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An outbreak of gastroenteritis among schoolchildren staying in a wildlife reserve: thorough investigation reveals Norway's largest cryptosporidiosis outbreak.

https://arctichealth.org/en/permalink/ahliterature137050
Source
Scand J Public Health. 2011 May;39(3):287-95
Publication Type
Article
Date
May-2011
Author
Gražina Rimšeliene
Line Vold
Lucy Robertson
Christian Nelke
Kjersti Søli
Øystein Haarklau Johansen
Frank S Thrana
Karin Nygård
Author Affiliation
European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden. Grazina.Rimseliene@fhi.no
Source
Scand J Public Health. 2011 May;39(3):287-95
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adult
Animals
Animals, Wild - parasitology
Child
Cohort Studies
Cryptosporidiosis - epidemiology - parasitology - transmission
Cryptosporidium parvum - isolation & purification
Feces - parasitology
Female
Food Microbiology
Food Parasitology
Gastroenteritis - epidemiology - parasitology
Humans
Internet
Male
Middle Aged
Norway - epidemiology
Oocysts - parasitology
Questionnaires
Retrospective Studies
Water Microbiology
Abstract
In March and April 2009, the Norwegian Institute of Public Health was notified about two groups of schoolchildren with gastroenteritis following a stay at a Norwegian wildlife reserve. Although at first considered a typical norovirus outbreak, an investigation that considered other possibilities was initiated.
A retrospective cohort study was conducted among schoolchildren visiting the reserve in the relevant weeks. A web-based questionnaire was distributed by email. Faecal samples of visitors and employees were analysed. The premises were inspected, and water samples and animal faeces analysed.
We received 141 replies (response rate 84%); 74 cases were identified. Cryptosporidium oocysts were detected in faecal samples from 9/12 (75%) visitors and 2/15 (13%) employees. One employee diagnosed with Cryptosporidium infection helped in the kitchen. Additionally, one pupil was diagnosed with norovirus infection. No food item was identified as a source of the outbreak. Pathogens were not detected in water samples taken in week 12, one week from the start of the outbreak. Escherichia coli, but not Cryptosporidium oocysts, were detected in water samples taken one month later.
Although Cryptosporidium is seldom considered as an aetiological agent of gastrointestinal illness in Norway, this outbreak indicates that it should not be excluded. In this cryptosporidiosis outbreak, the largest in Norway to date, the transmission vehicle was not definitively identified, but a food handler, water, and animal contact could not be excluded. We recommend improving hand hygiene routines, boiling drinking water, and emphasise that people who are unwell, particularly those working in catering, should stay away from work.
PubMed ID
21321048 View in PubMed
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[Are domestic Cryptosporidium and Giardia infections in Norway underdiagnosed?].

https://arctichealth.org/en/permalink/ahliterature182102
Source
Tidsskr Nor Laegeforen. 2003 Dec 4;123(23):3406-9
Publication Type
Article
Date
Dec-4-2003
Author
Karin Nygård
Line Vold
Lucy Robertson
Jørgen Lassen
Author Affiliation
Division for smittevern, Nasjonalt forkehelseinstitutt, Oslo. karin.nygard@fhi.no
Source
Tidsskr Nor Laegeforen. 2003 Dec 4;123(23):3406-9
Date
Dec-4-2003
Language
Norwegian
Publication Type
Article
Keywords
Animals
Cryptosporidiosis - diagnosis - epidemiology - parasitology
Cryptosporidium - isolation & purification
Diarrhea - parasitology
Feces - parasitology
Giardia lamblia - isolation & purification
Giardiasis - diagnosis - epidemiology - parasitology
Humans
Norway - epidemiology
Questionnaires
Abstract
Cryptosporidium and Giardia are recognised as common causes of waterborne disease in several countries. In order to describe investigative practices for these protozoan parasites in Norway, we surveyed medical microbiology laboratories nationwide for faecal screening policies and methods used for detection of Cryptosporidium and Giardia.
All medical microbiology laboratories in Norway received questionnaires on laboratory methods, indications for screening, and numbers of samples investigated over the 1998-2002 period.
Of the 22 laboratories that receive faecal samples, 17 had established diagnostic routines for Giardia detection, 14 for Cryptosporidium. Examination for Giardia cysts was standard procedure in all 17 laboratories, mainly in specimens from immigrants and travellers returning from abroad. Examination for Cryptosporidium was, on the other hand, infrequent. Ten of the 14 laboratories reported less than 10 examinations per year. Giardia was frequently detected, with 1 to 6% positive samples in the various laboratories. Cryptosporidium was seldom detected; all laboratories reported only 0-1 positive sample per year.
