GASTROENTERITIS - A WATERBORNE OUTBREAK AFFECTING 1600 PEOPLE IN A SMALL DANISH TOWN
GASTROENTERITIS - A WATERBORNE OUTBREAK AFFECTING 1600 PEOPLE IN A SMALL DANISH TOWN
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DOI：
10.1136/jech.48.5.453
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发表时间：
1994-10-01
影响因子：
6.3
通讯作者：
RONNE, T
中科院分区：
文献类型：
--
作者：
LAURSEN, E;MYGIND, O;RONNE, T
研究目的-检查（i）由于溢流而使自来水厂受到废水污染所造成的疾病程度及其与降水的相关性;（ii）潜在的二次传播;（iii）病假造成的经济损失。设计-一项历史跟踪研究，采用结构化的邮寄问卷。设置-1991年底和1992年初，大哥本哈根郊区的一个小社区。参与者-主要研究组由自来水厂供应的所有703户家庭组成（响应率：89%的家庭）。在邻近社区随机选择200户不同供水来源的家庭作为对照组（答复率：64%的家庭）。一个由149名儿童组成的日托小组（回应率：78%）及30名教师（答复率：83%的人住在哥本哈根市中心，但在自来水厂提供的四个日托中心度过了一天，和他们的家庭成员也进行了研究。测量和主要结果-共1455人在主要研究组中，88%的受访者报告有肠胃炎症状，特别是腹泻（83%）和呕吐（55%）。在对照组中，10%的人有胃肠炎的症状。腹泻发作与降水量相关性良好（斯皮尔曼相关系数：0.75; p = 0.0002）。家庭接触者的二次发病率为12%。没有发现病原体。受影响的人总共有1658天没有工作。因病假造成的生产损失达1600000丹麦克朗（180000磅）。如果当地医生和自来水厂工作人员对水可能受到污染的认识有所提高，就可以更早地采取干预措施，减少疾病的严重程度。疾病的爆发往往是由几个因素引起的，其中许多是技术性的，在这种情况下，这些因素共同起作用。建议注意每个因素。
Study objective - To examine (i) the extent of illness caused by contamination of a waterworks with waste water due to overflow, and its correlation with precipitation; (ii) the potential secondary spread; (iii) economic losses due to sick leave.Design - A historical follow up study with structured postal questionnaires.Setting - A small community on the outskirts of greater Copenhagen at the end of 1991 and the beginning of 1992.Participants - The main study group comprised all 703 households supplied by the waterworks (response rate: 89% of households). There was a control group of 200 randomly chosen households in neighbouring communities with a different water supply source (response rate: 64% of households). A day care group of all 149 children (response rate: 78%) and 30 teachers (response rate: 83%) who lived in central Copenhagen, but spent the day in four day care centres supplied by the waterworks, and members of their household was also studied.Measurements and main results - Altogether 1455 people (88% of respondents in the main study group) reported having had symptoms of gastroenteritis, particularly diarrhoea (83%) and vomiting (55%). In the control group, 10% had had symptoms of gastroenteritis. The onset of episodes with diarrhoea correlated well with precipitation (Spearman's correlation coefficient: 0.75; p = 0.0002). The secondary attack rate in household contacts was 12%. No pathogens were found. Affected people stayed home from work for a total of 1658 days. The cost of loss of production because of sick leave amounted to 1 600 000 Danish kroner (pound 180 000).Conclusions - The outbreak caused extensive illness correlated with precipitation, showed secondary spread, and was associated with major economic losses. Increased awareness among local physicians and waterworks personnel of the possibility of contamination of the water could have led to earlier intervention and reduced the extent of illness. Outbreaks are often caused by several factors, many of a technical nature, which in this case acted together. It is recommended that attention be paid to each factor.