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Novel Microbiological and Spatial Statistical Methods to Improve Strength of Epidemiological Evidence in a Community-Wide Waterborne Outbreak
Failures in the drinking water distribution system cause gastrointestinal outbreaks with multiple pathogens. A water distribution pipe breakage caused a community-wide waterborne outbreak in Vuorela, Finland, July 2012. We investigated this outbreak with advanced epidemiological and microbiological...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141750/ https://www.ncbi.nlm.nih.gov/pubmed/25147923 http://dx.doi.org/10.1371/journal.pone.0104713 |
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author | Jalava, Katri Rintala, Hanna Ollgren, Jukka Maunula, Leena Gomez-Alvarez, Vicente Revez, Joana Palander, Marja Antikainen, Jenni Kauppinen, Ari Räsänen, Pia Siponen, Sallamaari Nyholm, Outi Kyyhkynen, Aino Hakkarainen, Sirpa Merentie, Juhani Pärnänen, Martti Loginov, Raisa Ryu, Hodon Kuusi, Markku Siitonen, Anja Miettinen, Ilkka Santo Domingo, Jorge W. Hänninen, Marja-Liisa Pitkänen, Tarja |
author_facet | Jalava, Katri Rintala, Hanna Ollgren, Jukka Maunula, Leena Gomez-Alvarez, Vicente Revez, Joana Palander, Marja Antikainen, Jenni Kauppinen, Ari Räsänen, Pia Siponen, Sallamaari Nyholm, Outi Kyyhkynen, Aino Hakkarainen, Sirpa Merentie, Juhani Pärnänen, Martti Loginov, Raisa Ryu, Hodon Kuusi, Markku Siitonen, Anja Miettinen, Ilkka Santo Domingo, Jorge W. Hänninen, Marja-Liisa Pitkänen, Tarja |
author_sort | Jalava, Katri |
collection | PubMed |
description | Failures in the drinking water distribution system cause gastrointestinal outbreaks with multiple pathogens. A water distribution pipe breakage caused a community-wide waterborne outbreak in Vuorela, Finland, July 2012. We investigated this outbreak with advanced epidemiological and microbiological methods. A total of 473/2931 inhabitants (16%) responded to a web-based questionnaire. Water and patient samples were subjected to analysis of multiple microbial targets, molecular typing and microbial community analysis. Spatial analysis on the water distribution network was done and we applied a spatial logistic regression model. The course of the illness was mild. Drinking untreated tap water from the defined outbreak area was significantly associated with illness (RR 5.6, 95% CI 1.9–16.4) increasing in a dose response manner. The closer a person lived to the water distribution breakage point, the higher the risk of becoming ill. Sapovirus, enterovirus, single Campylobacter jejuni and EHEC O157:H7 findings as well as virulence genes for EPEC, EAEC and EHEC pathogroups were detected by molecular or culture methods from the faecal samples of the patients. EPEC, EAEC and EHEC virulence genes and faecal indicator bacteria were also detected in water samples. Microbial community sequencing of contaminated tap water revealed abundance of Arcobacter species. The polyphasic approach improved the understanding of the source of the infections, and aided to define the extent and magnitude of this outbreak. |
format | Online Article Text |
id | pubmed-4141750 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-41417502014-08-25 Novel Microbiological and Spatial Statistical Methods to Improve Strength of Epidemiological Evidence in a Community-Wide Waterborne Outbreak Jalava, Katri Rintala, Hanna Ollgren, Jukka Maunula, Leena Gomez-Alvarez, Vicente Revez, Joana Palander, Marja Antikainen, Jenni Kauppinen, Ari Räsänen, Pia Siponen, Sallamaari Nyholm, Outi Kyyhkynen, Aino Hakkarainen, Sirpa Merentie, Juhani Pärnänen, Martti Loginov, Raisa Ryu, Hodon Kuusi, Markku Siitonen, Anja Miettinen, Ilkka Santo Domingo, Jorge W. Hänninen, Marja-Liisa Pitkänen, Tarja PLoS One Research Article Failures in the drinking water distribution system cause gastrointestinal outbreaks with multiple pathogens. A water distribution pipe breakage caused a community-wide waterborne outbreak in Vuorela, Finland, July 2012. We investigated this outbreak with advanced epidemiological and microbiological methods. A total of 473/2931 inhabitants (16%) responded to a web-based questionnaire. Water and patient samples were subjected to analysis of multiple microbial targets, molecular typing and microbial community analysis. Spatial analysis on the water distribution network was done and we applied a spatial logistic regression model. The course of the illness was mild. Drinking untreated tap water from the defined outbreak area was significantly associated with illness (RR 5.6, 95% CI 1.9–16.4) increasing in a dose response manner. The closer a person lived to the water distribution breakage point, the higher the risk of becoming ill. Sapovirus, enterovirus, single Campylobacter jejuni and EHEC O157:H7 findings as well as virulence genes for EPEC, EAEC and EHEC pathogroups were detected by molecular or culture methods from the faecal samples of the patients. EPEC, EAEC and EHEC virulence genes and faecal indicator bacteria were also detected in water samples. Microbial community sequencing of contaminated tap water revealed abundance of Arcobacter species. The polyphasic approach improved the understanding of the source of the infections, and aided to define the extent and magnitude of this outbreak. Public Library of Science 2014-08-22 /pmc/articles/PMC4141750/ /pubmed/25147923 http://dx.doi.org/10.1371/journal.pone.0104713 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. |
spellingShingle | Research Article Jalava, Katri Rintala, Hanna Ollgren, Jukka Maunula, Leena Gomez-Alvarez, Vicente Revez, Joana Palander, Marja Antikainen, Jenni Kauppinen, Ari Räsänen, Pia Siponen, Sallamaari Nyholm, Outi Kyyhkynen, Aino Hakkarainen, Sirpa Merentie, Juhani Pärnänen, Martti Loginov, Raisa Ryu, Hodon Kuusi, Markku Siitonen, Anja Miettinen, Ilkka Santo Domingo, Jorge W. Hänninen, Marja-Liisa Pitkänen, Tarja Novel Microbiological and Spatial Statistical Methods to Improve Strength of Epidemiological Evidence in a Community-Wide Waterborne Outbreak |
title | Novel Microbiological and Spatial Statistical Methods to Improve Strength of Epidemiological Evidence in a Community-Wide Waterborne Outbreak |
title_full | Novel Microbiological and Spatial Statistical Methods to Improve Strength of Epidemiological Evidence in a Community-Wide Waterborne Outbreak |
title_fullStr | Novel Microbiological and Spatial Statistical Methods to Improve Strength of Epidemiological Evidence in a Community-Wide Waterborne Outbreak |
title_full_unstemmed | Novel Microbiological and Spatial Statistical Methods to Improve Strength of Epidemiological Evidence in a Community-Wide Waterborne Outbreak |
title_short | Novel Microbiological and Spatial Statistical Methods to Improve Strength of Epidemiological Evidence in a Community-Wide Waterborne Outbreak |
title_sort | novel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141750/ https://www.ncbi.nlm.nih.gov/pubmed/25147923 http://dx.doi.org/10.1371/journal.pone.0104713 |
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