While laboratories frequently screen faecal samples for Giardia, screening for Cryptosporidium is rare. Little is known about the public health significance of domestic infections with these parasites in Norway; further investigation is needed in order to estimate the burden of disease they cause and to implement control measures if required.
PubMed ID
14713982 View in PubMed
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Are the current notification criteria for Lyme borreliosis in Norway suitable? Results of an evaluation of Lyme borreliosis surveillance in Norway, 1995-2013.

https://arctichealth.org/en/permalink/ahliterature284789
Source
BMC Public Health. 2016 Aug 05;16:729
Publication Type
Article
Date
Aug-05-2016
Author
Emily MacDonald
Didrik Frimann Vestrheim
Richard A White
Kirstin Konsmo
Heidi Lange
Audun Aase
Karin Nygård
Pawel Stefanoff
Ingeborg Aaberge
Line Vold
Source
BMC Public Health. 2016 Aug 05;16:729
Date
Aug-05-2016
Language
English
Publication Type
Article
Keywords
Communicable diseases
Humans
Laboratories
Lyme Disease - diagnosis - epidemiology
Norway - epidemiology
Population Surveillance - methods
Registries
Surveys and Questionnaires
Abstract
The approach to surveillance of Lyme borreliosis varies between countries, depending on the purpose of the surveillance system and the notification criteria used, which prevents direct comparison of national data. In Norway, Lyme borreliosis is notifiable to the Surveillance System for Communicable Diseases (MSIS). The current notification criteria include a combination of clinical and laboratory results for borrelia infection (excluding Erythema migrans) but there are indications that these criteria are not followed consistently by clinicians and by laboratories. Therefore, an evaluation of Lyme borreliosis surveillance in Norway was conducted to describe the purpose of the system and to assess the suitability of the current notification criteria in order to identify areas for improvement.
The CDC Guidelines for Evaluation of Surveillance Systems were used to develop the assessment of the data quality, representativeness and acceptability of MSIS for surveillance of Lyme borreliosis. Data quality was assessed through a review of data from 1996 to 2013 in MSIS and a linkage of MSIS data from 2008 to 2012 with data from the Norwegian Patient Registry (NPR). Representativeness and acceptability were assessed through a survey sent to 23 diagnostic laboratories.
Completeness of key variables for cases reported to MSIS was high, except for geographical location of exposureThe NPR-MSIS linkage identified 1047 cases in both registries, while 363 were only reported to MSIS and 3914 were only recorded in NPR. A higher proportion of cases found in both registries were recorded as neuroborreliosis in MSIS (84.4 %) than those cases found only in MSIS (20.1 %). The trend (average yearly increase or decrease in reported cases) of neuroborreliosis in MSIS was not significantly different from the trend for all other clinical manifestations recorded in MSIS in negative binomial regression (p?=?0.3). The 16 surveyed laboratories (response proportion 70 %) indicated differences in testing practices and low acceptability of the notification criteria.
Given the challenges associated with diagnosing Lyme borreliosis, the selected notification criteria should be closely linked with the purpose of the surveillance system. Restricting reportable Lyme borreliosis to neuroborreliosis may increase validity, while a more sensitive case definition (potentially including erythema migrans) may better reflect the true burden of disease. We recommend revising the current notification criteria in Norway to ensure that they are unambiguous for clinicians and laboratories.
Notes
Cites: Parasit Vectors. 2011 May 19;4:8421595949
Cites: Lancet. 2012 Feb 4;379(9814):461-7321903253
Cites: J Public Health (Oxf). 2016 Mar 9;:null26966194
Cites: Euro Surveill. 2014 Aug 28;19(34):null25188613
Cites: Euro Surveill. 2011 Jul 07;16(27):null21794218
Cites: Ticks Tick Borne Dis. 2014 Apr;5(3):219-2424656810
Cites: Euro Surveill. 2005 Oct;10(10):235-816282646
Cites: APMIS. 2014 Nov;122(11):1114-2424730472
Cites: Clin Microbiol Infect. 2011 Jan;17(1):69-7920132258
Cites: Eur J Neurol. 2006 Nov;13(11):1213-517038034
Cites: MMWR Recomm Rep. 2001 Jul 27;50(RR-13):1-35; quiz CE1-718634202
Cites: Euro Surveill. 2015 Jul 16;20(28):null26212143
Cites: Clin Infect Dis. 2001 Sep 15;33(6):780-511512082
Cites: Euro Surveill. 2006 Jun 22;11(6):E060622.116819127
PubMed ID
27495236 View in PubMed
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Breaks and maintenance work in the water distribution systems and gastrointestinal illness: a cohort study.

