Efficacy of gaseous chlorine dioxide as a sanitizer against Cryptosporidium parvum, Cyclospora cayetanensis, and Encephalitozoon intestinalis on produce

Filters comprised of sand and Zero Valent Iron hold promise as tools to mitigate risk posed by Cyclospora cayetanensis oocysts

Irrigation water contaminated by human fecal material may elevate the risk of produce contamination with the enteric parasite Cyclospora cayetanensis. Oocysts of C. cayetanensis are resistant to commonly used disinfectants and a method of removing C. cayetanensis from irrigation water would mitigate this risk. We evaluated zero valent iron (ZVI) sand filtration as one such method. We sought to determine if sand filters containing ZVI outperformed those without ZVI. We first evaluated the abundant poultry parasites Eimeria maxima, E. tenella and E. acervulina as surrogates for C. cayetanensis. We determined if a miniaturized gravity fed ZVI-sand filter, scaled to evaluate scarce supplies of C. cayetanensis oocysts, provided useful information about the performance of larger filtration systems. Filters were inoculated with oocysts, rinsed, and the resulting filtrate examined microscopically for oocysts. We performed experiments to measure the effect of varying ZVI concentrations, repeated filter use, simulated agricultural water, and oocyst size and condition. We then compared the performance of mini filters to that of larger, gravity-fed pool filters and found that ZVI-sand filtration was far more effective at removing Eimeria spp. from water when compared to sand filtration, at both scales. Sand mini filters retained 13-54 % of E. acervulina oocysts, and pool filters retained 82 %, but when combined with 50 % (mini filter) or 35 % (pool filter) v/v ZVI, mini filters retained 89-99 % of oocysts and pool filters retained >99 %. The effectiveness of the mini filters increased with increasing ZVI concentration, and the addition of ZVI far outweighed the influence of any other measured variable. We then performed experiments including C. cayetanensis, which provided similar results to those utilizing Eimeria; 59 % of inoculated C. cayetanensis oocysts were retained in sand mini filters, and 97 % in mini filters composed of 35 % v/v ZVI. In sum, ZVI is highly effective in removing oocysts from water and Eimeria is a useful surrogate for C. cayetanensis to assess filtration. ZVI-sand filtration shows promise as a tool to mitigate the risk of C. cayetanensis contamination of irrigation water. Further studies should evaluate the performance of ZVI-sand in pressurized fast filtration systems under a range of field conditions.

Zero-Valent Iron and Sand Filtration Reduces Levels of Cyclospora cayetanensis Surrogates, Eimeria tenella and Eimeria acervulina, in Water

Recurring outbreaks of cyclosporiasis linked to fresh produce demonstrate the need to develop interventions to reduce C. cayetanensis in irrigation water. C. cayetanensis is resistant to commonly used irrigation water treatments, such as chemical sanitizers, making removal of oocysts by filtration the most suitable intervention. This study evaluated the reduction of Eimeria tenella and E. acervulina, as surrogates for C. cayetanensis, in water using filters packed with sand alone or mixtures of sand and zero-valent iron (ZVI). Water inoculated with Eimeria spp. oocysts was filtered through laboratory-scale (PVC column) and field-scale (swimming pool filter) filters packed with either 100% sand or 50% ZVI/50% sand (v/v). Filtered and backflush water was examined microscopically for oocysts. Laboratory-scale filters with 50% ZVI significantly (p < 0.05) reduced 99.9% of E. tenella oocysts compared to 55.3% with filters containing 100% sand. At the field-scale level, 50% ZVI filters significantly (p < 0.05) reduced 70.5% of E. acervulina oocysts compared to 54.5% by 100% sand filters. Filters were backflushed to examine the recovery of these parasites during routine filter-media cleaning procedures. Backflush recovery of oocysts ranged from 4.42-16.7%. The addition of ZVI significantly improved the reduction of Eimeria spp. oocysts at both filter scales. and should be further investigated as a potential irrigation water intervention to reduce C. cayetanensis.

Hastening Progress in Cyclospora Requires Studying Eimeria Surrogates

Cyclospora cayetanensis is an enigmatic human parasite that sickens thousands of people worldwide. The scarcity of research material and lack of any animal model or cell culture system slows research, denying the produce industry, epidemiologists, and regulatory agencies of tools that might aid diagnosis, risk assessment, and risk abatement. Fortunately, related species offer a strong foundation when used as surrogates to study parasites of this type. Species of Eimeria lend themselves especially well as surrogates for C. cayetanensis. Those Eimeria that infect poultry can be produced in abundance, share many biological features with Cyclospora, pose no risk to the health of researchers, and can be studied in their natural hosts. Here, we overview the actual and potential uses of such surrogates to advance understanding of C. cayetanensis biology, diagnostics, control, and genomics, focusing on opportunities to improve prevention, surveillance, risk assessment, and risk reduction. Studying Eimeria surrogates accelerates progress, closing important research gaps and refining promising tools for producers and food safety regulators to monitor and ameliorate the food safety risks imposed by this emerging, enigmatic parasite.

