title: An outbreak of hepatitis A associated with swimming in a public pool.
abstract: A multistate outbreak of hepatitis A was traced to a campground in Louisiana. Among 822 campers during one weekend, 20 developed hepatitis A. Case-patients ranged in age from 4 to 36 years; the highest attack rate (6.4%) was for children aged 5-9 years. A case-control study revealed that case-patients were more likely than controls to have swum in a public swimming pool on Saturday afternoon (19/19 vs. 26/38; odds ratio [OR], undefined; lower 95% confidence limit, 1.7). Case-patients were more likely than controls to have swum in the jacuzzi pool (16/19 vs. 10/26; OR, 8.0; 95% confidence interval, 1.5-47.1) or adult pool A (19/19 vs. 15/26; OR, undefined; lower 95% confidence limit, 2.6). Case-patients were also more likely to have swum for greater than 1 h and to have put their heads under the water. Because of the design of the filtering system of adult pool A, a cross-connection between a sewage line and the pool water intake line was possible. This outbreak may have been caused by transmission of hepatitis A through swimming; thus, swimming may serve as a mode of transmission of hepatitis A virus, especially among small children.
authors.affiliation: Louisiana Department of Health and Hospitals, Office of Public Health, New Orleans.
authors.forename: F J
authors.initials: FJ
authors.lastname: Mahoney
authors.forename: T A
authors.initials: TA
authors.lastname: Farley
authors.forename: K Y
authors.initials: KY
authors.lastname: Kelso
authors.forename: S A
authors.initials: SA
authors.lastname: Wilson
authors.forename: J M
authors.initials: JM
authors.lastname: Horan
authors.forename: L M
authors.initials: LM
authors.lastname: McFarland
mesh_terms: D000293:Adolescent; D000328:Adult; D002165:Camping; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004196:Disease Outbreaks; D006506:Hepatitis A / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008145:Louisiana / Q000453:epidemiology; D012722:Sewage; D011795:Surveys and Questionnaires; D013551:Swimming Pools; D014871:Water Microbiology; D014881:Water Supply
chemical_list: D012722:Sewage