Human viruses and viral indicators in marine water at two recreational beaches in Southern California, USA

Quantitative microbial risk assessment of gastrointestinal illness due to recreational exposure to E. coli and enterococci on the southern coasts of the Caspian Sea

Background

Gastrointestinal illness refers to a broad range of diseases that affect the digestive system, including infections caused by bacteria, viruses, and parasites. Quantitative Microbial Risk Assessment (QMRA) is a powerful tool used to evaluate the risks associated with microbial pathogens in various environments. The main objective of this study was to conduct a quantitative assessment of gastrointestinal illnesses that occur as a result of exposure to E. coli and enterococci during recreational activities on the southern coasts of the Caspian Sea.

Methods

Samples were collected from the recreational beaches along the border line of the Caspian Sea. The samples were analyzed for the presence and enumeration of E. coli and enterococci using the microplate method and membrane filtration techniques. Then, the annual and daily infection risks were computed using the Monte Carlo simulation approach.

Results

The results revealed that the risk of daily and annual infections on the coasts of Babolsar was higher than that on the coasts of Sari. Also, in the recreational waters of these beaches, the risk of infection by enterococci was higher than that posed by E. coli. In Babolsar, the average annual infection risk caused by E. coli and enterococci was 0.365 and 1 for children and 0.181 and 0.986 for adults. Also, in Sari, the average annual infection risk caused by E. coli and enterococci was 0.060 and 0.908 for children and 0.027 and 0.815 for adults. In addition, children were more likely than adults to become infected.

Conclusion

In light of the study's findings, due to the entry of untreated urban wastewater into the southern part of the Caspian Sea (northern Iran) and the high risk of infectious diseases for children, more control and health measures are necessary for children's swimming.

The Association of Helicobacter pylori Biofilm with Enterovirus 71 Prolongs Viral Viability and Survival

The transition time during which a virus leaves its host and infects the next susceptible host is critical for virus survival. Enterovirus 71 (EV71) is stable in aqueous environments, but its molecular interactions with bacteria and their biofilms are not well-established. Helicobacter pylori is a highly successful gut bacterial pathogen, with its capacity to form biofilms being linked to its transmission. Given that both are gut-associated microbes, we hypothesized that biofilms formed by H. pylori may play a significant role in the survival of EV71 in the external environment. In this study, we examine the interactions of EV71 with the preformed biofilm of H. pylori to mimic its natural state in the environment. Immunofluorescence confocal microscopy and scanning electron microscopy revealed that EV71 particles persisted for up to 10 days when incubated with the H. pylori biofilm. Furthermore, the presence of the H. pylori biofilm significantly augmented viral viability, as verified through virus plaque assays. Interestingly, the viability of EV71 was dependent on the quantity of H. pylori biofilm formation. Thus, two H. pylori strains able to generate large amounts of biofilm could facilitate EV71 viability for up to 17 days, whereas two other H. pylori strains that produced moderate or low quantities of biofilm could not prolong virus viability. It is interesting that biofilm contains N-acetyl-glucosamine and glycosaminoglycan, and that EV71 has binding affinity to cell-surface heparan sulfate glycosaminoglycan, which acts as an EV71 attachment receptor. The synergistic ability of H. pylori biofilm to promote EV71 viability for extended periods implies that H. pylori biofilm may serve as an additional pathway of EV71 transmission.

Searching for a Reliable Viral Indicator of Faecal Pollution in Aquatic Environments

The disposal of sewage in significant quantities poses a health hazard to aquatic ecosystems. These effluents can contain a wide range of pathogens, making faecal contamination a leading source of waterborne diseases around the world. Yet monitoring bacteria or viruses in aquatic environments is time consuming and expensive. The standard indicators of faecal pollution all have limitations, including difficulty in determining the source due to lack of host specificity, poor connection with the presence of non-bacterial pathogens, or low environmental persistence. Innovative monitoring techniques are sorely needed to provide more accurate and targeted solutions. Viruses are a promising alternative to faecal indicator bacteria for monitoring, as they are more persistent in ambient water, more abundant in faeces, and are extremely host-specific. Given the range of viruses found in diverse contexts, it is not easy to find one "ideal" viral indicator of faecal pollution; however, several are of interest. In parallel, the ongoing development of molecular techniques coupled with metagenomics and bioinformatics should enable improved ways to detect faecal contamination using viruses. This review examines the evolution of faecal contamination monitoring with the following aims (i) to identify the characteristics of the main viral indicators of faecal contamination, including human enteric viruses, bacteriophages, CRESS and plant viruses, (ii) to assess how these have been used to monitor water pollution in recent years, (iii) to evaluate the reliability of recent detection methods of such viruses, and (iv) to tentatively determine which viruses may be most effective as markers of faecal pollution.

