title: A waterborne outbreak of small round structured virus, campylobacter and shigella co-infections in La Neuveville, Switzerland, 1998.
abstract: An outbreak of gastro-enteritis occurred in La Neuveville, township with 3358 inhabitants. A retrospective cohort study of 1915 participants showed that 1607 (84%) had been ill. Campylobacter jejuni was isolated from 28 patient faecal samples, Shigella sonnei from 21 patients and small round structured viruses (SRSV) from 6 patients. More than one pathogen was identified in eight persons. The epidemic curve was characteristic of a point-source outbreak. The risk for illness was significantly higher among persons who had drank unboiled drinking water than among those who had not (1290 [80.3%] of 1607 vs. 86 [27.9%] of 308; RR = 2.87; 95% CI 2.40-3.45). Risk increased significantly with the quantity of water consumed (P < 0.00 x 10(-6)). An SRSV isolate from water and one human faeces had an identical DNA sequence. The outbreak was due to a pump failure producing a spill of sewage into the groundwater. We conclude that transmission was waterborne and that measures including early warning, basic hygiene and sanitation improvements controlled this epidemic.
authors: Health and Social Security Direction of Bern Canton, Offce of the Canton Physician, Switzerland.
authors: A M
authors: AM
authors: Maurer
authors: D
authors: D
authors: Stürchler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002169:Campylobacter Infections / Q000453:epidemiology*; D016123:Campylobacter jejuni / Q000302:isolation & purification / Q000472:pathogenicity; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012722:Sewage; D012764:Shigella sonnei / Q000302:isolation & purification / Q000472:pathogenicity; D013557:Switzerland / Q000453:epidemiology; D014881:Water Supply
chemical_list: D012722:Sewage