Norovirus Outbreak Caused by a New Septic System in a Dolomite Aquifer
Norovirus Outbreak Caused by a New Septic System in a Dolomite Aquifer
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DOI：
10.1111/j.1745-6584.2010.00686.x
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发表时间：
2011-01-01
期刊：
影响因子：
2.6
通讯作者：
Spencer, Susan K.
中科院分区：
文献类型：
--
作者：
Borchardt, Mark A.;Bradbury, Kenneth R.;Spencer, Susan K.
按照规定建造的化粪池系统通常不会导致地下水传播疾病的爆发，特别是在具有厚包气带的地区。然而，本案例研究表明，疾病爆发可能发生在这样的环境中，并概述了用于确认爆发源的流行病学，微生物和水文地质方法的组合。2007年6月初，威斯康星州东北部一家新餐馆的229名顾客和员工受到急性胃肠炎的影响，6人住院。流行病学病例对照分析表明，饮用餐厅井水与疾病相关（比值比= 3.2，95%置信区间= 0.9至11.4，P = 0.06）。微生物学分析（定量逆转录-聚合酶链反应）测量了井水中每升诺如病毒基因组I的50个基因组拷贝。核苷酸测序确定基因型为GI. 2，并进一步显示在顾客的粪便标本和化粪池中存在相同的病毒。示踪剂测试，使用染料在两个点注入化粪池系统中表明，污水是从坦克（通过泄漏配件）和渗透领域以及在6和15天，分别旅行。餐厅的化粪池系统和水井（85米深，在一个破碎的白云岩含水层中）都符合国家建筑规范。染料的早期到达井，这是188米的化粪池，位于35米厚的渗流区之下，表明在高度脆弱的水文地质环境中，遵守法规可能无法提供足够的保护，从粪便病原体。
Septic systems that are built in compliance with regulations are generally not expected to be the cause of groundwater borne disease outbreaks, especially in areas with thick vadose zones. However, this case study demonstrates that a disease outbreak can occur in such a setting and outlines the combination of epidemiological, microbiological, and hydrogeological methods used to confirm the source of the outbreak. In early June 2007, 229 patrons and employees of a new restaurant in northeastern Wisconsin were affected by acute gastroenteritis; 6 people were hospitalized. Epidemiological case-control analysis indicated that drinking the restaurant's well water was associated with illness (odds ratio = 3.2, 95% confidence interval = 0.9 to 11.4, P = 0.06). Microbiological analysis (quantitative reverse transcription-polymerase chain reaction) measured 50 genomic copies per liter of norovirus genogroup I in the well water. Nucleotide sequencing determined the genotype as GI.2 and further showed the identical virus was present in patrons' stool specimens and in the septic tank. Tracer tests using dyes injected at two points in the septic system showed that effluent was traveling from the tanks (through a leaking fitting) and infiltration field to the well in 6 and 15 d, respectively. The restaurant septic system and well (85-m deep, in a fractured dolomite aquifer) both conformed to state building codes. The early arrival of dye in the well, which was 188 m from the septic field and located beneath a 35-m thick vadose zone, demonstrates that in highly vulnerable hydrogeological settings, compliance with regulations may not provide adequate protection from fecal pathogens.