https://arctichealth.org/en/permalink/ahliterature164423
Source
Int J Epidemiol. 2007 Aug;36(4):873-80
Publication Type
Article
Date
Aug-2007
Author
Karin Nygård
Erik Wahl
Truls Krogh
Odd Atle Tveit
Erik Bøhleng
Aage Tverdal
Preben Aavitsland
Author Affiliation
Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway. kany@fhi.no
Source
Int J Epidemiol. 2007 Aug;36(4):873-80
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Case-Control Studies
Cohort Studies
Gastroenteritis - etiology
Humans
Logistic Models
Maintenance
Norway
Risk Assessment - methods
Sanitation
Water Pollution - adverse effects
Water supply
Abstract
During maintenance work or breaks on the water distribution system, water pressure occasionally will be reduced. This may lead to intrusion of polluted water-either at the place of repair or through cracks or leaks elsewhere in the distribution system. The objective of this study was to assess whether breaks or maintenance work in the water distribution system with presumed loss of water pressure was associated with an increased risk of gastrointestinal illness among recipients.
We conducted a cohort study among recipients of water from seven waterworks in Norway during 2003-04. One week after an episode of mains breaks or maintenance work on the water distribution system, the exposed and unexposed households were interviewed about gastrointestinal illness in the week following the episode.
During the 1-week period after the episode, 12.7% of the exposed households reported gastrointestinal illness in the household, compared with 8.0% in the unexposed households [risk ratio (RR) 1.58, 95% confidence interval (CI): 1.1, 2.3]. The risk was highest in households with higher average water consumption. The attributable fraction among the exposed households was 37% in the week following exposure.
Our results show that breaks and maintenance work in the water distribution systems caused an increased risk of gastrointestinal illness among water recipients. Better data on the occurrence of low-pressure episodes and improved registration of mains breaks and maintenance work on the water distribution network are needed in order to assess the public health burden of contamination of drinking water within the distribution network.
PubMed ID
17389718 View in PubMed
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Clinical features, therapeutic interventions and long-term aspects of hemolytic-uremic syndrome in Norwegian children: a nationwide retrospective study from 1999-2008.

https://arctichealth.org/en/permalink/ahliterature284010
Source
BMC Infect Dis. 2016 Jun 13;16:285
Publication Type
Article
Date
Jun-13-2016
Author
Gaute Reier Jenssen
Line Vold
Eirik Hovland
Hans-Jacob Bangstad
Karin Nygård
Anna Bjerre
Source
BMC Infect Dis. 2016 Jun 13;16:285
Date
Jun-13-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Anti-Bacterial Agents - therapeutic use
Blood Transfusion
Child
Child, Preschool
Diarrhea - etiology
Escherichia coli Infections - complications - physiopathology - therapy
Female
Heart Diseases - etiology
Hemolytic-Uremic Syndrome - complications - physiopathology - therapy
Humans
Hypertension - etiology
Infant
Kidney
Kidney Failure, Chronic - etiology
Kidney Transplantation
Male
Nervous System Diseases - etiology
Norway
Plasmapheresis
Proteinuria - etiology
Renal Dialysis
Renal Insufficiency, Chronic - etiology
Renal Replacement Therapy
Respiration, Artificial
Respiratory Tract Diseases - etiology
Retrospective Studies
Sepsis - etiology
Shiga-Toxigenic Escherichia coli
Abstract
Hemolytic-uremic syndrome (HUS) is a clinical triad of microangiopathic hemolytic anemia, impaired renal function and thrombocytopenia, primarily affecting pre-school-aged children. HUS can be classified into diarrhea-associated HUS (D(+)HUS), usually caused by Shiga toxin-producing Escherichia coli (STEC), and non-diarrhea-associated HUS (D(-)HUS), both with potentially serious acute and long-term complications. Few data exists on the clinical features and long-term outcome of HUS in Norway. The aim of this paper was to describe these aspects of HUS in children over a 10-year period.
