The Institute of Environmental Science & Research, PO Box 29-181, Christchurch, New Zealand.
The Institute of Environmental Science & Research, PO Box 29-181, Christchurch, New Zealand.
J Infect. 2020 Sep;81(3):390-395. doi: 10.1016/j.jinf.2020.06.065. Epub 2020 Jun 29.
We describe the investigation of a Campylobacter outbreak linked to contamination of an untreated, groundwater derived drinking water supply.
We analysed epidemiological data collected from clinician-confirmed diarrheal cases and estimated the total burden of Havelock North cases using an age-adjusted cross-sectional telephone survey. Campylobacter isolates from case fecal specimens, groundwater samples, and sheep fecal specimens from paddocks adjacent to the drinking water source were whole genome sequenced.
We estimate between 6260 and 8320 cases of illness including up to 2230 who lived outside the reticulation area, were linked to the contaminated water supply. Of these, 953 cases were physician reported, 42 were hospitalized, three developed Guillain-Barré syndrome, and Campylobacter infection contributed to at least four deaths. Of the 12 genotypes observed in cases, four were also observed in water, three were also observed in sheep and one was also observed in both water and sheep.
The contamination of the untreated reticulated water supply occurred following a very heavy rainfall event which caused drainage of sheep feces into a shallow aquifer. The existence of a routine clinical surveillance system for campylobacteriosis facilitated identification of the outbreak, recovery of clinical isolates, and early testing of the water for pathogens. Genotyping of the Campylobacter jejuni helped define the source of the outbreak and confirm outbreak periods and cases. Expected increases in heavy rainfall events and intensification of agriculture mean that additional safeguards are needed to protect populations from such drinking water outbreaks.
NZ Ministry of Health, Health Research Council, ESR SSIF, Royal Society.
我们描述了一起与未经处理的地下水饮用水供应污染有关的弯曲杆菌暴发的调查。
我们分析了从临床医生确诊的腹泻病例中收集的流行病学数据，并使用年龄调整的横断面电话调查估计了哈夫洛克北病例的总负担。从病例粪便标本、地下水样本以及紧邻饮用水源的牧场上的绵羊粪便标本中分离出弯曲杆菌分离株，并对其进行全基因组测序。
我们估计有 6260 至 8320 例疾病病例，其中包括多达 2230 例居住在管网区外的病例，这些病例与受污染的供水有关。在这些病例中，有 953 例由医生报告，42 例住院，3 例发展为格林-巴利综合征，至少有 4 例死亡与弯曲杆菌感染有关。在观察到的 12 种病例基因型中，有 4 种也存在于水中，3 种也存在于绵羊中，1 种也存在于水和绵羊中。
未经处理的管网供水的污染是在一次强降雨事件后发生的，该事件导致羊粪便排入浅层含水层。存在常规的弯曲杆菌病临床监测系统有助于识别暴发、回收临床分离株以及早期对水源进行病原体检测。空肠弯曲杆菌的基因分型有助于确定暴发的来源，并确认暴发时期和病例。预计强降雨事件的增加和农业的集约化意味着需要采取额外的保护措施，以保护人群免受此类饮用水暴发的影响。
新西兰卫生部、健康研究委员会、ESR SSIF、皇家学会。