Relationship between coliphage and Enterococcus at southern California beaches and implications for beach water quality management

Coliphage have been suggested as an alternative to fecal indicator bacteria for assessing recreational beach water quality, but it is unclear how frequently and at what types of beaches coliphage produces a different management outcome. Here we conducted side-by-side sampling of male-specific and somatic coliphage by the new EPA dead-end hollow fiber ultrafiltration (D-HFUF-SAL) method and Enterococcus at southern California beaches over two years. When samples were combined for all beach sites, somatic and male-specific coliphage both correlated with Enterococcus. When examined categorically, Enterococcus would have resulted in approximately two times the number of health advisories as somatic coliphage and four times that of male-specific coliphage,using recently proposed thresholds of 60 PFU/100 mL for somatic and 30 PFU/100 mL for male-specific coliphage. Overall, only 12% of total exceedances would have been for coliphage alone. Somatic coliphage exceedances that occurred in the absence of an Enterococcus exceedance were limited to a single site during south swell events, when this beach is known to be affected by nearby minimally treated sewage. Thus, somatic coliphage provided additional valuable health protection information, but may be more appropriate as a supplement to FIB measurements rather than as replacement because: (a) EPA-approved PCR methods for Enterococcus allow a more rapid response, (b) coliphage is more challenging owing to its greater sampling volume and laboratory time requirements, and (c) Enterococcus' long data history has yielded predictive management models that would need to be recreated for coliphage.

Virus contamination and infectivity in beach environment: Focus on sand and stranded material

To assess the exposure of beachgoers to viruses, a study on seawater, sand, and beach-stranded material was carried out, searching for human viruses, fecal indicator organisms, and total fungi. Moreover, for the first time, the genome persistence and infectivity of two model viruses was studied in laboratory-spiked sand and seawater samples during a one-week experiment. Viral genome was detected in 13.6 % of the environmental samples, but it was not infectious (Human Adenovirus - HAdV, and enterovirus). Norovirus and SARS-CoV-2 were not detected. The most contaminated samples were from sand and close to riverine discharges. In lab-scale experiments, the infectivity of HAdV5 decreased by ~1.5-Log₁₀ in a week, the one of Human Coronavirus-229E disappeared in <3 h in sand. The genome of both viruses persisted throughout the experiment. Our results confirm viral contamination of the beach and suggest HAdV as an index pathogen for beach monitoring and quantitative risk assessment.

Dynamics of pathogens and fecal indicators during riverbank filtration in times of high and low river levels

Riverbank filtration is an established and quantitatively important approach to mine high-quality raw water for drinking water production. Bacterial fecal indicators are routinely used to monitor hygienic raw water quality, however, their applicability in viral contamination has been questioned repeatedly. Additionally, there are concerns that the increasing frequency and intensity of meteorological and hydrological events, i.e., heavy precipitation and droughts leading to high and low river levels, may impair riverbank filtration performance. In this study, we explored the removal of adenovirus compared with several commonly used bacterial and viral water quality indicators during different river levels. In a seasonal study, water from the Rhine River, a series of groundwater monitoring wells, and a production well were regularly collected and analyzed for adenovirus, coliphages, E. coli, C. perfringens, coliform bacteria, the total number of prokaryotic cells (TCC), and the number of virus-like particles (TVPC) using molecular and cultivation-based assays. Additionally, basic physico-chemical parameters, including temperature, pH, dissolved organic carbon, and nutrients, were measured. The highest log10 reduction during the >72 m of riverbank filtration from the river channel to the production well was observed for coliforms (>3.7 log10), followed by E. coli (>3.4 log10), somatic coliphages (>3.1 log10), C. perfringens (>2.5 log10), and F+ coliphages (>2.1 log10) at high river levels. Adenovirus decreased by 1.6-3.1 log units in the first monitoring well (>32 m) and was not detected in further distant wells. The highest removal efficiency of adenovirus and most other viral and bacterial fecal indicators was achieved during high river levels, which were characterized by increased numbers of pathogens and indicators. During low river levels, coliforms and C. perfringens were occasionally present in raw water at the production well. Adenovirus, quantified via droplet digital PCR, correlated with E. coli, somatic coliphages, TCC, TVPC, pH, and DOC at high river levels. At low river levels, adenoviruses correlated with coliforms, TVPC, pH, and water travel time. We conclude that although standard fecal indicators are insufficient for assessing hygienic raw water quality, a combination of E. coli, coliforms and somatic coliphages can assess riverbank filtration performance in adenovirus removal. Furthermore, effects of extreme hydrological events should be studied on an event-to-event basis at high spatial and temporal resolutions. Finally, there is an urgent need for a lower limit of detection for pathogenic viruses in natural waters. Preconcentration of viral particles from larger water volumes (>100 L) constitutes a promising strategy.

