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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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Brote de gastroenteritis por agua potable de suministro público
Waterborne outbreak of gastroenteritis transmitted through the public water supply
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
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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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ISSN: 02139111
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