

@article {3646,
	title = {A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, {France}, 2000.},
	journal = {Clinical Microbiology and Infection},
	volume = {12},
	number = {6},
	year = {2006},
	pages = {561{\textendash}570},
	abstract = {<p>A large waterborne outbreak of infection that occurred during August 2000 in a local community in France was investigated initially via a rapid survey of visits to local physicians. A retrospective cohort study was then conducted on a random cluster sample of residents. Of 709 residents interviewed, 202 (28.5\{\%\}) were definite cases (at least three liquid stools/day or vomiting) and 62 (8.7\{\%\}) were probable cases (less than three liquid stools/day or abdominal pain). Those who had drunk tap water had a three-fold increased risk for illness (95\{\%\} \{\{\}CI\{\}\} 2.4-4.0). The risk increased with the amount of water consumed (chi-square trend: p \{{\textbackslash}textless\} 0.0001). Bacteriological analyses of stools were performed for 35 patients and virological analyses for 24 patients. Campylobacter coli, group A rotavirus and norovirus were detected in 31.5\{\%\}, 71.0\{\%\} and 21\{\%\} of samples, respectively. An extensive environmental investigation concluded that a groundwater source to this community had probably been contaminated by agricultural run-off, and a failure in the chlorination system was identified. This is the first documented waterborne outbreak of infection involving human C. coli infections. A better understanding of the factors influencing campylobacter transmission between hosts is required.</p>
},
	doi = {10.1111/j.1469-0691.2006.01441.x},
	url = {http://dx.doi.org/10.1111/j.1469-0691.2006.01441.x},
	author = {Gallay, A and De Valk, H and Cournot, M and Ladeuil, B and Hemery, C and Castor, C and Bon, F and M{\'e}graud, F and Le Cann, P and Desenclos, J C and Team, Outbreak Investigation}
}