Microbiological characterization of stormwater in a high-income neighborhood in Rio de Janeiro, Brazil

Stormwater harvesting and reuse in the urban environment is emerging as an alternative water source, despite human pathogens in the stormwater may represent a hazard to public health. This study presents the results of 1-year monitoring to evaluate the quality of stormwater obtained in a high-income neighborhood in Rio de Janeiro for a set of microbiological parameters as total coliforms, Escherichia coli (E. coli), human adenovirus (HAdV), human JC polyomavirus (JCPyV), Group A rotavirus (RVA), and norovirus GI and GII. Forty-eight stormwater samples obtained from two multiplex units presented total coliforms and E. coli in 91.7% (n = 44) and 58.3% (n = 28) of samples, while HAdV and JCPyV were detected in 20.8% (n = 10) and 12.5% (n = 6), respectively. Viral quantification ranged from 10³ to 10⁴ genomic copies/liter (GC/L) for HAdV and from 10¹ to 10⁴ GC/L for JCPyV. Neither RVA nor norovirus GI and GII was detected. Fifteen out of sixteen (93.8%) samples containing viruses were compliant as per fecal indicator bacteria (FIB) according to Brazilian standards for rainwater reuse and US EPA Guidelines for Water Reuse, suggesting that viruses monitoring should complement the study of bacterial indicators.

A baseline study of spatial variability of bacteria (total coliform, E. coli, and Enterococcus spp.) as biomarkers of pollution in ten tropical Atlantic beaches: concern for environmental and public health

Coastal water quality in urban cities is increasingly impacted by human activities such as agricultural runoff, sewage discharges, and poor sanitation. However, environmental factors controlling bacteria abundance remain poorly understood. The study employed multiple indicators to assess ten beach water qualities in Ghana during minor wet seasons. Environmental parameters (e.g. temperature, electrical conductivity, total dissolved solids) were measured in situ using the Horiba multiple parameter probe. Surface water samples were collected to measure total suspended solids, nutrients, and chlorophyll-a via standard methods and bacteria determination through membrane filtration. Environmental parameters measured showed no significant variation for the sample period. However, bacteria loads differ significantly (p = 0.024) among the beaches and influenced significantly by nitrate (55.3%, p = 0.02) and total dissolved solids (17.1%, p = 0.017). The baseline study detected an increased amount of total coliforms and faecal indicator bacteria (Escherichia coli and Enterococcus spp.) in beach waters along the coast of Ghana, suggesting faecal contamination, which can pose health risks. The mean ± standard deviations of bacteria loads in beach water are total coliforms (4.06 × 10³ ± 4.16 × 10³ CFU/100 mL), E. coli (7.06 × 10² ± 1.72 × 10³ CFU/100 mL), and Enterococcus spp. (6.15 × 10² ± 1.75 × 10³ CFU/100 mL). Evidence of pollution calls for public awareness to prevent ecological and health-related risks and policy reforms to control coastal water pollution. Future research should focus on identifying the sources of contamination in the tropical Atlantic region.

Contamination sources of the enteric virus in recreational marine water shift in a seasonal pattern

Human enteric virus occurrence in bathing beaches poses a potential health risk to swimmers. They may come from several sources, but the understanding of the seasonal contribution of contamination sources to virus occurrence is still lacking. Here, the surveillance of human enteric viruses at the First Bathing Beach in Qingdao was performed January-December 2018. The occurrence of Enteric viruses, assayed with quantitative polymerase chain reaction (qPCR), was analyzed at temporal and spatial levels to determine the viral contamination sources. The results showed that only Astroviruses (AstVs) and Adenoviruses (HAdVs) were found in the swimming area. Their occurrence correlated significantly with the sewage-polluted area, but HAdVs were only found in autumn and AstVs in spring. Meanwhile, enteric viruses in the swimming area showed significantly higher levels than the surrounding area, particularly AstVs in summer with the swimmer crowd. All these data imply that sewage discharge and swimmers co-contribute to the viral occurrence in a seasonal pattern, with the former being more focused in warm seasons (spring and autumn) and the latter in hot seasons (summer). These results indicate that sewage discharge and crowd swimmers, as unsafe swimming conditions, should be avoided to improve public health at the bathing beaches.

