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A community waterborne outbreak of salmonellosis and the effectiveness of a boil water order

Author

Listed:
  • Angulo, F.J.
  • Tippen, S.
  • Sharp, D.J.
  • Payne, B.
  • Collier, C.
  • Hill, J.E.
  • Barrett, T.J.
  • Clark, R.M.
  • Geldreich, E.E.
  • Denny Donnell Jr., H.
  • Swerdlow, D.L.

Abstract

Objectives. A 1993 large water-borne outbreak of Salmonella typhimurium infections in Gideon, Mo, a city of 1100 with an unchlorinated community water supply, was investigated to determine the source of contamination and the effectiveness of an order to boil water. Methods. A survey of household members in Gideon and the surrounding township produced information on diarrheal illness, water consumption, and compliance with the boil water order. Results. More than 650 persons were ill; 15 were hospitalized, and 7 died. Persons consuming city water were more likely to be ill (relative risk [RR] = 9.1, 95% confidence interval [CI] = 2.9, 28.4), and the attack rate increased with increased water consumption. S. typhimurium was recovered from samples taken from a city fire hydrant and a water storage tower. Persons in 31% (30/98) of city households had drunk unboiled water after being informed about the boil water order, including 14 individuals who subsequently became ill. Reasons for noncompliance included 'not remembering' (44%) and 'disbelieving' (25%) the order. Conclusions. Communities with deteriorating water systems risk widespread illness unless water supplies are properly operated and maintained. Effective education to improve compliance during boil water orders is needed.

Suggested Citation

  • Angulo, F.J. & Tippen, S. & Sharp, D.J. & Payne, B. & Collier, C. & Hill, J.E. & Barrett, T.J. & Clark, R.M. & Geldreich, E.E. & Denny Donnell Jr., H. & Swerdlow, D.L., 1997. "A community waterborne outbreak of salmonellosis and the effectiveness of a boil water order," American Journal of Public Health, American Public Health Association, vol. 87(4), pages 580-584.
    • Handle: RePEc:aph:ajpbhl:1997:87:4:580-584_8
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    Cited by:

    1. Steve E. Hrudey, 2011. "Safe Drinking Water Policy for Canada - Turning Hindsight into Foresight," C.D. Howe Institute Commentary, C.D. Howe Institute, issue 323, February.
    2. Robert L. Herrick & Steven G. Buchberger & Robert M. Clark & Margaret Kupferle & Regan Murray & Paul Succop, 2012. "A Markov Model To Estimate Salmonella Morbidity, Mortality, Illness Duration, And Cost," Health Economics, John Wiley & Sons, Ltd., vol. 21(10), pages 1169-1182, October.
    3. Shalinee Naidoo & Ademola O. Olaniran, 2013. "Treated Wastewater Effluent as a Source of Microbial Pollution of Surface Water Resources," IJERPH, MDPI, vol. 11(1), pages 1-22, December.
    4. Emily M. Zechman, 2011. "Agent‐Based Modeling to Simulate Contamination Events and Evaluate Threat Management Strategies in Water Distribution Systems," Risk Analysis, John Wiley & Sons, vol. 31(5), pages 758-772, May.
    5. Laura X. Henao‐Herreño & Ana M. López‐Tamayo & Juan P. Ramos‐Bonilla & Charles N. Haas & Johana Husserl, 2017. "Risk of Illness with Salmonella due to Consumption of Raw Unwashed Vegetables Irrigated with Water from the Bogotá River," Risk Analysis, John Wiley & Sons, vol. 37(4), pages 733-743, April.
    6. Lida Politi & Kassiani Mellou & Anthi Chrysostomou & Georgia Mandilara & Ioanna Spiliopoulou & Antonia Theofilou & Michalis Polemis & Kyriaki Tryfinopoulou & Theologia Sideroglou, 2024. "A Community Waterborne Salmonella Bovismorbificans Outbreak in Greece," IJERPH, MDPI, vol. 21(2), pages 1-14, February.

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