title: Gastrointestinal, influenza-like illness and dermatological complaints following exposure to floodwater: a cross-sectional survey in The Netherlands.
abstract: Extreme rainfall events may cause pluvial flooding, increasing the transmission of several waterborne pathogens. However, the risk of experiencing clinically overt infections following exposure to pluvial floodwater is poorly estimated. A retrospective cross-sectional survey was performed to quantify the occurrence of self-reported gastrointestinal, influenza-like illness (ILI) and dermatological complaints, and the frequency of visits to the general practitioner (GP), during a 4-week observation period following pluvial flooding at seven locations in The Netherlands. Questionnaires were sent to 817 flooded households, 149 (17%) of which returned the questionnaire reporting information for 199 participants. Contact with floodwater was significantly associated with increased occurrence of gastrointestinal [odds ratio (OR 4·44)], ILI (OR 2·75) and dermatological (OR 6·67) complaints, and GP visits (OR 2·72). Having hand contact with floodwater was associated with gastrointestinal and dermatological complaints, whereas ILI complaints were associated with being engaged in post-flooding cleaning operations and having walked/cycled through floodwater. This study shows that floodwater-associated diseases occur in urban settings following extreme rainfall events in a high-income country. As pluvial floods are expected to escalate in the future due to global climate change, further research is warranted to determine the disease burden of pluvial flooding and to assess the effect of different interventions, including raising awareness among stakeholders.
authors.affiliation: Institute for Risk Assessment Sciences,Utrecht University,Utrecht,The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: DE Man
authors.affiliation: Center for Infectious Disease Control,National Institute for Public Health and the Environment,Bilthoven,The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Mughini Gras
authors.affiliation: Center for Infectious Disease Control,National Institute for Public Health and the Environment,Bilthoven,The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Schimmer
authors.affiliation: Center for Infectious Disease Control,National Institute for Public Health and the Environment,Bilthoven,The Netherlands.
authors.forename: I H M
authors.initials: IH
authors.lastname: Friesema
authors.affiliation: Institute for Risk Assessment Sciences,Utrecht University,Utrecht,The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: DE Roda Husman
authors.affiliation: Center for Infectious Disease Control,National Institute for Public Health and the Environment,Bilthoven,The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: VAN Pelt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D055868:Floods; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D057566:Self Report; D012871:Skin Diseases / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
keywords: Epidemiology; veterinary epidemiology; water (quality)