F-specific coliphage detection by the Bluephage method

F-specific coliphages have been proposed as viral indicators of fecal pollution. These intestinal phages infect cells through the F-pili of the host strains used for their detection, Escherichia. coli HS/FAmp in the US-EPA standard method and Salmonella enterica WG49 in the ISO method. The recently designed Bluephage protocol allows the rapid detection of as low as one somatic coliphage in a working day. The current study describes a new Bluephage method designed to exclusively detect F-specific phages. It employs two new host strains, CB14 and CB16, which detect the same number of F-specific phages as their respective parental strains HS and WG49. In the Bluephage method, when the strain is lysed by bacteriophage infection, the yellow medium turns blue. As low as one F-specific phage was detected in 3 to 5 h by this approach and when the sample contained high phage concentrations, results were obtained in less than 3 h. The F-specific Bluephage method can be used with different sample volumes and allows phage quantification by the most probable number technique. Strain CB14 performed more consistently than CB16, with comparable detection efficiency after increasing the incubation time to 50 min without shaking.

Quantitative Microbial Risk Assessment as support for bathing waters profiling

Profiling bathing waters supported by Quantitative Microbial Risk Assessment (QMRA) is key to the WHO's recommendations for the 2020/2021 revision of the European Bathing Water Directive. We developed an area-specific QMRA model on four pathogens, using fecal indicator concentrations (E. coli, enterococci) for calculating pathogen loads. The predominance of illness was found to be attributable to Human Adenovirus, followed by Salmonella, Vibrio, and Norovirus. Overall, the cumulative illness risk showed a median of around 1 case/10000 exposures. The risk estimates were strongly influenced by the indicators that were used, suggesting the need for a more detailed investigation of the different sources of fecal contamination. Area-specific threshold values for fecal indicators were estimated on a risk-basis by modelling the cumulative risk against E. coli and enterococci concentrations. To improve bathing waters assessment, we suggest considering source apportionment, locally estimating of pathogen/indicator ratios, and calculating site-specific indicators thresholds based on risk assessment.

Enteric viruses, somatic coliphages and Vibrio species in marine bathing and non-bathing waters in Italy

Microbial safety of recreational waters is a significant public health issue. In this study we assessed the occurrence and quantity of enteric viruses in bathing and non-bathing waters in Italy, in parallel with microbial faecal indicators, somatic coliphages and Vibrio spp. Enteric viruses (aichivirus, norovirus and enterovirus) were detected in 55% of bathing water samples, including samples with bacterial indicator concentrations compliant with the European bathing water Directive. Aichivirus was the most frequent and abundant virus. Adenovirus was detected only in non-bathing waters. Somatic coliphages were identified in 50% bathing water samples, 80% of which showed simultaneous presence of viruses. Vibrio species were ubiquitous, with 9 species identified, including potential pathogens (V. cholerae, V. parahaemoylticus and V. vulnificus). This is the first study showing the occurrence and high concentration of Aichivirus in bathing waters and provides original information, useful in view of a future revision of the European Directive.

Norovirus and human adenovirus occurrence and diversity in recreational water in a karst aquifer in the Yucatan Peninsula, Mexico

AIMS

To determine the seasonal occurrence and diversity of norovirus (NoV) and human adenovirus (HAdV) in groundwater from sinkholes, and brackish water used for recreational activities in the karst aquifer of the Yucatan Peninsula, Mexico.

