Structural and biochemical alterations in Giardia lamblia cysts exposed to ozone

Wastewater treatment performance in microbiological removal and (oo)cyst viability assessed comparatively to fluorescence decay

Municipal wastewater is a source of pathogenic protozoan (oo)cysts and may play a significant role in spreading waterborne diseases. This scenario becomes more critical as treated sewage from municipal wastewater treatment plants (WWTP) is discharged into springs, which are often used for water supply, irrigation, recreation and, further downstream, indirect potable reuse, quite common in Brazil. This study aimed to elucidate, regarding microbiological quality, the performance of a full-scale WWTP, consisting of preliminary treatment, upflow anaerobic sludge blanket (UASB) reactor, activated sludge system and ultraviolet (UV) radiation disinfection. Pathogenic protozoa (Giardia spp. cysts and Cryptosporidium spp. oocysts), as well as microbiological indicators (Escherichia coli and Clostridium perfringens), were evaluated in terms of their removal. In addition, (oo)cyst viability and fluorescence reduction were assessed. By using the data obtained from this research, the prevalence of infection estimated for the population served by the WWTP was between 7.4% and 14.8% for giardiasis, and between 0.055% and 0.11% for cryptosporidiosis.

Cryptosporidium spp. and Giardia spp. (oo)cysts as target-organisms in sanitation and environmental monitoring: A review in microscopy-based viability assays

Cysts and (oo)cysts are the infective forms of parasitic protozoa, as Giardia and Cryptosporidium, which are widespread and associated to worldwide waterborne diseases outbreaks. These microorganisms pose a challenge to public health, as they are resistant to conventional disinfection methods, which make them important parameters when evaluating inactivation efficiency. However, when (oo)cysts are targets, it is challenging to infer inactivation efficacy, as it may require infectivity tests that are not often an option for laboratory routine analysis. In this scene, (oo)cyst viability based on induced excystation, membrane integrity and enzyme activity evaluated by dye inclusion and/or exclusion, as well as fluorescence reduction consist on microscopy-based techniques that may be options to estimate inactivation in the environmental context. This scoping review presents applications, advantages and limitations of these methodologies for viability assessment, in order to shed light on the (oo)cyst viability topic and provide insight strategies for choosing protocols in the environmental and sanitation field, in laboratory applications and novel research.

Flow cytometry applications in water treatment, distribution, and reuse: A review

Ensuring safe and effective water treatment, distribution, and reuse requires robust methods for characterizing and monitoring waterborne microbes. Methods widely used today can be limited by low sensitivity, high labor and time requirements, susceptibility to interference from inhibitory compounds, and difficulties in distinguishing between viable and non-viable cells. Flow cytometry (FCM) has recently gained attention as an alternative approach that can overcome many of these challenges. This article critically and systematically reviews for the first time recent literature on applications of FCM in water treatment, distribution, and reuse. In the review, we identify and examine nearly 300 studies published from 2000 to 2018 that illustrate the benefits and challenges of using FCM for assessing source-water quality and impacts of treatment-plant discharge on receiving waters, wastewater treatment, drinking water treatment, and drinking water distribution. We then discuss options for combining FCM with other indicators of water quality and address several topics that cut across nearly all applications reviewed. Finally, we identify priority areas in which more work is needed to realize the full potential of this approach. These include optimizing protocols for FCM-based analysis of waterborne viruses, optimizing protocols for specifically detecting target pathogens, automating sample handling and preparation to enable real-time FCM, developing computational tools to assist data analysis, and improving standards for instrumentation, methods, and reporting requirements. We conclude that while more work is needed to realize the full potential of FCM in water treatment, distribution, and reuse, substantial progress has been made over the past two decades. There is now a sufficiently large body of research documenting successful applications of FCM that the approach could reasonably and realistically see widespread adoption as a routine method for water quality assessment.

Pre-ozonation of source water: Assessment of efficacy against Giardia duodenalis cysts and effects on natural organic matter

The protozoan Giardia duodenalis is one of the parasites of primary concern in drinking water treatment plants, due to its resistance to chlorination. Another matter of concern regarding chlorination of drinking water is the formation of disinfection by-products in the presence of precursors such as natural organic matter (NOM). In this study, the effects of ozonation (5 mg L^-1) on G. duodenalis cysts in raw surface water from a drinking water treatment plant were evaluated, and the presence and alteration of NOM were assessed, as an indicative of the potential to prevent total organic halogen (TOX) formation during post-chlorination. Following ozone treatment, the presence of damaged cysts was observed by direct immunofluorescence assay (IFA) and confirmed by the molecular approach propidium monoazide-polymerase chain reaction (PMA-PCR). Using an animal model, analysis of the intestinal tissues revealed that 80% of the animals inoculated with ozonated water were positive for trophozoites. This study shows that analysis of intestinal fragments is imperative to accurately assess animal infection following inoculation of treated cysts. More importantly, considering the low infective dose of Giardia cysts in susceptible hosts, an ozone dosage usually applied in drinking water treatment plants did not completely inactivate G. duodenalis cysts in surface water. Nonetheless, the results suggest that competitive reactions with NOM have occurred, and the applied ozone dosage has proven useful to remove NOM reactivity, and thus prevent halogenated DBP formation during post-chlorination.

