A gastroenteritis outbreak associated with drinking water in a college in northwest China

An acute gastroenteritis outbreak occurred at a private college in June 2014 in northwest China. This outbreak involved two teachers and 629 students (range: 17–27 years, average 21.3 years). The main symptoms included non-bloody watery diarrhea, stomach ache, nausea, and vomiting, and the duration of illness ranged from 1 to 7 days. Eight of 18 water samples were disqualified. Thirty-four norovirus (NoV) RNA-positive samples were identified from 48 stool-related samples (genotyping results: 13 GII, 13 GI and 8 GI + GII mixture). Fourteen NoV samples were successfully characterized for genotype, including two GII.6, five GI.6, four GI.3, and three GI.1. Enteropathogenic Escherichia coli (EPEC) and enteroadherent Escherichia coli (EAEC) DNA was detected from patient stool specimens and water samples from well one; two EAEC strains and one EPEC strain were isolated from patient stool specimens. The risk ratios (RRs) associated with wells one and two were 1.66 and 1.49, respectively, and the RR associated with living in north dormitory building one was 2.59. The patients9 epidemiological characteristics, symptoms, and duration of illness indicated that NoV-contaminated water might be the origin of this outbreak, and RR analysis suggested that the two wells were linked to the outbreak.