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Salmonella investigation released

Posted: Friday, Mar 29th, 2013

Courier staff writer

ALAMOSA — Federal researchers waited for 18 months until they began to study the impacts that a 2008 salmonella outbreak had on the community.

Even then, the group of U.S. Centers for Disease Control and Prevention (CDC) investigators found that many of the people they interviewed had not regained their faith in the city’s municipal water service.

“I will never again fully trust the system or drink any tap water without some concern,” one typical respondent wrote.

“I still don’t feel safe drinking or cooking with the city water,” another person said. “I have spent a lot of money buying bottled water.”

The researchers said comments like those should serve as a reminder to all that officials must strengthen their efforts to inspect and safeguard drinking water storage facilities.

“Maintaining the integrity of the nation’s drinking water systems is a fundamental safeguard to protecting public health and preventing economic damage from waterborne disease outbreaks and should be a top public policy imperative,” they wrote.

The CDC’s study of the outbreak appeared nearly five years to the day after the Alamosa County Nursing Service received confirmation that three city residents — including two infants — were stricken with salmonella poisoning.

The bacterial infection typically causes diarrhea, fever and abdominal cramps. The symptoms can be more severe among infants, elderly people or others with weakened immune systems.

Altogether, officials tallied reports of 434 cases, including 124 laboratory-confirmed cases, 20 hospitalizations and one death. (The Colorado Department of Public Health and the Environment previously estimated the outbreak may have sickened up to 1,300 people, based on the results of a phone survey it conducted.)

Public health authorities soon traced the outbreak to the city’s unchlorinated water supply, which came from seven artesian wells. They later narrowed the likely source of contagion down to animal-related contamination of a cracked storage tank.

The discovery led public health officials to issue a March 19, 2008 warning that Alamosa’s water was not safe to drink. That advisory, along with other restrictions, was finally lifted on April 11 of that year.

Before the outbreak, more than 90 percent of all surveyed households relied on the city’s municipal supply for their drinking water needs.

Yet 18 months after officials lifted a boil-water advisory and declared the now-chlorinated water was safe to drink, almost 40 percent said they’d switched from tap water to bottled water. Another 15 percent said they installed new filters or additional filtration systems.

Only 30 percent reported they continued to drink the water that came out of their taps.

About half of the people who switched to bottled water reported that safety-related concerns factored into their decision.

The CDC reported that the lack of trust among those people is evident, judging by the comments they submitted.

Almost 370 individuals and 242 households said they suffered from diarrheal illnesses during the outbreak.

Most of the reported illnesses lasted for an average of about four days. However, more than one in three people who fell ill reported they were still experiencing related symptoms as of October 2009.

In rarer cases, respondents complained about skin or joint problems, bloody diarrhea, urinary tract infections, perforated bowels, peritonitis, septic arthritis and endocarditis.

Apart from the health-related impacts, surveyors found that the outbreak cost residents, business owners and government entities at least $2.6 million. But they called that estimate a conservative one, and said the actual numbers could be higher.

Residents spent about $273,000 on bottled water or filters, plus another $386,298 on lodging elsewhere. Not surprisingly, health care-related costs also accounted for a huge chunk of reported expenses: about $448,897 altogether.

A second survey found that local businesses were heavily affected, as well.

All told, the outbreak cost business owners an estimated $626,000, or nearly one-fourth of all reported expenses. The average business took a median hit of $8,750, according to the CDC’s estimates.

One in three business owners who responded to the survey said they were forced to temporarily close their doors during the outbreak.

At least one business owner reported that two to three months passed before his or her business returned to normal; four other businesses said their finances never bounced back to pre-outbreak levels.

The survey does not explain whether or not residents are still dealing with potential long-term impacts connected to the outbreak. Nor does it focus on the economic or health-related costs that might have affected residents, business owners or government entities beyond Alamosa’s city limits.

However, the survey team did try to form a representative picture of how the incident affected the community as a whole.

They mailed or hand-delivered copies of the survey to every household that received a water bill from the City of Alamosa.

Yet only 29 percent, or 771 eligible households, ultimately returned their surveys.

Overall, respondents tended to be older and moderately wealthier than the community at large. Women accounted for six out of 10 respondents; Hispanic residents and men as a group were less likely to respond.

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