We retrospectively collected data on clinical features, therapeutic interventions and long-term aspects directly from medical records of all identified HUS cases
Notes
Cites: Arch Pediatr Adolesc Med. 2002 Sep;156(9):893-90012197796
Cites: N Engl J Med. 2011 Jun 30;364(26):2561-321612462
Cites: Kidney Int. 2006 Aug;70(3):423-3116775594
Cites: J Infect Dis. 2002 Aug 15;186(4):493-50012195376
Cites: Lancet. 2005 Mar 19-25;365(9464):1073-8615781103
Cites: Kidney Int. 2001 Sep;60(3):831-4611532079
Cites: Acta Paediatr. 2014 Nov;103(11):1192-725039408
Cites: J Pediatr. 1994 Oct;125(4):519-267931869
Cites: Semin Thromb Hemost. 2014 Jun;40(4):508-1624802085
Cites: J Am Soc Nephrol. 1998 Jun;9(6):1126-339621299
Cites: Scand J Trauma Resusc Emerg Med. 2011 Jul 28;19:4421798000
Cites: N Engl J Med. 2013 Jun 6;368(23):2169-8123738544
Cites: Am J Kidney Dis. 2004 Jun;43(6):976-8215168377
Cites: Arch Pediatr. 1996 Jun;3(6):533-408881297
Cites: Eur J Pediatr. 2010 Jan;169(1):7-1319707787
Cites: J Pediatr. 2002 Aug;141(2):172-712183710
Cites: Eur J Pediatr. 2010 May;169(5):591-819830454
Cites: Pediatrics. 2002 Aug;110(2 Pt 1):371-612165593
Cites: Epidemiol Infect. 1993 Apr;110(2):183-968472763
Cites: Nephrol Dial Transplant. 2012 Jul;27(7):2673-8522802583
Cites: Emerg Infect Dis. 2005 Apr;11(4):590-615829199
Cites: Kidney Blood Press Res. 2010;33(5):399-40420948229
Cites: J Antimicrob Chemother. 2015 Sep;70(9):2440-626093376
Cites: Pediatrics. 2016 Jan;137(1):null26644486
Cites: Clin Infect Dis. 2012 Jul;55(1):33-4122431799
Cites: Nat Rev Nephrol. 2012 Nov;8(11):658-6922986362
Cites: Clin Infect Dis. 2012 May;54(10):1413-2122412065
Cites: Pediatr Nephrol. 2012 Jun;27(6):973-922252520
Cites: BMC Infect Dis. 2014 May 16;14:26524884396
Cites: Pediatr Nephrol. 2015 Mar;30(3):503-1325234636
Cites: Pediatr Infect Dis J. 2008 Jul;27(7):595-60118520972
Cites: Am J Transplant. 2013 Aug;13(8):2201-623731345
Cites: JAMA. 2003 Sep 10;290(10):1360-7012966129
Cites: Pathol Biol (Paris). 2015 Jun;63(3):136-4325845294
PubMed ID
27297224 View in PubMed
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Compliance with water advisories after water outages in Norway.

https://arctichealth.org/en/permalink/ahliterature309228
Source
BMC Public Health. 2019 Aug 29; 19(1):1188
Publication Type
Journal Article
Date
Aug-29-2019
Author
Susanne Hyllestad
Lamprini Veneti
Annechen Bahr Bugge
Thea Grav Rosenberg
Karin Nygård
Preben Aavitsland
Author Affiliation
Department of Zoonotic, Food- and Waterborne Infections, Norwegian Institute of Public Health, Oslo, Norway. Susanne.hyllestad@fhi.no.
Source
BMC Public Health. 2019 Aug 29; 19(1):1188
Date
Aug-29-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Awareness
Cross-Sectional Studies
Drinking Water - standards
Female
Guideline Adherence - statistics & numerical data
Humans
Male
Middle Aged
Norway
Pregnancy
Surveys and Questionnaires
Water Purification - methods - statistics & numerical data
Water Supply - statistics & numerical data
Young Adult
Abstract
Water advisories, especially those concerning boiling drinking water, are widely used to reduce risks of infection from contaminants in the water supply. Since the effectiveness of boil water advisories (BWAs) depends on public compliance, monitoring the public response to such advisories is essential for protecting human health. However, assessments of public compliance with BWAs remain sparse. Thus, this study was aimed at investigating awareness and compliance among residents who had received BWAs in Baerum municipality in Norway.
