ABSTRACT
In July 2006, public health services investigated an outbreak of acute gastroenteritis among staff and visitors of a popular ski resort in southern New Zealand. The source of the outbreak was a drinking water supply contaminated by human sewage. The virological component of the investigation played a major role in confirming the source of the outbreak. Drinking water, source stream water, and 31 fecal specimens from gastroenteritis outbreak cases were analyzed for the presence of norovirus (NoV). Water samples were concentrated by ultrafiltration, and real-time reverse transcription-PCR (RT-PCR) was used for rapid detection of NoV from both water and fecal samples. The implicated NoV strain was further characterized by DNA sequencing. NoV genogroup GI/5 was identified in water samples and linked case fecal specimens, providing clear evidence of the predominant pathogen and route of exposure. A retrospective cohort study demonstrated that staff who consumed drinking water from the resort supply were twice as likely to have gastroenteritis than those who did not. This is the first time that an outbreak of gastroenteritis in New Zealand has been conclusively linked to NoV detected in a community water supply. To our knowledge, this is the first report of the use of ultrafiltration combined with quantitative real-time RT-PCR and DNA sequencing for investigation of a waterborne NoV outbreak.
Subject(s)
Community-Acquired Infections/epidemiology , Community-Acquired Infections/virology , Disease Outbreaks , Gastroenteritis/epidemiology , Gastroenteritis/virology , Norovirus/classification , Norovirus/isolation & purification , Cluster Analysis , Feces/virology , Fresh Water/virology , Genotype , Humans , Molecular Sequence Data , New Zealand/epidemiology , Norovirus/genetics , Phylogeny , RNA, Viral/genetics , Reverse Transcriptase Polymerase Chain Reaction/methods , Sequence Analysis, DNA , UltrafiltrationABSTRACT
An outbreak of human Salmonella enterica serotype Typhimurium DT160 infection in New Zealand was investigated from May to August 2001. Handling of dead wild birds, contact with persons with diarrheal illness, and consumption of fast food were associated with infection. Contaminated roof-collected rainwater was also detected.