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Ahmed W, Schoen ME, Soller J, Harrison JC, Hamilton KA, Gebrwold M, Simpson SL, Payyappat S, Cassidy M, Harrison N, Besley C. Site-specific risk-based threshold (RBT) concentrations for sewage-associated markers in estuarine swimming waters. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 929:172448. [PMID: 38615775 DOI: 10.1016/j.scitotenv.2024.172448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/16/2024]
Abstract
This study establishes site-specific risk-based threshold (RBT) concentrations for sewage-associated markers, including Bacteroides HF183 (HF183), Lachnospiraceae Lachno3 (Lachno3), cross-assembly phage (CrAssphage), and pepper mild mottle virus (PMMoV), utilizing quantitative microbial risk assessment (QMRA) for recreational estuarine waters (EW). The QMRA model calculates a RBT concentration corresponding to a selected target illness risk for ingestion of EW contaminated with untreated sewage. RBT concentrations were estimated considering site-specific decay rates and concentrations of markers and reference pathogen (human norovirus; HNoV), aiding in the identification of high-risk days during the swimming season. Results indicated varying RBT concentrations for fresh (Day 0) and aged (Days 1 to 10) sewage contamination scenarios over 10 days. HF183 exhibited the highest RBT concentration (26,600 gene copis (GC)/100 mL) initially but decreased rapidly with aging (2570 to 3120 GC/100 mL on Day 10) depending on the decay rates, while Lachno3 and CrAssphage remained relatively stable. PMMoV, despite lower initial RBT (3920 GC/100 mL), exhibited increased RBT (4700 to 6440 GC/100 mL) with aging due to its slower decay rate compared to HNoV. Sensitivity analysis revealed HNoV concentrations as the most influential parameter. Comparison of marker concentrations in estuarine locations with RBT concentrations showed instances of marker exceedance, suggesting days of potential higher risks. The observed discrepancies between bacterial and viral marker concentrations in EW highlight the need for optimized sample concentration method and simultaneous measurement of multiple markers for enhanced risk predictions. Future research will explore the utility of multiple markers in risk management. Overall, this study contributes to better understanding human health risks in recreational waters, aiding regulators, and water quality managers in effective decision-making for risk prioritization and mitigation strategies.
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Affiliation(s)
- Warish Ahmed
- CSIRO Environment, Ecosciences Precinct, 41 Boggo Road, Dutton Park, QLD 4102, Australia.
| | - Mary E Schoen
- Soller Environmental, LLC, 3022 King St, Berkeley, CA 94703, USA
| | - Jeffrey Soller
- Soller Environmental, LLC, 3022 King St, Berkeley, CA 94703, USA
| | - Joanna Ciol Harrison
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ 85281, USA
| | - Kerry A Hamilton
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ 85281, USA; School of Sustainable Engineering and the Built Environment, Arizona State University, 660 S College Ave, Tempe, AZ 85281, USA
| | - Metasebia Gebrwold
- CSIRO Environment, Ecosciences Precinct, 41 Boggo Road, Dutton Park, QLD 4102, Australia
| | - Stuart L Simpson
- CSIRO Environment, Ecosciences Precinct, 41 Boggo Road, Dutton Park, QLD 4102, Australia
| | - Sudhi Payyappat
- Sydney Water, 2 Parramatta Square, Parramatta, NSW 2150, Australia
| | - Michele Cassidy
- Sydney Water, 2 Parramatta Square, Parramatta, NSW 2150, Australia
| | - Nathan Harrison
- Sydney Water, 2 Parramatta Square, Parramatta, NSW 2150, Australia
| | - Colin Besley
- Sydney Water, 2 Parramatta Square, Parramatta, NSW 2150, Australia
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Hamilton KA, Ciol Harrison J, Mitchell J, Weir M, Verhougstraete M, Haas CN, Nejadhashemi AP, Libarkin J, Gim Aw T, Bibby K, Bivins A, Brown J, Dean K, Dunbar G, Eisenberg JNS, Emelko M, Gerrity D, Gurian PL, Hartnett E, Jahne M, Jones RM, Julian TR, Li H, Li Y, Gibson JM, Medema G, Meschke JS, Mraz A, Murphy H, Oryang D, Owusu-Ansah EDGJ, Pasek E, Pradhan AK, Razzolini MTP, Ryan MO, Schoen M, Smeets PWMH, Soller J, Solo-Gabriele H, Williams C, Wilson AM, Zimmer-Faust A, Alja'fari J, Rose JB. Research gaps and priorities for quantitative microbial risk assessment (QMRA). RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024. [PMID: 38772724 DOI: 10.1111/risa.14318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 03/12/2024] [Accepted: 04/28/2024] [Indexed: 05/23/2024]
Abstract
The coronavirus disease 2019 pandemic highlighted the need for more rapid and routine application of modeling approaches such as quantitative microbial risk assessment (QMRA) for protecting public health. QMRA is a transdisciplinary science dedicated to understanding, predicting, and mitigating infectious disease risks. To better equip QMRA researchers to inform policy and public health management, an Advances in Research for QMRA workshop was held to synthesize a path forward for QMRA research. We summarize insights from 41 QMRA researchers and experts to clarify the role of QMRA in risk analysis by (1) identifying key research needs, (2) highlighting emerging applications of QMRA; and (3) describing data needs and key scientific efforts to improve the science of QMRA. Key identified research priorities included using molecular tools in QMRA, advancing dose-response methodology, addressing needed exposure assessments, harmonizing environmental monitoring for QMRA, unifying a divide between disease transmission and QMRA models, calibrating and/or validating QMRA models, modeling co-exposures and mixtures, and standardizing practices for incorporating variability and uncertainty throughout the source-to-outcome continuum. Cross-cutting needs identified were to: develop a community of research and practice, integrate QMRA with other scientific approaches, increase QMRA translation and impacts, build communication strategies, and encourage sustainable funding mechanisms. Ultimately, a vision for advancing the science of QMRA is outlined for informing national to global health assessments, controls, and policies.
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Affiliation(s)
- Kerry A Hamilton
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona, USA
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona, USA
| | - Joanna Ciol Harrison
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona, USA
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona, USA
| | - Jade Mitchell
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Mark Weir
- Division of Environmental Health Sciences and Sustainability Institute, The Ohio State University, Columbus, Ohio, USA
| | - Marc Verhougstraete
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA
| | - Charles N Haas
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - A Pouyan Nejadhashemi
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Julie Libarkin
- Department of Earth and Environmental Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Tiong Gim Aw
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Kyle Bibby
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, Indiana, USA
| | - Aaron Bivins
- Department of Civil & Environmental Engineering, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Joe Brown
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kara Dean
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Gwyneth Dunbar
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Joseph N S Eisenberg
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Monica Emelko
- Department of Civil and Environmental Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Daniel Gerrity
- Applied Research and Development Center, Southern Nevada Water Authority, Las Vegas, Nevada, USA
| | - Patrick L Gurian
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Michael Jahne
- Office of Research and Development, United States Environmental Protection Agency, Cincinnati, Ohio, USA
| | - Rachael M Jones
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Timothy R Julian
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Duebendorf, Switzerland
| | - Hongwan Li
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Yanbin Li
- Department of Biological and Agricultural Engineering, The University of Arkansas, Fayetteville, Arkansas, USA
| | - Jacqueline MacDonald Gibson
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Gertjan Medema
- KWR Water Research Institute, Nieuwegein, The Netherlands
- TU Delft, Delft, The Netherlands
| | - J Scott Meschke
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Alexis Mraz
- Department of Public Health, School of Nursing, Health and Exercise Science, The College of New Jersey, Ewing, New Jersey, USA
| | - Heather Murphy
- Ontario Veterinary College Department of Pathobiology, University of Guelph, Ontario, Canada
| | - David Oryang
- Food and Drug Administration (FDA), US Department of Health and Human Services (DHHS), Center for Food Safety and Applied Nutrition (CFSAN), College Park, United States
| | | | - Emily Pasek
- Department of Earth and Environmental Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Abani K Pradhan
- Department of Nutrition and Food Science & Center for Food Safety and Security Systems, University of Maryland, College Park, Maryland, USA
| | | | - Michael O Ryan
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Mary Schoen
- Soller Environmental, Berkeley, California, USA
| | - Patrick W M H Smeets
- KWR Water Research Institute, Nieuwegein, The Netherlands
- TU Delft, Delft, The Netherlands
| | | | - Helena Solo-Gabriele
- Department of Chemical, Environmental, and Materials Engineering, College of Engineering, University of Miami, Coral Gables, Florida, USA
| | - Clinton Williams
- US Arid Land Agricultural Research Center, Maricopa, Arizona, USA
| | - Amanda M Wilson
- Community, Environment & Policy Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA
| | | | - Jumana Alja'fari
- National Institute of Standards and Technology (NIST), Gaithersburg, Maryland, USA
| | - Joan B Rose
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
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Abney SE, Higham CA, Wilson AM, Ijaz MK, McKinney J, Reynolds KA, Gerba CP. Transmission of Viruses from Restroom Use: A Quantitative Microbial Risk Assessment. FOOD AND ENVIRONMENTAL VIROLOGY 2024; 16:65-78. [PMID: 38372960 DOI: 10.1007/s12560-023-09580-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/30/2023] [Indexed: 02/20/2024]
Abstract
Restroom use has been implicated in a number of viral outbreaks. In this study, we apply quantitative microbial risk assessment to quantify the risk of viral transmission by contaminated restroom fomites. We estimate risk from high-touch fomite surfaces (entrance/exit door, toilet seat) for three viruses of interest (SARS-CoV-2, adenovirus, norovirus) through eight exposure scenarios involving differing user behaviors, and the use of hand sanitizer following each scenario. We assessed the impacts of several sequences of fomite contacts in the restroom, reflecting the variability of human behavior, on infection risks for these viruses. Touching of the toilet seat was assumed to model adjustment of the seat (open vs. closed), a common touch point in single-user restrooms (home, small business, hospital). A Monte Carlo simulation was conducted for each exposure scenario (10,000 simulations each). Norovirus resulted in the highest probability of infection for all exposure scenarios with fomite surfaces. Post-restroom automatic-dispensing hand sanitizer use reduced the probability of infection for each virus by up to 99.75%. Handwashing within the restroom, an important risk-reduction intervention, was not found to be as effective as use of a non-touch hand sanitizer dispenser for reducing risk to near or below 1/1,000,000, a commonly used risk threshold for comparison.
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Affiliation(s)
- Sarah E Abney
- Department of Environmental Science, University of Arizona, Tucson, AZ, USA
| | - Ciara A Higham
- EPSRC Centre for Doctoral Training in Fluid Dynamics, University of Leeds, Leeds, UK
| | - Amanda M Wilson
- Department of Community, Environment, & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - M Khalid Ijaz
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, USA
| | - Julie McKinney
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, USA
| | - Kelly A Reynolds
- Department of Environmental Science, University of Arizona, Tucson, AZ, USA
- Department of Community, Environment, & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Charles P Gerba
- Department of Environmental Science, University of Arizona, Tucson, AZ, USA.
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Jung Y, Abney SE, Reynolds KA, Gerba CP, Wilson AM. Evaluating infection risks and importance of hand hygiene during the household laundry process using a quantitative microbial risk assessment approach. Am J Infect Control 2023; 51:1377-1383. [PMID: 37271422 DOI: 10.1016/j.ajic.2023.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/31/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Contaminated laundry contributes to infectious disease spread in residential and home health care settings. The objectives were to (1) evaluate pathogen transmission risks for individuals doing laundry, and (2) compare hand hygiene timing to reduce risks. METHODS A quantitative microbial risk assessment using experimental data from a laundry washing effectiveness study was applied to estimate infection risks from SARS-CoV-2, rotavirus, norovirus, nontyphoidal Salmonella, and Escherichia coli in 4 laundry scenarios: 1 baseline scenario (no hand hygiene event) and 3 hand hygiene scenarios (scenario 1: after moving dirty clothes to the washing machine, scenario 2: after moving washed clothes to the dryer, and scenario 3: hand hygiene events following scenario 1 and 2). RESULTS The average infection risks for the baseline scenario were all greater than 2 common risk thresholds (1.0×10-6and 1.0×10-4). For all organisms, scenario 1 yielded greater risk reductions (39.95%-99.86%) than scenario 2 (1.35%-55.25%). Scenario 3 further reduced risk, achieving 1.0×10-6(SARS-CoV-2) and 1.0×10-4risk thresholds (norovirus and E. coli). CONCLUSIONS The modeled results suggest individuals should reduce hand-to-facial orifice (eyes, nose, and mouth) contacts and conduct proper hand hygiene when handling contaminated garments. More empirical data are needed to confirm the estimated risks. DATA AVAILABILITY STATEMENT The data and code that support the findings of this study can be retrieved via a Creative Commons Zero v1.0 Universal license in GitHub at https://github.com/yhjung1231/Laundry-QMRAproject-2022.git DOI: http://doi.org/10.5281/zenodo.7122065.
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Affiliation(s)
- Yoonhee Jung
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, AZ, USA.
| | - Sarah E Abney
- García-Robles Fulbright Program, Centro de Investigación Científica de Yucatán, Yucatán, Mexico
| | - Kelly A Reynolds
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, AZ, USA
| | - Charles P Gerba
- Department of Environmental Science, College of Agriculture and Life Sciences, University of Arizona, AZ, USA
| | - Amanda M Wilson
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, AZ, USA
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5
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Gitter A, Gidley M, Mena KD, Ferguson A, Sinigalliano C, Bonacolta A, Solo-Gabriele H. Integrating microbial source tracking with quantitative microbial risk assessment to evaluate site specific risk based thresholds at two South Florida beaches. Front Microbiol 2023; 14:1210192. [PMID: 37901823 PMCID: PMC10602684 DOI: 10.3389/fmicb.2023.1210192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/20/2023] [Indexed: 10/31/2023] Open
Abstract
Quantitative microbial risk assessment (QMRA) can be used to evaluate health risks associated with recreational beach use. This study developed a site-specific risk assessment using a novel approach that combined quantitative PCR-based measurement of microbial source tracking (MST) genetic markers (human, dog, and gull fecal bacteria) with a QMRA analysis of potential pathogen risk. Water samples (n = 24) from two recreational beaches were collected and analyzed for MST markers as part of a broader Beach Exposure And Child Health Study that examined child behavior interactions with the beach environment. We report here the measurements of fecal bacteria MST markers in the environmental DNA extracts of those samples and a QMRA analysis of potential health risks utilizing the results from the MST measurements in the water samples. Human-specific Bacteroides was enumerated by the HF183 Taqman qPCR assay, gull-specific Catellicoccus was enumerated by the Gull2 qPCR assay, and dog-specific Bacteroides was enumerated by the DogBact qPCR assay. Derived reference pathogen doses, calculated from the MST marker concentrations detected in recreational waters, were used to estimate the risk of gastrointestinal illness for both children and adults. Dose-response equations were used to estimate the probability of the risk of infection (Pinf) per a swimming exposure event. Based on the QMRA simulations presented in this study, the GI risk from swimming or playing in water containing a mixture of human and non-human fecal sources appear to be primarily driven by the human fecal source. However, the estimated median GI health risk for both beaches never exceeded the U.S. EPA risk threshold of 32 illnesses per 1,000 recreation events. Our research suggests that utilizing QMRA together with MST can further extend our understanding of potential recreational bather risk by identifying the source contributing the greatest risk in a particular location, therefore informing beach management responses and decision-making.
