Submitted: 22 Sep 2023
Revision: 05 Dec 2023
Accepted: 27 Dec 2023
ePublished: 29 Dec 2023
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Avicenna J Clin Microbiol Infect. 2023;10(4): 137-144.
doi: 10.34172/ajcmi.3497
  Abstract View: 513
  PDF Download: 281

Original Article

Following WHO Guidelines to Respond to a Water Contamination Outbreak in the Edge of Hamadan, West of Iran

Fateme Torkaman Asadi 1 ORCID logo, Lida Rafati 2, Fahime Moeini 3, Salman Khazaei 4 ORCID logo, Taghi Taghi Hajilouei 3, Mahdi Khodabakhshi 3, Masoumeh Javaheri 3* ORCID logo

1 Infectious Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
2 Environment and Work Health Management, Vice-Chancellor for Health, Hamadan University of Medical Sciences, Hamadan, Iran
3 Deputy of Health, Hamadan University of Medical Sciences, Hamadan, Iran
4 Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
*Corresponding Author: Masoumeh Javaheri, Email: max.jevel@gmail.com, Email: max.jevel@gmail.com


Background: Water and foodborne disease outbreaks continually present formidable challenges to healthcare systems, leading to morbidity, mortality, and substantial economic losses. Investigating and reporting these outbreaks play a pivotal role in effectively controlling and mitigating future occurrences. This study endeavors to scrutinize an outbreak of water contamination in Mariyanaj, Hamadan, Iran, employing the World Health Organization’s (WHO’s) comprehensive 10-step framework.

Methods: In this descriptive study, we meticulously adhered to the WHO outbreak investigation and reporting guidelines, systematically progressing through each step to investigate and report the outbreak. Symptom/exposure samples, involving two samples per symptomatic individual, were collected and sent to the Center for Disease Control’s laboratory for examination. Additionally, we executed a case-control study (Step 7) to discern the root cause of the outbreak.

Results: The outbreak affected 919 individuals among 12115 residents of Mariyanaj city, with a male prevalence of 57.7%. The most impacted age group was 10-14 years. Predominant symptoms included abdominal pain, nausea, and vomiting. Through meticulous field investigations and the case-control study, the contaminated water source was identified. Human samples exhibited Escherichia coli and norovirus as the most prevalent pathogens, with E. coli also detected in water samples.

Conclusion: Despite advancements in outbreak investigation and reporting systems, the utilization of a standardized step-by-step approach proves more effective in identifying and managing outbreaks. The consistent monitoring of drinking water quality, particularly in times of water crises, emerges as a crucial factor in significantly preventing waterborne diseases.

Please cite this article as follows: Torkaman Asadi F, Rafati L, Moeini F, khazaei S, Hajilouei T, Khodabakhshi M, et al. Following WHO guidelines to respond to a water contamination outbreak in the edge of Hamadan, west of Iran. Avicenna J Clin Microbiol Infect. 2023; 10(4):137-144. doi:10.34172/ajcmi.3497
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