Aim: The aim of this study was to monitor the restricted water systems during the period of COVID-19 lockdown for the waterborne pathogen Legionella pneumophila. Selected water systems were monitored to evaluate the effect of stagnation in terms of Legionella colonization. Methodology and results: A total of 160 water samples were taken from buildings which were temporarily shut down or had restricted usage between April-December 2020. None of the sampling points had Legionella positive history in the last three years. All water samples were tested using classic microbiological culture as the gold standard and rapid Vermicon ScanVIT Legionella test kit combined with epifluorescence microscopy. Sixteen (10%) out of 160 water samples were recorded as Legionella-positive by both methods, where none of them was positive before the COVID-19 lockdown. All positives were tested as L. pneumophila serogroup 1 with latex agglutination kit. Conclusion, significance and impact of study Colonization of Legionella in stagnant water systems occurs rapidly. Before reopening, routine monitoring in buildings is extremely important especially under restricted use or closure is in case. Flushing, disinfecting and testing are crucial for minimizing the health risks for the public health.
Legionella ; Sanitary Engineering ; COVID-19 ; Waterborne Diseases ; Legionnaires' ; Disease

OBJECTIVES: There was an outbreak of foodborne and waterborne disease among high school students at Okcheon in June, 2018. First attack occurred June 5(th) but seven days later it was notified. The purpose of this investigation was to evaluate the pathogen of outbreak and cause of delayed notification. METHODS: First, we did a questionnaire survey for 61 cases and 122 controls to find what symptoms they had and whether they ate foods or drank water from June 2(nd) to June 12(th). Second, we investigated the environment of cafeteria and drinking water. Third, we examined specimen of cases and environment to identify bacteria or virus. RESULTS: Attack rate of this outbreak was 7.8%. Drinking water was strongly suspected as a source of infection in questionnaire survey but we could not find the exact time of exposure. Norovirus was identified in specimen of cases (2 students), drinking water (at main building and dormitory) and cafeteria (knife, dishtowel, hand of chef) CONCLUSIONS: We decided norovirus as the pathogen of this outbreak based on the clinical features of cases with diarrhea vomiting, abdominal pain and recovery within 2 or 3 days after onset, outbreak due to drinking water and microbiologic examination, And the cause of delayed notification might be the non-existence of the nurse teacher at that time and the lack of understanding of teachers on immediate notification under the outbreak. To prevent the delayed notification, notification system about outbreak of foodborne and waterborne disease in school is needed to be improved.
Abdominal Pain ; Bacteria ; Diarrhea ; Drinking Water ; Hand ; Humans ; Norovirus* ; Vomiting ; Water ; Waterborne Diseases*

OBJECTIVES: It was supposed to analyze status and affecting factors in water and food-borne communicable disease by screening entrants with diarrhea symptom at the point of entry in Korea METHODS: Symptomatic travelers with water and food-borne communicable diseases who entered Korea were diagnosed by a health declaration and detection of causative agents in water and food using laboratory tests. Among those entered in 2017, the affecting factors in the incidence of communicable diseases among those who had diarrhea at the entry into Korea, were analyzed, with frequency and chi-square test. RESULTS: The number of travel entrants with gastrointestinal communicable diseases increased by 40.19% from 2013 to 2017. The percentage of causative agents of water and food-borne communicable diseases was the highest at 69.2% from July to September. The rate of detection of causative agents of communicable disease pathogens in travelers from Southeast Asia entering Korea was 70.2%, which was higher than people arriving from East Asia and Central Asia (57.5%; p < 0.001). CONCLUSION: The positive ratio of causative agents of water and food-borne communicable diseases was high among travelers that had entered Korea from July to September, with a high number among entrants from Southeast Asia. Based on the positive detection of causative agents, the entry period and countries visited were statistically significant affecting factors (p < 0.001).
Asia ; Asia, Southeastern ; Communicable Diseases ; Diarrhea ; Far East ; Foodborne Diseases ; Incidence ; Korea ; Mass Screening ; Quarantine ; Water ; Waterborne Diseases