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Affiliation(s)
- Anna Gitter
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center Houston School of Public Health, El Paso, TX, United States
| | - Maribeth Gidley
- Cooperative Institute for Marine and Atmospheric Studies, University of Miami, Miami, FL, United States
- Atlantic Oceanographic and Meteorological Laboratory, National Oceanic and Atmospheric Administration, Miami, FL, United States
| | - Kristina D. Mena
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center Houston School of Public Health, El Paso, TX, United States
| | - Alesia Ferguson
- Department of Built Environment, North Carolina Agricultural and Technical State University, Greensboro, NC, United States
| | - Christopher Sinigalliano
- Atlantic Oceanographic and Meteorological Laboratory, National Oceanic and Atmospheric Administration, Miami, FL, United States
| | - Anthony Bonacolta
- Department of Marine Biology and Ecology, University of Miami, Miami, FL, United States
- Institut de Biologia Evolutiva (CSIC-Universitat Pompeu Fabra), Barcelona, Catalonia, Spain
| | - Helena Solo-Gabriele
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL, United States
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6
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Masciopinto C. Extension of probability models of the risk of infections by human enteric viruses. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:17499-17519. [PMID: 37920063 DOI: 10.3934/mbe.2023777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
This study presents a novel approach for obtaining reliable models and coefficients to estimate the probability of infection caused by common human enteric viruses. The aim is to provide guidance for public health policies in disease prevention and control, by reducing uncertainty and management costs in health risk assessments. Conventional dose-response (DR) models, based on the theory elaborated by Furumoto and Mickey [1], exhibit limitations stemming from the heterogeneity of individual host susceptibilities to infection resulting from ingesting aggregate viruses. Moreover, the scarcity of well-designed viral challenge experiments contributes to significant uncertainty in these DR models. To address these issues, we conducted a review of infection models used in health risk analysis, focusing on Norovirus (NoV) GI.1, pooled Enterovirus group (EV), Poliovirus 1/SM, and Echo-12 virus via contaminated water or food. Using a mechanistic approach, we reevaluated the known DR models and coefficients for the probability of individual host infection in the mentioned viruses based on dose-infection challenge experiments. Specifically, we sought to establish a relationship between the minimum infectious dose (ID) and the ID having a 50% probability of initiating host infection in the same challenge experiment. Furthermore, we developed a new formula to estimate the degree of aggregation of GI.1 NoV at the mean infectious dose. The proposed models, based on "exact" beta-Poisson DR models, effectively predicted infection probabilities from ingestion of both disaggregated and aggregate NoV GI.1. Through a numerical evaluation, we compared the results with the maximum likelihood estimation (MLE) probability obtained from a controlled challenge trial with the NoV GI.1 virus described in the literature, demonstrating the accuracy of our approach. By addressing the indetermination of the unmeasured degree of NoV aggregation in each single infectious dose, our models reduce overestimations and uncertainties in microbial risk assessments. This improvement enhances the management of health risks associated with enteric virus infections.
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Affiliation(s)
- Costantino Masciopinto
- Consiglio Nazionale delle Ricerche, Istituto di Ricerca Sulle Acque, Bari viale F. De Blasio 5, 70132 Italia
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Ge Y, Billings WZ, Opekun A, Estes M, Graham D, Leon J, Koelle K, Shen Y, Atmar R, Lopman B, Handel A. Effect of Norovirus Inoculum Dose on Virus Kinetics, Shedding, and Symptoms. Emerg Infect Dis 2023; 29:1349-1356. [PMID: 37347494 PMCID: PMC10310361 DOI: 10.3201/eid2907.230117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
The effect of norovirus dose on outcomes such as virus shedding and symptoms after initial infection is not well understood. We performed a secondary analysis of a human challenge study by using Bayesian mixed-effects models. As the dose increased from 4.8 to 4,800 reverse transcription PCR units, the total amount of shed virus in feces increased from 4.5 × 1011 to 3.4 × 1012 genomic equivalent copies; in vomit, virus increased from 6.4 × 105 to 3.0 × 107 genomic equivalent copies. Onset time of viral shedding in feces decreased from 1.4 to 0.8 days, and time of peak viral shedding decreased from 2.3 to 1.5 days. Time to symptom onset decreased from 1.5 to 0.8 days. One type of symptom score increased. An increase in norovirus dose was associated with more rapid shedding and symptom onset and possibly increased severity. However, the effect on virus load and shedding was inconclusive.
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Jahne MA, Schoen ME, Kaufmann A, Pecson BM, Olivieri A, Sharvelle S, Anderson A, Ashbolt NJ, Garland JL. Enteric pathogen reduction targets for onsite non-potable water systems: A critical evaluation. WATER RESEARCH 2023; 233:119742. [PMID: 36848851 PMCID: PMC10084472 DOI: 10.1016/j.watres.2023.119742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Onsite non-potable water systems (ONWS) collect and treat local source waters for non-potable end uses such as toilet flushing and irrigation. Quantitative microbial risk assessment (QMRA) has been used to set pathogen log10-reduction targets (LRTs) for ONWS to achieve the risk benchmark of 10-4 infections per person per year (ppy) in a series of two efforts completed in 2017 and 2021. In this work, we compare and synthesize the ONWS LRT efforts to inform the selection of pathogen LRTs. For onsite wastewater, greywater, and stormwater, LRTs for human enteric viruses and parasitic protozoa were within 1.5-log10 units between 2017 and 2021 efforts, despite differences in approaches used to characterize pathogens in these waters. For onsite wastewater and greywater, the 2017 effort used an epidemiology-based model to simulate pathogen concentrations contributed exclusively from onsite waste and selected Norovirus as the viral reference pathogen; the 2021 effort used municipal wastewater pathogen data and cultivable adenoviruses as the reference viral pathogen. Across source waters, the greatest differences occurred for viruses in stormwater, given the newly available municipal wastewater characterizations used for modeling sewage contributions in 2021 and the different selection of reference pathogens (Norovirus vs. adenoviruses). The roof runoff LRTs support the need for protozoa treatment, but these remain difficult to characterize due to the pathogen variability in roof runoff across space and time. The comparison highlights adaptability of the risk-based approach, allowing for updated LRTs as site specific or improved information becomes available. Future research efforts should focus on data collection of onsite water sources.
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Affiliation(s)
- Michael A Jahne
- Office of Research and Development, U.S. Environmental Protection Agency, 26 W. Martin Luther King Dr., Cincinnati, OH 45268, USA.
| | - Mary E Schoen
- Soller Environmental, LLC, 3022 King St., Berkeley, CA 94703, USA
| | - Anya Kaufmann
- Trussell Technologies, Inc., 1939 Harrison St., Oakland, CA 94612, USA
| | - Brian M Pecson
- Trussell Technologies, Inc., 1939 Harrison St., Oakland, CA 94612, USA
| | | | - Sybil Sharvelle
- Colorado State University, Department of Civil and Environmental Engineering, 1372 Campus Delivery, Fort Collins, CO 80523, USA
| | - Anita Anderson
- Minnesota Department of Health, 625 Robert St. N, St. Paul, MN 55164, USA
| | | | - Jay L Garland
- Office of Research and Development, U.S. Environmental Protection Agency, 26 W. Martin Luther King Dr., Cincinnati, OH 45268, USA
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9
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González-Fernández A, Symonds EM, Gallard-Gongora JF, Mull B, Lukasik JO, Rivera Navarro P, Badilla Aguilar A, Peraud J, Mora Alvarado D, Cantor A, Breitbart M, Cairns MR, Harwood VJ. Risk of Gastroenteritis from Swimming at a Wastewater-Impacted Tropical Beach Varies across Localized Scales. Appl Environ Microbiol 2023; 89:e0103322. [PMID: 36847564 PMCID: PMC10057883 DOI: 10.1128/aem.01033-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 01/21/2023] [Indexed: 03/01/2023] Open
Abstract
Population growth and changing climate are expected to increase human exposure to pathogens in tropical coastal waters. We examined microbiological water quality in three rivers within 2.3 km of each other that impact a Costa Rican beach and in the ocean outside their plumes during the rainy and dry seasons. We performed quantitative microbial risk assessment (QMRA) to predict the risk of gastroenteritis associated with swimming and the amount of pathogen reduction needed to achieve safe conditions. Recreational water quality criteria based on enterococci were exceeded in >90% of river samples but in only 13% of ocean samples. Multivariate analysis grouped microbial observations by subwatershed and season in river samples but only by subwatershed in the ocean. The modeled median risk from all pathogens in river samples was between 0.345 and 0.577, 10-fold above the U.S. Environmental Protection Agency (U.S. EPA) benchmark of 0.036 (36 illnesses/1,000 swimmers). Norovirus genogroup I (NoVGI) contributed most to risk, but adenoviruses raised risk above the threshold in the two most urban subwatersheds. The risk was greater in the dry compared to the rainy season, due largely to the greater frequency of NoVGI detection (100% versus 41%). Viral log10 reduction needed to ensure safe swimming conditions varied by subwatershed and season and was greatest in the dry season (3.8 to 4.1 dry; 2.7 to 3.2 rainy). QMRA that accounts for seasonal and local variability of water quality contributes to understanding the complex influences of hydrology, land use, and environment on human health risk in tropical coastal areas and can contribute to improved beach management. IMPORTANCE This holistic investigation of sanitary water quality at a Costa Rican beach assessed microbial source tracking (MST) marker genes, pathogens, and indicators of sewage. Such studies are still rare in tropical climates. Quantitative microbial risk assessment (QMRA) found that rivers impacting the beach consistently exceeded the U.S. EPA risk threshold for gastroenteritis of 36/1,000 swimmers. The study improves upon many QMRA studies by measuring specific pathogens, rather than relying on surrogates (indicator organisms or MST markers) or estimating pathogen concentrations from the literature. By analyzing microbial levels and estimating the risk of gastrointestinal illness in each river, we were able to discern differences in pathogen levels and human health risks even though all rivers were highly polluted by wastewater and were located less than 2.5 km from one another. This variability on a localized scale has not, to our knowledge, previously been demonstrated.
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Affiliation(s)
| | - Erin M. Symonds
- College of Marine Science, University of South Florida, Saint Petersburg, Florida, USA
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | | | - Bonnie Mull
- BCS Laboratories, Inc., Gainesville, Florida, USA
| | | | - Pablo Rivera Navarro
- Laboratorio Nacional de Aguas, Instituto Costarricense de Acueductos y Alcantarillados, Tres Ríos, Cartago, Costa Rica
| | - Andrei Badilla Aguilar
- Laboratorio Nacional de Aguas, Instituto Costarricense de Acueductos y Alcantarillados, Tres Ríos, Cartago, Costa Rica
| | - Jayme Peraud
- Department of Integrative Biology, University of South Florida, Tampa, Florida, USA
| | - Darner Mora Alvarado
- Laboratorio Nacional de Aguas, Instituto Costarricense de Acueductos y Alcantarillados, Tres Ríos, Cartago, Costa Rica
| | - Allison Cantor
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | - Mya Breitbart
- College of Marine Science, University of South Florida, Saint Petersburg, Florida, USA
| | - Maryann R. Cairns
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | - Valerie J. Harwood
- Department of Integrative Biology, University of South Florida, Tampa, Florida, USA
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Li C, Sylvestre É, Fernandez-Cassi X, Julian TR, Kohn T. Waterborne virus transport and the associated risks in a large lake. WATER RESEARCH 2023; 229:119437. [PMID: 36476383 DOI: 10.1016/j.watres.2022.119437] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/04/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
Waterborne enteric viruses in lakes, especially at recreational water sites, may have a negative impact on human health. However, their fate and transport in lakes are poorly understood. In this study, we propose a coupled water quality and quantitative microbial risk assessment (QMRA) model to study the transport, fate and infection risk of four common waterborne viruses (adenovirus, enterovirus, norovirus and rotavirus), using Lake Geneva as a study site. The measured virus load in raw sewage entering the lake was used as the source term in the water quality simulations for a hypothetical scenario of discharging raw wastewater at the lake surface. After discharge into the lake, virus inactivation was modeled as a function of water temperature and solar irradiance that varied both spatially and temporally during transport throughout the lake. Finally, the probability of infection, while swimming at a popular beach, was quantified and compared among the four viruses. Norovirus was found to be the most abundant virus that causes an infection probability that is at least 10 times greater than the other viruses studied. Furthermore, environmental inactivation was found to be an essential determinant in the infection risks posed by viruses to recreational water users. We determined that infection risks by enterovirus and rotavirus could be up to 1000 times lower when virus inactivation by environmental stressors was accounted for compared with the scenarios considering hydrodynamic transport only. Finally, the model highlighted the role of the wind field in conveying the contamination plume and hence in determining infection probability. Our simulations revealed that for beaches located west of the sewage discharge, the infection probability under eastward wind was 43% lower than that under westward wind conditions. This study highlights the potential of combining water quality simulation and virus-specific risk assessment for a safe water resources usage and management.
