context: In July 2006, public health services investigated an outbreak of acute gastroenteritis among staff and visitors of a popular ski resort in southern New Zealand.
  In July 2006, public health services investigated an outbreak of acute gastroenteritis among staff and visitors of a popular ski resort in southern New Zealand.
  The source of the outbreak was a drinking water supply contaminated by human sewage.
  The water supply for the ski resort was contaminated with human sewage.
  On 27 July 2006, public health authorities were informed about a possible outbreak of gastroenteritis among staff and visitors at a popular ski resort.
  A total of 218 cases were identified (115 ski resort staff and 103 visitors) in this outbreak.
  Drinking water, source stream water, and 31 fecal specimens from gastroenteritis outbreak cases were analyzed for the presence of norovirus (NoV).
  In addition, cases of rotavirus (one case), cryptosporidium (four cases), and campylobacter (two cases) were also identified.
  A case was dened as a resort staff member or visitor who developed diarrhea or vomiting on or after 21 July 2006.
  Symptoms included nausea, vomiting, or diarrhea.
  The water samples taken on 27 July 2006 showed significant levels of E. coli (range, 7.4 to 220 per 100 ml) and total coliforms (range, 72 to 1,100 per 100 ml) from the four points along the water supply, including the lake, storage tanks, and the main building, which housed the restaurants, and child care and health care services.
  In July 2006, public health services investigated an outbreak of acute gastroenteritis among staff and visitors of a popular ski resort in southern New Zealand.
  On 27 July 2006, public health authorities were informed about a possible outbreak of gastroenteritis among staff and visitors at a popular ski resort.
  A retrospective cohort investigation using a standardized questionnaire and analysis based on Epi Info v 3.3.2 (7) was conducted among ski resort staff to investigate the source of illness.
  Information was sought from the ski resort management about the design and management of the water supply and the sewerage system. The restaurant, child care, and health care facilities were also inspected.
  Comprehensive control measures were implemented starting 27 July 2006; these included work restrictions for sick staff, hand hygiene signage for staff and visitors, emergency chlorination of the water supply, and comprehensive environmental cleaning of the resorts facilities.
  Drinking water, source stream water, and 31 fecal specimens from gastroenteritis outbreak cases were analyzed for the presence of norovirus (NoV).
  Following notification of the outbreak, fecal samples were collected from 31 staff, visitors, and apartment dwellers with recent symptoms of acute gastroenteritis.
  Government agencies in New Zealand are reviewing their approach to water supply management with a particular focus on improved training for supply managers and the development of risk management plans.
  
answers: {'answer_start': [2292], 'text': ['work restrictions for sick staff, hand hygiene signage for staff and visitors, emergency chlorination of the water supply, and comprehensive environmental cleaning of the resorts facilities.']}