The HEV is a known cause of water-borne outbreaks of acute non-A non-B hepatitis in developing countries, which affects young people and may result in high mortality in pregnant women. In recent decades, however, HEV genotypes 3 and 4 have been known as a cause of sporadic zoonotic infections in older males from swine HEV worldwide. Most acute HEV infections are self-limited. On the other hand, in immunosuppressed patients, including solid organ transplant recipients, chronic HEV infections may exist and progress to liver cirrhosis or decompensation. Therefore, physicians need to recognize HEV as a major pathogen for acute and chronic hepatitis of unknown causes and investigate this disease.
Developing Countries ; Diagnosis ; Disease Outbreaks ; Female ; Genotype ; Hand ; Hepatitis E virus ; Hepatitis E ; Hepatitis ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Male ; Mortality ; Pregnant Women ; Swine ; Transplants ; Waterborne Diseases ; Zoonoses

The HEV is a known cause of water-borne outbreaks of acute non-A non-B hepatitis in developing countries, which affects young people and may result in high mortality in pregnant women. In recent decades, however, HEV genotypes 3 and 4 have been known as a cause of sporadic zoonotic infections in older males from swine HEV worldwide. Most acute HEV infections are self-limited. On the other hand, in immunosuppressed patients, including solid organ transplant recipients, chronic HEV infections may exist and progress to liver cirrhosis or decompensation. Therefore, physicians need to recognize HEV as a major pathogen for acute and chronic hepatitis of unknown causes and investigate this disease.
Developing Countries ; Diagnosis ; Disease Outbreaks ; Female ; Genotype ; Hand ; Hepatitis E virus ; Hepatitis E ; Hepatitis ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Male ; Mortality ; Pregnant Women ; Swine ; Transplants ; Waterborne Diseases ; Zoonoses

BACKGROUND: Water – related diseases are worldwide health concern. Microbial contamination and contaminant products in water are a source of disease outbreaks and development of cumulative toxic effects. Ensuring safe water is one of the goals to be achieved at the global level. The aim of this study was to assess publications on drinking and recreational water from a health point of view to understand current problems and future research trends in this field. METHODS: Scopus, the largest scientific electronic database, was used to retrieve related articles and present the results as bibliometric tables and maps. Search query was modified manually using related terms to maximize accuracy. RESULTS: A total of 2267 publications were retrieved with an average of 16.82 citations per article. The h-index of retrieved articles was 88. Visual mapping showed that E. coli, diarrhea, cryptosporidiosis, fluoride, arsenic, cancer, chlorine, trihalomethane, and H. pylori were most frequently encountered terms in title and abstract of retrieved articles. The number of articles on water microbiology was a significant (P < 0.01) predictor of worldwide productivity of water – related disease publications. Journal of Water and Health ranked first in number of publications with 136 (6.00 %) articles. The United States of America ranked first in productivity with a total of 623 (27.48 %) articles. Germany (15.44 %), India (16.00 %) and China (20.66 %) had the least international collaboration in water-related disease research. Environmental Protection Agency and Centers for Disease Prevention and Control were among top ten productive institutions. In the top ten cited articles, there were three articles about arsenic, one about aluminum, one about trihalomethane, one about nitrate, one about toxoplasmosis, one about gastroenteritis, and the remaining two articles were general ones. CONCLUSIONS: There was a linear increase in the number of publications on water – related diseases in the last decade. Arsenic, in drinking water is a serious concern. Cryptosporidiosis and other infectious gastroenteritis remain a major health risk of exposure to contaminated water. Increased number of publications from Asian countries was not associated with a high percentage of international collaboration.
Aluminum ; Americas ; Animals ; Arsenic ; Asian Continental Ancestry Group ; Bibliometrics* ; China ; Chlorine ; Cooperative Behavior ; Cryptosporidiosis ; Diarrhea ; Disease Outbreaks ; Drinking Water ; Drinking* ; Efficiency ; Fluorides ; Gastroenteritis ; Germany ; Humans ; India ; Toxoplasmosis ; Trihalomethanes ; United States ; United States Environmental Protection Agency ; Water ; Water Microbiology ; Waterborne Diseases*