{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T13:38:55Z","timestamp":1740145135253,"version":"3.37.3"},"reference-count":19,"publisher":"IWA Publishing","issue":"7","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["iwaponline.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Disruption of routine monitorization and chlorination of the water supply system during a week-long holiday led to a multi-organism gastroenteritis outbreak in a district with limited laboratory support. More than a 10-fold increase in patients with gastroenteritis was reported. Enteropathogenic Escherichia coli, Enteroaggregative E. coli, and norovirus were detected in human specimen samples. The main water tank and pipes were rusted; 13 out of the 19 water samples tested positive for total Coliform (1\u2013920 colony-forming units (CFU)\/100 ml) and E. coli (1\u2013720 CFU\/100 ml). Chlorine levels were below 0.2 ppm in seven of the nine samples. Information of 1,815 cases was obtained from the hospital records with a crude attack rate of 2.9%. Cases widespread in the district increased throughout the holiday, epidemic curve revealed a point-source outbreak. The case\u2013control study revealed that consumption of drinking tap water and using it to clean vegetables\/fruits were significantly associated with the illness. While drinking only bottled water had a protective effect against the illness. The culture technique showed that the water supply samples were positive for pathogenic bacteria. Upon decision in a multi-stakeholder meeting, the water tank was cleaned, and the Municipality initiated the renovation of the water supply system.<\/jats:p>","DOI":"10.2166\/wh.2022.037","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T12:33:06Z","timestamp":1655987586000},"page":"1064-1070","update-policy":"https:\/\/doi.org\/10.2166\/iwapcrossmarkpolicypage","source":"Crossref","is-referenced-by-count":0,"title":["An acute gastroenteritis outbreak associated with a contaminated water supply system, Turkey, 2018"],"prefix":"10.2166","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0231-9766","authenticated-orcid":false,"given":"Zeynep \u00d6zge","family":"\u00d6zg\u00fcler","sequence":"first","affiliation":[{"name":"a General Directorate of Public Health, Ministry of Health of Turkey, Adnan Saygun St, \u00c7ankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nayak","family":"Priyakanta","sequence":"additional","affiliation":[{"name":"b WHO Country Office Turkey, World Health Organization, WHO Country Office Turkey, Yukar\u0131 Dikmen, \u00c7ankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serap Cetin","family":"Coban","sequence":"additional","affiliation":[{"name":"a General Directorate of Public Health, Ministry of Health of Turkey, Adnan Saygun St, \u00c7ankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Akif","family":"Sezerol","sequence":"additional","affiliation":[{"name":"a General Directorate of Public Health, Ministry of Health of Turkey, Adnan Saygun St, \u00c7ankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irshad Ali","family":"Shaikh","sequence":"additional","affiliation":[{"name":"b WHO Country Office Turkey, World Health Organization, 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