Policy, practice and decision making for zoonotic disease management: water and Cryptosporidium

Inadequate water treatment quality as assessed by protozoa removal in Sarawak, Malaysia

Providing safe drinking-water to human civilization is indispensable; it is one of the most cost-effective means of reducing the disease burden of diarrhea. Unfortunately, water supply quality monitoring from public water treatment plants (WTPs) is often neglected or taken for granted. To determine the produced water quality, WTPs in Sarawak, Malaysia were assessed for their protozoa removal ability. A self-administered questionnaire based on the regulations in the Drinking-water Standards for New Zealand (DWSNZ) was developed. Optional 10-liter raw water samples were collected from willing WTPs for the detection of protozoan cysts. Routine physical and microbial testing of WTP parameters were also requested for raw water quality overview. Two of the nine assessed WTPs achieved three log credits in the treatment component, one of which belonged to Peninsular Malaysia. No log credits were obtained in the other tested components for any samples. Most of the WTPs employed “Coagulation, Sedimentation, and Filtration” using rapid gravity filters without enhancement (P < 0.05). Giardia cysts were detected in raw water sources used for treatment, and the geographical location was identified as an influencing factor for raw water quality. There is an urgent requirement for active collaboration and holistic approaches to review existing water management policies and interventions. WTPs in Sarawak did not achieve the log credits required to safeguard the microbial quality of the water supplied; however, only Giardia cysts were detected in 10-liter raw water samples despite routine microbial parameter monitoring showing disturbing contamination levels.

Integrated frameworks for assessing and managing health risks in the context of managed aquifer recharge with river water

Integrated assessment and management of water resources for the supply of potable water is increasingly important in light of projected water scarcity in many parts of the world. This article develops frameworks for regional-level waterborne human health risk assessment of chemical and microbiological contamination to aid water management, incorporating economic aspects of health risks. Managed aquifer recharge with surface water from a river in Southern Finland is used as an illustrative case. With a starting point in watershed governance, stakeholder concerns, and value-at-risk concepts, we merge common methods for integrative health risk analysis of contaminants to describe risks and impacts dynamically and broadly. This involves structuring analyses along the risk chain: sources-releases-environmental transport and fate-exposures-health effects-socio-economic impacts-management responses. Risks attributed to contaminants are embedded in other risks, such as contaminants from other sources, and related to benefits from improved water quality. A set of models along this risk chain in the case is presented. Fundamental issues in the assessment are identified, including 1) framing of risks, scenarios, and choices; 2) interaction of models and empirical information; 3) time dimension; 4) distributions of risks and benefits; and 5) uncertainties about risks and controls. We find that all these combine objective and subjective aspects, and involve value judgments and policy choices. We conclude with proposals for overcoming conceptual and functional divides and lock-ins to improve modeling, assessment, and management of complex water supply schemes, especially by reflective solution-oriented interdisciplinary and multi-actor deliberation.

Occurrence of Cryptosporidium spp. and Giardia spp. in a public water-treatment system, Paraná, Southern Brazil

The purpose of this study was to investigate the occurrence of Cryptosporidium spp. and Giardia spp. in a public water-treatment system. Samples of raw and treated water were collected and concentrated using the membrane filtration technique. Direct Immunofluorescence Test was performed on the samples. DNA extraction using a commercial kit was performed and the DNA extracted was submitted to a nested-PCR reaction (n-PCR) and sequencing. In the immunofluorescence, 2/24 (8.33%) samples of raw water were positive for Giardia spp.. In n-PCR and sequencing, 2/24 (8.33%) samples of raw water were positive for Giardia spp., and 2/24 (8.33%) samples were positive for Cryptosporidium spp.. The sequencing showed Cryptosporidium parvum and Giardia duodenalis DNA. In raw water, there was moderate correlation among turbidity, color and Cryptosporidium spp. and between turbidity and Giardia spp.. The presence of these protozoans in the water indicates the need for monitoring for water-treatment companies.

Integrated cryptosporidium assay to determine oocyst density, infectivity, and genotype for risk assessment of source and reuse water

