Reactive arthritis in a population exposed to an extensive waterborne gastroenteritis outbreak after sewage contamination in Pirkanmaa, Finland

Uotila, T.; Antonen, Jaakko; Laine, Janne; Kujansuu, Eila; Haapala, A-M; Lumio, Jukka; Vuento, Risto; Oksa, Heikki; Herrala, Jaakko; Kuusi, Markku; Mustonen, Jukka; Korpela, Markku; Outbre, for the Pirkanmaa Waterborne

doi:10.3109/03009742.2011.562533

Cited by 24 publications

(23 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This suggests the acute epidemic had no residual effects at a population level. Supporting evidence has been reported in regard of occurrence of reactive arthritis in this study area half a year after the incidence [23]. However, prior studies have shown that the effects of gastroenteritis from drinking water contaminated with Campylobacter may materialize later -with a delay of up to fifteen years- as increase in arthritis symptoms or inflammatory bowel disease [10], [15], [24], or in case of Giardia infection as functional gastrointestinal diseases [12].…”

Section: Discussionsupporting

confidence: 74%

Waterborne Outbreak of Gastroenteritis: Effects on Sick Leaves and Cost of Lost Workdays

et al. 2012

View full text Add to dashboard Cite

BackgroundIn 2007, part of a drinking water distribution system was accidentally contaminated with waste water effluent causing a gastroenteritis outbreak in a Finnish town.We examined the acute and cumulative effects of this incidence on sick leaves among public sector employees residing in the clean and contaminated areas, and the additional costs of lost workdays due to the incidence.MethodsDaily information on sick leaves of 1789 Finnish Public Sector Study participants was obtained from employers' registers. Global Positioning System-coordinates were used for linking participants to the clean and contaminated areas. Prevalence ratios (PR) for weekly sickness absences were calculated using binomial regression analysis. Calculations for the costs were based on prior studies.ResultsAmong those living in the contaminated areas, the prevalence of participants on sick leave was 3.54 (95% confidence interval (CI) 2.97–4.22) times higher on the week following the incidence compared to the reference period. Those living and working in the clean area were basically not affected, the corresponding PR for sick leaves was 1.12, 95% CI 0.73–1.73. No cumulative effects on sick leaves were observed among the exposed. The estimated additional costs of lost workdays due to the incidence were 1.8–2.1 million euros.ConclusionsThe prevalence of sickness absences among public sector employees residing in affected areas increased shortly after drinking water distribution system was contaminated, but no long-term effects were observed. The estimated costs of lost workdays were remarkable, thus, the cost-benefits of better monitoring systems for the water distribution systems should be evaluated.

show abstract

Section: Discussionsupporting

confidence: 74%

Waterborne Outbreak of Gastroenteritis: Effects on Sick Leaves and Cost of Lost Workdays

et al. 2012

View full text Add to dashboard Cite

show abstract

“…IL23 responses have been suggested to be enhanced in AS owing to altered micro bial composition of the gut. 56,57 Unlike reactive arthri tis, which can be triggered by gastro intestinal infection with Salmonella, Shigella, Yersinia or Campylobacter species, 58 AS does not seem to have an obvious infectious trigger. Instead, subtle alterations in the gut microbial commu nity (microbiome) might have an important role in AS pathogenesis.…”

Section: Progress In Non-mhc Geneticsmentioning

confidence: 99%

Genetics of ankylosing spondylitis—insights into pathogenesis

2015

View full text Add to dashboard Cite

Ankylosing spondylitis (AS), an immune-mediated arthritis, is the prototypic member of a group of conditions known as spondyloarthropathies that also includes reactive arthritis, psoriatic arthritis and enteropathic arthritis. Patients with these conditions share a clinical predisposition for spinal and pelvic joint dysfunction, as well as genetic associations, notably with HLA-B(*)27. Spondyloarthropathies are characterized by histopathological inflammation in entheses (regions of high mechanical stress where tendons and ligaments insert into bone) and in the subchondral bone marrow, and by abnormal osteoproliferation at involved sites. The association of AS with HLA-B(*)27, first described >40 years ago, led to hope that the cause of the disease would be rapidly established. However, even though many theories have been advanced to explain how HLA-B(*)27 is involved in AS, no consensus about the answers to this question has been reached, and no successful treatments have yet been developed that target HLA-B27 or its functional pathways. Over the past decade, rapid progress has been made in discovering further genetic associations with AS that have shed new light on the aetiopathogenesis of the disease. Some of these discoveries have driven translational ideas, such as the repurposing of therapeutics targeting the cytokines IL-12 and IL-23 and other factors downstream of this pathway. AS provides an excellent example of how hypothesis-free research can lead to major advances in understanding pathogenesis and to the development of innovative therapeutic strategies.

show abstract

“…Between 5% and 10% of patients with AS develop clinically diagnosed inflammatory bowel disease (IBD), and a further 70% of patients with AS develop subclinical gut inflammation [1,2]. In reactive arthritis, a member of the SpA family, inflammatory arthritis develops following urogenital infection with Chlamydia trachomatis or gastrointestinal infection with Campylobacter, Salmonella, Shigella, or Yersinia [3]. Such cause-and-effect relationships are not established for other SpAs.…”

Section: Ankylosing Spondylitismentioning

confidence: 99%

Microbes, the gut and ankylosing spondylitis

et al. 2013

View full text Add to dashboard Cite

It is increasingly clear that the interaction between host and microbiome profoundly affects health. There are 10 times more bacteria in and on our bodies than the total of our own cells, and the human intestine contains approximately 100 trillion bacteria. Interrogation of microbial communities by using classic microbiology techniques offers a very restricted view of these communities, allowing us to see only what we can grow in isolation. However, recent advances in sequencing technologies have greatly facilitated systematic and comprehensive studies of the role of the microbiome in human health and disease. Comprehensive understanding of our microbiome will enhance understanding of disease pathogenesis, which in turn may lead to rationally targeted therapy for a number of conditions, including autoimmunity.

show abstract

Reactive arthritis in a population exposed to an extensive waterborne gastroenteritis outbreak after sewage contamination in Pirkanmaa, Finland

Abstract: Taking into account the large population contaminated with potentially arthritogenic agents, the occurrence of ReA was rare and mild in character.

Cited by 24 publications

References 14 publications

Waterborne Outbreak of Gastroenteritis: Effects on Sick Leaves and Cost of Lost Workdays

Waterborne Outbreak of Gastroenteritis: Effects on Sick Leaves and Cost of Lost Workdays

Genetics of ankylosing spondylitis—insights into pathogenesis

Microbes, the gut and ankylosing spondylitis

Contact Info

Product

Resources

About