Lessons learned from ten investigations of waterborne gastroenteritis outbreaks, France, 1998–2006

Abstract

Ten outbreaks of waterborne acute gastroenteritis (AGE) have been investigated in France since 1998. These outbreaks have affected populations of over 1,000 people, with generally high attack rates. The causal agents have been identified in six of these events. Aetiologies involved mainly noroviruses and Cryptosporidium sp. The point of entry of the contamination was located in the distribution network in five outbreaks (waste water backflows in four cases and one case of contamination induced by maintenance work) and at the water collection facilities in five other cases. Once the outbreak was detected, epidemiological and environmental investigations and crisis management followed wellestablished procedures. Further progress in public health surveillance will depend on more complete and rapid detection and reporting. Automated analysis of health insurance data on the reimbursement of drugs for AGE should help make detection more complete. Improved reactivity depends primarily on the operator immediately reporting incidents that indicate a possible massive contamination of the water network to health authorities -in particular complaints from the population, which are the only early-warning alerts in the case of waste water backflows.

A capsule conjugate vaccine approach to prevent diarrheal disease caused byCampylobacter jejuni

“…[1][2][3][4] C. jejuni is a zoonotic pathogen and humans are most often infected by consumption of contaminated poultry, water, or raw milk. [5][6][7][8][9][10][11][12] The incidence of disease varies widely, ranging from hyperendemic levels (40 000/100 000 children less than 5 years old) in developing regions of the world, especially Southeast Asia, 4 to endemic levels (20-100/100 000 population) occurring as sporadic disease in young adults and infants in developed countries. 13 C. jejuni represent a significant cause of traveler's diarrhea in persons from industrialized nations visiting hyperendemic regions.…”

Massive outbreak of viral gastroenteritis associated with consumption of municipal drinking water in a European capital city

“…Waterborne disease outbreaks often involve acute gastroenteritis [5]. The symptoms of acute gastroenteritis range from mild, watery diarrhoea to severe febrile illness characterized by vomiting, diarrhoea and prostration.…”

Investigation of a Community Outbreak of Diarrhea Associated with Drinking Water in Suburb of Chengdu, China

“…Targeted actions were initiated immediately, including disinfection at houses of diarrhea cases, temporarily close well water, requirement towards farmers to stop washing vegetable and fruit with water from well and river, refreshing river by opening the dam, as well as health education. Accordingly, an effective disease surveillance system and emergency response mechanism are of great importance for the early detection and recognition of similar outbreaks as well as promptly epidemic control [13] [14].…”