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Affiliation(s)
- Chaojie Li
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering, (ENAC), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Émile Sylvestre
- Department Environmental Microbiology, Eawag-Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - Xavier Fernandez-Cassi
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering, (ENAC), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Timothy R Julian
- Department Environmental Microbiology, Eawag-Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Tamar Kohn
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering, (ENAC), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
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11
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Seis W, Rouault P, Miehe U, Ten Veldhuis MC, Medema G. Bayesian estimation of seasonal and between year variability of norovirus infection risks for workers in agricultural water reuse using epidemiological data. WATER RESEARCH 2022; 224:119079. [PMID: 36108400 DOI: 10.1016/j.watres.2022.119079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
Norovirus infections are among the major causes of acute gastroenteritis worldwide. In Germany, norovirus infections are the most frequently reported cause of gastroenteritis, although only laboratory confirmed cases are officially counted. The high infectivity and environmental persistence of norovirus, makes the virus a relevant pathogen for water related infections. In the 2017 guidelines for potable water reuse, the World Health Organization proposes Norovirus as a reference pathogen for viral pathogens for quantitative microbial risk assessment (QMRA). A challenge for QMRA is, that norovirus data are rarely available over long monitoring periods to assess inter-annual variability of the associated health risk, raising the question about the relevance of this source of variability regarding potential risk management alternatives. Moreover, norovirus infections show high prevalence during winter and early spring and lower incidence during summer. Therefore, our objective is to derive risk scenarios for assessing the potential relevance of the within and between year variability of norovirus concentrations in municipal wastewater for the assessment of health risks of fieldworkers, if treated wastewater is used for irrigation in agriculture. To this end, we use the correlation between norovirus influent concentration and reported epidemiological incidence (R²=0.93), found at a large city in Germany. Risk scenarios are subsequently derived from long-term reported epidemiological data, by applying a Bayesian regression approach. For assessing the practical relevance for wastewater reuse we apply the risk scenarios to different irrigation patterns under various treatment options, namely "status-quo" and "irrigation on demand". While status-quo refers to an almost all-year irrigation, the latter assumes that irrigation only takes place during the vegetation period from May - September. Our results indicate that the log-difference of infection risks between scenarios may vary between 0.8 and 1.7 log given the same level of pre-treatment. They also indicate that under the same exposure scenario the between-year variability of norovirus infection risk may be > 1log, which makes it a relevant factor to consider in future QMRA studies and studies which aim at evaluating safe water reuse applications. The predictive power and wider use of epidemiological data as a suitable predictor variable should be further validated with paired multi-year data.
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Affiliation(s)
- Wolfgang Seis
- Kompetenzzentrum Wasser Berlin gGmbH, Cicerostraße 24, Berlin 10709, Germany; Department of Water Management, Faculty of Civil Engineering & Geosciences, Delft University of Technology, Delft, GA 2600, the Netherlands.
| | - Pascale Rouault
- Kompetenzzentrum Wasser Berlin gGmbH, Cicerostraße 24, Berlin 10709, Germany
| | - Ulf Miehe
- Kompetenzzentrum Wasser Berlin gGmbH, Cicerostraße 24, Berlin 10709, Germany
| | - Marie-Claire Ten Veldhuis
- Department of Water Management, Faculty of Civil Engineering & Geosciences, Delft University of Technology, Delft, GA 2600, the Netherlands
| | - Gertjan Medema
- Department of Water Management, Faculty of Civil Engineering & Geosciences, Delft University of Technology, Delft, GA 2600, the Netherlands
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Deere D, Ryan U. Current assumptions for quantitative microbial risk assessment (QMRA) of Norovirus contamination of drinking water catchments due to recreational activities: an update. JOURNAL OF WATER AND HEALTH 2022; 20:1543-1557. [PMID: 36308498 DOI: 10.2166/wh.2022.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Contamination of drinking water from Norovirus (NoV) and other waterborne viruses is a major public health concern globally. Increasingly, quantitative microbial risk assessment (QMRA) is being used to assess the various risks from waterborne pathogens and evaluate control strategies. As urban populations grow and expand, there is increasing demand for recreational activities in drinking water catchments. QMRA relies on context-specific data to map out the pathways by which viruses can enter water and be transferred to drinking water consumers and identify risk factors and appropriate controls. This review examines the current evidence base and assumptions for QMRA analysis of NoV and other waterborne viral pathogens and recommends numerical values based on the most recent evidence to better understand the health risks associated with recreators in Australian drinking water sources; these are broadly applicable to all drinking water sources where recreational access is allowed. Key issues include the lack of an agreed upon data and dose-response models for human infectious NoV genotypes, faecal shedding by bathers, the extent of NoV infectivity and aggregation, resistance (secretor status) to NoV and the extent of secondary transmission.
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Affiliation(s)
- Dan Deere
- Water Futures and Water Research Australia, Sydney, Australia
| | - Una Ryan
- Harry Butler Institute, Murdoch University, Perth, Australia E-mail:
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13
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Pecson B, Kaufmann A, Sharvelle S, Post B, Leverenz H, Ashbolt N, Olivieri A. Risk-based treatment targets for onsite non-potable water systems using new pathogen data. JOURNAL OF WATER AND HEALTH 2022; 20:1558-1575. [PMID: 36308499 DOI: 10.2166/wh.2022.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Using local sources (roof runoff, stormwater, graywater, and onsite wastewater) to meet non-potable water demands can minimize potable water use in buildings and increase supply reliability. In 2017, an Independent Advisory Panel developed a risk-based framework to identify pathogen log reduction targets (LRTs) for onsite non-potable water systems (ONWSs). Subsequently, California's legislature mandated the development and adoption of regulations-including risk-based LRTs-for use in multifamily residential, commercial, and mixed-use buildings. A California Expert Panel was convened in 2021 to (1) update the LRT requirements using new, quantitative pathogen data and (2) propose treatment trains capable of meeting the updated LRTs. This paper presents the updated risk-based LRTs for multiple pathogens (viruses, protozoa, and bacteria) and an expanded set of end-uses including toilet flushing, clothes washing, irrigation, dust and fire suppression, car washing, and decorative fountains. The updated 95th percentile LRTs required for each source water, pathogen, and end-use were typically within 1-log10 of the 2017 LRTs regardless of the approach used to estimate pathogen concentrations. LRT requirements decreased with influent pathogen concentrations from wastewater to graywater to stormwater to roof runoff. Cost and footprint estimates provide details on the capital, operations and maintenance, and siting requirements for ONWS implementation.
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Affiliation(s)
- Brian Pecson
- Trussell Technologies, 1939 Harrison Street, Oakland, California 94612, USA E-mail:
| | - Anya Kaufmann
- Trussell Technologies, 1939 Harrison Street, Oakland, California 94612, USA E-mail:
| | - Sybil Sharvelle
- Colorado State University, Scott Bioengineering Building 246, Fort Collins, Colorado 80523, USA
| | - Brie Post
- Trussell Technologies, 1939 Harrison Street, Oakland, California 94612, USA E-mail:
| | - Harold Leverenz
- Department of Civil and Environmental Engineering, University of California, Davis, California 95616, USA
| | - Nicholas Ashbolt
- Faculty of Science and Engineering, Southern Cross University, Military Road, East Lismore, New South Wales 2480, Australia
| | - Adam Olivieri
- EOA, Inc., 1410 Jackson Street, Oakland, California 94612, USA
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14
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Jin T, Chen X, Nishio M, Zhuang L, Shiomi H, Tonosaki Y, Yokohata R, King MF, Kang M, Fujii K, Zhang N. Interventions to prevent surface transmission of an infectious virus based on real human touch behavior: a case study of the norovirus. Int J Infect Dis 2022; 122:83-92. [PMID: 35649497 PMCID: PMC9148625 DOI: 10.1016/j.ijid.2022.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Infectious viruses (e.g., SARS-CoV-2, norovirus) can transmit through surfaces. Norovirus has infected millions of individuals annually. Interventions on norovirus transmission in high-risk indoor environment are important. METHODS This study focused on a restaurant in Guangzhou, China. More than 41,000 touches by both diners and staff members were collected using video cameras. A surface transmission model was developed and combined with these real human touch behaviors to analyze the effectiveness of different norovirus prevention strategies. RESULTS When the virus carrier was a diner, the virus intake fraction of diners in the same table was the highest. Increasing the touch frequency on personal private surfaces would reduce the virus exposure. The virus intake fraction was reduced by 18.4% on average if public surfaces were not touched. Optimization on surface materials could reduce the virus intake fraction by 86.6%. Additionally, disinfecting tablecloths, clothes of diners, and chairs were the three most effective surface disinfection strategies. CONCLUSION Controlling human touch behavior (e.g., reducing the self-touches on mucous membranes) is more effective than surface disinfection in controlling norovirus transmission, but surface disinfection cannot be ignored because human behavior is difficult to be controlled.
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Affiliation(s)
- Tianyi Jin
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Xuguang Chen
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong province, China
| | - Masaya Nishio
- R&D-Safety Science, Kao Corporation, Japan,R&D-Strategy, Kao Corporation, Japan
| | - Linan Zhuang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Hiroyuki Shiomi
- R&D-Processing Development Research Laboratories, Kao Corporation, Japan
| | - Yosuke Tonosaki
- R&D-Processing Development Research Laboratories, Kao Corporation, Japan
| | | | | | - Min Kang
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong province, China
| | - Kenkichi Fujii
- R&D-Safety Science, Kao Corporation, Japan,R&D-Strategy, Kao Corporation, Japan
| | - Nan Zhang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China,Corresponding author: Nan Zhang, Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Room 204, Pingleyuan 100, Chaoyang District, Beijing, China, Telephone: +86 18210064566
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15
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Zhao Y, Shao L, Jia L, Zou B, Dai R, Li X, Jia F. Inactivation effects, kinetics and mechanisms of air- and nitrogen-based cold atmospheric plasma on Pseudomonas aeruginosa. INNOV FOOD SCI EMERG 2022. [DOI: 10.1016/j.ifset.2022.103051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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16
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Detangling Seasonal Relationships of Fecal Contamination Sources and Correlates with Indicators in Michigan Watersheds. Microbiol Spectr 2022; 10:e0041522. [PMID: 35730960 PMCID: PMC9431008 DOI: 10.1128/spectrum.00415-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Despite the widely acknowledged public health impacts of surface water fecal contamination, there is limited understanding of seasonal effects on (i) fate and transport processes and (ii) the mechanisms by which they contribute to water quality impairment. Quantifying relationships between land use, chemical parameters, and fecal bacterial concentrations in watersheds can help guide the monitoring and control of microbial water quality and explain seasonal differences. The goals of this study were to (i) identify seasonal differences in Escherichia coli and Bacteroides thetaiotaomicron concentrations, (ii) evaluate environmental drivers influencing microbial contamination during baseflow, snowmelt, and summer rain seasons, and (iii) relate seasonal changes in B. thetaiotaomicron to anticipated gastrointestinal infection risks. Water chemistry data collected during three hydroclimatic seasons from 64 Michigan watersheds were analyzed using seasonal linear regression models with candidate variables including crop and land use proportions, prior precipitation, chemical parameters, and variables related to both wastewater treatment and septic usage. Adaptive least absolute shrinkage and selection operator (LASSO) linear regression with bootstrapping was used to select explanatory variables and estimate coefficients. Regardless of season, wastewater treatment plant and septic system usage were consistently selected in all primary models for B. thetaiotaomicron and E. coli. Chemistry and precipitation-related variable selection depended upon season and organism. These results suggest a link between human pollution (e.g., septic systems) and microbial water quality that is dependent on flow regime. IMPORTANCE In this study, a data set of 64 Michigan watersheds was utilized to gain insights into fecal contamination sources, drivers, and chemical correlates across seasons for general E. coli and human-specific fecal indicators. Results reaffirmed a link between human-specific sources (e.g., septic systems) and microbial water quality. While the importance of human sources of fecal contamination and fate and transport variables (e.g., precipitation) remain important across seasons, this study provides evidence that fate and transport mechanisms vary with seasonal hydrologic condition and microorganism source. This study contributes to a body of research that informs prioritization of fecal contamination source control and surveillance strategy development to reduce the public health burden of surface water fecal contamination.
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17
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Tubatsi G, Kebaabetswe LP. Detection of Enteric Viruses from Wastewater and River Water in Botswana. FOOD AND ENVIRONMENTAL VIROLOGY 2022; 14:157-169. [PMID: 35150381 DOI: 10.1007/s12560-022-09513-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Waterborne diseases remain a public health concern in developing countries where many lack access to safe water. Water testing mainly uses bacterial indicators to assess water quality, which may not fully indicate the threat from other non-bacterial pathogens like enteric viruses. This study was done to ascertain and establish the viral load, the temporal and spatial distribution of rotavirus A and norovirus (GI and GII) in sewage and river water samples. A total of 45 samples of raw and treated sewage, and surface water, were collected from a sludge activated wastewater treatment plant in Gaborone, and after treatment from the Notwane River, Botswana, over a period of 9 months (February 2016 to October 2016). Viruses were concentrated using polyethylene glycol/NaCl precipitation. Virus detection was performed using real-time polymerase chain reaction (RT-PCR). Rotavirus A was the most prevalent (84.4% positive samples), followed by Norovirus GI (48.9% positive samples), and Norovirus GII 46.7% positive samples). Detected viral loads went up to 104 genome copies per liter (copies/L) for all the viruses. The enteric viruses were detected in all the study sites with highest detection from site S1 (inlet). There was no significant association between physicochemical parameters and viral loads, except for pH which showed significant relationship with rotavirus and norovirus GII (p ≤ 0.05). This is the first study in Botswana to highlight the occurrence and quantification of the enteric viruses in treated and untreated wastewater, as well as surface water.
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Affiliation(s)
- Gosaitse Tubatsi
- Department of Biological Sciences and Biotechnology, Botswana International University of Science and Technology, P/Bag 16, Palapye, Botswana
| | - Lemme P Kebaabetswe
- Department of Biological Sciences and Biotechnology, Botswana International University of Science and Technology, P/Bag 16, Palapye, Botswana.
