Norovirus Outbreak Associated with Swimming in a Recreational Lake Not Influenced by External Human Fecal Sources in The Netherlands, August 2012

Franciska M. Schets, Harold H. J. L. Van den Berg, Harry Vennema, Manon T. M. Pelgrim, Cees Collé, Saskia A. Rutjes and Willemijn J. Lodder
Additional contact information
Franciska M. Schets: National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
Harold H. J. L. Van den Berg: National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
Harry Vennema: National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
Manon T. M. Pelgrim: Public Health Service Veiligheids-en Gezondheidsregio Gelderland-Midden, Postbus 5364, 6802 EJ Arnhem, The Netherlands
Cees Collé: Province of Gelderland, Postbus 9090, 6800 GX Arnhem, The Netherlands
Saskia A. Rutjes: National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
Willemijn J. Lodder: National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands

IJERPH, 2018, vol. 15, issue 11, 1-9

Abstract: Swimming in fecally contaminated recreational water may lead to gastrointestinal illness. A recreational water-associated outbreak of norovirus (NoV) infections affecting at least 100 people in The Netherlands occurred in August 2012. Questionnaire responses from patients indicated swimming in recreational lake Zeumeren as the most likely cause of illness. Most patients visited the lake during the weekend of 18–19 August, during which the weather was exceptionally warm (maximum temperatures 32–33 °C), and visitor numbers elevated. Patients, mostly children, became ill with gastroenteritis 1–6 days (median 2 days) after exposure. Four stool samples from patients were NoV GI positive. Subsurface sandy soil from one of the beaches where most patients swam was NoV GI positive; the water sample was negative. The epidemiological curve and the timeline of investigation based on reported symptoms demonstrate the difficulty in discovering the source in recreational water outbreaks. A NoV outbreak in a recreational lake that is not subjected to external fecal contamination sources shows the need for active communication about human shedding of viruses during and after diarrheal episodes and the advice to refrain from swimming, even a few weeks after the symptoms have resolved.

Keywords: outbreak; recreational water; norovirus; swimming (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/15/11/2550/pdf (application/pdf)
https://www.mdpi.com/1660-4601/15/11/2550/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:15:y:2018:i:11:p:2550-:d:182694

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().