TY - JOUR T1 - Shigellosis Outbreak Associated with Contaminated Well Water in a Rural Elementary School: Sichuan Province, China, June 7–16, 2009 A1 - He, Fan A1 - Han, Ke A1 - Liu, Lunguang A1 - Sun, Wei A1 - Zhang, Lijie A1 - Zhu, Baoping A1 - Ma, Huilai Y1 - 2012/10/10 N2 - Objectives We investigated a shigellosis outbreak in an elementary school to identify the source of infection, mode of transmission and risk factors for illness. Methods In a case-control investigation, we compared the source of drinking water, consumption of untreated well water and suspected food items, and hygienic habits between case-students and randomly selected asymptomatic control-students, frequency-matched by class on a 1∶1 ratio. Results 18% of the 533 students and no teachers developed Shigella. 52%(44/85) of case-students and 17% (12/71) of control-students drank untreated well water (OR = 2.3, 95% CI = 1.1–5.8); 47% (n = 40/85) of case-students and 14% (10/71) of control-students drank untreated water from Well A (OR = 3.7, 95% CI = 1.3–11). The odds ratio increased with the amount of untreated Well A water consumed (p = 0.035, χ2 test for trend). Rectal swabs from 5 of 6 case-students and water from Well A yielded Shigella flexneri 2b. Conclusions This shigellosis outbreak was caused by drinking untreated water from a well polluted by Shigella flexneri 2b. JF - PLOS ONE JA - PLOS ONE VL - 7 IS - 10 UR - https://doi.org/10.1371/journal.pone.0047239 SP - e47239 EP - PB - Public Library of Science M3 - doi:10.1371/journal.pone.0047239 ER -