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18
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Burch TR, Stokdyk JP, Rice N, Anderson AC, Walsh JF, Spencer SK, Firnstahl AD, Borchardt MA. Statewide Quantitative Microbial Risk Assessment for Waterborne Viruses, Bacteria, and Protozoa in Public Water Supply Wells in Minnesota. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:6315-6324. [PMID: 35507527 PMCID: PMC9118547 DOI: 10.1021/acs.est.1c06472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 05/22/2023]
Abstract
Infection risk from waterborne pathogens can be estimated via quantitative microbial risk assessment (QMRA) and forms an important consideration in the management of public groundwater systems. However, few groundwater QMRAs use site-specific hazard identification and exposure assessment, so prevailing risks in these systems remain poorly defined. We estimated the infection risk for 9 waterborne pathogens based on a 2-year pathogen occurrence study in which 964 water samples were collected from 145 public wells throughout Minnesota, USA. Annual risk across all nine pathogens combined was 3.3 × 10-1 (95% CI: 2.3 × 10-1 to 4.2 × 10-1), 3.9 × 10-2 (2.3 × 10-2 to 5.4 × 10-2), and 1.2 × 10-1 (2.6 × 10-2 to 2.7 × 10-1) infections person-1 year-1 for noncommunity, nondisinfecting community, and disinfecting community wells, respectively. Risk estimates exceeded the U.S. benchmark of 10-4 infections person-1 year-1 in 59% of well-years, indicating that the risk was widespread. While the annual risk for all pathogens combined was relatively high, the average daily doses for individual pathogens were low, indicating that significant risk results from sporadic pathogen exposure. Cryptosporidium dominated annual risk, so improved identification of wells susceptible to Cryptosporidium contamination may be important for risk mitigation.
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Affiliation(s)
- Tucker R. Burch
- U.S.
Department of Agriculture−Agricultural Research Service (USDA−ARS),
Environmentally Integrated Dairy Management Research Unit, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- . Phone: 715-207-9244
| | - Joel P. Stokdyk
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- U.S.
Geological Survey, Upper Midwest Water Science Center, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
| | - Nancy Rice
- Minnesota
Department of Health, P.O. Box 64975, St. Paul, Minnesota 55164, United States
| | - Anita C. Anderson
- Minnesota
Department of Health, P.O. Box 64975, St. Paul, Minnesota 55164, United States
| | - James F. Walsh
- Minnesota
Department of Health, P.O. Box 64975, St. Paul, Minnesota 55164, United States
| | - Susan K. Spencer
- U.S.
Department of Agriculture−Agricultural Research Service (USDA−ARS),
Environmentally Integrated Dairy Management Research Unit, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
| | - Aaron D. Firnstahl
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- U.S.
Geological Survey, Upper Midwest Water Science Center, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
| | - Mark A. Borchardt
- U.S.
Department of Agriculture−Agricultural Research Service (USDA−ARS),
Environmentally Integrated Dairy Management Research Unit, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
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19
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Pouillot R, Smith M, Van Doren JM, Catford A, Holtzman J, Calci KR, Edwards R, Goblick G, Roberts C, Stobo J, White J, Woods J, DePaola A, Buenaventura E, Burkhardt W. Risk Assessment of Norovirus Illness from Consumption of Raw Oysters in the United States and in Canada. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:344-369. [PMID: 34121216 PMCID: PMC9291475 DOI: 10.1111/risa.13755] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 05/30/2023]
Abstract
Human norovirus (NoV) is the leading cause of foodborne illness in the United States and Canada. Bivalve molluscan shellfish is one commodity commonly identified as being a vector of NoV. Bivalve molluscan shellfish are grown in waters that may be affected by contamination events, tend to bioaccumulate viruses, and are frequently eaten raw. In an effort to better assess the elements that contribute to potential risk of NoV infection and illness from consumption of bivalve molluscan shellfish, the U.S. Department of Health and Human Services/Food and Drug Administration (FDA), Health Canada (HC), the Canadian Food Inspection Agency (CFIA), and Environment and Climate Change Canada (ECCC) collaborated to conduct a quantitative risk assessment for NoV in bivalve molluscan shellfish, notably oysters. This study describes the model and scenarios developed and results obtained to assess the risk of NoV infection and illness from consumption of raw oysters harvested from a quasi-steady-state situation. Among the many factors that influence the risk of NoV illness for raw oyster consumers, the concentrations of NoV in the influent (raw, untreated) and effluent (treated) of wastewater treatment plants (WWTP) were identified to be the most important. Thus, mitigation and control strategies that limit the influence from human waste (WWTP outfalls) in oyster growing areas have a major influence on the risk of illness from consumption of those oysters.
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Affiliation(s)
- Régis Pouillot
- U.S. Food and Drug Administration5001 Campus DriveCollege ParkMD20740USA
| | - Mark Smith
- Health Canada251 Sir Frederick Banting Driveway Tunney's Pasture, Mail Stop 2204EOttawaONK1A 0K9Canada
| | - Jane M. Van Doren
- U.S. Food and Drug Administration5001 Campus DriveCollege ParkMD20740USA
| | - Angela Catford
- Health Canada251 Sir Frederick Banting Driveway Tunney's Pasture, Mail Stop 2204EOttawaONK1A 0K9Canada
| | - Jennifer Holtzman
- Health Canada251 Sir Frederick Banting Driveway Tunney's Pasture, Mail Stop 2204EOttawaONK1A 0K9Canada
| | - Kevin R. Calci
- U.S. Food and Drug AdministrationGulf Coast Seafood LaboratoryDauphin IslandAL36528USA
| | - Robyn Edwards
- Canadian Food Inspection Agency1400 Merivale RoadOttawaONK1A 0Y9Canada
| | - Gregory Goblick
- U.S. Food and Drug AdministrationGulf Coast Seafood LaboratoryDauphin IslandAL36528USA
| | - Christopher Roberts
- Environment and Climate Change Canada45 Alderney Dr, 7th FloorDartmouthNSB2Y 2N6Canada
| | - Jeffrey Stobo
- Environment and Climate Change Canada45 Alderney Dr, 7th FloorDartmouthNSB2Y 2N6Canada
| | - John White
- Canadian Food Inspection Agency57 Central St., Suite 204SummersidePEC1N 3K9Canada
| | - Jacquelina Woods
- U.S. Food and Drug AdministrationGulf Coast Seafood LaboratoryDauphin IslandAL36528USA
| | - Angelo DePaola
- U.S. Food and Drug AdministrationGulf Coast Seafood LaboratoryDauphin IslandAL36528USA
| | - Enrico Buenaventura
- Health Canada251 Sir Frederick Banting Driveway Tunney's Pasture, Mail Stop 2204EOttawaONK1A 0K9Canada
| | - William Burkhardt
- U.S. Food and Drug AdministrationGulf Coast Seafood LaboratoryDauphin IslandAL36528USA
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20
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Nag R, Russell L, Nolan S, Auer A, Markey BK, Whyte P, O'Flaherty V, Bolton D, Fenton O, Richards KG, Cummins E. Quantitative microbial risk assessment associated with ready-to-eat salads following the application of farmyard manure and slurry or anaerobic digestate to arable lands. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:151227. [PMID: 34715220 DOI: 10.1016/j.scitotenv.2021.151227] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
Farmyard manure and slurry (FYM&S) and anaerobic digestate are potentially valuable soil conditioners providing important nutrients for plant development and growth. However, these organic fertilisers may pose a microbial health risk to humans. A quantitative microbial risk assessment (QMRA) model was developed to investigate the potential human exposure to pathogens following the application of FYM&S and digestate to agricultural land. The farm-to-fork probabilistic model investigated the fate of microbial indicators (total coliforms and enterococci) and foodborne pathogens in the soil with potential contamination of ready-to-eat salads (RTEs) at the point of human consumption. The processes examined included pathogen inactivation during mesophilic anaerobic digestion (M-AD), post-AD pasteurisation, storage, dilution while spreading, decay in soil, post-harvest washing processes, and finally, the potential growth of the pathogen during refrigeration/storage at the retail level in the Irish context. The QMRA highlighted a very low annual probability of risk (Pannual) due to Clostridium perfringens, norovirus, and Salmonella Newport across all scenarios. Mycobacterium avium may result in a very high mean Pannual for the application of raw FYM&S, while Cryptosporidium parvum and pathogenic E. coli showed high Pannual, and Listeria monocytogenes displayed moderate Pannual for raw FYM&S application. The use of AD reduces this risk; however, pasteurisation reduces the Pannual to an even greater extent posing a very low risk. An overall sensitivity analysis revealed that mesophilic-AD's inactivation effect is the most sensitive parameter of the QMRA, followed by storage and the decay on the field (all negatively correlated to risk estimate). The information generated from this model can help to inform guidelines for policymakers on the maximum permissible indicator or pathogen contamination levels in the digestate. The QMRA can also provide the AD industry with a safety assessment of pathogenic organisms resulting from the digestion of FYM&S.
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Affiliation(s)
- Rajat Nag
- University College Dublin, School of Biosystems and Food Engineering, Belfield, Dublin 4, Ireland.
| | - Lauren Russell
- Teagasc, Ashtown Food Research Centre, Ashtown, Dublin 15, Ireland; University College Dublin, School of Veterinary Medicine, Belfield, Dublin 4, Ireland.
| | - Stephen Nolan
- National University of Ireland Galway, School of Natural Sciences and Ryan Institute, Galway, Ireland.
| | - Agathe Auer
- University College Dublin, School of Veterinary Medicine, Belfield, Dublin 4, Ireland.
| | - Bryan K Markey
- University College Dublin, School of Veterinary Medicine, Belfield, Dublin 4, Ireland.
| | - Paul Whyte
- University College Dublin, School of Veterinary Medicine, Belfield, Dublin 4, Ireland.
| | - Vincent O'Flaherty
- National University of Ireland Galway, School of Natural Sciences and Ryan Institute, Galway, Ireland.
| | - Declan Bolton
- Teagasc, Ashtown Food Research Centre, Ashtown, Dublin 15, Ireland.
| | - Owen Fenton
- Teagasc, Environment Research Centre, Johnstown Castle, County Wexford, Ireland.
| | - Karl G Richards
- Teagasc, Environment Research Centre, Johnstown Castle, County Wexford, Ireland.
| | - Enda Cummins
- University College Dublin, School of Biosystems and Food Engineering, Belfield, Dublin 4, Ireland.
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21
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King M, Wilson AM, Weir MH, López‐García M, Proctor J, Hiwar W, Khan A, Fletcher LA, Sleigh PA, Clifton I, Dancer SJ, Wilcox M, Reynolds KA, Noakes CJ. Modeling fomite-mediated SARS-CoV-2 exposure through personal protective equipment doffing in a hospital environment. INDOOR AIR 2022; 32:e12938. [PMID: 34693567 PMCID: PMC8653260 DOI: 10.1111/ina.12938] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/20/2021] [Accepted: 09/18/2021] [Indexed: 06/08/2023]
Abstract
Self-contamination during doffing of personal protective equipment (PPE) is a concern for healthcare workers (HCW) following SARS-CoV-2-positive patient care. Staff may subconsciously become contaminated through improper glove removal; so, quantifying this exposure is critical for safe working procedures. HCW surface contact sequences on a respiratory ward were modeled using a discrete-time Markov chain for: IV-drip care, blood pressure monitoring, and doctors' rounds. Accretion of viral RNA on gloves during care was modeled using a stochastic recurrence relation. In the simulation, the HCW then doffed PPE and contaminated themselves in a fraction of cases based on increasing caseload. A parametric study was conducted to analyze the effect of: (1a) increasing patient numbers on the ward, (1b) the proportion of COVID-19 cases, (2) the length of a shift, and (3) the probability of touching contaminated PPE. The driving factors for the exposure were surface contamination and the number of surface contacts. The results simulate generally low viral exposures in most of the scenarios considered including on 100% COVID-19 positive wards, although this is where the highest self-inoculated dose is likely to occur with median 0.0305 viruses (95% CI =0-0.6 viruses). Dose correlates highly with surface contamination showing that this can be a determining factor for the exposure. The infection risk resulting from the exposure is challenging to estimate, as it will be influenced by the factors such as virus variant and vaccination rates.
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Affiliation(s)
| | - Amanda M. Wilson
- Department of Community, Environment, and PolicyMel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
| | - Mark H. Weir
- Division of Environmental Health SciencesThe Ohio State UniversityColumbusOhioUSA
| | | | | | - Waseem Hiwar
- School of Civil EngineeringUniversity of LeedsLeedsUK
| | - Amirul Khan
- School of Civil EngineeringUniversity of LeedsLeedsUK
| | | | | | - Ian Clifton
- Department of Respiratory MedicineSt. James's HospitalUniversity of LeedsLeedsUK
| | - Stephanie J. Dancer
- School of Applied SciencesEdinburgh Napier UniversityEdinburghUK
- Department of MicrobiologyHairmyres HospitalNHS LanarkshireGlasgowG75 8RGUK
| | - Mark Wilcox
- Healthcare Associated Infections Research GroupLeeds Teaching Hospitals NHS Trust and University of LeedsLeedsUK
| | - Kelly A. Reynolds
- Department of Community, Environment, and PolicyMel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
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22
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Li M, Song G, Liu R, Huang X, Liu H. Inactivation and risk control of pathogenic microorganisms in municipal sludge treatment: A review. FRONTIERS OF ENVIRONMENTAL SCIENCE & ENGINEERING 2022; 16:70. [PMID: 34608423 PMCID: PMC8482957 DOI: 10.1007/s11783-021-1504-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/28/2021] [Accepted: 07/12/2021] [Indexed: 05/05/2023]
Abstract
The rapid global spread of coronavirus disease 2019 (COVID-19) has promoted concern over human pathogens and their significant threats to public health security. The monitoring and control of human pathogens in public sanitation and health facilities are of great importance. Excessive sludge is an inevitable byproduct of sewage that contains human and animal feces in wastewater treatment plants (WWTPs). It is an important sink of different pollutants and pathogens, and the proper treatment and disposal of sludge are important to minimize potential risks to the environment and public health. However, there is a lack of comprehensive analysis of the diversity, exposure risks, assessment methods and inactivation techniques of pathogenic microorganisms in sludge. Based on this consideration, this review summarizes the control performance of pathogenic microorganisms such as enterovirus, Salmonella spp., and Escherichia coli by different sludge treatment technologies, including composting, anaerobic digestion, aerobic digestion, and microwave irradiation, and the mechanisms of pathogenic microorganism inactivation in sludge treatment processes are discussed. Additionally, this study reviews the diversity, detection methods, and exposure risks of pathogenic microorganisms in sludge. This review advances the quantitative assessment of pathogenic microorganism risks involved in sludge reuse and is practically valuable to optimize the treatment and disposal of sludge for pathogenic microorganism control.