METHODS AND RESULTS

Hollow fibre ultrafiltration was used to concentrate viruses and standard plaque assay methods were used to enumerate somatic and F+ specific coliphages as viral indicators. Real-time quantitative polymerase chain reaction assays were used to estimate the number of genome copies for NoV strains GI, and GII, and HAdVs. The predominant NoV genotypes and HAdV serotypes were identified by comparative sequence analysis. Somatic and male F+ specific coliphages were detected at concentrations up to 94 and 60 plaque-forming units per 100 ml respectively. The NoV genogroup I (GI) was associated with 50% of the sampled sites during the rainy season only, at concentrations ranging from 120 to 1600 genome copies per litre (GC l^-1 ). The NoV genogroup II (GII) was detected in 30 and 40% of the sampled sites during the rainy and dry seasons, respectively, at concentrations ranging from 10 to 290 GC l^-1 . During the rainy and dry seasons, HAdVs were detected in 20% of the sites, at concentrations ranging from 24 to 690 GC l^-1 . Identification of viral types revealed the presence of NoV GI.2, GII.Pe, GII.P16 and GII.P17, and HAdV F serotypes 40 and 41.

CONCLUSIONS

These findings demonstrate that NoVs and HAdVs are prevalent as virus contaminants in the karst aquifer, representing potential health risks particularly during the rainy season, in one of the most important areas used for tourism in Mexico.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is one of the few studies conducted in karst aquifers that provide a foundational baseline of the distribution, concentrations and diversity of NoVs and HadVs in these particular environments.

Human adenoviruses as waterborne index pathogens and their use for Quantitative Microbial Risk Assessment

The current microbial water quality standards are based on the monitoring of fecal indicator organisms, which are mainly bacterial indicators (i.e., Escherichia coli, intestinal enterococci), however epidemiological data indicate that viruses are important etiological agents of waterborne illnesses. Among waterborne viruses, human adenovirus can be considered as an index pathogen, owing to its abundance in sewage and persistence in the environment, as well as its potential infectivity. In this study, data on human adenoviruses from different water matrices (the entrance and exit of a water treatment plant, rivers and seawaters) were analyzed, in parallel with traditional fecal bacterial indicators and somatic coliphages. The results showed a 64% frequency of positive adenovirus samples, decreasing from the sewage system (100% at the entrance and 94% at the exit) to rivers (92% and 72% for different rivers) and seawater (21%). Adenovirus concentrations showed a significant correlation with somatic coliphages in one river and seawater, thus supporting the recent inclusion of coliphages as viral indicators in water safety guidelines. The data collected were used to estimate adenovirus to indicator ratios, which could be used as input in Quantitative Microbial Risk Assessment (QMRA) studies.

Estimation of Human Norovirus Infectivity from Environmental Water Samples by In Situ Capture RT-qPCR Method

Human noroviruses (HuNoVs) are highly infectious viruses for which water is an important medium of transmission. In this study, we explored a new in situ capture RT-qPCR (ISC-RT-qPCR) methodology to estimate the infectivity of HuNoV in environmental water samples. This assay was based on capturing encapsidated HuNoV by viral receptors, followed by in situ amplification of the captured viral genomes by RT-qPCR. We demonstrated that the ISC-RT-qPCR did not capture and enable signal amplification of heat-denatured Tulane Virus (TV) and HuNoVs. We further demonstrated that the sensitivity of ISC-RT-qPCR was equal or better than that of conventional RT-qPCR procedures for the detection of HuNoV GI and GII. We then utilized the ISC-RT-qPCR to detect HuNoV in environmental water samples for comparison against that from a conventional RT-qPCR procedure. TV was used as a process control virus. While complete inhibition of TV genomic signal was observed in 27% of samples tested by RT-qPCR, no inhibition of TV genomic signal was observed by ISC-RT-qPCR. From 72 samples tested positive for HuNoV GI signal by RT-qPCR, only 20 (27.8%) of these samples tested positive by ISC-RT-qPCR, suggesting that 72.2% of RT-qPCR-positive samples were unlikely to be infectious. From 16 samples tested positive for HuNoV GII signal by RT-qPCR, only one of these samples tested positive by ISC-RT-qPCR. Five samples that had initially tested negative for HuNoV GII signal by RT-qPCR, was tested as positive by ISC-RT-qPCR. Overall, ISC-RT-qPCR method provided an alternative assay to estimate infectivity of HuNoV in environmental samples.

