Godoy Pere, Artigues Antoni, Nuín Carmen, Aramburu Jesús, Pérez Montse, Domínguez Angela, Salleras Lluís
Delegación Territorial del Departamento de Sanidad y Seguridad Social. Lleida. España.
Med Clin (Barc). 2002 Nov 23;119(18):695-8. doi: 10.1016/s0025-7753(02)73545-8.
The aim of this study was to conduct a clinical-epidemiological and microbiological investigation into an outbreak of waterborne disease caused by Campylobacter jejuni due to the consumption of drinking water.
A historical cohort study was carried out among 237 residents of Torres de Segre (Lleida, Spain) who were selected using a systematic sample. We conducted a telephone interview about water consumption, symptoms and the onset of disease. We investigated samples of drinking water and stools from 14 patients. The risk associated with each water source was assessed by applying relative risk (RR) analysis at 95% confidence (CI) intervals.
The overall attack rate was 18.3% (43/237). The symptoms were: diarrhoea, 93.0% (18/43); abdominal pain, 80.9% (34/42); nausea; 56,1% (23/41); vomits, 42.9% (18/42), and fever, 11.9% (5/42). Only 5.8% of patients contact with his physician. The consumption of drinking water was statistically associated with the disease (RR = 3.0; 95% CI, 1.7-5.3), while the consumption of bottled water (RR = 0.6; 95% CI 0.3-1.0) and water from other villages (RR = 0.3; 95% CI, 0.1-1.1) were a protection factor. The day of outbreak notification we did not detect any residual chlorine in the drinking water: it was qualified as no potable and we isolated Campylobacter jejuni in 8 samples stools.
This research highlights the potential importance of waterborne outbreaks of gastroenteritis due to Campylobacter jejuni transmitted through untreated drinking water and suggests to need systematic controls over drinking water and the proper register of their results.
本研究旨在对因饮用受污染饮用水引发的空肠弯曲菌水源性疾病暴发进行临床流行病学和微生物学调查。
对西班牙莱里达省托雷斯 - 德塞格雷的237名居民进行历史性队列研究,采用系统抽样方法选取研究对象。通过电话访谈了解他们的饮水情况、症状及发病时间。对14例患者的饮用水和粪便样本进行检测。采用相对危险度(RR)分析评估95%置信区间(CI)下各水源与疾病的关联风险。
总体发病率为18.3%(43/237)。症状包括:腹泻,93.0%(18/43);腹痛,80.9%(34/42);恶心,56.1%(23/41);呕吐,42.9%(18/42);发热,11.9%(5/42)。仅有5.8%的患者就医。饮用自来水与疾病存在统计学关联(RR = 3.0;95% CI,1.7 - 5.3),而饮用瓶装水(RR = 0.6;95% CI 0.3 - 1.0)和其他村庄的水(RR = 0.3;95% CI,0.1 - 1.1)为保护因素。在暴发报告当日,饮用水中未检测到余氯,判定该饮用水不合格,且在8份粪便样本中分离出空肠弯曲菌。
本研究强调了未经处理的饮用水传播空肠弯曲菌导致水源性肠胃炎暴发的潜在重要性,并建议对饮用水进行系统监测并妥善记录监测结果。