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Early outbreak detection by linking health advice line calls to water distribution areas retrospectively demonstrated in a large waterborne outbreak of cryptosporidiosis in Sweden.

Abstract In the winter and spring of 2011 a large outbreak of cryptosporidiosis occurred in Skellefteå municipality, Sweden. This study summarizes the outbreak investigation in terms of outbreak size, duration, clinical characteristics, possible source(s) and the potential for earlier detection using calls to a health advice line.
PMID
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Authors

Mayor MeshTerms

Disease Outbreaks

Early Diagnosis

Keywords

Cryptosporidiosis

Cryptosporidium hominis

Early outbreak detection

Syndromic surveillance

Journal Title bmc public health
Publication Year Start




PMID- 28420373
OWN - NLM
STAT- MEDLINE
DA  - 20170419
DCOM- 20170426
LR  - 20170426
IS  - 1471-2458 (Electronic)
IS  - 1471-2458 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Apr 18
TI  - Early outbreak detection by linking health advice line calls to water
      distribution areas retrospectively demonstrated in a large waterborne outbreak of
      cryptosporidiosis in Sweden.
PG  - 328
LID - 10.1186/s12889-017-4233-8 [doi]
AB  - BACKGROUND: In the winter and spring of 2011 a large outbreak of
      cryptosporidiosis occurred in Skelleftea municipality, Sweden. This study
      summarizes the outbreak investigation in terms of outbreak size, duration,
      clinical characteristics, possible source(s) and the potential for earlier
      detection using calls to a health advice line. METHODS: The investigation
      included two epidemiological questionnaires and microbial analysis of samples
      from patients, water and other environmental sources. In addition, a
      retrospective study based on phone calls to a health advice line was performed by
      comparing patterns of phone calls between different water distribution areas.
      RESULTS: Our analyses showed that approximately 18,500 individuals were affected 
      by a waterborne outbreak of cryptosporidiosis in Skelleftea in 2011. This makes
      it the second largest outbreak of cryptosporidiosis in Europe to date.
      Cryptosporidium hominis oocysts of subtype IbA10G2 were found in patient and
      sewage samples, but not in raw water or in drinking water, and the initial
      contamination source could not be determined. The outbreak went unnoticed to
      authorities for several months. The analysis of the calls to the health advice
      line provides strong indications early in the outbreak that it was linked to a
      particular water treatment plant. CONCLUSIONS: We conclude that an earlier
      detection of the outbreak by linking calls to a health advice line to water
      distribution areas could have limited the outbreak substantially.
FAU - Bjelkmar, Par
AU  - Bjelkmar P
AUID- ORCID: http://orcid.org/0000-0002-5560-865X
AD  - Department of Monitoring and Evaluation, Public Health Agency of Sweden, 171 83, 
      Solna, Sweden. [email protected]
FAU - Hansen, Anette
AU  - Hansen A
AD  - Department of Microbiology, Public Health Agency of Sweden, Solna, Sweden.
FAU - Schonning, Caroline
AU  - Schonning C
AD  - Department of Monitoring and Evaluation, Public Health Agency of Sweden, 171 83, 
      Solna, Sweden.
FAU - Bergstrom, Jakob
AU  - Bergstrom J
AD  - Department of Monitoring and Evaluation, Public Health Agency of Sweden, 171 83, 
      Solna, Sweden.
FAU - Lofdahl, Margareta
AU  - Lofdahl M
AD  - Department of Monitoring and Evaluation, Public Health Agency of Sweden, 171 83, 
      Solna, Sweden.
FAU - Lebbad, Marianne
AU  - Lebbad M
AD  - Department of Microbiology, Public Health Agency of Sweden, Solna, Sweden.
FAU - Wallensten, Anders
AU  - Wallensten A
AD  - Department of Monitoring and Evaluation, Public Health Agency of Sweden, 171 83, 
      Solna, Sweden.
AD  - Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
FAU - Allestam, Gorel
AU  - Allestam G
AD  - Department of Monitoring and Evaluation, Public Health Agency of Sweden, 171 83, 
      Solna, Sweden.
FAU - Stenmark, Stephan
AU  - Stenmark S
AD  - Department of Clinical Microbiology, Umea University, Umea, Sweden.
FAU - Lindh, Johan
AU  - Lindh J
AD  - Department of Cell and Molecular Biology, Uppsala University, Uppsala, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20170418
PL  - England
TA  - BMC Public Health
JT  - BMC public health
JID - 100968562
RN  - 0 (Sewage)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Cryptosporidiosis/*diagnosis/*epidemiology
MH  - Cryptosporidium/isolation & purification
MH  - *Disease Outbreaks/prevention & control/statistics & numerical data
MH  - *Early Diagnosis
MH  - Female
MH  - Hotlines/*statistics & numerical data
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Middle Aged
MH  - Population Surveillance/*methods
MH  - Retrospective Studies
MH  - Seasons
MH  - Sewage/microbiology
MH  - Surveys and Questionnaires
MH  - Sweden/epidemiology
MH  - Water Purification
MH  - Water Supply/*statistics & numerical data
MH  - Young Adult
PMC - PMC5395832
OTO - NOTNLM
OT  - Cryptosporidiosis
OT  - Cryptosporidium hominis
OT  - Early outbreak detection
OT  - Syndromic surveillance
EDAT- 2017/04/20 06:00
MHDA- 2017/04/27 06:00
CRDT- 2017/04/20 06:00
PHST- 2017/01/05 [received]
PHST- 2017/04/06 [accepted]
AID - 10.1186/s12889-017-4233-8 [doi]
AID - 10.1186/s12889-017-4233-8 [pii]
PST - epublish
SO  - BMC Public Health. 2017 Apr 18;17(1):328. doi: 10.1186/s12889-017-4233-8.

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