{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:37:13Z","timestamp":1791196633156,"version":"4.1.0"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2014,6,19]],"date-time":"2014-06-19T00:00:00Z","timestamp":1403136000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>We investigated a gastroenteritis outbreak in Erzurum city, Turkey in December 2012 to identify its cause and mode of transmission. We defined a probable case as onset of diarrhoea (\u2a7e3 episodes\/day) or vomiting, plus fever or nausea or abdominal pain during 19\u201327 December, 2012 in an Erzurum city resident. In a case-control study we compared exposures of 95 randomly selected probable cases and 95 neighbourhood-matched controls. We conducted bacterial culture and real-time multiplex PCR for identification of pathogens. During the week before illness onset, 72% of cases and 15% of controls only drank water from antique neighbourhood fountains; conversely, 16% of cases and 65% of controls only drank bottled or tap water (adjusted odds ratio 20, 95% confidence interval 4\u00b76\u201384, after controlling for age and sex using conditional logistic regression). Of eight stool specimens collected, two were positive for<jats:italic>Shigella sonnei<\/jats:italic>, one for astrovirus, one for astrovirus and norovirus, and one for astrovirus and rotavirus. Water samples from the fountains had elevated total coliform (38\u2013300\/100\u00a0ml) and<jats:italic>Escherichia coli<\/jats:italic>(22\u2013198\/100\u00a0ml) counts. In conclusion, drinking contaminated fountain water caused this multi-pathogen outbreak. Residents should stop drinking water from these fountains, and clean water from the water treatment plant should be connected to the fountains.<\/jats:p>","DOI":"10.1017\/s0950268814001459","type":"journal-article","created":{"date-parts":[[2014,6,19]],"date-time":"2014-06-19T10:40:21Z","timestamp":1403174421000},"page":"704-710","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":16,"title":["A large multi-pathogen gastroenteritis outbreak caused by drinking contaminated water from antique neighbourhood fountains, Erzurum city, Turkey, December 2012"],"prefix":"10.1017","volume":"143","author":[{"given":"F.","family":"SEZEN","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"AVAL","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"A\u011eKURT","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015e.","family":"YILMAZ","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"TEMEL","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"G\u00dcLE\u015eEN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"KORUKLUO\u011eLU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. B.","family":"SUCAKLI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. A.","family":"TORUNO\u011eLU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.-P.","family":"ZHU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2014,6,19]]},"reference":[{"key":"S0950268814001459_ref1","unstructured":"UNICEF\/WHO. Diarrhoea: why children are still dying and what can be done. New York: United Nations Children's Fund, 2009."},{"key":"S0950268814001459_ref17","unstructured":"Pr\u00fcss-\u00dcst\u00fcn A , Safer water, better health: costs, benefits and sustainability of interventions to protect and promote health. Geneva, Switzerland: World Health Organization, 2008, 60 pp (http:\/\/whqlibdoc.who.int\/publications\/2008\/9789241596435_eng.pdf). Accessed 5 March 2014."},{"key":"S0950268814001459_ref20","first-page":"814","article-title":"Ten great public health achievements\u00a0\u2013\u00a0worldwide, 2001\u20132010","volume":"60","year":"2011","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"S0950268814001459_ref5","volume-title":"The World's Water 2004\u20132005: The Biennial Report on Freshwater Resources","author":"Gleick","year":"2004"},{"key":"S0950268814001459_ref16","doi-asserted-by":"publisher","DOI":"10.2166\/wh.2007.010"},{"key":"S0950268814001459_ref22","unstructured":"Republic of Turkey. Law on General Hygiene (No. 1489). Act No. 1593. 6 May 1930 (http:\/\/www.saglik.gov.tr\/TR\/belge\/1-459\/tarihi24041930--sayisi1593--rg-tarihi06051930--rg-sayis-.html). Accessed 5 March 2014."},{"key":"S0950268814001459_ref3","first-page":"241","volume-title":"Infectious Disease Epidemiology Theory and Practice","author":"Dick","year":"2007"},{"key":"S0950268814001459_ref18","doi-asserted-by":"publisher","DOI":"10.2166\/wh.2007.009"},{"key":"S0950268814001459_ref15","unstructured":"Hutton G , Haller L . Evaluation of the costs and benefits of water and sanitation improvements at the global level. Geneva: World Health Organization, 2004 (http:\/\/wwwlive.who.int\/entity\/water_sanitation_health\/wsh0404.pdf). Accessed 5 March 2014."},{"key":"S0950268814001459_ref13","first-page":"3142","article-title":"First reported waterborne outbreak of Cryptosporidiosis with cyclospora co-infection in Turkey","volume":"12","author":"Aksoy","year":"2007","journal-title":"Eurosurveillance"},{"key":"S0950268814001459_ref10","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268810002141"},{"key":"S0950268814001459_ref7","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1056\/NEJM199407213310304","article-title":"A massive outbreak in Milwaukee of Cryptosporidium infection transmitted through the public water supply","volume":"331","author":"Mac","year":"1994","journal-title":"New England Journal of Medicine"},{"key":"S0950268814001459_ref11","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.9430"},{"key":"S0950268814001459_ref6","volume-title":"Water Follies: Groundwater Pumping and the Fate of America's Fresh Waters","author":"Glennon","year":"2002"},{"key":"S0950268814001459_ref9","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1017\/S0950268813000939","article-title":"A large waterborne gastroenteritis outbreak in central Greece, March 2012: challenges for the investigation and management","volume":"142","author":"Mellou","year":"2014","journal-title":"Epidemiology and Infection"},{"key":"S0950268814001459_ref4","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-08650-6"},{"key":"S0950268814001459_ref21","volume-title":"Maxcy-Rosenau-Last Public Health and Preventive Medicine","author":"Wallace","year":"2008"},{"key":"S0950268814001459_ref19","first-page":"621","article-title":"Achievements in Public Health, 1900\u20131999: control of infectious diseases","volume":"48","year":"1999","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"S0950268814001459_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2006.01441.x"},{"key":"S0950268814001459_ref14","first-page":"17","article-title":"A waterborne outbreak of epidemic diarrhea due to group A rotavirus in Malatya, Turkey","volume":"34","author":"Koroglu","year":"2011","journal-title":"Microbiologica"},{"key":"S0950268814001459_ref12","first-page":"39","article-title":"Surveillance for waterborne disease and outbreaks associated with drinking water and water not intended for drinking\u00a0\u2013\u00a0United States, 2005\u20132006","volume":"57","author":"Yoder","year":"2008","journal-title":"Morbidity and Mortality Weekly Report. 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