A Community Waterborne Salmonella Bovismorbificans Outbreak in Greece

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. Case definition categories were used in a 1:3 case-control study. Cases and control...

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Published in:International journal of environmental research and public health 2024-02, Vol.21 (2), p.167
Main Authors: Politi, Lida, Mellou, Kassiani, Chrysostomou, Anthi, Mandilara, Georgia, Spiliopoulou, Ioanna, Theofilou, Antonia, Polemis, Michalis, Tryfinopoulou, Kyriaki, Sideroglou, Theologia
Format: Article
Language:English
Subjects:
Adolescent
Case-Control Studies
Chlorine
COVID-19 diagnostic tests
Demographics
Disease Outbreaks
Drinking water
Drinking Water - microbiology
Epidemics
Gastroenteritis
Gastroenteritis - etiology
Greece - epidemiology
Humans
Hypotheses
Industrialized nations
Investigations
Laboratories
Public health
Salmonella
Salmonella - genetics
Scandals
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Summary: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. 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. 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). ( ) 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. Epidemiological and molecular data revealed a waterborne 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.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph21020167