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COMMUNITY HEALTH
THE HORRENDOUS CIRCUMSTANCES OF MAY 2000 RESULTED IN AN INCREASED PUBLIC AWARENESS OF WATER-BORNE PATHOGENS. THE SHORT- AND LONG-TERM HEALTH RISKS ASSOCIATED WITH CONTAMINATED WATER ARE INVESTIGATED IN THIS SEVEN-YEAR PROJECT.
ABSTRACT
The contamination of the Walkerton, Ontario, municipal water with E. coli 0157:H7 and Campylobacter in May 2000 resulted in at least 2,300 cases of gastrointestinal illness. There were 28 confirmed cases of hemolytic uremic syndrome, the most severe kidney complication. The provincial Ministry of Health and Long-Term Care determined that a study needed to be conducted on the long-term health effects associated with drinking the contaminated water. The Walkerton Health Study, a seven-year project, was established as a screening and treatment clinic to identify and treat those people experiencing illness and to study long-term health effects.
This article describes the challenges, infrastructure support, staffing, and recruitment and retention efforts required to screen over 4,000 people in a yearly clinic visit. Clinical and laboratory algorithms are used to identify participants requiring specialist assessment. Design of the computer-based survey includes advanced data entry and display control, essential to ensuring accurate data for analysis. Findings from Years 1, 2 and 3 are briefly discussed.
KEYWORDS: E. coli, Campylobacter, Walkerton, water-borne pathogens, water contamination
The Walkerton Health Study (WHS) is a seven-year project established in response to the contamination of the Walkerton municipal water supply in May 2000. Walkerton is a community of approximately 5,000 people located in a prime agricultural area of Ontario. The town's water system had a groundwater supply obtained from drilled wells, each with chlorinator units. The water was contaminated with Escherichia coll (E. coli) 0157:H7, Campylobacter, Salmonella and other bacterial pathogens. This contamination resulted in at least 2,300 cases of gastrointestinal (GI) illness in both adults and children. There were 28 confirmed cases of hemolytic urémie syndrome (HUS), the most severe kidney complication. Of that number, 23 were children. One child died in the early stages of the disease, and eight children required kidney dialysis. Six other deaths were directly attributed to the contaminated water.
During the catastrophe, initial medical care focused on the acute management of infected individuals. Because of overwhelmed health services, many ill adults did not seek medical attention. Afterwards, the provincial Ministry of...