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Gastrointestinal, influenza-like illness and dermatological complaints following exposure to floodwater: a cross-sectional survey in The Netherlands

  • H. DE MAN (a1) (a2) (a3), L. MUGHINI GRAS (a3) (a4), B. SCHIMMER (a3), I. H. M. FRIESEMA (a3), A. M. DE RODA HUSMAN (a1) (a3) and W. VAN PELT (a3)...

Summary

Extreme rainfall events may cause pluvial flooding, increasing the transmission of several waterborne pathogens. However, the risk of experiencing clinically overt infections following exposure to pluvial floodwater is poorly estimated. A retrospective cross-sectional survey was performed to quantify the occurrence of self-reported gastrointestinal, influenza-like illness (ILI) and dermatological complaints, and the frequency of visits to the general practitioner (GP), during a 4-week observation period following pluvial flooding at seven locations in The Netherlands. Questionnaires were sent to 817 flooded households, 149 (17%) of which returned the questionnaire reporting information for 199 participants. Contact with floodwater was significantly associated with increased occurrence of gastrointestinal [odds ratio (OR 4·44)], ILI (OR 2·75) and dermatological (OR 6·67) complaints, and GP visits (OR 2·72). Having hand contact with floodwater was associated with gastrointestinal and dermatological complaints, whereas ILI complaints were associated with being engaged in post-flooding cleaning operations and having walked/cycled through floodwater. This study shows that floodwater-associated diseases occur in urban settings following extreme rainfall events in a high-income country. As pluvial floods are expected to escalate in the future due to global climate change, further research is warranted to determine the disease burden of pluvial flooding and to assess the effect of different interventions, including raising awareness among stakeholders.

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Corresponding author

* Author for corresponding: Dr H. De Man, Institute for Risk Assessment Sciences, Division of Veterinary Public Health (VPH), PO Box 80175, 3508 TD Utrecht, The Netherlands. (Email: h.deman@uu.nl)

