title: An outbreak of gastroenteritis in a holiday resort in Italy: epidemiological survey, implementation and application of preventive measures.
abstract: A major gastroenteritis outbreak was reported in a vacation resort in Central Italy in 2003. A total of 183 cases were identified. The case-control study identified a statistically significant correlation between the disease and sea bathing, use of sanitary facilities in bungalows and of common showers. Stool samples taken from people affected were found positive for Norovirus (68%, 13 of 19 samples), Rotavirus (38%, 1 of 14 samples) and Campylobacter (7%, 3 of 8 samples). Environmental investigations revealed serious faecal contamination of the groundwater and the presence of Norovirus in the seawater near the resort. The mixing of groundwater and seawater with the non-drinking water system - which was also found to be connected to the drinking water system - had a primary role in the onset and spread of infection within the village. The complete absence of any gastroenteritis epidemics among the site guests since 2006 demonstrates the effectiveness of the environmental corrective measures taken.
authors.affiliation: Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, 64100 Teramo, Italy. g.migliorati@izs.it
authors.forename: Giacomo
authors.initials: G
authors.lastname: Migliorati
authors.forename: Vincenza
authors.initials: V
authors.lastname: Prencipe
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ripani
authors.forename: Cristina
authors.initials: C
authors.lastname: Di Francesco
authors.forename: Claudia
authors.initials: C
authors.lastname: Casaccia
authors.forename: Silvia
authors.initials: S
authors.lastname: Crudeli
authors.forename: Nicola
authors.initials: N
authors.lastname: Ferri
authors.forename: Armando
authors.initials: A
authors.lastname: Giovannini
authors.forename: Maria Maddalena
authors.initials: MM
authors.lastname: Marconi
authors.forename: Cristina
authors.initials: C
authors.lastname: Marfoglia
authors.forename: Valeria
authors.initials: V
authors.lastname: Melai
authors.forename: Giovanni
authors.initials: G
authors.lastname: Savini
authors.forename: Giampiero
authors.initials: G
authors.lastname: Scortichini
authors.forename: Primula
authors.initials: P
authors.lastname: Semprini
authors.forename: Franco Maria
authors.initials: FM
authors.lastname: Ruggeri