Waterborne outbreak in a rural area in Greece during the COVID-19 pandemic: contribution of community pharmacies.

INTRODUCTION: On 15 June 2020, the National Public Health Organization was informed about the identification of two cases of Escherichia coli Ο157 infection in a small town in the Peloponnese Region in Greece and we suspected an outbreak. METHODS: We asked the local pharmacist to assist us to verify the outbreak by providing the daily number of over-the-counter anti-diarrheal drugs sold from 20 May 2020 onwards. The pharmacist asked customers with gastroenteritis to submit stool samples at the local hospital. Samples were tested for 22 pathogens. We conducted a 1 : 1 case-control study. Cases and controls were retrieved from the pharmacy client list. Chlorination records of the water supply system were retrieved, and water samples were tested for microbiological indicators and viruses. RESULTS: The increased number of sales of anti-diarrheal drugs verified the outbreak. Overall, 58 cases and 57 controls were recruited for the study. Tap water consumption (odds ratio (OR)=10.9, 95% confidence interval (CI)=3.1-38.0, p<0.001) and consumption of ice cubes made from tap water (OR=39.3, 95%CI=10.3-150.9, p<0.001) were independently associated with gastroenteritis occurrence. Eleven stool samples were tested; one was positive for shigatoxin-producing E. coli, one for enteropathogenic E. coli, four for E. coli Ο157 and one for Salmonella spp. Four samples tested negative. Five water samples collected on 18 June tested negative. The residual chlorine on 5 and 14 June ranged from 0.12 mg/L to 0.14 mg/L. CONCLUSION: This was the first investigation of a waterborne outbreak in Greece performed with the collaboration of a local pharmacy. The COVID-19 pandemic favored the use of alternative resources and channels of communication with the local population, which can also be used in the future, especially in remote areas of the country.

The protective effects of zinc in lead-induced testicular and epididymal toxicity in Wistar rats.

The aim of this study was to investigate the beneficial effects of zinc (Zn) in preventing lead (Pb)-induced reproductive toxicity in Wistar rats. The rats were divided into four groups, namely, control group, Pb group, Zn group, and Pb + Zn group. Animals were exposed to Pb (819 mg of Pb/L) or Zn (71 mg of Zn/L) or both through drinking water for 65 days. Rats exposed to Pb showed decreased weights of testes and accessory sex organs. Significant decrease in the testicular daily sperm production, epididymal sperm count, motility, viability, and number of hypoosmotic tail coiled sperm was observed in Pb-exposed rats. Testicular 3ß- and 17ß-hydroxysteroid dehydrogenase activity levels and circulatory testosterone levels were also decreased significantly in Pb-exposed rats. A significant increase in the lipid peroxidation products with a significant decrease in the activities of catalase and superoxide dismutase were observed in the testes and epididymis of Pb-exposed rats. Moreover, the testicular architecture showed lumens devoid of sperm in Pb-exposed rats. Supplementation of Zn mitigated Pb-induced oxidative stress and restored the spermatogenesis and steroidogenesis in Pb-exposed rats. In conclusion, cotreatment of Zn is effective for recovering suppressed spermatogenesis, steroidogenesis, elevated oxidative status, and histological damage in the testis of rats treated with Pb.

Water from fruit or the river? Examining hydration strategies and gastrointestinal illness among Tsimane' adults in the Bolivian Amazon.

OBJECTIVE: Water is an essential nutrient overlooked in many cross-cultural studies of human nutrition. The present article describes dietary water intake patterns among forager-horticulturalist adults in lowland Bolivia, compares daily intake with international references and examines if variation in how people acquire water relates to gastrointestinal illness. DESIGN: Cross-sectional observational study used survey, anthropometric and qualitative methods with Tsimane' adults selected by age and sex stratification sampling in one community. SETTING: Research occurred in one Tsimane' village in the Beni department, Bolivia with limited access to clean water. The 24 h diet and health recalls were conducted in July-August 2012 and qualitative interviews/ethnographic observation in September-October 2013. SUBJECTS: Forty-five Tsimane' household heads (49% men) took part in the first data collection and twenty-two Tsimane' (55% men) were included in the follow-up interviews. RESULTS: Men and women reported consuming 4·9 litres and 4·4 litres of water daily from all dietary sources, respectively. On average, water from foods represented 50 % of total water intake. Thirteen per cent of participants reported symptoms of gastrointestinal illness. In a logistic regression model adjusted for age, BMI, sex and raw water consumed, each percentage increase in water obtained from foods was associated with a reduced risk of gastrointestinal illness (OR=0·92; 95% CI 0·85, 0·99). CONCLUSIONS: Both total water intake and percentage of water from foods were higher than averages in industrialized countries. These findings suggest that people without access to clean water may rely on water-rich foods as a dietary adaptation to reduce pathogen exposures.