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Waterborne outbreak of gastroenteritis in a religious summer camp in Norway, 2002

Published online by Cambridge University Press:  26 February 2004

K. NYGÅRD
Affiliation:
Department of Infectious Disease Epidemiology, Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway
L. VOLD
Affiliation:
Department of Infectious Disease Epidemiology, Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway European Programme for Intervention Epidemiology Training, Sweden
E. HALVORSEN
Affiliation:
Regional Food Control Authority of Midt-Rogaland, Norway
E. BRINGELAND
Affiliation:
Regional Food Control Authority of Midt-Rogaland, Norway
J. A. RØTTINGEN
Affiliation:
Department of Infectious Disease Epidemiology, Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway Institute for Nutrition Research, University of Oslo, Norway
P. AAVITSLAND
Affiliation:
Department of Infectious Disease Epidemiology, Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway
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Abstract

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In July 2002 an outbreak of acute gastroenteritis occurred in a camp facility in western Norway during a 10-day seminar, with around 300 guests staying overnight and several day-time visitors. Environmental and epidemiological investigations were conducted to identify and eliminate the source of the outbreak, prevent further transmission and describe the impact of the outbreak. Of 205 respondents, 134 reported illness (attack rate, 65%). Multivariate analysis showed drinking water and taking showers at the camp-site to be significant risk factors. Secondary person-to-person spread among visitors or outside of the camp was found. Norovirus was identified in 8 out of the 10 stool samples analysed. Indicators of faecal contamination were found in samples from the private untreated water supply, but norovirus could not be identified. This outbreak investigation illustrates the importance of norovirus as a cause of waterborne illness and the additional exacerbation through person-to-person transmission in closed settings. Since aerosol transmission through showering contributed to the spread, intensified hygienic procedures such as isolation of cases and boiling of water may not be sufficient to terminate outbreaks with norovirus.

Type
Research Article
Copyright
© 2004 Cambridge University Press