Cryptosporidium continues to be problematic for the water industry, with risk assessments often indicating that treatment barriers may fail under extreme conditions. However, risk analyses have historically used oocyst densities and not considered either oocyst infectivity or species/genotype, which can result in an overestimation of risk if the oocysts are not human infective. We describe an integrated assay for determining oocyst density, infectivity, and genotype from a single-sample concentrate, an important advance that overcomes the need for processing multiple-grab samples or splitting sample concentrates for separate analyses. The assay incorporates an oocyst recovery control and is compatible with standard primary concentration techniques. Oocysts were purified from primary concentrates using immunomagnetic separation prior to processing by an infectivity assay. Plate-based cell culture was used to detect infectious foci, with a monolayer washing protocol developed to allow recovery and enumeration of oocysts. A simple DNA extraction protocol was developed to allow typing of any wells containing infectious Cryptosporidium. Water samples from a variety of source water and wastewater matrices, including a semirural catchment, wastewater, an aquifer recharge site, and storm water, were analyzed using the assay. Results demonstrate that the assay can reliably determine oocyst densities, infectivity, and genotype from single-grab samples for a variety of water matrices and emphasize the varying nature of Cryptosporidium risk extant throughout source waters and wastewaters. This assay should therefore enable a more comprehensive understanding of Cryptosporidium risk for different water sources, assisting in the selection of appropriate risk mitigation measures.

Cryptosporidium and Giardia in surface water: a case study from Michigan, USA to inform management of rural water systems

Cryptosporidium and Giardia pose a threat to human health in rural environments where water supplies are commonly untreated and susceptible to contamination from agricultural animal waste/manure, animal wastewater, septic tank effluents and septage. Our goals for this paper are to: (1) explore the prevalence of these protozoan parasites, where they are found, in what quantities, and which genotypes are present; (2) examine relationships between disease and land use comparing human health risks between rural and urban environments; and (3) synthesize available information to gain a better understanding of risk and risk management for rural water supplies. Our results indicate that Cryptosporidium and Giardia were more prevalent in rural versus urban environments based on the number of positive samples. Genotyping showed that both the human and animal types of the parasites are found in rural and urban environments. Rural areas had a higher incidence of disease compared to urban areas based on the total number of disease cases. Cryptosporidiosis and giardiasis were both positively correlated (p < 0.001) with urban area, population size, and population density. Finally, a comprehensive strategy that creates knowledge pathways for data sharing among multiple levels of management may improve decision-making for protecting rural water supplies.

Assessing calves as carriers of Cryptosporidium and Giardia with zoonotic potential on dairy and beef farms within a water catchment area by mutation scanning

In the present study, we undertook a molecular epidemiological survey of Cryptosporidium and Giardia in calves on three dairy and two beef farms within an open drinking water catchment area (Melbourne, Australia). Faecal samples (n = 474) were collected from calves at two time points (5 months apart) and tested using a PCR-based mutation scanning-targeted sequencing phylogenetic approach, employing regions within the genes of small subunit (SSU) of ribosomal RNA (designated partial SSU), 60 kDa glycoprotein (pgp60) and triose phosphate isomerase (ptpi) as genetic markers. Using partial SSU, the C. bovis, C. parvum, C. ryanae and a new genotype of Cryptosporidium were characterised from totals of 74 (15.6%), 35 (7.3%), 37 (7.8%) and 9 (1.9%) samples, respectively. Using pgp60, C. parvum genotype IIa subgenotype A18G3R1 was detected in 29 samples. Using ptpi, G. duodenalis assemblages A and E were detected in totals of 10 (2.1%) and 130 (27.4%) samples, respectively. The present study showed that a considerable proportion of dairy and beef calves in this open water catchment region excreted Cryptosporidium (i.e. subgenotype IIaA18G3R1) and Giardia (e.g. assemblage A) that are consistent with those infecting humans, inferring that they are of zoonotic importance. Future work should focus on exploring, in a temporal and spatial way, whether these parasites occur in the environment and water of the catchment reservoir.

A comparative analysis of current microbial water quality risk assessment and management practices in British Columbia and Ontario, Canada

Bacteria, protozoa and viruses are ubiquitous in aquatic environments and may pose threats to water quality for both human and ecosystem health. Microbial risk assessment and management in the water sector is a focus of governmental regulation and scientific inquiry; however, stark gaps remain in their application and interpretation. This paper evaluates how water managers practice microbial risk assessment and management in two Canadian provinces (BC and Ontario). We assess three types of entities engaged in water management along the source-to-tap spectrum (watershed agencies, water utilities, and public health authorities). We analyze and compare the approaches used by these agencies to assess and manage microbial risk (including scope, frequency, and tools). We evaluate key similarities and differences, and situate them with respect to international best practices derived from literatures related to microbial risk assessment and management. We find considerable variability in microbial risk assessment frameworks and management tools in that approaches 1) vary between provinces; 2) vary within provinces and between similar types of agencies; 3) have limited focus on microbial risk assessment for ecosystem health and 4) diverge considerably from the literature on best practices. We find that risk assessments that are formalized, routine and applied system-wide (i.e. from source-to-tap) are limited. We identify key limitations of current testing methodologies and looking forward consider the outcomes of this research within the context of new developments in microbial water quality monitoring such as tests derived from genomics and metagenomics based research.