title: Did a severe flood in the Midwest cause an increase in the incidence of gastrointestinal symptoms?
abstract: Severe flooding occurred in the midwestern United States in 2001. Since November 2000, coincidentally, data on gastrointestinal symptoms had been collected for a drinking water intervention study in a community along the Mississippi River that was affected by the flood. After the flood had subsided, the authors asked these subjects (n = 1,110) about their contact with floodwater. The objectives of this investigation were to determine whether rates of gastrointestinal illness were elevated during the flood and whether contact with floodwater was associated with increased risk of gastrointestinal illness. An increase in the incidence of gastrointestinal symptoms during the flood was observed (incidence rate ratio = 1.29, 95% confidence interval: 1.06, 1.58), and this effect was pronounced among persons with potential sensitivity to infectious gastrointestinal illness. Tap water consumption was not related to gastrointestinal symptoms before, during, or after the flood. An association between gastrointestinal symptoms and contact with floodwater was also observed, and this effect was pronounced in children. This appears to be the first report of an increase in endemic gastrointestinal symptoms in a longitudinal cohort prospectively observed during a flood. These findings suggest that severe climatic events can result in an increase in the endemic incidence of gastrointestinal symptoms in the United States.
authors.affiliation: Human Studies Division, National Health and Environmental Effects Research Laboratory, Epidemiology and Biomarkers Branch, Environmental Protection Agency, Chapel Hill, NC, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Wade
authors.forename: Sukhminder K
authors.initials: SK
authors.lastname: Sandhu
authors.forename: Deborah
authors.initials: D
authors.lastname: Levy
authors.forename: Sherline
authors.initials: S
authors.lastname: Lee
authors.forename: Mark W
authors.initials: MW
authors.lastname: LeChevallier
authors.forename: Louis
authors.initials: L
authors.lastname: Katz
authors.forename: John M
authors.initials: JM
authors.lastname: Colford
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D015331:Cohort Studies; D004190:Disasters / Q000706:statistics & numerical data*; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D015146:Midwestern United States / Q000453:epidemiology; D011159:Population Surveillance; D012621:Seasons; D014876:Water Pollution / Q000032:analysis / Q000706:statistics & numerical data