Novel Microbiological and Spatial Statistical Methods to Improve Strength of Epidemiological Evidence in a Community-Wide Waterborne Outbreak

被引：32

作者：

Jalava, Katri ^{[1
]}

Rintala, Hanna ^{[2
]}

Ollgren, Jukka ^{[1
]}

Maunula, Leena ^{[3
]}

Gomez-Alvarez, Vicente ^{[4
]}

Revez, Joana ^{[3
]}

Palander, Marja ^{[1
]}

Antikainen, Jenni ^{[5
]}

Kauppinen, Ari ^{[6
]}

Rasanen, Pia ^{[1
]}

Siponen, Sallamaari ^{[1
]}

Nyholm, Outi ^{[1
]}

Kyyhkynen, Aino ^{[1
]}

Hakkarainen, Sirpa ^{[2
]}

Merentie, Juhani ^{[2
]}

Parnanen, Martti ^{[2
]}

Loginov, Raisa ^{[5
]}

Ryu, Hodon ^{[4
]}

Kuusi, Markku ^{[1
]}

Siitonen, Anja ^{[1
]}

Miettinen, Ilkka ^{[6
]}

Domingo, Jorge W. Santo ^{[4
]}

Hanninen, Marja-Liisa ^{[3
]}

Pitkanen, Tarja ^{[6
]}

机构：

[1] Natl Inst Hlth & Welf, Dept Infect Dis Surveillance & Control, Helsinki, Finland

[2] Siilinjarvi Municipal, Siilinjarvi, Finland

[3] Univ Helsinki, Dept Food Hyg & Environm Hlth, Helskinki, Finland

[4] US EPA, Off Res & Dev, Cincinnati, OH 45268 USA

[5] Helsinki Univ Hosp, Lab HUSLAB, Helsinki, Finland

[6] Natl Inst Hlth & Welf, Dept Environm Hlth, Kuopio, Finland

来源：

PLOS ONE | 2014年 / 9卷 / 08期

关键词：

REAL-TIME PCR; FIELD GEL-ELECTROPHORESIS; CAMPYLOBACTER-JEJUNI; DISTRIBUTION-SYSTEM; HUMAN SAPOVIRUSES; WASTE-WATER; RIVER WATER; DRINKING; GASTROENTERITIS; IDENTIFICATION;

D O I：

10.1371/journal.pone.0104713

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

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.

引用

页数：13

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