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A Community Waterborne Salmonella Bovismorbificans Outbreak in Greece

Author

Listed:
  • Lida Politi

    (Department of Microbial Resistance and Infections in Health Care Settings, Directorate of Surveillance and Prevention of Infectious Diseases, National Public Health Organization, 15123 Athens, Greece)

  • Kassiani Mellou

    (Directorate of Surveillance and Prevention of Infectious Diseases, National Public Health Organization, 15123 Athens, Greece)

  • Anthi Chrysostomou

    (Department of Foodborne and Waterborne Diseases, Directorate of Surveillance and Prevention of Infectious Diseases, National Public Health Organization, 15123 Athens, Greece)

  • Georgia Mandilara

    (National Reference Centre for Salmonella and Shigella, School of Public Health, University of West Attica, 11521 Athens, Greece)

  • Ioanna Spiliopoulou

    (Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece)

  • Antonia Theofilou

    (Water Microbiology Laboratory, Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece)

  • Michalis Polemis

    (National Electronic Antimicrobial Resistance Surveillance Network, Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece)

  • Kyriaki Tryfinopoulou

    (Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece)

  • Theologia Sideroglou

    (Department of Foodborne and Waterborne Diseases, Directorate of Surveillance and Prevention of Infectious Diseases, National Public Health Organization, 15123 Athens, Greece)

Abstract

Background: In August 2022, the Hellenic National Public Health Organisation was notified about a gastroenteritis outbreak in town A in Southern Greece. Investigations aimed to identify the source and implement control measures. Methods: Case definition categories were used in a 1:3 case–control study. Cases and controls were interviewed about various exposures. Cases’ stool samples were cultured on agar plates and characterised by serotyping, antimicrobial susceptibility testing and Pulse Field Gel Electrophoresis (PFGE). Environmental investigations included tap water sampling for microbiological and chemical analysis in town A and inspection of the water supply system. Results: We identified 33 cases (median age: 17 years). Tap water consumption was the only significant risk factor for gastroenteritis (OR = 5.46, 95% CI = 1.02–53.95). Salmonella ( S. ) Bovismorbificans isolated from eight stool and one tap water samples had identical PFGE profiles. No resistant isolates were identified. Residual chlorine levels were lower than the acceptable limits before and during the outbreak. We advised consumption of bottled water and adherence to strict hand hygiene rules until tap water was declared suitable for drinking. Conclusions: Epidemiological and molecular data revealed a waterborne S. Bovismorbificans outbreak in town A. We recommend local water safety authorities to ensure that residual chlorine levels comply with the legislation towards water safety planning, to mitigate risks.

Suggested Citation

  • 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.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:2:p:167-:d:1331048
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    References listed on IDEAS

    as
    1. 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.
    2. Ari Kauppinen & Tarja Pitkänen & Haider Al-Hello & Leena Maunula & Anna-Maria Hokajärvi & Ruska Rimhanen-Finne & Ilkka T. Miettinen, 2019. "Two Drinking Water Outbreaks Caused by Wastewater Intrusion Including Sapovirus in Finland," IJERPH, MDPI, vol. 16(22), pages 1-14, November.
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