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A waterborne outbreak with a single clone of Campylobacter jejuni in the Danish town of Køge in May 2010.
MedLine Citation:
PMID:  22385125     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: In Denmark, large-scale waterborne outbreaks are rare. This report describes the investigation of an outbreak that occurred in the town of Køge in May 2010. Methods: The epidemiological investigation consisted of hypothesis generating telephone interviews, followed by a cohort study among approximately 20,000 residents using an online questionnaire. Odds ratios were calculated for exposures including the number of glasses of tap water consumed. Geographical spreading was assessed using a geographical information system. The microbiological investigation included cultures of stool samples and flagellin-typing. In the environmental investigation, water samples were tested for Escherichia coli and coliform counts and for DNA of Campylobacter, Enterococcus, and Bacteroides. During the outbreak investigation a water boiling order was enforced, as tap water was considered a potential source. Results: Of 45 patients with laboratory confirmed Campylobacter infection in the municipality of Køge in May, 43 lived in the area covered by the central water supply. Of 61 patients with laboratory confirmed Campylobacter jejuni by 8 June, 50 shared a common flagellin gene type - flaA type 36 (82%). The epidemic curve from the cohort study showed a wave of diarrhoea onset from 14 to 20 May (n = 176). Among these patients, the development of diarrhoea was associated with drinking tap water with a dose-response pattern (linear increase by 2 glasses: odds ratio 1.40, 95% confidence interval 1.16-1.70). No bacterial DNA was found in water samples. Conclusions: These findings indicated a point source contamination of tap water with a single clone of C. jejuni which likely occurred on 12-13 May. The water boiling order was lifted on 18 June.
Authors:
Sophie-Madeleine Gubbels; Katrin G Kuhn; Jonas T Larsson; Marianne Adelhardt; Jørgen Engberg; Pernille Ingildsen; Line Wilchen Hollesen; Steen Muchitsch; Kåre Mølbak; Steen Ethelberg
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-4
Journal Detail:
Title:  Scandinavian journal of infectious diseases     Volume:  -     ISSN:  1651-1980     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215333     Medline TA:  Scand J Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
European Programme for Intervention Epidemiology Training (EPIET) , European Centre for Disease Prevention and Control, Stockholm , Sweden.
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