Novel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak.
Failures in the drinking water distribution system cause gastrointestinal outbreaks with multiple pathogens. A water distribution pipe breakage caused a community-wide waterborne outbreak in Vuorela, Finland, July 2012. We investigated this outbreak with advanced epidemiological and microbiological...
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Public Library of Science (PLoS)
2014
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oai:doaj.org-article:a93ddd23bb2c4aabb64a8f80f2b3e56b2021-11-25T06:03:38ZNovel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak.1932-620310.1371/journal.pone.0104713https://doaj.org/article/a93ddd23bb2c4aabb64a8f80f2b3e56b2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25147923/?tool=EBIhttps://doaj.org/toc/1932-6203Failures in the drinking water distribution system cause gastrointestinal outbreaks with multiple pathogens. A water distribution pipe breakage caused a community-wide waterborne outbreak in Vuorela, Finland, July 2012. We investigated this outbreak with advanced epidemiological and microbiological methods. A total of 473/2931 inhabitants (16%) responded to a web-based questionnaire. Water and patient samples were subjected to analysis of multiple microbial targets, molecular typing and microbial community analysis. Spatial analysis on the water distribution network was done and we applied a spatial logistic regression model. The course of the illness was mild. Drinking untreated tap water from the defined outbreak area was significantly associated with illness (RR 5.6, 95% CI 1.9-16.4) increasing in a dose response manner. The closer a person lived to the water distribution breakage point, the higher the risk of becoming ill. Sapovirus, enterovirus, single Campylobacter jejuni and EHEC O157:H7 findings as well as virulence genes for EPEC, EAEC and EHEC pathogroups were detected by molecular or culture methods from the faecal samples of the patients. EPEC, EAEC and EHEC virulence genes and faecal indicator bacteria were also detected in water samples. Microbial community sequencing of contaminated tap water revealed abundance of Arcobacter species. The polyphasic approach improved the understanding of the source of the infections, and aided to define the extent and magnitude of this outbreak.Katri JalavaHanna RintalaJukka OllgrenLeena MaunulaVicente Gomez-AlvarezJoana RevezMarja PalanderJenni AntikainenAri KauppinenPia RäsänenSallamaari SiponenOuti NyholmAino KyyhkynenSirpa HakkarainenJuhani MerentieMartti PärnänenRaisa LoginovHodon RyuMarkku KuusiAnja SiitonenIlkka MiettinenJorge W Santo DomingoMarja-Liisa HänninenTarja PitkänenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 8, p e104713 (2014) |
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Medicine R Science Q Katri Jalava Hanna Rintala Jukka Ollgren Leena Maunula Vicente Gomez-Alvarez Joana Revez Marja Palander Jenni Antikainen Ari Kauppinen Pia Räsänen Sallamaari Siponen Outi Nyholm Aino Kyyhkynen Sirpa Hakkarainen Juhani Merentie Martti Pärnänen Raisa Loginov Hodon Ryu Markku Kuusi Anja Siitonen Ilkka Miettinen Jorge W Santo Domingo Marja-Liisa Hänninen Tarja Pitkänen Novel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak. |
| description |
Failures in the drinking water distribution system cause gastrointestinal outbreaks with multiple pathogens. A water distribution pipe breakage caused a community-wide waterborne outbreak in Vuorela, Finland, July 2012. We investigated this outbreak with advanced epidemiological and microbiological methods. A total of 473/2931 inhabitants (16%) responded to a web-based questionnaire. Water and patient samples were subjected to analysis of multiple microbial targets, molecular typing and microbial community analysis. Spatial analysis on the water distribution network was done and we applied a spatial logistic regression model. The course of the illness was mild. Drinking untreated tap water from the defined outbreak area was significantly associated with illness (RR 5.6, 95% CI 1.9-16.4) increasing in a dose response manner. The closer a person lived to the water distribution breakage point, the higher the risk of becoming ill. Sapovirus, enterovirus, single Campylobacter jejuni and EHEC O157:H7 findings as well as virulence genes for EPEC, EAEC and EHEC pathogroups were detected by molecular or culture methods from the faecal samples of the patients. EPEC, EAEC and EHEC virulence genes and faecal indicator bacteria were also detected in water samples. Microbial community sequencing of contaminated tap water revealed abundance of Arcobacter species. The polyphasic approach improved the understanding of the source of the infections, and aided to define the extent and magnitude of this outbreak. |
| format |
article |
| author |
Katri Jalava Hanna Rintala Jukka Ollgren Leena Maunula Vicente Gomez-Alvarez Joana Revez Marja Palander Jenni Antikainen Ari Kauppinen Pia Räsänen Sallamaari Siponen Outi Nyholm Aino Kyyhkynen Sirpa Hakkarainen Juhani Merentie Martti Pärnänen Raisa Loginov Hodon Ryu Markku Kuusi Anja Siitonen Ilkka Miettinen Jorge W Santo Domingo Marja-Liisa Hänninen Tarja Pitkänen |
| author_facet |
Katri Jalava Hanna Rintala Jukka Ollgren Leena Maunula Vicente Gomez-Alvarez Joana Revez Marja Palander Jenni Antikainen Ari Kauppinen Pia Räsänen Sallamaari Siponen Outi Nyholm Aino Kyyhkynen Sirpa Hakkarainen Juhani Merentie Martti Pärnänen Raisa Loginov Hodon Ryu Markku Kuusi Anja Siitonen Ilkka Miettinen Jorge W Santo Domingo Marja-Liisa Hänninen Tarja Pitkänen |
| author_sort |
Katri Jalava |
| title |
Novel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak. |
| title_short |
Novel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak. |
| title_full |
Novel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak. |
| title_fullStr |
Novel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak. |
| title_full_unstemmed |
Novel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak. |
| title_sort |
novel microbiological and spatial statistical methods to improve strength of epidemiological evidence in a community-wide waterborne outbreak. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2014 |
| url |
https://doaj.org/article/a93ddd23bb2c4aabb64a8f80f2b3e56b |
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