Norovirus in Bottled Water Associated with Gastroenteritis Outbreak, Spain, 2016

Abstract

In April 2016, an outbreak of gastrointestinal illness (4,136 cases) occurred in Catalonia, Spain. We detected high levels of norovirus genotypes I and II in office water coolers associated with the outbreak. Infectious viral titer estimates were 33-49 genome copies/L for genotype I and 327-660 genome copies/L for genotype II.

Keywords: Catalonia; Spain; bottled water; enteric infections; gastroenteritis; norovirus; outbreak; viruses.

Figure

Waterborne norovirus outbreak in Catalonia, Spain, April 15–25, 2016 (n = 4,136 cases). A) Geographic distribution of the number of cases and affected companies in the Catalonian Health regions. Inset shows location of region in Spain. Map outlines obtained from https://commons.wikimedia.org/wiki/File:Catalonia_location_map.svg. B) Time distribution of reported cases. Cases are displayed according to the dates of the press release from the Public Health Agency of Catalonia (http://premsa.gencat.cat/pres_fsvp/AppJava/notapremsavw/292423/ca/salut-publica-dona-tancat-brot-gastroenteritis-transmes-consum-daigua-envasada.do). Although the onset of the outbreak was on April 11, the first report of the number of cases was on April 15, and the outbreak was declared over on April 25 with a total of 4,136 reported cases, including both primary and secondary cases.