An outbreak of acute gastroenteritis associated with contaminated bottled water in a university – Jiangxi, China, 2012

Authors

  • Ruiping Wang China Field Epidemiology Training Programme (CFETP) Beijing, China and Songjiang Center for Disease Control and Prevention, Shanghai, China.
  • Huijian Cheng
  • Jun Zong
  • Ping Yu
  • Weijie Fu
  • Fuqiang Yang
  • Guoqing Shi
  • Guang Zeng

DOI:

https://doi.org/10.5365/wpsar.2012.3.4.009

Abstract

Background: On 23 May 2012, a university in Jiangxi, China reported a gastroenteritis outbreak. We investigated the outbreak to identify the agent, source and mode of transmission and to recommend control measures.

Methods: A case was defined as any person from the university with onset of diarrhoea (>3times/24h) from 1 to 31 May 2012. Active case finding was conducted by reviewing university hospital and drug-store records and interviewing students, workers and teachers. We then conducted a case-control study in which we compared food, water and environmental exposure history. Water samples were collected and tested.

Results: We identified 417 cases – an attack rate (AR) of 4.7% (417/8781) for the university. There were 416 student cases (AR = 5.7%) distributed across all 11 colleges, five of which were more heavily affected (AR range = 5.9%–14%). In the case-control study, cases had higher odds of having drunk bottled water (odds ratio [OR] = 4.1; 95% confidence interval [CI] = 1.7–9.9), and there was a dose–response relationship (X2trend = 4.6, P < 0.05). Drinking boiled bottled water was inversely associated with being a case (OR = 0.22, 95% CI = 0.07–0.71). Eating in any of the three university canteens or drinking water from the city water supply was not associated with being a case. Pathogenic Escherichia coli was isolated from two unopened bottled water specimens and from four student cases.

Conclusion: This gastroenteritis outbreak was most likely caused by contaminated bottled water. The company in question has been shut down and no further cases have been reported. Increased regulation of bottled water plants and better coordination between different investigators for future outbreaks is recommended.

Downloads

How to Cite

1.
Wang R, Cheng H, Zong J, Yu P, Fu W, Yang F, Shi G, Zeng G. An outbreak of acute gastroenteritis associated with contaminated bottled water in a university – Jiangxi, China, 2012. Western Pac Surveill Response J [Internet]. 2013 May 30 [cited 2026 Apr. 10];3(4). Available from: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/169

Issue

Vol. 3 No. 4 (2012): October – December

Section

Outbreak investigations in the Western Pacific - Outbreak Investigation Report

License

You are free to:

  • Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
  • Adapt — remix, transform, and build upon the material for any purpose, even commercially.
  • The licensor cannot revoke these freedoms as long as you follow the license terms.

Under the following terms:

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

Notices:

When the Licensor is an intergovernmental organization, disputes will be resolved by mediation and arbitration unless otherwise agreed.

You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.

No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.