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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Scott A Seys, MPH1, John Sarisky, MPH, RS2, Annette G Heryford, MS1, Hugh Mainzer, DVM, MS3, Alicia D Anderson, DVM, MPH4, Charles Higgins, MPH, RS3, Stephan S Monroe, PhD4, G Shay Fout, PhD5, and Karl J Musgrave, DVM, MPH1. (1) Epidemiology Section, Wyoming Department of Health, 2300 Capitol Avenue, Fourth Floor, Cheyenne, WY 82002, 307-777-7172, saseys@state.wy.us, (2) EHSB, NCEH, CDC, 4770 Buford HWY NE, MS F-28, Atlanta, GA 30341-3717, (3) NCEH/ EHSB, Centers for Disease Control and Prevention, MS F-28 4770 Buford Hwy, Atlanta, GA 30341-3717, (4) NCID/DVRD, Centers for Disease Control and Prevention, MailStop G-04, 1600 Clifton RD, N.E., Atlanta, GA 30333, (5) National Exposure Research Laboratory, U.S. Environmental Protection Agency, 26 W. Martin Luther King Jr. Dr., Cincinnati, OH 45268
Background: In February 2001, the Wyoming Department of Health received reports of gastroenteritis among persons who had been snowmobiling in the Big Horn Mountains. Laboratory testing suggested that exposure to a Norwalk-like virus in drinking water from a lodge was responsible for the illness.
Methods: Environmental health specialists and epidemiologists from several state and federal agencies coordinated an investigation of environmental risk factors and system-based failures. The environmental assessment of three area lodges included food service operations, water supply systems, and sewage disposal. A retrospective cohort study was conducted among 82 guests to identify risk factors associated with illness. Stool and water system samples were collected for laboratory analysis.
Results: Statistical analysis suggested that illness was associated with water consumption at one lodge (RR=3.3, 95% C.I.=(1.4, 7.7)). Reverse transcriptase-polymerase chain reaction (RT-PCR) testing on 13 stool samples yielded 8 positives for Norwalk-like virus (NLV) genogroup II, with 3 distinct sequence types detected. Fecal contamination of one of three operating wells was also found and one of the samples tested positive for NLV genogroup II. The environmental assessment of the property revealed that an inadequately installed sewage system was delivering effluent into shallow soil with poor filtering capacity.
Conclusion: This outbreak illustrates waterborne transmission of viral gastroenteritis and the advantages of coordinating a systems-based model of environmental assessment with traditional epidemiologic and laboratory practices. Preventing future system deficiencies depends on understanding the relevant protective components of facility operations including the surrounding physical environment, food service, water supply, and sewage systems.
Learning Objectives: At the conclusion of the session, the participant will be able to
Keywords: Environmental Health, Water
Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Supported in part by Centers for Disease Control and Prevention cooperative agreement U50/CCU816789-02