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2009-06-18Zeitschriftenartikel DOI: 10.1017/S095026880999015X
Massive outbreak of viral gastroenteritis associated with consumption of municipal drinking water in a European capital city
dc.contributor.authorWerber, Dirk
dc.contributor.authorLausevic, D.
dc.contributor.authorMugosa, B.
dc.contributor.authorVratnica, Z.
dc.contributor.authorIvanovic-Nikolic, L.
dc.contributor.authorZizic, L.
dc.contributor.authorAlexandre-Bird, A.
dc.contributor.authorFiore, L.
dc.contributor.authorRuggeri, F. M.
dc.contributor.authorBartolo, I. Di
dc.contributor.authorBattistone, A.
dc.contributor.authorGassiloud, B.
dc.contributor.authorPerelle, S.
dc.contributor.authorKaluski, D. Nitzan
dc.contributor.authorKivi, M.
dc.contributor.authorAndraghetti, R.
dc.contributor.authorPollock, K. G. J.
dc.date.accessioned2018-05-07T14:00:39Z
dc.date.available2018-05-07T14:00:39Z
dc.date.created2010-06-18
dc.date.issued2009-06-18none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/rePU64rAodEog/PDF/27cqJdh7U6T6A.pdf
dc.identifier.urihttp://edoc.rki.de/176904/683
dc.description.abstractOn 24 August 2008, an outbreak alert regarding cases of acute gastroenteritis in Podgorica triggered investigations to guide control measures. From 23 August to 7 September, 1699 cases were reported in Podgorica (population 136 000) and we estimated the total size of the outbreak to be 10 000–15 000 corresponding to an attack rate of ~10%. We conducted an age- and neighbourhood-matched case-control study, microbiologically analysed faecal and municipal water samples and assessed the water distribution system. All cases (83/83) and 90% (89/90) of controls drank unboiled chlorinated municipal water [matched odds ratio (mOR) 11·2, 95% confidence interval (CI), 1·6–∞]. Consumption of bottled water was inversely associated with illness (mOR 0·3, 95% CI 0·1–0·8). Analyses of faecal samples identified six norovirus genotypes (21/38 samples) and occasionally other viruses. Multiple defects in the water distribution system were noted. These results suggest that the outbreak was caused by faecally contaminated municipal water. It is unusual to have such a large outbreak in a European city especially when the municipal water supply is chlorinated. Therefore, it is important to establish effective multiple-barrier water-treatment systems whenever possible, but even with an established chlorinated supply, sustained vigilance is central to public health.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut
dc.subjectAdolescenteng
dc.subjectHumanseng
dc.subjectFemaleeng
dc.subjectGastroenteritis/epidemiologyeng
dc.subjectMaleeng
dc.subjectChildeng
dc.subjectAdulteng
dc.subjectCase-Control Studieseng
dc.subjectCaliciviridae Infections/virologyeng
dc.subjectDisease Outbreaks/statistics & numerical dataeng
dc.subjectGastroenteritis/virologyeng
dc.subjectYoung Adulteng
dc.subjectCaliciviridae Infections/epidemiologyeng
dc.subjectFeces/virologyeng
dc.subjectMontenegro/epidemiologyeng
dc.subjectNoroviruseng
dc.subjectWater Microbiologyeng
dc.subjectWater Supplyeng
dc.subject.ddc610 Medizin
dc.titleMassive outbreak of viral gastroenteritis associated with consumption of municipal drinking water in a European capital city
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-1009481
dc.identifier.doi10.1017/S095026880999015X
dc.identifier.doihttp://dx.doi.org/10.25646/608
local.edoc.container-titleEpidemiology and Infection
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=6418284
local.edoc.container-publisher-nameCambridge University Press
local.edoc.container-volume137
local.edoc.container-issue12
local.edoc.container-year2009

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