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Affiliation(s)
- Mengtian Li
- State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085 China
- University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Ge Song
- State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085 China
- University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Ruiping Liu
- Center for Water and Ecology, School of Environment, Tsinghua University, Beijing, 100084 China
| | - Xia Huang
- School of Environment, Tsinghua University, Beijing, 100084 China
| | - Huijuan Liu
- Center for Water and Ecology, School of Environment, Tsinghua University, Beijing, 100084 China
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23
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Hamadieh Z, Hamilton KA, Silverman AI. Systematic review of the relative concentrations of noroviruses and fecal indicator bacteria in wastewater: considerations for use in quantitative microbial risk assessment. JOURNAL OF WATER AND HEALTH 2021; 19:918-932. [PMID: 34874900 PMCID: wh_2021_068 DOI: 10.2166/wh.2021.068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Human noroviruses are a leading cause of food- and water-borne disease, which has led to an interest in quantifying norovirus health risks using quantitative microbial risk assessment (QMRA). Given the limited availability of quantitative norovirus data to input to QMRA models, some studies have applied a conversion factor to estimate norovirus exposure based on measured fecal indicator bacteria (FIB) concentrations. We conducted a review of peer-reviewed publications to identify the concentrations of noroviruses and FIB in raw, secondary-treated, and disinfected wastewater. A meta-analysis was performed to determine the ratios of norovirus-FIB pairs in each wastewater matrix and the variables that significantly impact these ratios. Norovirus-to-FIB ratios were found to be significantly impacted by the norovirus genotype, month of sample collection, geographic location, and the extent of wastewater treatment. Additionally, we evaluated the impact of using a FIB-to-virus conversion factor in QMRA and found that the choice of conversion ratio has a great impact on estimated health risks. For example, the use of a conversion ratio previously used in the World Health Organization Guidelines for the Safe Use of Wastewater, Excreta and Greywater predicted health risks that were significantly lower than those estimated with measured norovirus concentrations used as inputs. This work emphasizes the gold standard of using measured pathogen concentrations directly as inputs to exposure assessment in QMRA. While not encouraged, if one must use a FIB-to-virus conversion ratio to estimate norovirus dose, the ratio should be chosen carefully based on the target microorganisms (i.e., strain, genotype, or class), prevalence of disease, and extent of wastewater treatment.
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Affiliation(s)
- Zelfa Hamadieh
- Department of Civil and Urban Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA E-mail:
| | - Kerry A Hamilton
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ, USA; The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, AZ, USA
| | - Andrea I Silverman
- Department of Civil and Urban Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA E-mail: ; School of Global Public Health, New York University, New York, NY, USA
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24
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Sobolik JS, Newman KL, Jaykus LA, Bihn EA, Leon JS. Norovirus transmission mitigation strategies during simulated produce harvest and packing. Int J Food Microbiol 2021; 357:109365. [PMID: 34488004 PMCID: PMC8510003 DOI: 10.1016/j.ijfoodmicro.2021.109365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 08/04/2021] [Accepted: 08/15/2021] [Indexed: 02/07/2023]
Abstract
In the agricultural setting, core global food safety elements, such as hand hygiene and worker furlough, should reduce the risk of norovirus contamination on fresh produce. However, the effect of these practices has not been characterized. Using a quantitative microbial risk model, we evaluated the individual and combined effect of farm-based hand hygiene and worker furlough practices on the maximum risk of norovirus infection from three produce commodities (open leaf lettuce, vine tomatoes, and raspberries). Specifically, we tested two scenarios where a harvester's and packer's norovirus infection status was: 1) assumed positive; or 2) assigned based on community norovirus prevalence estimates. In the first scenario with a norovirus-positive harvester and packer, none of the individual interventions modeled reduced produce contamination to below the norovirus infectious dose. However, combined interventions, particularly high handwashing compliance (100%) and efficacy (6 log10 virus removal achieved using soap and water for 30 s), reduced produce contamination to <1-82 residual virus. Translating produce contamination to maximum consumer infection risk, 100% handwashing with a 5 log10 virus removal was necessary to achieve an infection risk below the threshold of 0.032 infections per consumption event. When community-based norovirus prevalence estimates were applied to the harvester and packer, the single interventions of 100% handwashing with 3 log10 virus removal (average 0.02 infection risk per consumption event) or furlough of the packer (average 0.03 infection risk per consumption event) reduced maximum infection risk to below the 0.032 threshold for all commodities. Bundled interventions (worker furlough, 100% glove compliance, and 100% handwashing with 1-log10 virus reduction) resulted in a maximum risk of 0.02 per consumption event across all commodities. These results advance the evidence-base for global produce safety standards as effective norovirus contamination and risk mitigation strategies.
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Affiliation(s)
- Julia S Sobolik
- Emory University, Gangarosa Department of Environmental Health, Atlanta, GA 30322, USA.
| | - Kira L Newman
- Emory University, Hubert Department of Global Health, Atlanta, GA 30322, USA
| | - Lee-Ann Jaykus
- North Carolina State University, Food, Bioprocessing, & Nutrition Sciences, Raleigh, NC 27695, USA
| | - Elizabeth A Bihn
- Cornell University, Department of Food Science, Ithaca, NY 14853, USA
| | - Juan S Leon
- Emory University, Hubert Department of Global Health, Atlanta, GA 30322, USA
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25
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Assessment of the Impact on Human Health of the Presence of Norovirus in Bivalve Molluscs: What Data Do We Miss? Foods 2021; 10:foods10102444. [PMID: 34681492 PMCID: PMC8535557 DOI: 10.3390/foods10102444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 01/22/2023] Open
Abstract
In the latest One Health ECDC EFSA technical report, Norovirus in fish and fishery products have been listed as the agent/food pair causing the highest number of strong-evidence outbreaks in the EU in 2019. This review aims to identify data gaps that must be filled in order to increase knowledge on Norovirus in bivalve molluscs, perform a risk assessment and rank the key mitigation strategies for this biological hazard, which is relevant to public health. Virologic determinations are not included in any of the food safety and process hygiene microbiologic criteria reflected in the current European regulations. In addition, the Escherichia coli-based indices of acceptable faecal contamination for primary production, as well as the food safety criteria, do not appear sufficient to indicate the extent of Norovirus contamination. The qualitative risk assessment data collected in this review suggests that bivalve molluscs present a high risk to human health for Norovirus only when consumed raw or when insufficiently cooked. On the contrary, the risk can be considered negligible when they are cooked at a high temperature, while information is still scarce for non-thermal treatments.
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26
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Wilson AM, King M, López‐García M, Clifton IJ, Proctor J, Reynolds KA, Noakes CJ. Effects of patient room layout on viral accruement on healthcare professionals' hands. INDOOR AIR 2021; 31:1657-1672. [PMID: 33913202 PMCID: PMC8242823 DOI: 10.1111/ina.12834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/25/2021] [Accepted: 03/23/2021] [Indexed: 05/16/2023]
Abstract
Healthcare professionals (HCPs) are exposed to highly infectious viruses, such as norovirus, through multiple exposure routes. Understanding exposure mechanisms will inform exposure mitigation interventions. The study objective was to evaluate the influences of hospital patient room layout on differences in HCPs' predicted hand contamination from deposited norovirus particles. Computational fluid dynamic (CFD) simulations of a hospital patient room were investigated to find differences in spatial deposition patterns of bioaerosols for right-facing and left-facing bed layouts under different ventilation conditions. A microbial transfer model underpinned by observed mock care for three care types (intravenous therapy (IV) care, observational care, and doctors' rounds) was applied to estimate HCP hand contamination. Viral accruement was contrasted between room orientation, care type, and by assumptions about whether bioaerosol deposition was the same or variable by room orientation. Differences in sequences of surface contacts were observed for care type and room orientation. Simulated viral accruement differences between room types were influenced by mostly by differences in bioaerosol deposition and by behavior sequences when deposition patterns for the room orientations were similar. Differences between care types were likely driven by differences in hand-to-patient contact frequency, with doctors' rounds resulting in the greatest predicted viral accruement on hands.
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Affiliation(s)
- Amanda M. Wilson
- Rocky Mountain Center for Occupational and Environmental HealthUniversity of UtahSalt Lake CityUTUSA
- Department of Family and Preventive MedicineSchool of MedicineUniversity of UtahSalt Lake CityUTUSA
- Department of Community, Environment, & PolicyMel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonAZUSA
| | | | | | - Ian J. Clifton
- The Leeds Regional Adult Cystic Fibrosis CentreSt. James's University HospitalLeeds Teaching Hospital NHS TrustLeedsUK
| | | | - Kelly A. Reynolds
- Department of Community, Environment, & PolicyMel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonAZUSA
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27
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Zhiteneva V, Carvajal G, Shehata O, Hübner U, Drewes JE. Quantitative microbial risk assessment of a non-membrane based indirect potable water reuse system using Bayesian networks. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 780:146462. [PMID: 33774303 DOI: 10.1016/j.scitotenv.2021.146462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
Risk-based approaches are used to define performance standards for water and wastewater treatment to meet health-based targets and to ensure safe and reliable water quality for desired end use. In this study, a screening level QMRA for a non-membrane based indirect potable reuse (IPR) system utilizing the sequential managed aquifer recharge technology (SMART) concept was conducted. Ambient removals of norovirus, Campylobacter and Cryptosporidium in advanced water treatment (AWT) steps were combined in a probabilistic QMRA utilizing Bayesian networks constructed in Netica. Results revealed that all pathogens complied with disease burden at the 95th percentile, and according to the assumptions taken about pathogen removal, Cryptosporidium was the pathogen with the greatest risk. Through systematic sensitivity analysis, targeted scenario analysis, and backwards inferencing, critical control points for each pathogen were determined, demonstrating the usefulness of Bayesian networks as a diagnostic tool in quantifying risk of water reuse treatment scenarios.
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Affiliation(s)
- Veronika Zhiteneva
- Chair of Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, 85748 Garching, Germany
| | - Guido Carvajal
- Facultad de Ingeniería, Universidad Andrés Bello, Antonio Varas 880, Providencia, Santiago, Chile
| | - Omar Shehata
- Chair of Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, 85748 Garching, Germany
| | - Uwe Hübner
- Chair of Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, 85748 Garching, Germany.
| | - Jörg E Drewes
- Chair of Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, 85748 Garching, Germany
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28
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Kang MS, Park JH, Kim HJ. Predictive Modeling for the Growth of Salmonella spp. in Liquid Egg White and Application of Scenario-Based Risk Estimation. Microorganisms 2021; 9:microorganisms9030486. [PMID: 33669000 PMCID: PMC7996612 DOI: 10.3390/microorganisms9030486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 12/20/2022] Open
Abstract
The objective of the study was to develop a predictive model of Salmonella spp. growth in pasteurized liquid egg white (LEW) and to estimate the salmonellosis risk using the baseline model and scenario analysis. Samples were inoculated with six strains of Salmonella, and bacterial growth was observed during storage at 10–37 °C. The primary models were developed using the Baranyi model for LEW. For the secondary models, the obtained specific growth rate (μmax) and lag phase duration were fitted to a square root model and Davey model, respectively, as functions of temperature (R2 ≥ 0.98). For μmax, the values were satisfied within an acceptable range (Af, Bf: 0.70–1.15). The probability of infection (Pinf) due to the consumption of LEW was zero in the baseline model. However, scenario analysis suggested possible salmonellosis for the consumption of LEW. Because Salmonella spp. proliferated much faster in LEW than in egg white (EW) during storage at 20 and 30 °C (p < 0.01), greater Pinf may be obtained for LEW when these products are stored at the same conditions. The developed predictive model can be applied to the risk management of Salmonella spp. along the food chain, including during product storage and distribution.
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Affiliation(s)
- Mi Seon Kang
- Korea Food Research Institute, Wanju, Jeollabuk-do 55365, Korea; (M.S.K.); (J.H.P.)
- Department of Food Biotechnology, University of Science and Technology, Daejeon 34113, Korea
| | - Jin Hwa Park
- Korea Food Research Institute, Wanju, Jeollabuk-do 55365, Korea; (M.S.K.); (J.H.P.)
| | - Hyun Jung Kim
- Korea Food Research Institute, Wanju, Jeollabuk-do 55365, Korea; (M.S.K.); (J.H.P.)
- Department of Food Biotechnology, University of Science and Technology, Daejeon 34113, Korea
- Correspondence: ; Tel.: +82-63-219-9271
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29
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Holcomb D, Palli L, Setty K, Uprety S. Water and health seminar and special issue highlight ideas that will change the field. Int J Hyg Environ Health 2021; 234:113716. [PMID: 33639583 DOI: 10.1016/j.ijheh.2021.113716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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30
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Holcomb D, Palli L, Setty K, Uprety S. Water and health seminar and special issue highlight ideas that will change the field. Int J Hyg Environ Health 2021; 226:113529. [PMID: 32307040 DOI: 10.1016/j.ijheh.2020.113529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Seis W, Rouault P, Medema G. Addressing and reducing parameter uncertainty in quantitative microbial risk assessment by incorporating external information via Bayesian hierarchical modeling. WATER RESEARCH 2020; 185:116202. [PMID: 32738602 DOI: 10.1016/j.watres.2020.116202] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 07/17/2020] [Accepted: 07/18/2020] [Indexed: 06/11/2023]
Abstract
Probabilistic quantitative microbial risk assessment (QMRA) studies define model inputs as random variables and use Monte-Carlo simulation to generate distributions of potential risk outcomes. If local information on important QMRA model inputs is missing, it is widely accepted to justify assumptions about these model inputs by using external literature information. A question, which remains unexplored, is the extent to which previously published external information should influence local estimates in cases of nonexistent, scarce, and moderate local data. This question can be addressed by employing Bayesian hierarchical modeling (BHM). Thus, we study the effects and potential benefits of BHM on risk and performance target calculations at three wastewater treatment plants (WWTP) in comparison to alternative statistical modeling approaches (separate modeling, no-pooling, complete pooling). The treated wastewater from the WWTPs is used for restricted irrigation, potable reuse, or influences recreational waters, respectively. We quantify the extent to which external data affects local risk estimations in each case depending on the statistical modeling approach applied. Modeling approaches are compared by calculating the pointwise expected log-predictive density for each model. As reference pathogens and example data, we use locally collected Norovirus genogroup II data with varying sample sizes (n = 4, n = 7, n = 27), and complement local information with external information from 44 other WWTPs (n = 307). Results indicate that BHM shows the highest predictive accuracy and improves estimates by reducing parameter uncertainty when data are scarce. In such situations, it may affect risk and performance target calculations by orders of magnitude in comparison to using local data alone. Furthermore, it allows making generalizable inferences about new WWTPs, while providing the necessary flexibility to adjust for different levels of information contained in the local data. Applying this flexible technique more widely may contribute to improving methods and the evidence base for decision-making in future QMRA studies.