References

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1. Intergovernmental Panel on Climate Change. Fifth Assessment Report (http://www.ipcc.ch/), 2013.
2. Semenza, JC, Menne, B. Climate change and infectious diseases in Europe. Lancet Infectious Diseases 2009; 9: 365375.
3. Cann, KF, et al. Extreme water-related weather events and waterborne disease. Epidemiology and Infection 2013; 141: 671686.
4. Jacobs, AFG, Heusinkveld, BG, Holtslag, AAM. Eighty years of meteorological observations at Wageningen, The Netherlands: precipitation and evapotranspiration. International Journal of Climatology 2010; 30: 13151321.
5. ten Veldhuis, JAE, et al. Microbial risks associated with exposure to pathogens in contaminated urban flood water. Water Research 2010; 44: 29102918.
6. Fewtrell, L, et al. The microbiology of urban UK floodwaters and a quantitative microbial risk assessment of flooding and gastrointestinal illness. Journal of Flood Risk Management 2011; 4: 7787.
7. Jablecki, J, et al. Infectious disease and dermatologic conditions in evacuees and rescue workers after Hurricane Katrina – multiple states, August–September, 2005. Morbidity and Mortality Weekly Report. Surveillance Summaries 2005; 54: 961964.
8. de Man, H, et al. Quantitative assessment of infection risk from exposure to waterborne pathogens in urban floodwater. Water Research 2014; 48: 9099.
9. Schmid, D, et al. Outbreak of norovirus infection associated with contaminated flood water, Salzburg, 2005. Eurosurveillance 2005; 10.
10. Dewan, AM, et al. Typhoid fever and its association with environmental factors in the Dhaka metropolitan area of Bangladesh: a spatial and time-series approach. PLoS Neglected Tropical Diseases 2013; 7.
11. Hashizume, M, et al. The effect of rainfall on the incidence of cholera in Bangladesh. Epidemiology 2008; 19: 103110.
12. Doorduyn, Y, et al. Risk factors for Salmonella Enteritidis and Typhimurium (DT104 and non-DT104) infections in The Netherlands: predominant roles for raw eggs in Enteritidis and sandboxes in Typhimurium infections. Epidemiology and Infection 2006; 134: 617626.
13. Doorduyn, Y, Van Pelt, W, Havelaar, AH. The burden of infectious intestinal disease (IID) in the community: a survey of self-reported IID in The Netherlands. Epidemiology and Infection 2012; 140: 11851192.
14. Mughini-Gras, L, et al. Risk factors for human salmonellosis originating from pigs, cattle, broiler chickens and egg laying hens: a combined case-control and source attribution analysis. PLoS ONE 2014; 9.
15. Cameron, AC, Gelbach, JB, Miller, DL. Robust inference with multi-way clustering. NBER Technical Working Paper No. 327, 2006.
16. Thompson, SB. Simple formulas for standard errors that cluster by both firm and time. Journal of Financial Economics 2011; 99: 110.
17. Dohoo, IR, Wayne, M, Stryhn, HE (eds). Veterinary Epidemiologic Research. Charlottetown PEI: University of Prince Edward Island, 2009.
18. Hill, T, Lewicki, P (eds). Statistics: Methods and Applications: a Comprehensive Reference for Science, Industry, and Data Mining. Tulsa, OK: StatSoft Inc., 2006, pp. 832.
19. Mughini-Gras, L, et al. Campylobacteriosis in returning travellers and potential secondary transmission of exotic strains. Epidemiology and Infection 2014; 142: 12771288.
20. Mughini, Gras L, et al. Risk factors for campylobacteriosis of chicken, ruminant, and environmental origin: a combined case-control and source attribution analysis. PLoS ONE 2012; 7.
21. Harper, SL, et al. Lived experience of acute gastrointestinal illness in Rigolet, Nunatsiavut: ‘Just suffer through it’. Social Science and Medicine 2015; 126: 8698.
22. Clark, S, et al. The burden and determinants of self-reported acute gastrointestinal illness in an Indigenous Batwa Pygmy population in southwestern Uganda. Epidemiology and Infection 2015; 143: 22872298.
23. Vittinghoff, E, McCulloch, CE. Relaxing the rule of ten events per variable in logistic and cox regression. American Journal of Epidemiology 2007; 165: 710718.
24. Claeskens, G, Aerts, M, Molenberghs, G. A quadratic bootstrap method and improved estimation in logistic regression. Statistics and Probability Letters 2003; 61: 383394.
25. Nemes, S, et al. Bias in odds ratios by logistic regression modelling and sample size. BMC Medical Research Methodology 2009; 9.
26. Efron, B, Tibshirani, R. Improvements on cross-validation: the .632+ bootstrap method. Journal of the American Statistical Association 1997; 92: 548560.
27. Sales-Ortells, H, Medema, G. Screening-level microbial risk assessment of urban water locations: a tool for prioritization. Environmental Science & Technology 2014; 48: 97809789.
28. Swart, AN, et al. The protective effects of temporary immunity under imposed infection pressure. Epidemics 2012; 4: 4347.
29. Friesema, IH, van Gageldonk-Lafeber, AB, van Pelt, W. Extension of traditional infectious disease surveillance with a repeated population survey. European Journal of Public Health 2015; 25: 130134.
30. Fernandes, T, et al. Gastroenteritis associated with accidental contamination of drinking water with partially treated water. Epidemiology and Infection 2007; 135: 818826.
31. Schmid, D, et al. Outbreak of norovirus infection associated with contaminated flood water, Salzburg, 2005. Eurosurveillance 10(24); 2005.
32. Seto, W, et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet 2003; 361: 15191520.
33. Majowicz, SE, et al. A common, symptom-based case definition for gastroenteritis. Epidemiology and Infection 2008; 136: 886894.
34. Heijne, JC, et al. Enhanced hygiene measures and norovirus transmission during an outbreak. Emerging Infectious Diseases 2009; 15: 2430.
35. Wheeler, JG, et al. Study of infectious intestinal disease in England: rates in the community, presenting to general practice, and reported to national surveillance. British Medical Journal 1999; 318: 10461050.
36. Schalk, JAC, et al. Isolation of Legionella pneumophila from pluvial floods by amoebal coculture. Applied and Environmental Microbiology 2012; 78: 45194521.
37. Smith, K, Kay, D, Fewtrell, L. Examination of the microbiology of urban flood water components. Urban Flood Management project report for the Flood Risk Management Research Consortium, University of Wales, Aberystwyth, 2007.
38. World Health Organization. Guidelines for drinking-water quality, 4th edn (http://www.who.int/water_sanitation_health/publications/2011/dwq_guidelines/en/index.html). 2011.
39. Hashizume, M, et al. Hydroclimatological variability and dengue transmission in Dhaka, Bangladesh: a time-series study. BMC Infectious Diseases 2012; 12.
40. McMichael, AJ. Extreme weather events and infectious disease outbreaks. Virulence 2015; 6: 539543.
41. Goris, MGA, et al. Human leptospirosis trends, The Netherlands, 1925–2008. Emerging Infectious Diseases 2013; 19: 371378.
42. Watts, N, et al. Health and climate change: policy responses to protect public health. Lancet (in press).
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Epidemiology & Infection
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