cases of affected families. Evaluation of the Richmond Heights public water supply disclosed numerous inadequacies in both design and operation. One of the wells providing water to the community was continuously contaminated with excessive levels of fecal coliforms from a nearby septic tank, and a breakdown in chlorination on January 14-15 caused approximately 1 million gallons of inadequately chlorinated water from the contaminated well to be distributed to the community 48 hours before the epidemic began. Correction of deficiencies in the water plant was undertaken by the utility company; the residents of Richmond Heights were instructed to boil their drinking water or to use commercially bottled water pending completion of corrective measures. A FUll scale study is planned for all similar public water supplies in Dade County.

Septic tanks as larval habitats for the mosquitoes Aedes aegypti and Culex quinquefasciatus in Playa-Playita, Puerto Rico

“…In addition to their potential role as a vector habitat, septic tanks have been shown to have other detrimental effects on the local environment and inhabitants. Septic tank usage has been associated with increased incidences of viral and bacterial enteric diseases and at least one outbreak of gastroenteritis has been traced to the faecal contamination of a public water supply from a nearby septic system (Weissman et al , 1976; Borchardt et al , 2003; Ozkan et al , 2007). In addition to biological pathogens, septic tanks can also serve as a source of nitrates and other potentially harmful chemicals (Liu et al , 2005).…”

A fatal waterborne disease epidemic in Walkerton, Ontario: comparison with other waterborne outbreaks in the developed world

“…Concerns about contamination from farming were raised at the commissioning of the well in 1978 but no explicit source protection measures were ever adopted. Poor location was a factor at Disraeli where Richmond Height, FL, USA 1,200 cases of gastroenteritis, likely Weissman et al, 1976January-March 1974 shigellosis served by chlorinated shallow (6-15 m) groundwater Bradford, PA, USA 3,500 cases of gastroenteritis of unidentified Akin & Jakubowski, 1986September-December 1979 aetiology in a chlorinated groundwater supply Bramham, England 3,000 cases of gastroenteritis of unidentified Short, 1988July 1980 aetiology in a direct filtered and chlorinated supply Eagle-Vail, CO, USA 80 cases of gastroenteritis likely rotavirus in a Hopkins et al, 1986March 1981 direct filtered and chlorinated supply Orangeville, ON, Canada 241 cases of campylobacteriosis in an Millson et al, 1991April 1985 unchlorinated groundwater supply Pittsfield MA, USA 3,800 cases of giardiasis in a chlorinated Kent et al, 1988November 1985-January but unfiltered water supply 1986 Disraeli, PQ, Canada 50 cases of gastroenteritis associated with Tessier et al, 1987August 1986 three cases of campylobacteriosis in an unchlorinated, unfiltered surface supply Penticton, BC, Canada 3,000 cases of giardiasis in a chlorinated, Moorehead et al, 1990June 1986 unfiltered, surface/groundwater supply…”

Shigellosis Outbreak in Al Batinah South Governorate, Oman: Case-control study

“…These are all factors that introduce a greater risk of acute gastroenteritis. [24][25][26] The importance of regularly cleaning overhead tanks, changing water filters, using closed containers to collect household waste, emptying full septic tanks and maintaining general hygiene in household surroundings should be stressed in this community setting. Additionally, common houseflies are mechanical vectors of Shigella and, as these organisms cohabitate with humans, they can readily contaminate food and eating utensils.…”