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A Norwalk-like virus waterborne community outbreak in a Swedish village during peak holiday season

Published online by Cambridge University Press:  23 September 2003

J. CARRIQUE-MAS
Affiliation:
Swedish Institute for Infectious Disease Control, 17182 Solna, Sweden European Programme for Intervention Epidemiology Training (EPIET), 17182 Solna, Sweden
Y. ANDERSSON
Affiliation:
Swedish Institute for Infectious Disease Control, 17182 Solna, Sweden
B. PETERSÉN
Affiliation:
Dalarna County Council of Communicable Disease Control, Falu lasarett, 79182 Falun, Dalarna, Sweden
K.-O. HEDLUND
Affiliation:
Swedish Institute for Infectious Disease Control, 17182 Solna, Sweden
N. SJÖGREN
Affiliation:
Swedish Institute for Infectious Disease Control, 17182 Solna, Sweden
J. GIESECKE
Affiliation:
Swedish Institute for Infectious Disease Control, 17182 Solna, Sweden
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Abstract

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An outbreak of gastroenteritis due to Norwalk-like virus (NLV) affecting approximately 500 people occurred in a Swedish ski resort during February–March 2002. Epidemiological investigations were performed on cohorts of schoolchildren, permanent residents and skiers visiting the area. Attack rates were respectively 39·7, 29·9 and 38·5%. Drinking un-boiled water originating from one of the three communal water systems was a significant risk factor for all groups. For schoolchildren, the risk of illness increased with increasing amount of water consumed. Nine of 12 stool samples of patients analysed tested positive for NLV. The water tested negative for indicator bacteria and results of NLV tests were inconclusive. In the absence of microbiological findings, the environmental authorities were reluctant to act based on the epidemiological analysis alone, and intervention was delayed until mid-April, following the discovery of a crack in a sewage pipe 10 m from the well.

Type
Research Article
Copyright
© 2003 Cambridge University Press