Real scale environmental monitoring of zoonotic protozoa and helminth eggs in biosolid samples in Brazil

Biosolid is the product of the activated sludge treatment system and its final disposition is subject of ongoing discussion as this residue can therefore harbor a great number and variety of pathogens. This study was aimed to (1) monitor the presence of Giardia and Cryptosporidium in biosolid samples from a treatment plant in Campinas, SP, Brazil, (2) observe Giardia cyst wall morphological integrity in treated samples using scanning electron microscopy (SEM) and (3) verify the presence and viability of helminth eggs. Cysts were present in 33.3 % of the samples, whereas oocysts were detected in 8.3 %. Viable Ascaris sp. Toxocara sp. and similar to Trichuris sp. eggs were found through the use of Mexican Official Norm. Results demonstrate the difficulties inherent in working with biosolid as factors such as temperature, ionic strength and pH influenced the recovery of cysts and oocysts. Pores and ruptures were not observed in cyst wall visualized by SEM following 45 days of exposure to sunlight, only minimal morphological changes. These observations emphasize both the importance of adequate treatment of sewage sludge and the need to develop appropriate techniques for the detection of Giardia and Cryptosporidium in this type of sample. This is the first time that a study was done in a real scale for biosolid samples in determining the presence of pathogenic protozoa as Giardia and Cryptosporidium in Brazil, and also observed minimal cyst wall damage after sunlight treatment.

Risk assessment of Giardia from a full scale MBR sewage treatment plant caused by membrane integrity failure

Membrane bioreactors (MBR) are highly efficient at intercepting particles and microbes and have become an important technology for wastewater reclamation. However, many pathogens can accumulate in activated sludge due to the long residence time usually adopted in MBR, and thus may pose health risks when membrane integrity problems occur. This study presents data from a survey on the occurrence of water-borne Giardia pathogens in reclaimed water from a full-scale wastewater treatment plant with MBR experiencing membrane integrity failure, and assessed the associated risk for green space irrigation. Due to membrane integrity failure, the MBR effluent turbidity varied between 0.23 and 1.90 NTU over a period of eight months. Though this turbidity level still met reclaimed water quality standards (≤5 NTU), Giardia were detected at concentrations of 0.3 to 95 cysts/10 L, with a close correlation between effluent turbidity and Giardia concentration. All β-giardin gene sequences of Giardia in the WWTP influents were genotyped as Assemblages A and B, both of which are known to infect humans. An exponential dose-response model was applied to assess the risk of infection by Giardia. The risk in the MBR effluent with chlorination was 9.83×10(-3), higher than the acceptable annual risk of 1.0×10(-4). This study suggested that membrane integrity is very important for keeping a low pathogen level, and multiple barriers are needed to ensure the biological safety of MBR effluent.

Quantification of Giardia transcripts during in vitro excystation: interest for the estimation of cyst viability

The aim of the present study was to evaluate the potential of transcript quantification as an indicator of Giardia cyst viability. The variations of beta-giardin, EF1A and ADHE mRNAs were quantified during excystation by real-time RT-PCR assays and compared with the percentages of viability estimated using propidium iodide staining and in vitro excystation. The first experiments were performed with purified G. duodenalis assemblage B cysts. When 55% of excysting protozoa were observed, the increase of the selected transcripts ranged from 0.40+/-0.13 to 0.97+/-0.11 log10 after 1h of incubation in excystation medium. Purified cysts were also stored at 4 degrees C for up to 56 days and analysed at several sampling times. Significant correlations were observed between the variations of the selected mRNAs and the percentages of viability estimated with staining and excystation methods. Among the three transcripts, beta-giardin appeared to be the most appropriate to study the viability of Giardia cysts concentrated from wastewater samples.

Class B alkaline stabilization to achieve pathogen inactivation

Liming is a cost-effective treatment currently employed in many Class B biosolids production plants in the United States. A bench scale model of lime stabilization was designed to evaluate the persistence of viral, bacterial and parasitic pathogens. The survival of fecal coliforms, Salmonella, adenovirus type 5, rotavirus Wa, bacteriophage MS-2, Cryptosporidium parvum oocysts, Giardia lamblia cysts, and Ascaris lumbricoides ova was evaluated under lime stabilization conditions in a water matrix. Fecal coliforms and Salmonella were undetectable following 2 hours of lime stabilization, demonstrating a 7-log reduction. Adenovirus, MS-2 and rotavirus were below detectable levels following 2 h of liming, demonstrating a 4-log reduction. G. lamblia cysts were also inactivated. A. lumbricoides ova remained viable following 72 hours of liming as did C. parvum oocysts. While this study confirmed that Ascaris ova are resistant to liming, their scarcity in sludge and low recovery efficiencies limit their use as indicator. The persistence of C. parvum oocysts after exposure to lime, suggests that this parasite would be a better choice as indicator for evaluating biosolids intended for land application. The studies done with adenovirus Type 5, rotavirus Wa and male specific bacteriophage provided preliminary data demonstrating similar inactivation rates. Monitoring anthropogenic viruses is a time consuming, labor intensive and expensive process. If further studies could demonstrate that phage could be used as an indicator of other enteric viruses, enhanced monitoring could result in greater acceptance of land application of biosolids while demonstrating no increased public health threat.

