Abstract
Urban canal swimming events are popular in the Netherlands. In 2015, two city canal swimming events took place, in Utrecht (Utrecht Singel Swim, USS) and in Amsterdam (Amsterdam City Swim, ACS). This prospective study characterizes the health risks associated with swimming in urban waters. Online questionnaires were sent to 160 (USS) and 2,692 (ACS) participants, with relatives of participants who did not swim completing the questionnaire as a control. Swimming water specimens and stool specimens of diarrheic participants in the ACS group were analysed. A total of 49% of USS and 51% of ACS swimmers returned their questionnaires. Nine percent of USS swimmers and 4% of non-swimmers reported gastrointestinal complaints (aRR 2.1; 95% CI: 0.3-16), while a total of 31% of ACS swimmers and 5% of non-swimmers reported gastrointestinal complaints (aRR 6.3; 95% CI: 4.1-9.5). AGI risk among ACS participants was directly related to increasing number of mouthfuls of water swallowed. Various norovirus genotypes were detected in five out of seven stool specimens taken from ACS participants and in all three tested ACS water samples. We conclude that the AGI risk among open-water swimmers in urban areas depends on the circ*mstances around the event. The epidemiological curve, the statistical association between swimming and AGI, and the microbiological evidence for norovirus in stool and water specimens suggest that AGI outbreak after the ACS event was due to water contamination by multiple norovirus strains, which is possibly linked to sewage overflow due to prior heavy rainfall. There is need for more targeted preventive measurements and recommendations for organizers, municipal authorities and participants to prevent this reoccurring in the future.
| Original language | English |
|---|---|
| Article number | e0174732 |
| Number of pages | 13 |
| Journal | PLoS One |
| Volume | 12 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2017 |
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Joosten, R., Sonder, G., Parkkali, S., Brandwagt, D., Fanoy, E., Mughini-Gras, L., Lodder, W., Ruland, E., Siedenburg, E., Kliffen, S., & van Pelt, W. (2017). Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study. PLoS One, 12(4), Article e0174732. https://doi.org/10.1371/journal.pone.0174732
Joosten, Rosa ; Sonder, Gerard ; Parkkali, Saara et al. / Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015 : A prospective study. In: PLoS One. 2017 ; Vol. 12, No. 4.
@article{715dcbcae9204a709d6539036b83f0a6,
title = "Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study",
abstract = "Urban canal swimming events are popular in the Netherlands. In 2015, two city canal swimming events took place, in Utrecht (Utrecht Singel Swim, USS) and in Amsterdam (Amsterdam City Swim, ACS). This prospective study characterizes the health risks associated with swimming in urban waters. Online questionnaires were sent to 160 (USS) and 2,692 (ACS) participants, with relatives of participants who did not swim completing the questionnaire as a control. Swimming water specimens and stool specimens of diarrheic participants in the ACS group were analysed. A total of 49% of USS and 51% of ACS swimmers returned their questionnaires. Nine percent of USS swimmers and 4% of non-swimmers reported gastrointestinal complaints (aRR 2.1; 95% CI: 0.3-16), while a total of 31% of ACS swimmers and 5% of non-swimmers reported gastrointestinal complaints (aRR 6.3; 95% CI: 4.1-9.5). AGI risk among ACS participants was directly related to increasing number of mouthfuls of water swallowed. Various norovirus genotypes were detected in five out of seven stool specimens taken from ACS participants and in all three tested ACS water samples. We conclude that the AGI risk among open-water swimmers in urban areas depends on the circ*mstances around the event. The epidemiological curve, the statistical association between swimming and AGI, and the microbiological evidence for norovirus in stool and water specimens suggest that AGI outbreak after the ACS event was due to water contamination by multiple norovirus strains, which is possibly linked to sewage overflow due to prior heavy rainfall. There is need for more targeted preventive measurements and recommendations for organizers, municipal authorities and participants to prevent this reoccurring in the future.",
author = "Rosa Joosten and Gerard Sonder and Saara Parkkali and Diederik Brandwagt and Ewout Fanoy and Lapo Mughini-Gras and Willemijn Lodder and Erik Ruland and Evelien Siedenburg and Suzanne Kliffen and {van Pelt}, Wilfrid",
year = "2017",
doi = "10.1371/journal.pone.0174732",
language = "English",
volume = "12",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "4",
}
Joosten, R, Sonder, G, Parkkali, S, Brandwagt, D, Fanoy, E, Mughini-Gras, L, Lodder, W, Ruland, E, Siedenburg, E, Kliffen, S & van Pelt, W 2017, 'Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study', PLoS One, vol. 12, no. 4, e0174732. https://doi.org/10.1371/journal.pone.0174732
Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study. / Joosten, Rosa; Sonder, Gerard; Parkkali, Saara et al.
