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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La potabilidad del agua induce a descartar el posible origen h&#237;drico de los brotes&#46; El objetivo fue investigar un brote de gastroenteritis por agua potable de suministro p&#250;blico&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Despu&#233;s de la notificaci&#243;n de un brote de gastroenteritis en el municipio de Baqueira &#40;Valle de Ar&#225;n&#41; se dise&#241;&#243; un estudio epidemiol&#243;gico de cohortes retrospectivo&#46; Mediante un muestreo sistem&#225;tico se eligi&#243; a 87 personas hospedadas en los hoteles y a 62 alojadas en diferentes apartamentos&#46; Se recogi&#243; informaci&#243;n sobre 4 factores &#40;consumo de agua de la red&#44; bocadillos&#44; agua y alimentos en las pistas de esqu&#237;&#41; y presencia de s&#237;ntomas&#46; Se determin&#243; la existencia de cloro&#44; se analiz&#243; el agua de la red y se realiz&#243; un coprocultivo a 4 enfermos&#46; La implicaci&#243;n de cada factor se determin&#243; con el riesgo relativo &#40;RR&#41; y su intervalo de confianza &#40;IC&#41; del 95&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La incidencia de gastroenteritis fue del 51&#44;0&#37; &#40;76&#47;149&#41;&#46; Los porcentajes de los s&#237;ntomas fueron los siguientes&#58; fiebre&#44; 27&#44;0&#37;&#59; diarrea&#44; 87&#44;5&#37;&#59; n&#225;useas&#44; 50&#44;7&#37;&#59; v&#243;mitos&#44; 30&#44;3&#37;&#44; y dolor abdominal&#44; 80&#44;0&#37;&#46; El &#250;nico factor que present&#243; un riesgo estad&#237;sticamente significativo fue el consumo de agua de la red &#40;RR &#61; 11&#44;0&#59; IC del 95&#37;&#44; 1&#44;6-74&#44;7&#41;&#46; La calificaci&#243;n sanitaria del agua fue de potabilidad&#46; Se observ&#243; un defecto de situaci&#243;n del clorador en el dep&#243;sito&#44; que fue corregido&#46; Se recomend&#243; incrementar a&#250;n m&#225;s las concentraciones de cloro&#44; lo cual se acompa&#241;&#243; de una disminuci&#243;n de los casos&#46; Los coprocultivos de los 4 enfermos fueron negativos para las enterobacterias investigadas&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El estudio demuestra la posibilidad de presentaci&#243;n de brotes h&#237;dricos por agua cualificada como potable y sugiere la necesidad de mejorar la investigaci&#243;n microbiol&#243;gica &#40;determinaci&#243;n de protozoos y virus&#41; en este tipo de brotes&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The chlorination of public water supplies has led researchers to largely discard drinking water as a potential source of gastroenteritis outbreaks&#46; The aim of this study was to investigate an outbreak of waterborne disease associated with drinking water from public supplies&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A historical cohort study was carried out following notification of a gastroenteritis outbreak in Baqueira &#40;Valle de Ar&#225;n&#44; Spain&#41;&#46; We used systematic sampling to select 87 individuals staying at hotels and 67 staying in apartments in the target area&#46;</p><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">Information was gathered on four factors &#40;consumption of water from the public water supply&#44; sandwiches&#44; water and food in the ski resorts&#41; as well as on symptoms&#46; We assessed residual chlorine in drinking water&#44; analyzed samples of drinking water&#44; and studied stool cultures from 4 patients&#46; The risk associated with each water source and food type was assessed by means of relative risk &#40;RR&#41; and 95&#37; confidence intervals &#40;CI&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The overall attack rate was 51&#46;0&#37; &#40;76&#47;149&#41;&#46; The main symptoms were diarrhea 87&#46;5&#37;&#44; abdominal pain 80&#46;0&#37;&#44; nausea 50&#46;7&#37;&#44; vomiting 30&#46;3&#37;&#44; and fever 27&#46;0&#37;&#46; The only factor associated with a statistically significant risk of disease was consumption of drinking water &#40;RR &#61; 11&#46;0&#59; 95&#37; CI&#44; 1&#46;6-74&#46;7&#41;&#46; No residual chlorine was detected in the drinking water&#44; which was judged acceptable&#46; A problem associated with the location of the chlorinator was observed and corrected&#46; We also recommended an increase in chlorine levels&#44; which was followed by a reduction in the number of cases&#46; The results of stool cultures of the four patients were negative for enterobacteria&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">This study highlights the potential importance of waterborne outbreaks of gastroenteritis transmitted through drinking water considered acceptable and suggests the need to improve microbiological research into these outbreaks &#40;viruses and protozoa detection&#41;&#46;</p>"
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Vol. 17. Núm. 3.
Páginas 204-209 (mayo - junio 2003)
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Vol. 17. Núm. 3.
Páginas 204-209 (mayo - junio 2003)
Open Access
Brote de gastroenteritis por agua potable de suministro público
Waterborne outbreak of gastroenteritis transmitted through the public water supply
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6281
P. Godoya,b,
Autor para correspondencia
godoy@slle.scs.ec

