Campylobacteriosis Outbreak Associated With Contaminated Municipal Water Supply

Nebraska, 2017

Caitlin Pedati, MD; Samir Koirala, MBBS; Tom Safranek, MD; Bryan F. Buss, DVM; Anna V. Carlson, PhD

Morbidity and Mortality Weekly Report. 2019;68(7):169-173.

Public Health Response

Wells 3 and 4 were both permanently removed from service on March 16, and no additional illnesses were reported with onset after March 21. On April 25, NDHHS reclassified these wells to Emergency Status, meaning the well can only be pumped during a case of emergency (e.g., fire, drought, etc.) for nonpotable purposes. Furthermore, meetings were held with area stakeholders to present these findings as evidence to support the award of a planning grant to city A to explore options for a new, higher-volume well to be dug to an acceptable depth in a different location.

1 2 3 4

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Table 1. Volume* and percentage of water pumped from each city A well, by week — Nebraska, 2017
Dates	Volume (%)				Total volume
Dates	Well 2	Well 3^†	Well 4^†	Well 5	Total volume
February 15–21, 2017	278 (40.0)	0 (0)	417 (60.0)	0 (0)	695
February 22–27, 2017	282 (48.8)	296 (51.2)	0 (0)	0 (0)	578
February 28–March 7, 2017	327 (40.0)	0 (0)	491 (60.0)	0 (0)	818
March 8–13, 2017	207 (32.7)	0 (0)	0 (0)	426 (67.3)	633

* x 1,000 gallons.
^† Well 3 and well 4 were adjacent to the ditch flooded by livestock wastewater (February 22–25).

Table 2. Potential exposures reported by survey respondents included for analysis (n = 94) in a community-wide campylobacteriosis investigation and corresponding odds ratios — city A, Nebraska, February 23–March 9, 2017
Exposure	No. (%)				OR (95% CI)*
	Cases (n = 38)		Controls (n = 56)
	Exposed	Not exposed	Exposed	Not exposed
City tap water	36 (94.7)	2 (5.3)	39 (69.6)	17 (30.4)	7.84 (1.69–36.36)
Unpasteurized milk	0 (0)	38 (100)	0 (0)	56 (100)	Undefined
Any chicken	12 (33.3)	24 (66.7)	24 (42.8)	32 (57.1)	0.66 (0.27–1.59)
Ground beef	24 (66.7)	12 (33.3)	33 (62.3)	20 (37.7)	1.21 (0.49–2.94)
Animal contact	19 (51.4)	18 (48.7)	40 (72.7)	15 (27.3)	0.39 (0.16–0.95)