Journal Article

Did a Severe Flood in the Midwest Cause an Increase in the Incidence of Gastrointestinal Symptoms?

Timothy J. Wade, Sukhminder K. Sandhu, Deborah Levy, Sherline Lee, Mark W. LeChevallier, Louis Katz and John M. Colford

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 159, issue 4, pages 398-405
Published in print February 2004 | ISSN: 0002-9262
Published online February 2004 | e-ISSN: 1476-6256 | DOI:
Did a Severe Flood in the Midwest Cause an Increase in the Incidence of Gastrointestinal Symptoms?

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Severe flooding occurred in the midwestern United States in 2001. Since November 2000, coincidentally, data on gastrointestinal symptoms had been collected for a drinking water intervention study in a community along the Mississippi River that was affected by the flood. After the flood had subsided, the authors asked these subjects (n = 1,110) about their contact with floodwater. The objectives of this investigation were to determine whether rates of gastrointestinal illness were elevated during the flood and whether contact with floodwater was associated with increased risk of gastrointestinal illness. An increase in the incidence of gastrointestinal symptoms during the flood was observed (incidence rate ratio = 1.29, 95% confidence interval: 1.06, 1.58), and this effect was pronounced among persons with potential sensitivity to infectious gastrointestinal illness. Tap water consumption was not related to gastrointestinal symptoms before, during, or after the flood. An association between gastrointestinal symptoms and contact with floodwater was also observed, and this effect was pronounced in children. This appears to be the first report of an increase in endemic gastrointestinal symptoms in a longitudinal cohort prospectively observed during a flood. These findings suggest that severe climatic events can result in an increase in the endemic incidence of gastrointestinal symptoms in the United States.

Keywords: communicable diseases; diarrhea; gastrointestinal tract; natural disasters; water; Abbreviations: CI, confidence interval; IRR, incidence rate ratio; RDD, random digit dialing; WET, Water Evaluation Trial.

Journal Article.  5294 words.  Illustrated.

Subjects: Public Health and Epidemiology

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