Efficacy of Chlorine Dioxide Gas Against Hepatitis A Virus on Blueberries, Blackberries, Raspberries, and Strawberries

Seeking a means of sanitizing berries, the effectiveness of steady state levels of gaseous chlorine dioxide (ClO₂) against hepatitis A virus (HAV) on laboratory-contaminated berries was determined. The generated ClO₂ was maintained with 1 or 2 mg/l air inside a 269-l glove box to treat 50 g batches of blueberries, raspberries, and blackberries, and 100 g batches of strawberries that were immersion coated with HAV. Normalized data for ClO₂ (ppm-h/g product) is reported as a function of ClO₂ concentration, treatment time, and weight of treated product. Treatments of ClO₂ ranging from 1.00 to 6.27 ppm-h/g berry were evaluated. When compared to untreated HAV-contaminated berries, log reductions of HAV were > 2.1 for all berry types and conditions tested indicating the gaseous ClO₂ was effective. The average log reduction with strawberries, raspberries, blueberries and blackberries treated with 1.00 ppm-h/g, the lowest ClO₂ treatment tested, were 2.44, 2.49, 3.23, and 3.45, respectively. The highest treatment of 6.27 ppm-h/g was applied at two different gas concentrations of 1 mg/l and 2 mg/l. Average log reductions for blueberries and strawberries treated with 6.27 ppm-h/g were 4.34 and 4.42, and 4.03 and 3.51, applied at 1 mg/l and 2 mg/l, respectively. For blackberries and raspberries 3.20 and 3.24, and 3.23 and 3.97 log reductions were observed for 6.27 ppm-h/g treatments applied at 1 mg/l and 2 mg/l, respectively. Results indicate that HAV contamination of berries can be substantially reduced by gaseous ClO₂ and offer industry a waterless means of sanitizing berries against HAV.

A scoping review of the detection, epidemiology and control of Cyclospora cayetanensis with an emphasis on produce, water and soil

Cyclospora cayetanensis is a parasite causing cyclosporiasis (an illness in humans). Produce (fruits, vegetables, herbs), water and soil contaminated with C. cayetanensis have been implicated in human infection. The objective was to conduct a scoping review of primary research in English on the detection, epidemiology and control of C. cayetanensis with an emphasis on produce, water and soil. MEDLINE® (Web of ScienceTM), Agricola (ProQuest), CABI Global Health, and Food Science and Technology Abstracts (EBSCOhost) were searched from 1979 to February 2020. Of the 349 relevant primary research studies identified, there were 75 detection-method studies, 40 molecular characterisation studies, 38 studies of Cyclospora in the environment (33 prevalence studies, 10 studies of factors associated with environmental contamination), 246 human infection studies (212 prevalence/incidence studies, 32 outbreak studies, 60 studies of environmental factors associated with non-outbreak human infection) and eight control studies. There appears to be sufficient literature for a systematic review of prevalence and factors associated with human infection with C. cayetanensis. There is a dearth of publicly available detection-method studies in soil (n = 0) and water (n = 2), prevalence studies on soil (n = 1) and studies of the control of Cyclospora (particularly on produce prior to retail (n = 0)).

Giardia duodenalis in humans and animals - Transmission and disease

Giardia duodenalis is a protozoan parasite infecting the upper intestinal tract of humans, as well as domestic and wild animals worldwide. Transmission of giardiasis occurs through the faecal-oral route, and may be either direct (i.e., person-to-person, animal-to-animal or zoonotic) or indirect (i.e., waterborne or foodborne). While asymptomatic infections are common in both humans and animals, a wide range of enteric symptoms have been reported, along with extra-intestinal and post-infectious complications. A definitive diagnosis of giardiasis is generally made by detection of cysts in stool specimens through microscopical examination of wet mounts, or through the use of permanent or fluorescent antibody stains. More recently, molecular methods have become popular for diagnosis and for testing environmental samples. Symptomatic giardiasis is often treated to reduce the duration of symptoms, to prevent complications, and to minimize transmission of the parasite to other hosts. Direct faecal-oral transmission of giardiasis can be largely controlled thorough improved hygiene and sanitation. In the case of waterborne transmission, a multiple barrier approach, including limiting access of people and animals to watersheds and reservoirs, and treatment using flocculation, filtration and disinfection, is necessary to minimize the risk. Since foodborne transmission is often associated with the consumption of fresh produce, a number of control measures can be taken during pre- and post-harvest, as well as at the food handler/consumer level to minimize the risk of contamination, or for removing or inactivating parasites. Good husbandry and farm management practices are important in controlling the spread of giardiasis in livestock and companion animals.

