HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Angulo, F J Articles by Swerdlow, D L Search for Related Content PubMed PubMed Citation Articles by Angulo, F J Articles by Swerdlow, D L

A community waterborne outbreak of salmonellosis and the effectiveness of a boil water order.

F J Angulo, S Tippen, D J Sharp, B J Payne, C Collier, J E Hill, T J Barrett, R M Clark, E E Geldreich, H D Donnell, Jr and D L Swerdlow

National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga., USA.

OBJECTIVES: A 1993 large water-borne outbreak of Salmonella typhimurium infections in Gideon, Mo, a city of 1100 with an unchlorinated community water supply, was investigated to determine the source of contamination and the effectiveness of an order to boil water. METHODS: A survey of household members in Gideon and the surrounding township produced information on diarrheal illness, water consumption, and compliance with the boil water order. RESULTS: More than 650 persons were ill; 15 were hospitalized, and 7 died. Persons consuming city water were more likely to be ill (relative risk [RR] = 9.1, 95% confidence interval [CI] = 2.9, 28.4), and the attack rate increased with increased water consumption. S. typhimurium was recovered from samples taken from a city fire hydrant and a water storage tower. Persons in 31% (30/ 98) of city households had drunk unboiled water after being informed about the boil water order, including 14 individuals who subsequently became ill. Reasons for noncompliance included "not remembering" (44%) and "disbelieving" (25%) the order. CONCLUSIONS: Communities with deteriorating water systems risk widespread illness unless water supplies are properly operated and maintained. Effective education to improve compliance during boil water orders is needed.

This article has been cited by other articles:

				P. K. Ram, E. Blanton, D. Klinghoffer, M. Platek, J. Piper, S. Straif-Bourgeois, M. R. Bonner, and E. D. Mintz Household Water Disinfection in Hurricane-Affected Communities of Louisiana: Implications for Disaster Preparedness for the General Public Am J Public Health, April 1, 2007; 97(Supplement_1): S130 - S135. [Abstract] [Full Text] [PDF]

				W. R. Hogan, F.-C. Tsui, O. Ivanov, P. H. Gesteland, S. Grannis, J. M. Overhage, J. M. Robinson, and M. M. Wagner Detection of Pediatric Respiratory and Diarrheal Outbreaks from Sales of Over-the-counter Electrolyte Products J. Am. Med. Inform. Assoc., November 1, 2003; 10(6): 555 - 562. [Abstract] [Full Text] [PDF]

				A. Gallay, V. Vaillant, P. Bouvet, P. Grimont, and J.-C. Desenclos How Many Foodborne Outbreaks of Salmonella Infection Occurred in France in 1995? : Application of the Capture-Recapture Method to Three Surveillance Systems Am. J. Epidemiol., July 15, 2000; 152(2): 171 - 177. [Abstract] [Full Text] [PDF]

				R. G. Villar, M. D. Macek, S. Simons, P. S. Hayes, M. J. Goldoft, J. H. Lewis, L. L. Rowan, D. Hursh, M. Patnode, and P. S. Mead Investigation of Multidrug-Resistant Salmonella Serotype Typhimurium DT104 Infections Linked to Raw-Milk Cheese in Washington State JAMA, May 19, 1999; 281(19): 1811 - 1816. [Abstract] [Full Text] [PDF]

				K. A. Cook, T. E. Dobbs, W. G. Hlady, J. G. Wells, T. J. Barrett, N. D. Puhr, G. A. Lancette, D. W. Bodager, B. L. Toth, C. A. Genese, et al. Outbreak of Salmonella Serotype Hartford Infections Associated With Unpasteurized Orange Juice JAMA, November 4, 1998; 280(17): 1504 - 1509. [Abstract] [Full Text] [PDF]

				G. E. Schutze, R. S. Kirby, E. L. Flick, R. Stefanova, K. D. Eisenach, and M. D. Cave Epidemiology and Molecular Identification of Salmonella Infections in Children Arch Pediatr Adolesc Med, July 1, 1998; 152(7): 659 - 664. [Abstract] [Full Text] [PDF]