In: PLoS One, Vol. 12, No. 4, e0174732, 2017.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015
T2 - A prospective study
AU - Joosten, Rosa
AU - Sonder, Gerard
AU - Parkkali, Saara
AU - Brandwagt, Diederik
AU - Fanoy, Ewout
AU - Mughini-Gras, Lapo
AU - Lodder, Willemijn
AU - Ruland, Erik
AU - Siedenburg, Evelien
AU - Kliffen, Suzanne
AU - van Pelt, Wilfrid
PY - 2017
Y1 - 2017
N2 - Urban canal swimming events are popular in the Netherlands. In 2015, two city canal swimming events took place, in Utrecht (Utrecht Singel Swim, USS) and in Amsterdam (Amsterdam City Swim, ACS). This prospective study characterizes the health risks associated with swimming in urban waters. Online questionnaires were sent to 160 (USS) and 2,692 (ACS) participants, with relatives of participants who did not swim completing the questionnaire as a control. Swimming water specimens and stool specimens of diarrheic participants in the ACS group were analysed. A total of 49% of USS and 51% of ACS swimmers returned their questionnaires. Nine percent of USS swimmers and 4% of non-swimmers reported gastrointestinal complaints (aRR 2.1; 95% CI: 0.3-16), while a total of 31% of ACS swimmers and 5% of non-swimmers reported gastrointestinal complaints (aRR 6.3; 95% CI: 4.1-9.5). AGI risk among ACS participants was directly related to increasing number of mouthfuls of water swallowed. Various norovirus genotypes were detected in five out of seven stool specimens taken from ACS participants and in all three tested ACS water samples. We conclude that the AGI risk among open-water swimmers in urban areas depends on the circ*mstances around the event. The epidemiological curve, the statistical association between swimming and AGI, and the microbiological evidence for norovirus in stool and water specimens suggest that AGI outbreak after the ACS event was due to water contamination by multiple norovirus strains, which is possibly linked to sewage overflow due to prior heavy rainfall. There is need for more targeted preventive measurements and recommendations for organizers, municipal authorities and participants to prevent this reoccurring in the future.
AB - Urban canal swimming events are popular in the Netherlands. In 2015, two city canal swimming events took place, in Utrecht (Utrecht Singel Swim, USS) and in Amsterdam (Amsterdam City Swim, ACS). This prospective study characterizes the health risks associated with swimming in urban waters. Online questionnaires were sent to 160 (USS) and 2,692 (ACS) participants, with relatives of participants who did not swim completing the questionnaire as a control. Swimming water specimens and stool specimens of diarrheic participants in the ACS group were analysed. A total of 49% of USS and 51% of ACS swimmers returned their questionnaires. Nine percent of USS swimmers and 4% of non-swimmers reported gastrointestinal complaints (aRR 2.1; 95% CI: 0.3-16), while a total of 31% of ACS swimmers and 5% of non-swimmers reported gastrointestinal complaints (aRR 6.3; 95% CI: 4.1-9.5). AGI risk among ACS participants was directly related to increasing number of mouthfuls of water swallowed. Various norovirus genotypes were detected in five out of seven stool specimens taken from ACS participants and in all three tested ACS water samples. We conclude that the AGI risk among open-water swimmers in urban areas depends on the circ*mstances around the event. The epidemiological curve, the statistical association between swimming and AGI, and the microbiological evidence for norovirus in stool and water specimens suggest that AGI outbreak after the ACS event was due to water contamination by multiple norovirus strains, which is possibly linked to sewage overflow due to prior heavy rainfall. There is need for more targeted preventive measurements and recommendations for organizers, municipal authorities and participants to prevent this reoccurring in the future.
U2 - 10.1371/journal.pone.0174732
DO - 10.1371/journal.pone.0174732
M3 - Article
C2 - 28369101
SN - 1932-6203
VL - 12
JO - PLoS One
JF - PLoS One
IS - 4
M1 - e0174732
ER -
Joosten R, Sonder G, Parkkali S, Brandwagt D, Fanoy E, Mughini-Gras L et al. Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study. PLoS One. 2017;12(4):e0174732. doi: 10.1371/journal.pone.0174732