Concurrent Detection of Human Norovirus and Bacterial Pathogens in Water Samples from an Agricultural Region in Central California Coast

Bacterial pathogens and human norovirus (HuNoV) are major cause for acute gastroenteritis caused by contaminated food and water. Public waterways can become contaminated from a variety of sources and flood after heavy rain events, leading to pathogen contamination of produce fields. We initiated a survey of several public watersheds in a major leafy green produce production region of the Central California Coast to determine the prevalence of HuNoV as well as bacterial pathogens. Moore swabs were used to collect environmental samples bi-monthly at over 30 sampling sites in the region. High prevalence of HuNoV and bacterial pathogens were detected in environmental water samples in the region. The overall detection rates of HuNoV, O157 Shiga toxin-producing Escherichia coli (STEC), non-O157 STEC, Salmonella, and Listeria were 25.58, 7.91, 9.42, 59.65, and 44.30%, respectively. The detection rates of Salmonella and L. monocytogenes were significantly higher in the spring. Fall and spring had elevated detection rates of O157 STEC. The overall detection rates of non-O157 STEC in the fall were lower than the other seasons but not significant. The overall detection rates of HuNoV were highest in fall, followed by spring and winter, with summer being lowest and significantly lower than other seasons. This study presented the first study of evaluating the correlation between the detection rate of HuNoV and the detection rates of four bacterial pathogens from environmental water. Overall, there was no significant difference in HuNoV detection rates between samples testing positive or negative for the four bacterial pathogens tested. Pathogens in animal-impacted and human-impacted areas were investigated. There were significant higher detection rates in animal-impacted areas than that of human-impacted areas for bacterial pathogens. However, there was no difference in HuNoV detection rates between these two areas. The overall detection levels of generic E. coli and detection rate of HuNoV showed no correlation.

Bacteriophages as indicators of faecal pollution and enteric virus removal

Bacteriophages are an attractive alternative to faecal indicator bacteria (FIB), particularly as surrogates of enteric virus fate and transport, due to their closer morphological and biological properties. Based on a review of published data, we summarize densities of coliphages (F+ and somatic), Bacteroides spp. and enterococci bacteriophages (phages) in individual human waste, raw wastewater, ambient fresh and marine waters and removal through wastewater treatment processes utilizing traditional treatments. We also provide comparisons with FIB and enteric viruses whenever possible. Lastly, we examine fate and transport characteristics in the aquatic environment and provide an overview of the environmental factors affecting their survival. In summary, concentrations of bacteriophages in various sources were consistently lower than FIB, but more reflective of infectious enteric virus levels. Overall, our investigation indicates that bacteriophages may be adequate viral surrogates, especially in built systems, such as wastewater treatment plants.

SIGNIFICANCE AND IMPACT OF THE STUDY

Bacteriophage are alternative fecal indicators that may be better surrogates for viral pathogens than fecal indicator bacteria (FIB). This report offers a summary of the existing literature concerning the utility of bacteriophage as indicators of viral presence (fecal sources and surface waters) and persistence (in built infrastructure and aquatic environments). Our findings indicate that bacteriophage levels in all matrices examined are consistently lower than FIB, but similar to viral pathogens. Furthermore, in built infrastructure (e.g. wastewater treatment systems) bacteriophage closely mimic viral pathogen persistence suggesting they may be adequate sentinels of enteric virus removal.

Evaluation of the dry and wet weather recreational health risks in a semi-enclosed marine embayment in Southern California

For many coastal regions around the world, recreational beach water quality is assessed using fecal indicator bacteria (FIB). However, the utility of FIB as indicators of recreational water illness (RWI) risk has been questioned, particularly in coastal settings with no obvious sources of human sewage. In this study we employed a source-apportionment quantitative microbial risk assessment (SA-QMRA) to assess RWI risk at a popular semi-enclosed recreational beach in Southern California (Baby Beach, City of Dana Point) with no obvious point sources of human sewage. Our SA-QMRA results suggest that, during dry weather, the median RWI risk at this beach is below the U.S. EPA recreational water quality criteria (RWQC) of 36 illness cases per 1000 bathers. During wet weather, the median RWI risk predicted by SA-QMRA depends on the assumed level of human waste associated with stormwater; the RWI risk is below the EPA RWQC illness risk benchmark 100% of the time provided that <2% of the FIB in stormwater are of human origin. However, these QMRA outcomes contrast strongly with the EPA RWQC for 30-day geometric mean of enterococci bacteria. Our results suggest that SA-QMRA is a useful framework for estimating robust RWI risk that takes into account local information about possible human and non-human sources of FIB.

