Norovirus Gastroenteritis outbreak in Kurdistan Province: Contamination of the Water Supply System

Nasrollah Veisi, Seyed Mehdi Hosseini, Ardashir Rahimzadeh, Mansoureh Mirzaei, H. Rezaei, Mansour Navshad, Seyede Parvin Ghazaei, Payam Shokri, Meysam Olfatifar, Khosro Kazempour
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Abstract

Background and aim: Noroviruses are the most common known cause of non-bacterial acute gastroenteritis in worldwide. Norovirus gastroenteritis most often occurs in the winter with vomiting and diarrhea. Materials and Methods: This cross sectional study was done to evaluate the outbreak of gastroenteritis in one of the villages of Kurdistan province, 1-12 February 2019. During this period, 149 people developed joint illness and symptoms of diarrhea, vomiting, abdominal cramps, and their information was recorded. Data analysis was done with Stata7 software. Results: Attack rate of the total population in the village was 31.17%. Also, Attack rate in rural men and women was 26.5 percent and 36.24 percent, respectively. The median age of the patients was 26.5 years. The mean and standard deviation of patients' age in the first days of outbreak were less than other days that this relationship was statistically meaningful (P = 0.003). The most common symptoms were non-bloody diarrhea (57.71%), vomiting (52.34%), abdominal cramp (26.17%) and nausea (24.83%). According to the shape of the epidemic curve, the outbreak was a community-wide outbreak caused by the norovirus virus. Conclusion: Based on clinical evidence, epidemiological examination, results of human and water samples analysis, outbreaks occurred due to the consumption of drinking water contaminated with norovirus. To prevent similar outbreaks, it is recommended to fix the bugs observed in the water supply system and implement the water safety program.
库尔德斯坦省爆发诺如病毒肠胃炎:供水系统污染
背景和目的:诺如病毒是世界范围内最常见的非细菌性急性胃肠炎的病因。诺如病毒胃肠炎最常发生在冬季,伴有呕吐和腹泻。材料和方法:本横断面研究旨在评估2019年2月1日至12日在库尔德斯坦省一个村庄爆发的肠胃炎。在此期间,149人出现了关节疾病和腹泻、呕吐、腹部痉挛的症状,他们的信息被记录下来。数据分析采用Stata7软件。结果:全村人口发病率为31.17%。农村男性和女性的发病率分别为26.5%和36.24%。患者的中位年龄为26.5岁。发病首天患者年龄的均值和标准差均小于其他天数,相关性有统计学意义(P = 0.003)。最常见的症状为无血性腹泻(57.71%)、呕吐(52.34%)、腹部痉挛(26.17%)和恶心(24.83%)。根据流行曲线的形状,这次暴发是由诺如病毒引起的社区范围暴发。结论:根据临床证据、流行病学检查、人和水样分析结果,疫情的发生是由于饮用了被诺如病毒污染的饮用水。为了防止类似的爆发,建议修复供水系统中观察到的漏洞,并实施水安全计划。
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