We conducted a cross-sectional study among 2764 residents who had received water advisories by SMS in the municipality of Baerum between January and September 2017. We analysed data from two focus group discussions and an online survey sent to all residents who had received an advisory. We conducted descriptive analyses and calculated odds ratios (OR) using logistic regression to identify associations of compliance and awareness with demographic characteristics.
Of the 611 respondents, 67% reported that they had received a water advisory notification. Effective compliance rate with safe drinking water practices, either by storing clean drinking water or boiling tap water, after a water outage was 72% among those who remembered receiving a notification. Compliance with safe drinking water advisories was lower among men than women (OR 0.53, 95% CI 0.29-0.96), but was independent of age, education and household type. The main reason for respondents' non-compliance with safe water practices was that they perceived the water to be safe to drink after letting it flush through the tap until it became clear.
Awareness of advisories was suboptimal among residents who had received notifications, but compliance was high. The present study highlights the need to improve the distribution, phrasing and content of water advisory notifications to achieve greater awareness and compliance. Future studies should include hard-to-reach groups with adequate data collection approaches and examine the use of BWAs in a national context to inform future policies on BWAs.
PubMed ID
31464621 View in PubMed
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Disseminated and chronic Lyme borreliosis in Norway, 1995 - 2004.

https://arctichealth.org/en/permalink/ahliterature13704
Source
Euro Surveill. 2005 Oct 1;10(10)
Publication Type
Article
Date
Oct-1-2005
Author
Karin Nygard Karin
Arne Broch Brantsaeter
R. Mehl
Author Affiliation
Norwegian Institute of Public Health, Division of Infectious Disease Control.
Source
Euro Surveill. 2005 Oct 1;10(10)
Date
Oct-1-2005
Language
English
Publication Type
Article
Abstract
iosis was the most common clinical manifestation (71%), followed by arthritis/arthralgia (22%) and acrodermatitis chronica atrophicans (5%). Forty six per cent of patients were admitted to hospital. Prevention of borreliosis in Norway relies on measures to prevent tick bites, such as use of protective clothing and insect repellents, and early detection and removal of ticks. Antibiotics are generally not recommended for prophylaxis after tick bites in Norway.
PubMed ID
16282646 View in PubMed
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Emerging genotype (GGIIb) of norovirus in drinking water, Sweden.

https://arctichealth.org/en/permalink/ahliterature30564
Source
Emerg Infect Dis. 2003 Dec;9(12):1548-52
Publication Type
Article
Date
Dec-2003
Author
Karin Nygård
Maria Torvén
Camilla Ancker
Siv Britt Knauth
Kjell-Olof Hedlund
Johan Giesecke
Yvonne Andersson
Lennart Svensson
Author Affiliation
Swedish Institute for Infectious Disease Control, Solna, Sweden.
Source
Emerg Infect Dis. 2003 Dec;9(12):1548-52
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Base Sequence
Caliciviridae Infections - epidemiology - pathology - virology
Child
Disease Outbreaks
Feces - virology
Gastroenteritis - epidemiology - pathology - virology
Genotype
Humans
Molecular Sequence Data
Norovirus - genetics - isolation & purification
Phylogeny
Polymerase Chain Reaction
RNA, Viral - chemistry - genetics
Research Support, Non-U.S. Gov't
Sequence Analysis, DNA
Sweden - epidemiology
Water Microbiology
Water supply
Abstract
From May through June 2001, an outbreak of acute gastroenteritis that affected at least 200 persons occurred in a combined activity camp and conference center in Stockholm County. The source of illness was contaminated drinking water obtained from private wells. The outbreak appears to have started with sewage pipeline problems near the kitchen, which caused overflow of the sewage system and contaminated the environment. While no pathogenic bacteria were found in water or stools specimens, norovirus was detected in 8 of 11 stool specimens and 2 of 3 water samples by polymerase chain reaction. Nucleotide sequencing of amplicons from two patients and two water samples identified an emerging genotype designated GGIIb, which was circulating throughout several European countries during 2000 and 2001. This investigation documents the first waterborne outbreak of viral gastroenteritis in Sweden, where nucleotide sequencing showed a direct link between contaminated water and illness.
PubMed ID
14720394 View in PubMed
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The establishment and first experiences of a crisis advisory service for water supplies in Norway.