Sources of bathing water pollution in northern Tuscany (Italy): Effects of meteorological variables

This study was carried out in a popular tourist destination located in Italy, where short-term pollution posed the problem of low quality status of bathing waters (according to European Directive) owing to the fecal contamination caused by drainage ditches. Our goal was to understand the role of meteorological conditions on freshwater and seawater bacterial indicator levels, and the impact of polluted streams on seawater contamination. To this aim, results from surface waters were analyzed during five bathing seasons, from 2011 to 2015. Our results demonstrated a relationship between bacterial densities and rainfall amount and a time-dependent dilution effect of the sea between the two halves of each bathing season. This analytical survey confirmed the strategic role of meteorological variables in bathing waters quality, and it could be a support for generation and development of predicting models of indicator levels for bathing area.

Epidemiologic evaluation of multiple alternate microbial water quality monitoring indicators at three California beaches

INTRODUCTION

Advances in molecular methods provide new opportunities for directly measuring pathogens or host-associated markers of fecal pollution instead of relying on fecal indicator bacteria (FIB) alone for beach water quality monitoring. Adoption of new indicators depends on identifying relationships between either the presence or concentration of the indicators and illness among swimmers. Here we present results from three epidemiologic studies in which a broad range of bacterial and viral indicators of fecal contamination were measured simultaneously by either culture or molecular methods along with Enterococcus to assess whether they provide better health risk prediction than current microbial indicators of recreational water quality.

METHODS

We conducted prospective cohort studies at three California beaches -- Avalon Bay (Avalon), Doheny State Beach (Doheny), Surfrider State Beach (Malibu) -- during the summers of 2007, 2008 and 2009. The studies enrolled 10,785 swimmers across the beaches and recorded each swimmer's water exposure. Water and sand samples were collected several times per day at multiple locations at each beach and analyzed for up to 41 target indicators using 67 different methodologies. Interviewers contacted participants by phone 10-14 days later and recorded symptoms of gastrointestinal illness occurring after their beach visit. Regression models were used to evaluate the association between water quality indicators and gastrointestinal illness among swimmers at each beach.

RESULTS

F+ coliphage (measured using EPA Method 1602) exhibited a stronger association with GI illness than did EPA Method 1600 at the two beaches where it was measured, while a molecular method, F+ RNA Coliphage Genotype II, was the only indicator significantly associated with GI illness at Malibu. MRSA, a known pathogen, had the strongest association with GI illness of any microbe measured at Avalon. There were two methods targeting human-associated fecal anaerobic bacteria that were more strongly associated with GI illness than EPA Method 1600, but only at Avalon. No indicator combinations consistently had a higher odds ratio than EPA Method 1600, but one composite indicator, based on the number of pathogens detected at a beach, was significantly associated with gastrointestinal illness at both Avalon and Doheny when freshwater flow was high.

DISCUSSION

While EPA Method1600 performed adequately at two beaches based on its consistency of association with gastrointestinal illness and the precision of its estimated associations, F+ coliphage measured by EPA Method 1602 had a stronger association with GI illness under high risk conditions at the two beaches where it was measured. One indicator, F+ Coliphage Genotype II was the only indicator significantly associated with GI illness at Malibu. Several indicators, particularly those targeting human associated bacteria, exhibited relationships with GI illness that were equal to or greater than that of EPA Method 1600 at Avalon, which has a focused human fecal source. Our results suggest that site-specific conditions at each beach determine which indicator or indicators best predict GI illness.

Estimation of concentration ratio of indicator to pathogen-related gene in environmental water based on left-censored data

A stochastic model for estimating the ratio between a fecal indicator and a pathogen based on left-censored data, which includes a substantially high number of non-detects, was constructed. River water samples were taken for 16 months at six points in a river watershed, and conventional fecal indicators (total coliforms and general Escherichia coli), genetic markers (Bacteroides spp.), and virulence genes (eaeA of enteropathogenic E. coli and ciaB of Campylobacter jejuni) were quantified. The quantification of general E. coli failed to predict the presence of the virulence gene from enteropathogenic E. coli, different from what happened with genetic markers (Total Bac and Human Bac). A Bayesian model that was adapted to left-censored data with a varying analytical quantification limit was applied to the quantitative data, and the posterior predictive distributions of the concentration ratio were predicted. When the sample size was 144, simulations conducted in this study suggested that 39 detects were enough to accurately estimate the distribution of the concentration ratio, when combined with a dataset with a positive rate higher than 99%. To evaluate the level of accuracy in the estimation, it is desirable to perform a simulation using an artificially generated left-censored dataset that has the identical number of non-detects as the actual data.