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Affiliation(s)
- Wolfgang Seis
- Kompetenzzentrum Wasser Berlin gGmbH, Cicerostraße 24, 10709, Berlin, Germany; Delft University of Technology, The Netherlands.
| | - Pascale Rouault
- Kompetenzzentrum Wasser Berlin gGmbH, Cicerostraße 24, 10709, Berlin, Germany
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32
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Simhon A, Pileggi V, Flemming CA, Lai G, Manoharan M. Norovirus risk at a golf course irrigated with reclaimed water: Should QMRA doses be adjusted for infectiousness? WATER RESEARCH 2020; 183:116121. [PMID: 32877809 DOI: 10.1016/j.watres.2020.116121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
About 25 golf courses in Ontario, Canada have environmental compliance approvals to use reclaimed water for irrigation, where disinfection is confirmed through E. coli limits. A previous study at five Ontario municipal wastewater treatment plants (WWTPs) confirmed that enteric viruses are less susceptible to disinfection than E. coli, when plants provided conventional (secondary or tertiary) treatment and routine (chlorine or UV) disinfection. Here we query whether these four treatment-disinfection scenarios plus 60-day lagoon storage of disinfected effluent would be sufficient to reduce norovirus genogroups I and II (NoV GI and GII) risk of infection to tolerable levels for a golfer who incidentally ingests NoV after handling wet golf balls at a golf course irrigated with reclaimed water. We used our RT-qPCR NoV enumeration datasets from the four treatment-disinfection scenarios above and modeled detected and non-detected NoV by Bayesian inference in 'R'. Monte Carlo simulation included pre-disinfection NoV GI and GII gene copy densities; Ontario WWTP-derived chlorine and UV log10 reductions; literature-derived effluent storage decay parameters and golfer ingested volumes, followed by six different NoV dose-response (DR) models. Quantitative Microbial Risk Assessment (QMRA) results suggest that there is an unacceptable NoV infection risk when using the conservative assumption that all detected NoV particles (RT-qPCR gene copies) are infectious, in both aggregated or disaggregated form. However, after adjusting for PCR target sequences and for infectiousness using data from recently published studies on cultivation of human NoV in human intestinal enteroids, we noted a significant reduction of infection risk. However, this less conservative (i.e., less protective) assumption for water reuse applications such as golf course irrigation may not be corroborated until human NoV are efficiently and routinely grown in cell cultures. In addition, further studies on drivers of NoV risk estimation by DR models are needed, e.g., the extent of NoV particle aggregation resulting from wastewater treatment, as well as the role of immunity. Meantime, regulatory agencies could consider more stringent treatment-disinfection requirements that target enteric viruses rather than E. coli and testing of actual reclaimed irrigation waters.
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Affiliation(s)
- Albert Simhon
- Ontario Ministry of the Environment, Conservation and Parks, Technical Assessment and Standards Development Branch, 40 St. Clair Ave. West, 7th Floor, Toronto, ON, M4V 1M2, Canada.
| | - Vince Pileggi
- Ontario Ministry of the Environment, Conservation and Parks, Technical Assessment and Standards Development Branch, 40 St. Clair Ave. West, 7th Floor, Toronto, ON, M4V 1M2, Canada.
| | - Cecily A Flemming
- Ontario Ministry of the Environment, Conservation and Parks, Technical Assessment and Standards Development Branch, 40 St. Clair Ave. West, 7th Floor, Toronto, ON, M4V 1M2, Canada.
| | - George Lai
- Ontario Ministry of the Environment, Conservation and Parks, Technical Assessment and Standards Development Branch, 40 St. Clair Ave. West, 7th Floor, Toronto, ON, M4V 1M2, Canada.
| | - Mano Manoharan
- Ontario Ministry of the Environment, Conservation and Parks, Technical Assessment and Standards Development Branch, 40 St. Clair Ave. West, 7th Floor, Toronto, ON, M4V 1M2, Canada.
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Chacón L, Barrantes K, Santamaría-Ulloa C, Solano M, Reyes L, Taylor L, Valiente C, Symonds EM, Achí R. A Somatic Coliphage Threshold Approach To Improve the Management of Activated Sludge Wastewater Treatment Plant Effluents in Resource-Limited Regions. Appl Environ Microbiol 2020; 86:e00616-20. [PMID: 32591380 PMCID: PMC7440787 DOI: 10.1128/aem.00616-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/06/2020] [Indexed: 11/20/2022] Open
Abstract
Effective wastewater management is crucial to ensure the safety of water reuse projects and effluent discharge into surface waters. Multiple studies have demonstrated that municipal wastewater treatment with conventional activated sludge processes is inefficient for the removal of a wide spectrum of viruses in sewage. In this study, a well-accepted statistical approach was used to investigate the relationship between viral indicators and human enteric viruses during wastewater treatment in a resource-limited region. Influent and effluent samples from five urban wastewater treatment plants (WWTPs) in Costa Rica were analyzed for somatic coliphage and human enterovirus, hepatitis A virus, norovirus genotypes I and II, and rotavirus. All WWTPs provide primary treatment followed by conventional activated sludge treatment prior to discharge into surface waters that are indirectly used for agricultural irrigation. The results revealed a statistically significant relationship between the detection of at least one of the five human enteric viruses and somatic coliphage. Multiple logistic regression and receiver operating characteristic curve analysis identified a threshold of 3.0 × 103 (3.5 log10) somatic coliphage PFU per 100 ml, which corresponded to an increased likelihood of encountering enteric viruses above the limit of detection (>1.83 × 102 virus targets/100 ml). Additionally, quantitative microbial risk assessment was executed for farmers indirectly reusing WWTP effluent that met the proposed threshold. The resulting estimated median cumulative annual disease burden complied with World Health Organization recommendations. Future studies are needed to validate the proposed threshold for use in Costa Rica and other regions.IMPORTANCE Effective wastewater management is crucial to ensure safe direct and indirect water reuse; nevertheless, few countries have adopted the virus log reduction value management approach established by the World Health Organization. In this study, we investigated an alternative and/or complementary approach to the virus log reduction value framework for the indirect reuse of activated sludge-treated wastewater effluent. Specifically, we employed a well-accepted statistical approach to identify a statistically sound somatic coliphage threshold value which corresponded to an increased likelihood of human enteric virus detection. This study demonstrates an alternative approach to the virus log reduction value framework which can be applied to improve wastewater reuse practices and effluent management.
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Affiliation(s)
- Luz Chacón
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Kenia Barrantes
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Carolina Santamaría-Ulloa
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Melissa Solano
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Liliana Reyes
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Lizeth Taylor
- College of Microbiology (Facultad de Microbiología), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Carmen Valiente
- National Water Laboratory (Laboratorio Nacional de Aguas), Costa Rican Institute of Aqueducts and Sewerage (Instituto Costarricense de Acueductos y Alcantarillados), Tres Ríos, Costa Rica
| | - Erin M Symonds
- College of Marine Science, University of South Florida, St. Petersburg, Florida, USA
| | - Rosario Achí
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
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Noroviruses are highly infectious but there is strong variation in host susceptibility and virus pathogenicity. Epidemics 2020; 32:100401. [PMID: 32721875 DOI: 10.1016/j.epidem.2020.100401] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 06/18/2020] [Accepted: 07/14/2020] [Indexed: 02/06/2023] Open
Abstract
Noroviruses are a major public health concern: their high infectivity and environmental persistence have been documented in several studies. Genetic sequencing shows that noroviruses are highly variable, and exhibit rapid evolution. A few human challenge studies have been performed with norovirus, leading to estimates of their infectivity. However, such incidental estimates do not provide insight into the biological variation of the virus and the interaction with its human host. To study the variation in infectivity and pathogenicity of norovirus, multiple challenge studies must be analysed jointly, to compare their differences and describe how virus infectivity and host susceptibility vary. Since challenge studies can only provide a small sample of the diversity in the natural norovirus population, outbreaks should be exploited as an additional source of information. The present study shows how challenge studies and 'natural experiments' can be combined in a multilevel dose response framework. Infectivity and pathogenicity are analysed by secretor status as a host factor, and genogroup as a pathogen factor. Infectivity, characterized as the estimated mean infection risk when exposed to 1 genomic copy (qPCR unit)is 0.28 for GI norovirus, and 0.076 for GII virus, both in Se+ subjects. The corresponding risks of acute enteric illness are somewhat lower, about 0.2 (GI) and 0.035 (GII), in outbreaks. Se- subjects are protected, with substantially lower risks of infection (0.00007 and 0.015 at a dose of 1 GC of GI and GII virus, respectively). The present study shows there is considerable variability in risk of infection and especially risk of acute symptoms following infection with norovirus. These challenge and outbreak data consistently indicate high infectivity among secretor positives and protection in secretor negatives.
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Wilson AM, Reynolds KA, Jaykus LA, Escudero-Abarca B, Gerba CP. Comparison of estimated norovirus infection risk reductions for a single fomite contact scenario with residual and nonresidual hand sanitizers. Am J Infect Control 2020; 48:538-544. [PMID: 31676157 DOI: 10.1016/j.ajic.2019.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND The purpose of this study was to relate experimentally measured log10 human norovirus reductions for a nonresidual (60% ethanol) and a residual (quaternary ammonium-based) hand sanitizer to infection risk reductions. METHODS Human norovirus log10 reductions on hands for both sanitizers were experimentally measured using the ASTM International Standard E1838-10 method, with modification. Scenarios included product application to: (1) inoculated fingerpads with 30- and 60-second contact times, and (2) hands followed by inoculation with human norovirus immediately and 4 hours later. Hand sanitizer efficacies were used in a mathematical model estimating norovirus infection risk from a single hand-to-fomite contact under low and high environmental contamination conditions. RESULTS The largest log10 reductions for the residual and nonresidual hand sanitizers were for a 60-second contact time, reducing infection risk by approximately 99% and 85%, respectively. Four hours after application, the residual hand sanitizer reduced infection risks by 78.5% under high contamination conditions, whereas the nonresidual hand sanitizer offered no reduction. DISCUSSION Log10 virus and infection risk reductions were consistently greater for the residual hand sanitizer under all scenarios. Further data describing residual hand sanitizer efficacy with additional contamination or tactile events are needed. CONCLUSIONS Residual antinoroviral hand sanitizers may reduce infection risks for up to 4 hours.
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Human Health Risks Associated with Recreational Waters: Preliminary Approach of Integrating Quantitative Microbial Risk Assessment with Microbial Source Tracking. WATER 2020. [DOI: 10.3390/w12020327] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Gastrointestinal (GI) illness risks associated with exposure to waters impacted by human and nonhuman fecal sources were estimated using quantitative microbial risk assessment (QMRA). Microbial source tracking (MST) results had identified Escherichia coli (E. coli) contributors to the waterbody as human and unidentified (10%), cattle and domestic animals (25%), and wildlife (65%) in a rural watershed. The illness risks associated with ingestion during recreation were calculated by assigning reference pathogens for each contributing source and using pathogen dose–response relationships. The risk of GI illness was calculated for a specific sampling site with a geometric mean of E. coli of 163 colony forming units (cfu) 100 mL−1, and the recreational standard of E. coli, 126 cfu 100 mL−1. While the most frequent sources of fecal indicator bacteria at the sampling site were nonhuman, the risk of illness from norovirus, the reference pathogen representing human waste, contributed the greatest risk to human health. This study serves as a preliminary review regarding the potential for incorporating results from library-dependent MST to inform a QMRA for recreational waters. The simulations indicated that identifying the sources contributing to the bacterial impairment is critical to estimate the human health risk associated with recreation in a waterbody.
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Randazzo W, Piqueras J, Evtoski Z, Sastre G, Sancho R, Gonzalez C, Sánchez G. Interlaboratory Comparative Study to Detect Potentially Infectious Human Enteric Viruses in Influent and Effluent Waters. FOOD AND ENVIRONMENTAL VIROLOGY 2019; 11:350-363. [PMID: 31154654 DOI: 10.1007/s12560-019-09392-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/27/2019] [Indexed: 05/18/2023]
Abstract
Wastewater represents the main reusable water source after being adequately sanitized by wastewater treatment plants (WWTPs). In this sense, only bacterial quality indicators are usually checked to this end, and human pathogenic viruses usually escape from both sanitization procedures and controls, posing a health risk on the use of effluent waters. In this study, we evaluated a protocol based on aluminum adsorption-precipitation to concentrate several human enteric viruses, including norovirus genogroup I (NoV GI), NoV GII, hepatitis A virus (HAV), astrovirus (HAstV), and rotavirus (RV), with limits of detection of 4.08, 4.64, 5.46 log genomic copies (gc)/L, 3.31, and 5.41 log PCR units (PCRU)/L, respectively. Furthermore, the method was applied in two independent laboratories to monitor the presence of NoV GI, NoV GII, and HAV in effluent and influent waters collected from five WWTPs at two different sampling dates. Concomitantly, a viability PMAxx-RT-qPCR was applied to all the samples to get information on the potential infectivity of both influent and effluent waters. The ranges of the titers in influent waters for NoV GI, NoV GII, RV, and HAstV were 4.80-7.56, 5.19-7.31 log gc/L, 5.41-6.52, and 4.59-7.33 log PCRU/L, respectively. In effluent waters, the titers ranged between 4.08 and 6.27, 4.64 and 6.08 log gc/L, < 5.51, and between 3.31 and 5.58 log PCRU/L. Moreover, the viral titers detected by viability RT-qPCR showed statistical differences with RT-qPCR alone, suggesting the potential viral infectivity of the samples despite some observed reductions. The proposed method could be applied in ill-equipped laboratories, due to the lack of a requirement for a specific apparatus (i.e., ultracentrifuge).
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Affiliation(s)
- Walter Randazzo
- Department of Microbiology and Ecology, University of Valencia, Av. Dr. Moliner, 50, Burjassot, 46100, Valencia, Spain.
