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Waterborne Norovirus outbreak at a seaside resort likely originating from municipal water distribution system failure

  • G. M. Giammanco (a1), F. Bonura (a1), N. Urone (a1), G. Purpari (a2), M. Cuccia (a3), A. Pepe (a1), S. Li Muli (a1), V. Cappa (a1), C. Saglimbene (a3), G. Mandolfo (a3), A. Marino (a3), A. Guercio (a2), I. Di Bartolo (a4) and S. De Grazia (a1)...

Abstract

In May 2016 a Norovirus (NoV) gastroenteritis outbreak involved a high school class visiting a seaside resort near Taormina (Mascali, Sicily). Twenty-four students and a teacher were affected and 17 of them showed symptoms on the second day of the journey, while the others got ill within the following 2 days. Symptoms included vomiting, diarrhoea and fever, and 12 students required hospitalisation. Stool samples tested positive for NoV genome by Real-Time polymerase chain reaction assay in all 25 symptomatic subjects. The GII.P2/GII.2 NoV genotype was linked to the outbreak by ORF1/ORF2 sequence analysis. The epidemiological features of the outbreak were consistent with food/waterborne followed by person-to-person and/or vomit transmission. Food consumed at a shared lunch on the first day of the trip was associated to illness and drinking un-bottled tap water was also considered as a risk factor. The analysis of water samples revealed the presence of bacterial indicators of faecal contamination in the water used in the resort as well as in other areas of the municipal water network, linking the NoV gastroenteritis outbreak to tap water pollution from sewage leakage. From a single water sample, an amplicon whose sequence corresponded to the capsid genotype recovered from patients could be obtained.

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Copyright

Corresponding author

Author for correspondence: Giovanni M. Giammanco, E-mail: giovanni.giammanco@unipa.it

