title: An outbreak of gastroenteritis caused by norovirus-contaminated groundwater at a waterpark in Korea.
abstract: In January 2008, an outbreak of acute gastroenteritis at a waterpark was reported to the Bundang-gu Public Health Center in Seongnam, Korea. To determine the etiological agent and mode of transmission, a retrospective cohort study was done using structured questionnaires and stool samples from patients who had current gastrointestinal symptoms and three food handlers were tested. A total of 67 (31.0%) students and teachers developed acute gastroenteritis. No food items were associated with an increased risk of the illness. Norovirus was detected in 3 stool specimens collected from 6 patients who had severe diarrhea using semi-nested RT-PCR. All the specimens contained the genogroup I strains of the norovirus. Norovirus was also detected in the groundwater samples from the waterpark. In the nucleotide sequencing analysis, all the genogroup I noroviruses from the patients and groundwater samples were identified as the norovirus genotype I-4 strain. They were indistinguishable by DNA sequencing with a 97% homology. We conclude the outbreak of acute gastroenteritis caused by the norovirus was closely related to the contaminated groundwater.
authors.affiliation: Epidemic Intelligence Service, Division of Public Health Policy, Gyeonggi Provincial Office, Suwon, Korea.
authors.forename: Seong-Joon
authors.initials: SJ
authors.lastname: Koh
authors.forename: Han Gil
authors.initials: HG
authors.lastname: Cho
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Kim
authors.forename: Bo Youl
authors.initials: BY
authors.lastname: Choi
mesh_terms: D000328:Adult; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology*; D002648:Child; D015331:Cohort Studies; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology; D005260:Female; D005618:Fresh Water / Q000821:virology*; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D005838:Genotype; D006801:Humans; D008297:Male; D029322:Norovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D010802:Phylogeny; D056910:Republic of Korea; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017423:Sequence Analysis, RNA