- Department of Preservation and Food Safety Technologies, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain.
| | | | - Zoran Evtoski
- Department of Preservation and Food Safety Technologies, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain
- Department of Life, Health and Environmental Sciences, University of L'Aquila, P.le Salvatore Tommasi, 1, 67100, L'Aquila, Italy
| | | | - Raquel Sancho
- GAMASER, Isaac Peral, 4, Paterna, 46980, Valencia, Spain
| | | | - Gloria Sánchez
- Department of Preservation and Food Safety Technologies, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain.
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Soller JA, Eftim SE, Nappier SP. Comparison of Predicted Microbiological Human Health Risks Associated with de Facto, Indirect, and Direct Potable Water Reuse. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2019; 53:13382-13389. [PMID: 31577425 PMCID: PMC7155932 DOI: 10.1021/acs.est.9b02002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Increasing interest in recycling water for potable purposes makes understanding the risks associated with potential acute microbial hazards important. We compared risks from de facto reuse, indirect potable reuse (IPR), and direct potable reuse (DPR) scenarios using a previously published quantitative microbial risk assessment methodology and literature review results. The de facto reuse simulation results are compared to a Cryptosporidium spp. database collected for the Long Term 2 Enhanced Surface Water Treatment Rule's information collection rule (ICR) and to a literature review of norovirus (NoV) densities in ambient surface waters. The de facto simulation results with a treated wastewater effluent contribution of 1% in surface waters and a residence time of 30 days most closely match the ICR dataset. The de facto simulations also suggest that using NoV monitoring data from surface waters may overestimate microbial risks, compared to NoV data from raw sewage coupled with wastewater treatment reduction estimates. The predicted risks from IPR and DPR are consistently lower than those for the de facto reuse scenarios assuming the AWTFs are operating within design specifications. These analyses provide insight into the microbial risks associated with various potable reuse scenarios and highlight the need to carefully consider drinking water treatment choices when wastewater effluent is a component of any drinking water supply.
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Affiliation(s)
- Jeffrey A Soller
- Soller Environmental, LLC , 3022 King Street , Berkeley , California 94703 , United States
| | - Sorina E Eftim
- ICF, LLC , 9300 Lee Highway , Fairfax , Virginia 22031 , United States
| | - Sharon P Nappier
- US Environmental Protection Agency, Office of Water, Office of Science and Technology , 1200 Pennsylvania Avenue, NW , Washington , District of Columbia 20460 , United States
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Sunger N, Hamilton KA, Morgan PM, Haas CN. Comparison of pathogen-derived 'total risk' with indicator-based correlations for recreational (swimming) exposure. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:30614-30624. [PMID: 29644614 DOI: 10.1007/s11356-018-1881-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/26/2018] [Indexed: 05/03/2023]
Abstract
Typical recreational water risk to swimmers is assessed using epidemiologically derived correlations by means of fecal indicator bacteria (FIB). It has been documented that concentrations of FIB do not necessarily correlate well with protozoa and viral pathogens, which pose an actual threat of illness and thus sometimes may not adequately assess the overall microbial risks from water resources. Many of the known pathogens have dose-response relationships; however, measuring water quality for all possible pathogens is impossible. In consideration of a typical freshwater receiving secondarily treated effluent, we investigated the level of consistency between the indicator-derived correlations and the sum of risks from six reference pathogens using a quantitative microbial risk assessment (QMRA) approach. Enterococci and E. coli were selected as the benchmark FIBs, and norovirus, human adenovirus (HAdV), Campylobacter jejuni, Salmonella enterica, Cryptosporidium spp., and Giardia spp. were selected as the reference pathogens. Microbial decay rates in freshwater and uncertainties in exposure relationships were considered in developing our analysis. Based on our exploratory assessment, the total risk was found within the range of risk estimated by the indicator organisms, with viral pathogens as dominant risk agents, followed by protozoan and bacterial pathogens. The risk evaluated in this study captured the likelihood of gastrointestinal illnesses only, and did not address the overall health risk potential of recreational waters with respect to other disease endpoints. Since other highly infectious pathogens like hepatitis A and Legionella spp. were not included in our analysis, these estimates should be interpreted with caution.
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Affiliation(s)
- Neha Sunger
- Department of Health, West Chester University, 855 South New Street, West Chester, PA, 19383, USA.
| | - Kerry A Hamilton
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, 251 Curtis Hall, 3141 Chestnut St, Philadelphia, PA, 19104, USA
| | - Paula M Morgan
- Department of Health, West Chester University, 855 South New Street, West Chester, PA, 19383, USA
| | - Charles N Haas
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, 251 Curtis Hall, 3141 Chestnut St, Philadelphia, PA, 19104, USA
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Zhang Q, Gallard J, Wu B, Harwood VJ, Sadowsky MJ, Hamilton KA, Ahmed W. Synergy between quantitative microbial source tracking (qMST) and quantitative microbial risk assessment (QMRA): A review and prospectus. ENVIRONMENT INTERNATIONAL 2019; 130:104703. [PMID: 31295713 DOI: 10.1016/j.envint.2019.03.051] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/21/2019] [Accepted: 03/21/2019] [Indexed: 05/20/2023]
Abstract
The use of microbial source tracking (MST) marker genes has grown in recent years due to the need to attribute point and non-point fecal contamination to specific sources. Quantitative microbial risk assessment (QMRA) is a modeling approach used to estimate health risks from exposure to feces-contaminated water and associated pathogens. A combination of these approaches [quantitative MST (qMST) and QMRA] can provide additional pathogen-related information for prioritizing and addressing health risks, compared to reliance on conventional fecal indicator bacteria (FIB). To inform expansion of this approach, a review of published qMST-QMRA studies was conducted to summarize the state of the science and to identify research needs. The reviewed studies primarily aimed to identify what levels of MST marker genes in hypothetical recreational waterbodies would exceed the United States Environmental Protection Agency (USEPA) risk benchmarks for primary contact recreators. The QMRA models calculated relationships between MST marker gene(s) and reference pathogens based on published data in the literature. The development of a robust, accurate relationship was identified as an urgent research gap for qMST-QMRA. This metric requires additional knowledge to quantify the relationship between MST marker genes and the degree of variability in decay of pathogens as a dynamic function of environmental conditions and combinations of fecal sources at multiple spatial and temporal scales. Improved characterization of host shedding rates of host-associated microorganisms (i.e., MST marker genes), as well as fate and transport of these microorganisms and their nucleic acids, would facilitate expansion of this approach to other exposure pathways. Incorporation of information regarding the recovery efficiency, and host-specificity of MST marker genes into QMRA model parameters, and the sensitivity analysis, would greatly improve risk management and site-specific water monitoring criteria.
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Affiliation(s)
- Qian Zhang
- BioTechnology Institute, University of Minnesota, 1479 Gortner Ave, St. Paul, MN 55108, USA
| | - Javier Gallard
- Department of Integrative Biology, SCA 110, University of South Florida, 4202 East Fowler Ave, Tampa, FL 33620, USA
| | - Baolei Wu
- School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, No. 13 Yanta Road, Xi'an, Shaanxi 710055, PR China
| | - Valerie J Harwood
- Department of Integrative Biology, SCA 110, University of South Florida, 4202 East Fowler Ave, Tampa, FL 33620, USA
| | - Michael J Sadowsky
- BioTechnology Institute, University of Minnesota, 1479 Gortner Ave, St. Paul, MN 55108, USA; Department of Soil, Water & Climate and Department of Plant & Microbial Biology, University of Minnesota, 1991 Upper Buford Ave, St. Paul, MN 55108, USA
| | - Kerry A Hamilton
- School for Sustainable Engineering and the Built Environment, Arizona State University, 660 S College Ave, Tempe, AZ 85281, USA; The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S McAllister Ave, Tempe, AZ 85281, USA
| | - Warish Ahmed
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, QLD 4102, Australia.
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Abstract
The European Commission requested scientific technical assistance for the analysis of a European Union coordinated monitoring programme on the prevalence of norovirus in raw oysters. A total of 2,180 valid samples were taken from production areas and 2,129 from dispatch centres, taken over two consecutive years, ensuring the precision and the confidence desired in the estimation. The prevalence at production areas was estimated to be 34.5% (CI: 30.1-39.1%), while for batches from dispatch centres it was 10.8% (CI: 8.2-14.4%). The analyses show a strong seasonal effect, with higher contamination in the period November to April, as well as lower contamination for Class A areas than other classes. These associations were observed in both production areas and batches from dispatch centres. The results for both genogroups were above the respective limit of quantification (LOQ) in less than 10% of the samples taken. The simple substitution of not-detected and positive samples below the LOQ, by half of the limit of detection and half of the LOQ, respectively, produced estimates of the proportion of samples above or equal to 300 copies per gram (cpg) comparable to the statistical model. The current bacteriological microbiological criteria applicable to live bivalve molluscs might be complemented by a norovirus criterion. The analyses of the substitution approach show that selection of a potential limit within a microbiological criterion close to or lower than the LOQ (for example, less than 300 cpg, given the current test used in this survey) would be difficult to apply. This survey only assessed thresholds from the perspective of the analytical capability and not that of human health risk.
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Nappier SP, Soller JA, Eftim SE. Potable Water Reuse: What Are the Microbiological Risks? Curr Environ Health Rep 2019; 5:283-292. [PMID: 29721701 DOI: 10.1007/s40572-018-0195-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW With the increasing interest in recycling water for potable reuse purposes, it is important to understand the microbial risks associated with potable reuse. This review focuses on potable reuse systems that use high-level treatment and de facto reuse scenarios that include a quantifiable wastewater effluent component. RECENT FINDINGS In this article, we summarize the published human health studies related to potable reuse, including both epidemiology studies and quantitative microbial risk assessments (QMRA). Overall, there have been relatively few health-based studies evaluating the microbial risks associated with potable reuse. Several microbial risk assessments focused on risks associated with unplanned (or de facto) reuse, while others evaluated planned potable reuse, such as indirect potable reuse (IPR) or direct potable reuse (DPR). The reported QMRA-based risks for planned potable reuse varied substantially, indicating there is a need for risk assessors to use consistent input parameters and transparent assumptions, so that risk results are easily translated across studies. However, the current results overall indicate that predicted risks associated with planned potable reuse scenarios may be lower than those for de facto reuse scenarios. Overall, there is a clear need to carefully consider water treatment train choices when wastewater is a component of the drinking water supply (whether de facto, IPR, or DPR). More data from full-scale water treatment facilities would be helpful to quantify levels of viruses in raw sewage and reductions across unit treatment processes for both culturable and molecular detection methods.
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Affiliation(s)
- Sharon P Nappier
- U.S. Environmental Protection Agency, Office of Water, Office of Science and Technology, 1200 Pennsylvania Avenue, NW, Washington, DC, 20460, USA.
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Capsid Integrity qPCR—An Azo-Dye Based and Culture-Independent Approach to Estimate Adenovirus Infectivity after Disinfection and in the Aquatic Environment. WATER 2019. [DOI: 10.3390/w11061196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Recreational, reclaimed and drinking source waters worldwide are under increasing anthropogenic pressure, and often contain waterborne enteric bacterial, protozoan, and viral pathogens originating from non-point source fecal contamination. Recently, the capsid integrity (ci)-qPCR, utilizing the azo-dyes propidium monoazide (PMA) or ethidium monoazide (EMA), has been shown to reduce false-positive signals under laboratory conditions as well as in food safety applications, thus improving the qPCR estimation of virions of public health significance. The compatibility of two widely used human adenovirus (HAdV) qPCR protocols was evaluated with the addition of a PMA/EMA pretreatment using a range of spiked and environmental samples. Stock suspensions of HAdV were inactivated using heat, UV, and chlorine before being quantified by cell culture, qPCR, and ci-qPCR. Apparent inactivation of virions was detected for heat and chlorine treated HAdV while there was no significant difference between ci-qPCR and qPCR protocols after disinfection by UV. In a follow-up comparative analysis under more complex matrix conditions, 51 surface and 24 wastewater samples pre/post UV treatment were assessed for enteric waterborne HAdV to evaluate the ability of ci-qPCR to reduce the number of false-positive results when compared to conventional qPCR and cell culture. Azo-dye pretreatment of non-UV inactivated samples was shown to improve the ability of molecular HAdV quantification by reducing signals from virions with an accessible genome, thereby increasing the relevance of qPCR results for public health purposes, particularly suited to resource-limited low and middle-income settings.
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Masciopinto C, De Giglio O, Scrascia M, Fortunato F, La Rosa G, Suffredini E, Pazzani C, Prato R, Montagna MT. Human health risk assessment for the occurrence of enteric viruses in drinking water from wells: Role of flood runoff injections. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 666:559-571. [PMID: 30807946 DOI: 10.1016/j.scitotenv.2019.02.107] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/06/2019] [Accepted: 02/07/2019] [Indexed: 05/18/2023]
Abstract
We demonstrated that floods can induce severe microbiological contamination of drinking water from wells and suggest strategies to better address water safety plans for groundwater drinking supplies. Since 2002, the Italian Water Research Institute (IRSA) has detected hepatitis A virus, adenovirus, rotavirus, norovirus, and enterovirus in water samples from wells in the Salento peninsula, southern Italy. Perturbations in the ionic strength in water flow can initiate strong virus detachments from terra rossa sediments in karst fractures. This study therefore explored the potential health impacts of prolonged runoff injections in Salento groundwater caused by severe flooding during October 2018. A mathematical model for virus fate and transport in fractures was applied to determine the impact of floodwater injection on groundwater quality by incorporating mechanisms that affect virus attachment/detachment and survival in flowing water at microscale. This model predicted target concentrations of enteric viruses that can occur unexpectedly in wells at considerable distances (5-8 km) from the runoff injection site (sinkhole). Subsequently, the health impact of viruses in drinking water supplied from contaminated wells was estimated during the summer on the Salento coast. Specific unpublished dose-response model coefficients were proposed to determine the infection probabilities for Echo-11 and Polio 1 enteroviruses through ingestion. The median (50%) risk of infection was estimated at 6.3 · 10-3 with an uncertainty of 23%. The predicted burden of diseases was 4.89 disability adjusted life years per year, i.e., twice the maximum tolerable disease burden. The results highlight the requirement for additional water disinfection treatments in Salento prior to the distribution of drinking water. Moreover, monthly controls of enteric virus occurrence in water from wells should be imposed by a new water framework directive in semiarid regions because of the vulnerability of karst carbonate aquifers to prolonged floodwater injections and enteric virus contamination.
