Early outbreak detection by linking health advice line calls to water distribution areas retrospectively demonstrated in a large waterborne outbreak of cryptosporidiosis in SwedenReportar como inadecuado




Early outbreak detection by linking health advice line calls to water distribution areas retrospectively demonstrated in a large waterborne outbreak of cryptosporidiosis in Sweden - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Public Health

, 17:328

Infectious Disease epidemiology

Abstract

BackgroundIn the winter and spring of 2011 a large outbreak of cryptosporidiosis occurred in Skellefteå municipality, Sweden. This study summarizes the outbreak investigation in terms of outbreak size, duration, clinical characteristics, possible sources and the potential for earlier detection using calls to a health advice line.

MethodsThe investigation included two epidemiological questionnaires and microbial analysis of samples from patients, water and other environmental sources. In addition, a retrospective study based on phone calls to a health advice line was performed by comparing patterns of phone calls between different water distribution areas.

ResultsOur analyses showed that approximately 18,500 individuals were affected by a waterborne outbreak of cryptosporidiosis in Skellefteå in 2011. This makes it the second largest outbreak of cryptosporidiosis in Europe to date. Cryptosporidium hominis oocysts of subtype IbA10G2 were found in patient and sewage samples, but not in raw water or in drinking water, and the initial contamination source could not be determined. The outbreak went unnoticed to authorities for several months. The analysis of the calls to the health advice line provides strong indications early in the outbreak that it was linked to a particular water treatment plant.

ConclusionsWe conclude that an earlier detection of the outbreak by linking calls to a health advice line to water distribution areas could have limited the outbreak substantially.

KeywordsEarly outbreak detection Cryptosporidiosis Syndromic surveillance Cryptosporidium hominis AbbreviationsBWNBoil water notice

GIGastrointestinal

IFLImmunofluorescence

IMSImmunomagnetic separation

OROdds ratio

PCRPolymerase chain reaction

RFLPFragment length polymorphism

SWTPSewage water treatment plan

UVUltraviolet

WTPWater treatment plant

Electronic supplementary materialThe online version of this article doi:10.1186-s12889-017-4233-8 contains supplementary material, which is available to authorized users.





Autor: Pär Bjelkmar - Anette Hansen - Caroline Schönning - Jakob Bergström - Margareta Löfdahl - Marianne Lebbad - Anders Wall

Fuente: https://link.springer.com/







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