title: Internet use and epidemiologic investigation of gastroenteritis outbreak.
abstract: In March 2000, a large outbreak of gastroenteritis occurred in a community where a regional computer network provides free Internet access for 42% of the households. We conducted an epidemiologic investigation using the Internet for data collection. Norovirus was identified in stool samples of nine patients but not in the municipal water supply. Of households with access to the network, 19% participated in the survey. The overall attack rate by household was 63%. Drinking water from the nonchlorinated community water system was associated with illness (relative risk [RR] 1.6; 95% confidence interval [CI] 1.1 to 2.2); drinking water only from a private well was associated with decreased likelihood of illness (RR 0.3; 95% CI 0.1 to 0.8). Data collection through the Internet was efficient. Internet surveys may become more common in epidemiologic investigations and have the potential to provide data rapidly, enabling appropriate public health action. However, methods should be developed to increase response rates and minimize bias.
authors.affiliation: Department of Infectious Disease Epidemiology, National Public Health Institute, Mannerheimintie 166, 000300 Helsinki, Finland. markku.kuusi@ktl.fi
authors.forename: Markku
authors.initials: M
authors.lastname: Kuusi
authors.forename: J Pekka
authors.initials: JP
authors.lastname: Nuorti
authors.forename: Leena
authors.initials: L
authors.lastname: Maunula
authors.forename: Ilkka
authors.initials: I
authors.lastname: Miettinen
authors.forename: Hannu
authors.initials: H
authors.lastname: Pesonen
authors.forename: Carl-Henrik
authors.initials: CH
authors.lastname: von Bonsdorff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D004196:Disease Outbreaks; D004812:Epidemiologic Methods; D005260:Female; D005387:Finland / Q000453:epidemiology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000302:isolation & purification / Q000472:pathogenicity*; D014871:Water Microbiology