Gastroenteritis Outbreaks after Contamination of Water Supply Systems: Public Health Response Gaps and Challenges, Greece, 2004–2023
Abstract
:1. Introduction
2. Methods
2.1. Definitions
2.2. Data Source
2.3. Statistical Analysis
2.4. Ethical Considerations
3. Results
3.1. Notification of WGDOs, 2004–2023
3.2. Timeliness of Reporting
3.3. Time and Place of the Outbreaks
3.4. Size of the Outbreaks
3.5. Demographics and Severity of Disease
3.6. Analytical Epidemiology
3.7. Laboratory Investigation of Clinical Samples
3.8. Environmental Investigation
3.9. Classification of WGDOs
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Time * | Region | Number of Cases | Number of Laboratory-Confirmed Cases | Type of Study | Measure of Association | Pathogen (Clinical Samples) | Water Sampling before or after Chlorination | Contributing Factors |
---|---|---|---|---|---|---|---|---|
15 February 2004–10 March 2004 | Crete | 37 | 35 | CCS | OR = 10.91 (95%CI: 1.86–63.8) | Salmonella typhimurium | Unknown |
|
27 May 2009–7 June 2009 | Crete | 54 | 54 | CCS and CCrS | OR = 5.88 (95%CI: 1.75–20.0) OR = 4.39 (95%CI: 1.30–14.8) | Campylobacter jejuni | After | Shortcomings in water sanitation procedures |
10 January 2012–16 February 2012 | Central Macedonia | 79 | 7 | CS | RR = 2.34 (95%CI: 1.55–3.53) | Norovirus and Adenovirus | Before |
|
6 March 2012–21 March 2012 | Thessaly | 552 | 38 | CCS | OR = 2.18 (95%CI: 1.11–4.28) | Rotavirus | Before |
|
9 August 2015–30 August 2015 | Central Macedonia | 230 | 7 | CCS | OR = 36.9 (p = 0.018) | Norovirus | Before |
|
25 January 2019–4 February 2019 | Western Macedonia | 638 | 11 | CCS and CS | OR = 10 (95%CI: 2.09–93.4) RR = 2.22 (95%CI: 1.42–3.46) | Mixed aetiology (norovirus, Campylobacter jejuni, EHEC and EPEC) | After | Unknown |
29 May 2020–18 June 2020 | Peloponnese | 87 | 6 | CCS | OR = 10.9 (95%CI: 3.1–38.0) | Mixed aetiology (STEC, EPEC, E. coli O157) | Unknown | Shortcomings in water sanitation procedures |
10 August 2022–24 August 2022 | Peloponnese | 33 | 15 | CCS | OR = 5.46 (95%CI: 1.02–53.95) | Salmonella Bovismorbificans | Unknown | Unknown |
2 March 2023–14 March 2023 | Central Greece | 39 | 1 | CCS | OR = 3.02, (95%CI: 0.88–10.82) | Norovirus | Unknown | Unknown |
Pathogen | n (%) |
---|---|
Norovirus | 7 (35.0%) |
Salmonella spp. | 2 (10.0%) |
S. Typhimurium | 1 (5.0%) |
S. Enteritidis | 1 (5.0%) |
S. Bovismorbificans | 1 (5.0%) |
Shigella flexneri | 2 (10.0%) |
Campylobacter jejuni | 2 (10.0%) |
Rotavirus | 2 (10.0%) |
Mixed aetiology | 2 (10.0%) |
Total | 20 (100.0%) |
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Sideroglou, T.; Chrysostomou, A.; Politi, L.; Georgalis, L.; Mellou, K. Gastroenteritis Outbreaks after Contamination of Water Supply Systems: Public Health Response Gaps and Challenges, Greece, 2004–2023. Int. J. Environ. Res. Public Health 2024, 21, 701. https://doi.org/10.3390/ijerph21060701
Sideroglou T, Chrysostomou A, Politi L, Georgalis L, Mellou K. Gastroenteritis Outbreaks after Contamination of Water Supply Systems: Public Health Response Gaps and Challenges, Greece, 2004–2023. International Journal of Environmental Research and Public Health. 2024; 21(6):701. https://doi.org/10.3390/ijerph21060701
Chicago/Turabian StyleSideroglou, Theologia, Anthi Chrysostomou, Lida Politi, Leonidas Georgalis, and Kassiani Mellou. 2024. "Gastroenteritis Outbreaks after Contamination of Water Supply Systems: Public Health Response Gaps and Challenges, Greece, 2004–2023" International Journal of Environmental Research and Public Health 21, no. 6: 701. https://doi.org/10.3390/ijerph21060701