Correspondencia: Dr. P. Godoy. Vall d'Aneu, 45. 25199 Lleida. España
, C. Borrullc, M. Palàc, I. Caubetc, P. Bacha, C. Nuína, L. Espineta, J. Torresa, G. Miradaa
a Delegación Territorial del Departamento de Sanidad y Seguridad Social de Lleida
b Facultad de Medicina. Universidad de Lleida
c Servici Aranés Dera Salut. Lleida. España
Este artículo ha recibido

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Información del artículo
Resumen
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Estadísticas
Resumen
Introducción

La potabilidad del agua induce a descartar el posible origen hídrico de los brotes. El objetivo fue investigar un brote de gastroenteritis por agua potable de suministro público.

Métodos

Después de la notificación de un brote de gastroenteritis en el municipio de Baqueira (Valle de Arán) se diseñó un estudio epidemiológico de cohortes retrospectivo. Mediante un muestreo sistemático se eligió a 87 personas hospedadas en los hoteles y a 62 alojadas en diferentes apartamentos. Se recogió información sobre 4 factores (consumo de agua de la red, bocadillos, agua y alimentos en las pistas de esquí) y presencia de síntomas. Se determinó la existencia de cloro, se analizó el agua de la red y se realizó un coprocultivo a 4 enfermos. La implicación de cada factor se determinó con el riesgo relativo (RR) y su intervalo de confianza (IC) del 95%.

Resultados

La incidencia de gastroenteritis fue del 51,0% (76/149). Los porcentajes de los síntomas fueron los siguientes: fiebre, 27,0%; diarrea, 87,5%; náuseas, 50,7%; vómitos, 30,3%, y dolor abdominal, 80,0%. El único factor que presentó un riesgo estadísticamente significativo fue el consumo de agua de la red (RR = 11,0; IC del 95%, 1,6-74,7). La calificación sanitaria del agua fue de potabilidad. Se observó un defecto de situación del clorador en el depósito, que fue corregido. Se recomendó incrementar aún más las concentraciones de cloro, lo cual se acompañó de una disminución de los casos. Los coprocultivos de los 4 enfermos fueron negativos para las enterobacterias investigadas.

Conclusiones

El estudio demuestra la posibilidad de presentación de brotes hídricos por agua cualificada como potable y sugiere la necesidad de mejorar la investigación microbiológica (determinación de protozoos y virus) en este tipo de brotes.

Palabras clave:
Epidemiología
Brotes epidémicos
Brotes hídricos
Agua de consumo
Abstract
Introduction

The chlorination of public water supplies has led researchers to largely discard drinking water as a potential source of gastroenteritis outbreaks. The aim of this study was to investigate an outbreak of waterborne disease associated with drinking water from public supplies.

Methods

A historical cohort study was carried out following notification of a gastroenteritis outbreak in Baqueira (Valle de Arán, Spain). We used systematic sampling to select 87 individuals staying at hotels and 67 staying in apartments in the target area.

Information was gathered on four factors (consumption of water from the public water supply, sandwiches, water and food in the ski resorts) as well as on symptoms. We assessed residual chlorine in drinking water, analyzed samples of drinking water, and studied stool cultures from 4 patients. The risk associated with each water source and food type was assessed by means of relative risk (RR) and 95% confidence intervals (CI).

Results

The overall attack rate was 51.0% (76/149). The main symptoms were diarrhea 87.5%, abdominal pain 80.0%, nausea 50.7%, vomiting 30.3%, and fever 27.0%. The only factor associated with a statistically significant risk of disease was consumption of drinking water (RR = 11.0; 95% CI, 1.6-74.7). No residual chlorine was detected in the drinking water, which was judged acceptable. A problem associated with the location of the chlorinator was observed and corrected. We also recommended an increase in chlorine levels, which was followed by a reduction in the number of cases. The results of stool cultures of the four patients were negative for enterobacteria.

Conclusions

This study highlights the potential importance of waterborne outbreaks of gastroenteritis transmitted through drinking water considered acceptable and suggests the need to improve microbiological research into these outbreaks (viruses and protozoa detection).

Key words:
Epidemiology
Outbreak
Waterborne outbreak
Drinking water
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