An outbreak of gastroenteritis on a passenger cruise ship

O'Mahony, Mary C.; Noah, Norman; Evans, Bryant; Harper, David M.; Rowe, B.; Lowes, J. A.; Pearson, Andrew; Goode, Brant

doi:10.1017/s0022172400065311

Cited by 18 publications

(7 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Faecal coliforms were isolated from tap water, and drinking tap water was the only risk factor associated with illness in a case-control study ( p = 0.01). There were several defects in the ship's water system including potentially faulty chlorination, and defective covers possibly allowing bilge water into the water tanks (O'Mahony et al 1986). On a global scale diarrhoeal illness due to E. coli is a major cause of morbidity and mortality, especially in children.…”

Section: Resultsmentioning

confidence: 99%

Assessment of drinking water quality using ICP-MS and microbiological methods in the Bholakpur area, Hyderabad, India

Abdul

Mutnuri

Dattatreya

et al. 2011

Environ Monit Assess

View full text Add to dashboard Cite

A total of 16 people died and over 500 people were hospitalized due to diarrhoeal illness in the Bholakpur area of Hyderabad, India on 6th May 2009. A study was conducted with immediate effect to evaluate the quality of municipal tap water of the Bholakpur locality. The study consists of the determination of physico-chemical properties, trace metals, heavy metals, rare earth elements and microbiological quality of drinking water. The data showed the variation of the investigated parameters in samples as follows: pH 7.14 to 8.72, EC 455 to 769 μS/cm, TDS 303.51 to 515.23 ppm and DO 1.01 to 6.83 mg/L which are within WHO guidelines for drinking water quality. The water samples were analyzed for 27 elements (Li, Be, B, Na, Mg, Al, Si, K, Ca, V, Cr, Mn, Fe, Ni, Co, Cu, Zn, As, Se, Rb, Sr, Mo, Ag, Cd, Sb, Ba and Pb) using inductively coupled plasma-mass spectrometry (ICP-MS). The concentrations of Fe (0.12 to 1.13 mg/L), Pb (0.01 to 0.07 mg/L), Cu (0.01 to 0.19 mg/L), Ni (0.01 to 0.15 mg/L), Al (0.16 to 0.49 mg/L), and Na (38.36 to 68.69 mg/L) were obtained, which exceed the permissible limits of the World Health Organization (WHO) for drinking water quality guidelines. The remaining elements were within the permissible limits. The microbiological quality of water was tested using standard plate count, membrane filtration technique, thermotolerant coliform (TTC), and most probable number (MPN) methods. The total heterotrophic bacteria ranged from 1.0 × 10(5) to 18 × 10(7 )cfu/ml. Total viable bacteria in all the water samples were found to be too numerable to count and total number of coliform bacteria in all water samples were found to be of order of 1,100 to >2,400 MPN index/100 ml. TTC tested positive for coliform bacteria at 44.2°C. All the water samples of the study area exceeded the permissible counts of WHO and that (zero and minimal counts) of the control site (National Geophysical Research Institute) water samples. Excessively high colony numbers indicate that the water is highly contaminated with microorganisms and is hazardous for drinking purposes. Bacteriological pollution of drinking water supplies caused diarrhoeal illness in Bholakpur, which is due to the infiltration of contaminated water (sewage) through cross connection, leakage points, and back siphoning.

show abstract

Section: Resultsmentioning

confidence: 99%

Assessment of drinking water quality using ICP-MS and microbiological methods in the Bholakpur area, Hyderabad, India

Abdul

Mutnuri

Dattatreya

et al. 2011

Environ Monit Assess

View full text Add to dashboard Cite

show abstract

“…ETEC-associated waterborne outbreaks recently have been traced to water taken aboard at non-US ports without adequate subsequent chlorination or other water treatment. Whether food-or waterborne, E. coli remains a pathogen of note [27][28][29][30][31]. Fortunately, outbreaks of Salmonella species, Shigella species, Campylobacter species, and Yersinia species are extremely rare.…”

