J Korean Med Sci.  2011 Jan;26(1):28-32. 10.3346/jkms.2011.26.1.28.

An Outbreak of Gastroenteritis Caused by Norovirus-Contaminated Groundwater at a Waterpark in Korea

Affiliations
  • 1Epidemic Intelligence Service, Division of Public Health Policy, Gyeonggi Provincial Office, Suwon, Korea.
  • 2Division of Microbiology, Gyeonggi-do Institute of Health and Environment, Suwon, Korea.
  • 3Department of Internal Medicine and Hepatology Center, Bundang Jesaeng General Hospital, Seongnam, Korea.
  • 4Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea. bychoi@hanyang.ac.kr

Abstract

In January 2008, an outbreak of acute gastroenteritis at a waterpark was reported to the Bundang-gu Public Health Center in Seongnam, Korea. To determine the etiological agent and mode of transmission, a retrospective cohort study was done using structured questionnaires and stool samples from patients who had current gastrointestinal symptoms and three food handlers were tested. A total of 67 (31.0%) students and teachers developed acute gastroenteritis. No food items were associated with an increased risk of the illness. Norovirus was detected in 3 stool specimens collected from 6 patients who had severe diarrhea using semi-nested RT-PCR. All the specimens contained the genogroup I strains of the norovirus. Norovirus was also detected in the groundwater samples from the waterpark. In the nucleotide sequencing analysis, all the genogroup I noroviruses from the patients and groundwater samples were identified as the norovirus genotype I-4 strain. They were indistinguishable by DNA sequencing with a 97% homology. We conclude the outbreak of acute gastroenteritis caused by the norovirus was closely related to the contaminated groundwater.

Keyword

Norovirus; Gastroenteritis; Disease Outbreaks; Contaminated Groundwater; DNA Sequencing

MeSH Terms

Adult
Caliciviridae Infections/*epidemiology/*virology
Child
Cohort Studies
*Disease Outbreaks
Feces/virology
Female
Fresh Water/*virology
Gastroenteritis/*epidemiology/*virology
Genotype
Humans
Male
Norovirus/classification/genetics/*isolation & purification
Phylogeny
Republic of Korea
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction
Sequence Analysis, RNA

Figure

  • Fig. 1 Phylogenetic analysis of norovirus genogroup-I at a waterpark in Gyeonggi-do. Analysis was conducted using MegAlign, version 5.03 (DNAStar, Madison, Wis). The noroviruses detected in the fecal specimens from the patients of this outbreak were typed as GI-4 (most similar to GI-4 Chiba the GenBank accession number AF145896), as was the norovirus isolated from the groundwater.


Cited by  2 articles

Epidemiological Study of Ground-waterborne Norovirus GI.3-associated Gastroenteritis Outbreaks in Gyeonggi Province of South Korea in May 2011
Myung-Jin Lee, Woon-Ho Kim, Han-Gil Cho, Sang-Seob Lee
J Bacteriol Virol. 2012;42(3):232-241.    doi: 10.4167/jbv.2012.42.3.232.

Guideline for the Antibiotic Use in Acute Gastroenteritis
Youn Jeong Kim, Ki-Ho Park, Dong-Ah Park, Joonhong Park, Byoung Wook Bang, Seung Soon Lee, Eun Jung Lee, Hyo-Jin Lee, Sung Kwan Hong, Yang Ree Kim
Infect Chemother. 2019;51(2):217-243.    doi: 10.3947/ic.2019.51.2.217.


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