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Unexplained acute fever after a hot bath

I Atterholm, K Ganrot-Norlin, T Hallberg

    Lancet (London, England)
    |October 1, 1977
    PubMed
    Summary
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    An unidentified agent caused flu-like symptoms in 56 people after a hot bath, transmitted via inhalation. Investigations of the water source revealed no unusual findings, leaving the cause of the outbreak unknown.

    Area of Science:

    • Environmental Health
    • Infectious Disease Epidemiology

    Background:

    • A cluster of acute, self-limiting illnesses occurred in individuals following a shared exposure.
    • The symptoms included fever, chills, respiratory issues, and myalgia, with onset approximately 4 hours post-exposure.

    Purpose of the Study:

    • To investigate the cause of an outbreak of unexplained illness linked to a common water source.
    • To identify the etiological agent and transmission route of the observed symptoms.

    Main Methods:

    • Epidemiological investigation of affected individuals and their residential area.
    • Analysis of the shared water source for bacteriological and chemical contaminants, including endotoxins and algae.
    • Clinical observation of patient symptoms and laboratory findings, noting polymorphonuclear leucocytosis.

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    Main Results:

    • The outbreak affected 56 individuals, predominantly those using water from a specific source.
    • Symptoms, including fever, chills, and respiratory distress, lasted 6 to 15 hours.
    • Inhalation was identified as the primary route of pathogen entry.
    • Extensive water quality testing did not reveal any anomalies or known toxins.

    Conclusions:

    • The outbreak was caused by an unidentified etiological agent transmitted through inhalation.
    • Despite thorough investigation, the source and nature of the agent remain undetermined.
    • Further research is needed to identify the causal agent and prevent future occurrences.