Association between Brainerd Diarrhea and Zebra Mussel Infestations

Abstract

Brainerd Diarrhea is a syndrome of acute onset of watery, non-bloody diarrhea that lasts for a duration of 4 weeks or more. The index case of Brainerd Diarrhea was recorded in 1983, in the first such outbreak in Brainerd, Minnesota.In 1989, a prohibited invasive species named Zebra Mussels (Dreissena polymorpha) were found in the great lakes of the United States. The 7 recorded outbreaks of Brainerd diarrhea were correlated with the location and time of zebra mussel infestations. The first outbreak that occurred due to consumption of raw milk took place in Minnesota which is near the waters infested by zebra mussels. All other outbreaks were related to consumption of contaminated unchlorinated water occurred in regions not directly close to the infested rivers. However, since infestations are thought to occur due to human activity, undocumented infestations faraway are still possible. Evidence shows minor correlations between Brainerd Diarrhea outbreaks and Zebra Mussel infestations. However, none of the facts are strong enough to establish or deny a significant correlation or causation. Further cohort studies and research need to be done on the recent discoveries of Zebra Mussel infestations and new Brainerd diarrhea outbreaks. The primary search engine used to gather information for this review was ScienceDirect and PubMed. More than 35 articles and case reports were reviewed and only 20 were shortlisted and used as references. None of the studies included were restricted to study design, but studies with less than 10 participants/patients were excluded from the review.