Section: Associated Agents and Therapymentioning

confidence: 99%

Outbreaks of gastrointestinal diseases on cruise ships: Lessons from three decades of progress

Lawrence

2004

Curr Infect Dis Rep

View full text Add to dashboard Cite

Dramatic improvements in sanitary engineering and, especially, operational procedures aboard cruise ships began in the mid-1970s after several large outbreaks of acute gastroenteritis. The US Centers for Disease Control and Prevention's Vessel Sanitation Program, working with the cruise industry, conducts ship inspections, provides public access to ship sanitation scores, and reports outbreak investigations. The significant increase in median ship sanitation scores over the past decade has been concomitant with a reduction in outbreak frequency to 3.7 per 1000 cruises. Most outbreaks of the past decade were linked to noroviruses (Norwalk-like viruses), enterotoxigenic Escherichia coli, or the residual "unknown" causes. Although norovirus outbreaks may begin as foodborne or waterborne disease, easy person-to-person transmission occurs through fecal- or vomitus-splattered surfaces, other items, clothing, and especially, hands. Control of person-to-person spread of illness among crew and passengers becomes the major objective. Rigorous handwashing, environmental disinfection, and other food service job-related restrictions are required to prevent multiple outbreaks on the same ship. Vigilance by public health and industry officials has prevented many thousands of illnesses and some associated deaths. Clinicians providing pretravel health advice and post-travel diagnoses and care can benefit from and contribute to epidemiologic investigations and thereby enhance the health of cruise passengers individually and collectively.

show abstract

“…These categories include enteropathogenic E. coli, enterotoxigenic E. coli, enteroinvasive E. coli, enteroag‐gregative E. coli, diffuse adherent E. coli, and enterohemorrhagic E. coli (also known as shiga toxin‐producing E. coli ). The most commonly occurring of these is the enterohemorrhagic strain known as E. coli O157, which has been the causative agent in several waterborne disease outbreaks (Barwick et al, 2000; Swerdlow et al, 1992; CDC, 1991; O'Mahony et al, 1986; Rosenberg et al, 1977; Schroeder et al, 1968). The pathogenic E. coli strains produce symptoms ranging from mild diarrhea to severe watery or bloody diarrhea, cramping, headache, and in some cases hemolytic uremic syndrome, which may result in kidney failure or even death (Barwick et al, 2000; Paton & Paton, 1998).…”

Section: Introductionmentioning

confidence: 99%

E. coli as a public health indicator of drinking water quality

Standridge¹

2008

Journal AWWA

View full text Add to dashboard Cite

Public health practitioners and water providers have been testing water for microbial contaminants for more than a century. In the United States, public water testing is regulated by federal law. The specifics of the federal law are enforced through such rules as the Total Coliform Rule (TCR). A negotiated rule‐making process to amend the TCR is under way. As this process proceeds, it is important that stakeholders have access to the latest information pertinent to the discussion. This article provides information to be used in evaluating Escherichia coli for inclusion in the amended rule as a potential indicator for drinking water monitoring. Advances in the techniques used for coliform and E. coli testing, new understanding about distribution system biofilms, newly emerged waterborne pathogens, and international changes in the use of E. coli as an indicator all combine to underscore the importance of reconsidering the role of E. coli as an indicator organism.

show abstract

An outbreak of gastroenteritis on a passenger cruise ship

Cited by 18 publications

References 4 publications

Assessment of drinking water quality using ICP-MS and microbiological methods in the Bholakpur area, Hyderabad, India

Assessment of drinking water quality using ICP-MS and microbiological methods in the Bholakpur area, Hyderabad, India

Outbreaks of gastrointestinal diseases on cruise ships: Lessons from three decades of progress

E. coli as a public health indicator of drinking water quality

Contact Info

Product

Resources

About