Giardiasis: a pharmacotherapy review

Giardia lamblia, the cause of human giardiasis, is among the most common intestinal protozoa worldwide. Human infection may range from asymptomatic shedding of giardial cysts to symptomatic giardiasis, being responsible for abdominal cramps, nausea, acute or chronic diarrhoea, with malabsorption and failure of children to thrive. At present, treatment options include the nitroimidazoles derivatives; especially metronidazole, which has been the mainstay of treatment for decades and is still widely used. The increasing number of reports of refractory cases with this group of drugs and other antigiardial agents, has raised concern and led to a search for other compounds, some of which have arisen due to the introduction of drugs initially addressed to other diseases. The present article examines some of the most important points of antigiardial pharmacotherapy available at present and the future prospects of development of new agents.

Inactivation of protozoan parasites in food, water, and environmental systems

Protozoan parasites can survive under ambient and refrigerated storage conditions when associated with a range of substrates. Consequently, various treatments have been used to inactivate protozoan parasites (Giardia, Cryptosporidium, and Cyclospora) in food, water, and environmental systems. Physical treatments that affect survival or removal of protozoan parasites include freezing, heating, filtration, sedimentation, UV light, irradiation, high pressure, and ultrasound. Ozone is a more effective chemical disinfectant than chlorine or chlorine dioxide for inactivation of protozoan parasites in water systems. However, sequential inactivation treatments can optimize existing treatments through synergistic effects. Careful selection of methods to evaluate inactivation treatments is needed because many studies that have employed vital dye stains and in vitro excystation have produced underestimations of the effectiveness of these treatments.

Inactivation of enteric adenovirus and feline calicivirus by ozone

Little information is available regarding the effectiveness of ozone on the inactivation of caliciviruses and enteric adenoviruses. Inactivation experiments were conducted with feline calicivirus (FCV), closely related to the human caliciviruses based on nucleic acid organization and capsid architecture, and adenovirus type 40 (AD40). Experiments were carried out in buffered disinfectant demand free water at pH 7 and 5 degrees C. Ct values; concentration of ozone multiplied by contact time with virus; were determined from application of the efficiency factor hom (EFH) model. Ct values for 4-log (99.99%) ozone inactivation at 5 degrees C and pH 7 ranged from 0.07 to 0.60 mg/l min for AD40 and <0.01 to 0.03 mg/l min for FCV. Ct values listed in the US environmental protection agency "Guidance Manual for Compliance with Filtration and Disinfection Requirements for Public Water Systems Using Surface Water Sources" were higher than Ct values generated by this study. Very low ozone residuals (<0.01(mg/l) substantially inactivated FCV and AD40 under the studied conditions.

Giardia intestinalis

PURPOSE OF REVIEW

Giardia intestinalis (syn. duodenalis or lamblia) is one of the most common intestinal parasites in the world, with an estimated 2.8 x 10(6) infections per year in humans, and it contributes to diarrhea and nutritional deficiencies in children in developing regions. The wide prevalence of Giardia and its unique place in evolutionary biology have led to ongoing research.

RECENT FINDINGS

Research into the basic biology of Giardia has highlighted some of its unique properties as an 'early-branching' eukaryote. Although Giardia do not contain mitochondria, they have developed pathways to perform some mitochondrial functions. Investigations into encystation and excystation have identified new gene products that are important in cyst wall formation, and signal transduction events that occur during excystation. The ability to transfect Giardia stably will lead to an improved understanding of its development and metabolism. Molecular typing of G. intestinalis isolates indicates that most animal parasites are not associated with human infection. Insights into immunology have helped define the role of IL-6 in the early control of murine giardiasis, and the contributions of IgA in controlling infection. Further studies of giardiasis in poorly nourished children in developing regions supports an important contributing role of Giardia in stunting and cognitive impairment. Finally, new diagnostic assays using antigen detection are being evaluated and a new agent, nitazoxanide, has been approved in the USA for the treatment of giardiasis and cryptosporidiosis in children.

SUMMARY

Research into the biology of Giardia should increase knowledge about protist differentiation and will complement studies in other biological systems. Continued study of the role of Giardia in chronic diarrhea and malnutrition in developing regions will help focus strategies to improve childhood growth and nutrition.