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Affiliation(s)
- Costantino Masciopinto
- Consiglio Nazionale delle Ricerche, Istituto di Ricerca Sulle Acque (IRSA), Reparto di Chimica e Tecnologia delle Acque, Bari, Italy.
| | - Osvalda De Giglio
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi Aldo Moro, Bari, Italy
| | - Maria Scrascia
- Dipartimento di Biologia, Università degli Studi Aldo Moro, Bari, Italy
| | | | - Giuseppina La Rosa
- Dipartimento Ambiente e Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Elisabetta Suffredini
- Dipartimento di Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Roma, Italy
| | - Carlo Pazzani
- Dipartimento di Biologia, Università degli Studi Aldo Moro, Bari, Italy
| | - Rosa Prato
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Foggia, Italy
| | - Maria Teresa Montagna
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi Aldo Moro, Bari, Italy
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Gonzales-Gustavson E, Rusiñol M, Medema G, Calvo M, Girones R. Quantitative risk assessment of norovirus and adenovirus for the use of reclaimed water to irrigate lettuce in Catalonia. WATER RESEARCH 2019; 153:91-99. [PMID: 30703677 DOI: 10.1016/j.watres.2018.12.070] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/22/2018] [Accepted: 12/31/2018] [Indexed: 05/21/2023]
Abstract
Wastewater is an important resource in water-scarce regions of the world, and its use in agriculture requires the guarantee of acceptable public health risks. The use of fecal indicator bacteria to evaluate safety does not represent viruses, the main potential health hazards. Viral pathogens could complement the use of fecal indicator bacteria in the evaluation of water quality. In this study, we characterized the concentration and removal of human adenovirus (HAdV) and norovirus genogroup II (NoV GII), highly abundant and important viral pathogens found in wastewater, in two wastewater treatment plants (WWTPs) that use different tertiary treatments (constructed wetland vs conventional UV, chlorination and Actiflo® treatments) for a year in Catalonia. The main objective of this study was to develop a Quantitative Microbial Risk Assessment for viral gastroenteritis caused by norovirus GII and adenovirus, associated with the ingestion of lettuce irrigated with tertiary effluents from these WWTPs. The results show that the disease burden of NoV GII and HAdV for the consumption of lettuce irrigated with tertiary effluent from either WWTP was higher than the WHO recommendation of 10-6 DALYs for both viruses. The WWTP with constructed wetland showed a higher viral reduction on average (3.9 and 2.8 logs for NoV GII and HAdV, respectively) than conventional treatment (1.9 and 2.5 logs) but a higher variability than the conventional WWTP. Sensitivity analysis demonstrated that the input parameters used to estimate the viral reduction by treatment and viral concentrations accounted for much of the model output variability. The estimated reductions required to reach the WHO recommended levels in tertiary effluent are influenced by the characteristics of the treatments developed in the WWTPs, and additional average reductions are necessary (in WWTP with a constructed wetland: A total of 6.7 and 5.1 logs for NoV GII and HAdV, respectively; and in the more conventional treatment: 7 and 5.6 logs). This recommendation would be achieved with an average quantification of 0.5 genome copies per 100 mL in reclaimed water for both viruses. The results suggest that the analyzed reclaimed water would require additional treatments to achieve acceptable risk in the irrigation of vegetables with reclaimed water.
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Affiliation(s)
- Eloy Gonzales-Gustavson
- Laboratory of Virus Contaminants of Water and Food, Section of Microbiology, Virology and Biotechnology, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Avinguda Diagonal 643, 08028, Barcelona, Catalonia, Spain; Tropical and Highlands Veterinary Research Institute, School of Veterinary Medicine, San Marcos University, Carretera Central s/n, El Mantaro, Peru.
| | - Marta Rusiñol
- Laboratory of Virus Contaminants of Water and Food, Section of Microbiology, Virology and Biotechnology, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Avinguda Diagonal 643, 08028, Barcelona, Catalonia, Spain.
| | - Gertjan Medema
- KWR Watercycle Research Institute, P.O. Box 1072, 3430, BB Nieuwegein, the Netherlands; The Netherlands and Delft University of Technology, the Netherlands.
| | - Miquel Calvo
- Section of Statistics, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Avinguda Diagonal 643, 08028, Barcelona, Catalonia, Spain.
| | - Rosina Girones
- Laboratory of Virus Contaminants of Water and Food, Section of Microbiology, Virology and Biotechnology, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Avinguda Diagonal 643, 08028, Barcelona, Catalonia, Spain.
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Mohammed H, Seidu R. Climate-driven QMRA model for selected water supply systems in Norway accounting for raw water sources and treatment processes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 660:306-320. [PMID: 30640099 DOI: 10.1016/j.scitotenv.2018.12.460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/28/2018] [Accepted: 12/30/2018] [Indexed: 06/09/2023]
Abstract
Formulating effective management intervention measures for water supply systems requires investigation of potential long-term impacts. This study applies an integrated multiple regression, random forest regression, and quantitative microbial risk assessment (QMRA) modelling approach to assess the effect of climate-driven precipitation on pathogen infection risks in three drinking water treatment plants (WTPs) in Norway. Pathogen removal efficacies of treatment steps were calculated using process models. The results indicate that while the WTPs investigated generally meet the current water safety guidelines, risks of Norovirus and Cryptosporidium infection may be of concern in the future. The pathogen infections attributable to current projections of average precipitation in the study locations may be low. However, the pathogen increases in the drinking water sources due to the occurrence of extreme precipitation events in the catchments could substantially increase the risks of pathogen infections. In addition, without optimal operation of the UV disinfection steps in the WTPs, both the present and potential future infection risks could be high. Therefore, the QMRA models demonstrated the need for improved optimization of key treatment steps in the WTPs, as well as implementation of stringent regulations in protecting raw water sources in the country. The variety of models applied and the pathogen: E. coli used in the study introduce some uncertainties in the results, thus, management decisions that will be based on the results should consider these limitations. Nevertheless, the integration of predictive models with QMRA as applied in this study could be a useful method for climate impact assessment in the water supply industry.
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Affiliation(s)
- Hadi Mohammed
- Water and Environmental Engineering Group, Department of Civil Engineering, Institute for Marine Operations and Civil Engineering, Norwegian University of Science and Technology (NTNU) in Ålesund, Larsgårdsvegen 2, 6009 Ålesund, Norway.
| | - Razak Seidu
- Water and Environmental Engineering Group, Department of Civil Engineering, Institute for Marine Operations and Civil Engineering, Norwegian University of Science and Technology (NTNU) in Ålesund, Larsgårdsvegen 2, 6009 Ålesund, Norway
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Probabilistic risk model of norovirus transmission during handling and preparation of fresh produce in school foodservice operations. Int J Food Microbiol 2019; 290:159-169. [DOI: 10.1016/j.ijfoodmicro.2018.09.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 09/04/2018] [Accepted: 09/29/2018] [Indexed: 12/30/2022]
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Canales RA, Reynolds KA, Wilson AM, Fankem SLM, Weir MH, Rose JB, Abd-Elmaksoud S, Gerba CP. Modeling the role of fomites in a norovirus outbreak. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2019; 16:16-26. [PMID: 30274562 DOI: 10.1080/15459624.2018.1531131] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Norovirus accounts for a large portion of the gastroenteritis disease burden, and outbreaks have occurred in a wide variety of environments. Understanding the role of fomites in norovirus transmission will inform behavioral interventions, such as hand washing and surface disinfection. The purpose of this study was to estimate the contribution of fomite-mediated exposures to infection and illness risks in outbreaks. A simulation model in discrete time that accounted for hand-to-porous surfaces, hand-to-nonporous surfaces, hand-to-mouth, -eyes, -nose, and hand washing events was used to predict 17 hr of simulated human behavior. Norovirus concentrations originated from monitoring contamination levels on surfaces during an outbreak on houseboats. To predict infection risk, two dose-response models (fractional Poisson and 2F1 hypergeometric) were used to capture a range of infection risks. A triangular distribution describing the conditional probability of illness given an infection was multiplied by modeled infection risks to estimate illness risks. Infection risks ranged from 70.22% to 72.20% and illness risks ranged from 21.29% to 70.36%. A sensitivity analysis revealed that the number of hand-to-mouth contacts and the number of hand washing events had strong relationships with model-predicted doses. Predicted illness risks overlapped with leisure setting and environmental attack rates reported in the literature. In the outbreak associated with the viral concentrations used in this study, attack rates ranged from 50% to 86%. This model suggests that fomites may have accounted for 25% to 82% of illnesses in this outbreak. Fomite-mediated exposures may contribute to a large portion of total attack rates in outbreaks involving multiple transmission modes. The findings of this study reinforce the importance of frequent fomite cleaning and hand washing, especially when ill persons are present.
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Affiliation(s)
- Robert A Canales
- a Mel & Enid Zuckerman College of Public Health , The University of Arizona , Tucson , AZ
| | - Kelly A Reynolds
- a Mel & Enid Zuckerman College of Public Health , The University of Arizona , Tucson , AZ
| | - Amanda M Wilson
- a Mel & Enid Zuckerman College of Public Health , The University of Arizona , Tucson , AZ
| | - Sonia L M Fankem
- a Mel & Enid Zuckerman College of Public Health , The University of Arizona , Tucson , AZ
- b Department of Soil, Water, and Environmental Science , The University of Arizona , Tucson , AZ
| | - Mark H Weir
- c College of Public Health , The Ohio State University , Columbus , OH
| | - Joan B Rose
- d Department of Fisheries and Wildlife , Michigan State University , East Lansing , MI
| | - Sherif Abd-Elmaksoud
- e Environmental Virology Laboratory, Department of Water Pollution Research , National Research Centre , Cairo , Egypt
| | - Charles P Gerba
- a Mel & Enid Zuckerman College of Public Health , The University of Arizona , Tucson , AZ
- b Department of Soil, Water, and Environmental Science , The University of Arizona , Tucson , AZ
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Anastasopoulou A, Kolios A, Somorin T, Sowale A, Jiang Y, Fidalgo B, Parker A, Williams L, Collins M, McAdam E, Tyrrel S. Conceptual environmental impact assessment of a novel self-sustained sanitation system incorporating a quantitative microbial risk assessment approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 639:657-672. [PMID: 29800857 PMCID: PMC6021597 DOI: 10.1016/j.scitotenv.2018.05.062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 05/04/2018] [Accepted: 05/05/2018] [Indexed: 05/24/2023]
Abstract
In many developing countries, including South Africa, water scarcity has resulted in poor sanitation practices. The majority of the sanitation infrastructures in those regions fail to meet basic hygienic standards. This along with the lack of proper sewage/wastewater infrastructure creates significant environmental and public health concerns. A self-sustained, waterless "Nano Membrane Toilet" (NMT) design was proposed as a result of the "Reinvent the Toilet Challenge" funded by the Bill and Melinda Gates Foundation. A "cradle-to-grave" life cycle assessment (LCA) approach was adopted to study the use of NMT in comparison with conventional pour flush toilet (PFT) and urine-diverting dry toilet (UDDT). All three scenarios were applied in the context of South Africa. In addition, a Quantitative Microbial Risk Assessment (QMRA) was used to reflect the impact of the pathogen risk on human health. LCA study showed that UDDT had the best environmental performance, followed by NMT and PFT systems for all impact categories investigated including human health, resource and ecosystem. This was mainly due to the environmental credits associated with the use of urine and compost as fertilizers. However, with the incorporation of the pathogen impact into the human health impact category, the NMT had a significant better performance than the PFT and UDDT systems, which exhibited an impact category value 4E + 04 and 4E + 03 times higher, respectively. Sensitivity analysis identified that the use of ash as fertilizer, electricity generation and the reduction of NOx emissions were the key areas that influenced significantly the environmental performance of the NMT system.
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Affiliation(s)
| | - Athanasios Kolios
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
| | - Tosin Somorin
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
| | - Ayodeji Sowale
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
| | - Ying Jiang
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
| | - Beatriz Fidalgo
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
| | - Alison Parker
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
| | - Leon Williams
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
| | - Matt Collins
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
| | - Ewan McAdam
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
| | - Sean Tyrrel
- School of Water, Energy and Environment, Cranfield University, MK43 0AL, UK.
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50
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Methods for Handling Left-Censored Data in Quantitative Microbial Risk Assessment. Appl Environ Microbiol 2018; 84:AEM.01203-18. [PMID: 30120116 DOI: 10.1128/aem.01203-18] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 08/08/2018] [Indexed: 01/27/2023] Open
Abstract
Data below detection limits, left-censored data, are common in environmental microbiology, and decisions in handling censored data may have implications for quantitative microbial risk assessment (QMRA). In this paper, we utilize simulated data sets informed by real-world enterovirus water data to evaluate methods for handling left-censored data. Data sets were simulated with four censoring degrees (low [10%], medium [35%], high [65%], and severe [90%]) and one real-life censoring example (97%) and were informed by enterovirus data assuming a lognormal distribution with a limit of detection (LOD) of 2.3 genome copies/liter. For each data set, five methods for handling left-censored data were applied: (i) substitution with LOD/[Formula: see text], (ii) lognormal maximum likelihood estimation (MLE) to estimate mean and standard deviation, (iii) Kaplan-Meier estimation (KM), (iv) imputation method using MLE to estimate distribution parameters (MI method 1), and (v) imputation from a uniform distribution (MI method 2). Each data set mean was used to estimate enterovirus dose and infection risk. Root mean square error (RMSE) and bias were used to compare estimated and known doses and infection risks. MI method 1 resulted in the lowest dose and infection risk RMSE and bias ranges for most censoring degrees, predicting infection risks at most 1.17 × 10-2 from known values under 97% censoring. MI method 2 was the next overall best method. For medium to severe censoring, MI method 1 may result in the least error. If unsure of the distribution, MI method 2 may be a preferred method to avoid distribution misspecification.IMPORTANCE This study evaluates methods for handling data with low (10%) to severe (90%) left-censoring within an environmental microbiology context and demonstrates that some of these methods may be appropriate when using data containing concentrations below a limit of detection to estimate infection risks. Additionally, this study uses a skewed data set, which is an issue typically faced by environmental microbiologists.
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