Skip common site navigation and headers
United States Environmental Protection Agency
Exposure Research
Begin Hierarchical Links EPA Home > Research & Development > Exposure Research > Publications/Presentations > End Hierarchical Links

 

Coordinating Systems-Based Environmental Public Health Practice With Epidemiology and Laboratory Analysis: A Waterborne Outbreak of Norwalk-Like Virus in the Big Horn Mountains of Wyoming

spacer
spacer
Abstract:Background: In February 2001, the Wyoming Department of Health received reports of cases of gastroenteritis among persons who had been snowmobiling in the Big Horn Mountains. Laboratory testing suggested that exposure to a Norwalk-like virus was responsible for the illness.

Methods: Environmental health specialists and epidemiologists from several state and federal agencies coordinated an investigation of environmental risk factors and system-based failures. The environmental assessment of three area lodges included food service operations, water supply systems, and sewage disposal. A retrospective cohort study was conducted among 82 guests to identify risk factors associated with illness. Stool and water samples were collected for laboratory analysis.

Results : Statistical analysis suggested that illness was associated with water consumed at one of the three area lodges (RR=3.3, 95% C.I.=(1.4,7.7)). Reverse transcriptase-polymerase chain reaction (RT-PCR) testing on 13 stool samples yielded 8 positives for Norwalk-like virus (NLV) genogroup II, with 3 distinct sequence types detected. Fecal contaminaiton of one of three operating wells was also found and one of the samples tested positive for NLV genogroup II. The environmental assessment of the property revealed that an inadequately installed sewage system was delivering effluent into shallow soil with poor filtering capacity.

Conclusion: This outbreak illustrates waterborne transmission of viral gastroenteritis and the advantages of coordinating a systems-based model of enviromental asssessment with traditional epidemiologic and laboratory practices. Preventing future system deficiencies depends on understanding the relevant protective components of facility operations including the surrounding physical environment, food service, water supply, and sewage systems.

spacer
Citation:Seys, S. A., H. M. Mainzer, A. G. Heryford, A. D. Anderson, S. S. Monroe, G. S. Fout, J. P. Sarisky, and K. J. Musgrave. Coordinating Systems-Based Environmental Public Health Practice With Epidemiology and Laboratory Analysis: A Waterborne Outbreak of Norwalk-Like Virus in the Big Horn Mountains of Wyoming. Presented at American Public Health Association Annual Meeting, Philadelphia, PA, November 9-13, 2002.
spacer
spacer
Contact: Mary P. O'Bryant - (919)-541-4871 or obriant.mary@epa.gov
spacer
Division: Microbiological & Chemical Exposure Assessment Division
spacer
Branch: Biohazard Assessment Research Branch
spacer
Product Type: Abstrct/Oral
spacer
Presented: 11/09/2002
spacer
Related Entries:
spacer
Bullet Item Detecting Ccl-Related, Emerging Waterborne Human Viruses and Viral Indicators for Exposure Assessment
spacer Relationship Reason:   A Project of the Product
spacer
spacer
spacer

 

ORD Home | Search EPA | Search NERL | Search EIMS | Contacts | Help

 
Begin Site Footer

EPA Home | Privacy and Security Notice | Contact Us

Last Updated on Monday, October 22, 2007
URL: http://cfpub.epa.gov