https://arctichealth.org/en/permalink/ahliterature305013
Source
J Water Health. 2020 Aug; 18(4):545-555
Publication Type
Journal Article
Date
Aug-2020
Author
Susanne Hyllestad
Vidar Lund
Karin Nygård
Preben Aavitsland
Line Vold
Author Affiliation
Norwegian Institute of Public Health, Section of Zoonotic, Food- and Waterborne Infections, P.O. Box 222 Skøyen, 0213 Oslo, Norway E-mail: susanne.hyllestad@fhi.no; University of Oslo, Faculty of Medicine, Institute of Health and Society, Oslo, Norway.
Source
J Water Health. 2020 Aug; 18(4):545-555
Date
Aug-2020
Language
English
Publication Type
Journal Article
Keywords
Consultants
Humans
Norway
Water
Water Microbiology
Water Pollution
Water supply
Abstract
Water supply systems, in particular small-scale water supply systems, are vulnerable to adverse events that may jeopardise safe drinking water. The consequences of contamination events or the failure of daily operations may be severe, affecting many people. In Norway, a 24-hour crisis advisory service was established in 2017 to provide advice on national water supplies. Competent and expert advisors from water suppliers throughout the country assist other water suppliers and individuals who may be in need of advice during an adverse event. This paper describes the establishment of this service and experiences from the first three years of its operation. Since the launch of the service, water suppliers across Norway have consulted it approximately one to two times a month for advice, in particular about contamination events and near misses. The outcomes have helped to improve guidance on water hygiene issues at the national level.
PubMed ID
32833680 View in PubMed
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Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study.

https://arctichealth.org/en/permalink/ahliterature70875
Source
BMC Infect Dis. 2004 Oct 29;4:45
Publication Type
Article
Date
Oct-29-2004
Author
Hanne M Eriksen
Philippe J Guerin
Karin Nygård
Marika Hjertqvist
Birgitta de Jong
Angela M C Rose
Markku Kuusi
Ulrike Durr
A G Rojas
Cato Mør
Preben Aavitsland
Author Affiliation
European Programme for Intervention Epidemiology Training, Stocholm, Sweden. hanne.merete.eriksen@fhi.no
Source
BMC Infect Dis. 2004 Oct 29;4:45
Date
Oct-29-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Atlantic Islands - epidemiology
Caliciviridae Infections - diagnosis - epidemiology - etiology
Cohort Studies
Diarrhea
Disease Outbreaks
Female
Food Poisoning - epidemiology - etiology
Gastroenteritis - diagnosis - epidemiology - etiology
Health facilities
Humans
Male
Middle Aged
Norovirus
Psoriasis - complications - therapy
Questionnaires
Retrospective Studies
Scandinavia - ethnology
Spain - epidemiology
Vomiting
Abstract
BACKGROUND: Between November 2 and 10, 2002 several patients with psoriasis and personnel staying in the health centre in Gran Canaria, Spain fell ill with diarrhoea, vomiting or both. Patient original came from Norway, Sweden and Finland. The patient group was scheduled to stay until 8 November. A new group of patients were due to arrive from 7 November. METHODS: A retrospective cohort study was conducted to assess the extent of the outbreak, to identify the source and mode of transmission and to prevent similar problems in the following group. RESULTS: Altogether 41% (48/116) of persons staying at the centre fell ill. Norovirus infection was suspected based on clinical presentations and the fact that no bacteria were identified. Kaplan criteria were met. Five persons in this outbreak were hospitalised and the mean duration of diarrhoea was 3 days. The consequences of the illness were more severe compared to many other norovirus outbreaks, possibly because many of the cases suffered from chronic diseases and were treated with drugs reported to affect the immunity (methotrexate or steroids).During the two first days of the outbreak, the attack rate was higher in residents who had consumed dried fruit (adjusted RR = 3.1; 95% CI: 1.4-7.1) and strawberry jam (adjusted RR = 1.9; 95% CI: 0.9-4.1) than those who did not. In the following days, no association was found. The investigation suggests two modes of transmission: a common source for those who fell ill during the two first days of the outbreak and thereafter mainly person to person transmission. This is supported by a lower risk associated with the two food items at the end of the outbreak. CONCLUSIONS: We believe that the food items were contaminated by foodhandlers who reported sick before the outbreak started. Control measures were successfully implemented; food buffets were banned, strict hygiene measures were implemented and sick personnel stayed at home >48 hours after last symptoms.
PubMed ID
15511300 View in PubMed
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24 records – page 1 of 3.