Epidemiology and Infection

Research Article

Gastroenteritis associated with accidental contamination of drinking water with partially treated water

T. M. A. FERNANDESa1a2, C. SCHOUTa3, A. M. De RODA HUSMANa4, A. EILANDERa3, H. VENNEMAa5 and Y. T. H. P. van DUYNHOVENa2 c1

a1 European Programme for Intervention Epidemiology Training (EPIET), National Institute for Public Health and the Environment (RIVM), The Netherlands

a2 Department for Infectious Diseases Epidemiology, RIVM, The Netherlands

a3 Public Health Service, Utrecht, The Netherlands

a4 Microbiological Laboratory for Health Protection, RIVM, The Netherlands

a5 Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, RIVM, The Netherlands

SUMMARY

Due to human error, drinking water supplied to a new housing estate in The Netherlands was contaminated with grey water. The cohort of 921 accidentally exposed households (area A) had a higher attack rate for diarrhoea (54·1%) than a non-exposed cohort of 1529 households from an adjacent area (B) (24%) (RR 2·3, 95% CI 1·9–2·7). Household water score showed a dose-response with illness, in both areas A and B. For each 1000 inhabitants, 19·8 cases in area A, 7·0 cases in control area B (RRAB 2·2, 95% CI 1·3–3·8) and 3·3 cases in a more distant control area C (RRAC 4·6, 95% CI 2·7–8·0) were diagnosed with gastroenteritis by their general practitioner. A gastroenteritis outbreak associated with consumption of contaminated drinking water was observed in the exposed area. The use of grey water was banned in 2003, with the exception of rainwater use for flushing toilets. The risk of rainwater use is currently being investigated.

(Accepted September 29 2006)

(Online publication November 17 2006)

Correspondence:

c1 *Author for correspondence: Y. T. H. P. van Duynhoven, Ph.D., Project Manager, Gastroenteritis in Humans, Deputy Head, Centre for Infectious Disease Epidemiology, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, The Netherlands. (Email: y.van.duynhoven@rivm.nl)

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