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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
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.
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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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