References

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1.Patel, MM, et al. (2009) Noroviruses: a comprehensive review. Journal of Clinical Virology 44, 18.
2.Matthews, JE, et al. (2012) The epidemiology of published norovirus outbreaks: a review of risk factors associated with attack rate and genogroup. Epidemiology and Infection 140, 11611172.
3.Green, KY (2013) Caliciviridae: the Noroviruses. In Knipe, DM and Howley, PM (eds). Fields Virology. 6th edn. Philadelphia: Wolters Kluwer Health/Lippincott Williams and Wilkins, pp. 949979.
4.Glass, RI, Parashar, UD and Estes, MK (2009) Norovirus gastroenteritis. New England Journal of Medicine 361, 17761785.
5.Vinjé, J (2015) Advances in laboratory methods for detection and typing of norovirus. Journal of Clinical Microbiology 53, 373381.
6.Siebenga, JJ, et al. (2009) Norovirus illness is a global problem: emergence and spread of norovirus GII.4 variants, 2001–2007. The Journal of Infectious Diseases 200, 802812.
7.Hewitt, J, et al. (2007) Gastroenteritis outbreak caused by waterborne norovirus at a New Zealand ski resort. Applied and Environmental Microbiology 73, 78537857.
8.Lindesmith, L, et al. (2003) Human susceptibility and resistance to Norwalk virus infection. Nature Medicine 9, 548553.
9.Centers for Disease Control and Prevention (CDC) database (2017) About Norovirus. Available at https://www.cdc.gov/norovirus/about/index.html (Accessed 19 October 2017).
10.Maunula, L, Miettinen, IT and von Bonsdorff, CH (2005) Norovirus outbreaks from drinking water. Emerging Infectious Diseases 11, 17161721.
11.Vega, E, et al. (2014) Genotypic and epidemiologic trends of norovirus outbreaks in the United States, 2009 to 2013. Journal of Clinical Microbiology 52, 147155.
12.Moreira, NA and Bondelind, M (2017) Safe drinking water and waterborne outbreaks. Journal of Water and Health 15, 8396.
13.Kaplan, JE, et al. (1982) Epidemiology of Norwalk gastroenteritis and the role of Norwalk virus in outbreaks of acute nonbacterial gastroenteritis. Annals of Internal Medicine 96, 756761.
14.Nygard, K, et al. (2004) Waterborne outbreak of gastroenteritis in a religious summer camp in Norway, 2002. Epidemiology and Infection 132, 223229.
15.Li, Y, et al. (2013) An outbreak of norovirus gastroenteritis associated with a secondary water supply system in a factory in south China. BMC Public Health 13, 283.
16.Zhou, X, et al. (2012) Epidemiological and molecular analysis of a waterborne outbreak of norovirus GII.4. Epidemiology and Infection 140, 22822289.
17.Zhou, N, et al. (2016) A waterborne norovirus gastroenteritis outbreak in a school, eastern China. Epidemiology and Infection 144, 12121219.
18.Givon-Lavi, N, Greenberg, D and Dagan, R (2008) Comparison between two severity scoring scales commonly used in the evaluation of rotavirus gastroenteritis in children. Vaccine 26, 57985801.
19.Kageyama, T, et al. (2003) Broadly reactive and highly sensitive assay for Norwalk-like viruses based on real-time quantitative reverse transcription-PCR. Journal of Clinical Microbiology 41, 15481557.
20.Vinje, J and Koopmans, MP (1996) Molecular detection and epidemiology of small round-structured viruses in outbreaks of gastroenteritis in the Netherlands. Journal of Infectious Diseases 174, 610615.
21.Kojima, S, et al. (2002) Genogroup-specific PCR primers for detection of Norwalk-like viruses. Journal of Virological Methods 100, 107114.
22.Istituto Superiore, di Sanità (2007) Analytical methods for water intended for human consumption according to the Italian Legislative Decree 31/2001. In Lucia, Bonadonna and Massimo, Ottaviani (eds). Microbiological methods. iv, 204 p. Rapporti ISTISAN 07/5, pp. 144160.
23.da Silva, AK, et al. (2007) Evaluation of removal of noroviruses during wastewater treatment, using real-time reverse transcription-PCR: different behaviors of genogroups I and II. Applied and Environmental Microbiology 73, 78917897.
24.Duizer, E, et al. (2007) Probabilities in norovirus outbreak diagnosis. Journal of Clinical Virology 40, 3842.
25.Solano, R, et al. (2014) Person-to-person transmission of norovirus resulting in an outbreak of acute gastroenteritis at a summer camp. European Journal of Gastroenterology & Hepatology 26, 11601166.
26.Kauppinen, A and Miettinen, IT. (2017) Persistence of Norovirus GII genome in drinking water and wastewater at different temperatures. Pathogens 6, 48.
27.Boccia, D, et al. (2002) Waterborne outbreak of Norwalk-like virus gastroenteritis at a tourist resort, Italy. Emerging Infectious Diseases 8, 563568.
28.Scarcella, C, et al. (2009) An outbreak of viral gastroenteritis linked to municipal water supply, Lombardy, Italy, June 2009. Euro Surveillance 2009; Published online: 23 July 2009.
29.Giammanco, GM, et al. (2014) Investigation and control of a Norovirus outbreak of probable waterborne transmission through a municipal groundwater system. Journal of Water and Health 12, 452464.
30.Seitz, SR, et al. (2011) Norovirus infectivity in humans and persistence in water. Applied and Environmental Microbiology 77, 68846888.
31.Kingsley, DH, et al. (2017) Evaluation of chlorine treatment levels for inactivation of human Norovirus and MS2 bacteriophage during sewage treatment. Applied and Environmental Microbiology 83, e0127017. doi: 10.1128/AEM.01270-17.
32.Shin, GA and Sobsey, MD (2008) Inactivation of norovirus by chlorine disinfection of water. Water Research 42, 45624568.
33.Centers for Disease Control and Prevention (CDC) database. A Guide to Drinking Water Treatment Technologies for Household Use. Available at http://www.cdc.gov/healthywater/drinking/travel/household_water_treatment.html (Accessed 19 October 2017).
34.Gerba, CP, et al. (1979) Failure of indicator bacteria to reflect the occurrence of enteroviruses in marine waters. American Journal of Public Health 69, 11161119.
35.Haramoto, E, et al. (2006) Seasonal profiles of human noroviruses and indicator bacteria in a wastewater treatment plant in Tokyo, Japan. Water Science and Technology 54, 301308.
36.Lucena, F, et al. (2006) Occurrence of bacterial indicators and bacteriophages infecting enteric bacteria in groundwater in different geographical areas. Journal of Applied Microbiology 101, 96102.
37.Cannon, JL, et al. (2017) Genetic and epidemiologic trends of Norovirus outbreaks in the United States from 2013 to 2016 demonstrated emergence of novel GII.4 recombinant viruses. Journal of Clinical Microbiology 55, 22082221.
38.Ruis, C, et al. (2017) The emerging GII.P16-GII.4 Sydney 2012 norovirus lineage is circulating worldwide, arose by late-2014 and contains polymerase changes that may increase virus transmission. PloS ONE 12, e0179572. doi: 10.1371/journal.pone.0179572.
39.Iritani, N, et al. (2012) Increase of GII.2 norovirus infections during the 2009-2010 season in Osaka City, Japan. Journal of Medical Virology 84, 517525.
40.Olszewski, J, et al. (2005) Comparison of 2 ultrafiltration system for the concentration of seeded viruses from environmental waters. Canadian Journal of Microbiology 51, 295303.

Keywords

Waterborne Norovirus outbreak at a seaside resort likely originating from municipal water distribution system failure

  • G. M. Giammanco (a1), F. Bonura (a1), N. Urone (a1), G. Purpari (a2), M. Cuccia (a3), A. Pepe (a1), S. Li Muli (a1), V. Cappa (a1), C. Saglimbene (a3), G. Mandolfo (a3), A. Marino (a3), A. Guercio (a2), I. Di Bartolo (a4) and S. De Grazia (a1)...

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