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

• Koh SJ
• Cho HG
• Kim BH
• Choi BY

• KMID: 1777972
• DOI: http://doi.org/10.3346/jkms.2011.26.1.28

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.

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