Evaluation of Steady-State Gaseous Chlorine Dioxide Treatment for the Inactivation of Tulane virus on Berry Fruits

The effectiveness of steady-state levels of gaseous chlorine dioxide (ClO₂) against Tulane virus (TV), a human norovirus surrogate, on berries was determined. The generated ClO₂ was maintained at 1 mg/L inside a 269 L glove box to treat two 50 g batches of blueberries, raspberries, and blackberries, and two 100 g batches of strawberries that were immersion coated with TV. The standardized/normalized treatment concentrations of ClO₂ ranging from 0.63 to 4.40 ppm-h/g berry were evaluated. When compared to untreated TV contaminated berries, log reductions of TV were in excess of 2.9 log PFU/g for all berry types and conditions tested, indicating that ClO₂ was highly effective. In general, the efficacy of all ClO₂ treatments on log reductions of TV on all berries was not significantly different (p < 0.05). The average log reduction with strawberries, raspberries, blueberries, and blackberries, treated with the lowest ClO₂ concentration, 0.63 ppm-h/g, were 2.98, 3.40, 3.82, and 4.17 log PFU/g, respectively. Overall results suggest that constant levels of ClO₂ could be quite effective against foodborne viruses.

Parasite contamination of berries: Risk, occurrence, and approaches for mitigation

Fresh fruits and vegetables, including berries, are essential components of a healthy diet and are relevant in the prevention of chronic non-communicable diseases such as cancer and heart disease. Associations between diet and health are becoming an increasing focus of consumers, and, in response, consumption of fresh berries has been increasing rapidly in recent decades. However, increased consumption of berries may be associated with an increased risk of acquiring foodborne infections, including parasites. In this review, we describe how parasite contamination of berries may occur at several points on the farm-to-fork pathway, starting from the use of contaminated water for irrigation and pesticide application, and contact with animal and human faeces during cultivation, through contaminated harvesting equipment, and including unhygienic practices of berry pickers in the production field or others handling berries prior to consumption. Parasite transmission stages tend to be robust and therefore likely to survive from contamination in the field, through the various stages of harvesting, packaging, and sale, until consumption. We describe outbreaks of parasitic disease associated with consumption of berries - so far only described for Cyclospora and Trypanosoma cruzi, both of which are briefly introduced - but also show from survey data summarised in this review that sporadic infections or undetected outbreaks associated with contaminated berries may also occur. In addition, we describe methods for assessing whether berries are contaminated with parasite transmission stages, with emphasis on the challenges associated with analysing this particular matrix. Emphasis on current possibilities for mitigation and control are addressed; avoidance of contamination and implementation of good management practices and a hazard analysis and critical control points (HACCP) approach are essential.

Use of a common laboratory glassware detergent improves recovery of Cryptosporidium parvum and Cyclospora cayetanensis from lettuce, herbs and raspberries

The success of any protocol designed to detect parasitic protozoa on produce must begin with an efficient initial wash step. Cryptosporidium parvum and Cyclospora cayetanensis oocysts were seeded onto herbs, lettuces and raspberries, eluted with one of four wash solutions and the recovered number of oocysts determined via fluorescent microscopy. Recovery rates for fluorescein thiosemicarbazide labeled C. parvum oocysts seeded onto spinach and raspberries and washed with de-ionized water were 38.4 ± 10.1% and 34.9 ± 6.2%, respectively. Two alternative wash solutions viz. 1M glycine, pH 5.5 and a detachment solution were tested also using labeled C. parvum seeded spinach and raspberries. No statistically significant difference was noted in the recovery rates. However, a wash solution containing 0.1% Alconox, a laboratory glassware detergent, resulted in a significant improvement in oocyst recovery. 72.6 ± 6.6% C. parvum oocysts were recovered from basil when washed with 0.1% Alconox compared to 47.9 ± 5.8% using detachment solution. Also, C. cayetanensis oocysts were seeded onto lettuces, herbs and raspberries and the recovery using de-ionized water were compared to 0.1% Alconox wash: basil 17.5 ± 5.0% to 76.1 ± 14.0%, lollo rosso lettuce 38.3 ± 5.5% to 72.5 ± 8.1%, Tango leaf lettuce 45.9 ± 5.4% to 71.1 ± 7.8% and spring mix (mesclun) 39.8 ± 0.7% to 80.2 ± 11.3%, respectively. These results suggest that the use of Alconox in a wash solution significantly improves recovery resulting in the detection of these parasitic protozoa on high risk foods.

Efficacy of levulinic acid-sodium dodecyl sulfate against Encephalitozoon intestinalis, Escherichia coli O157:H7, and Cryptosporidium parvum

Foodborne parasites are characterized as being highly resistant to sanitizers used by the food industry. In 2009, a study reported the effectiveness of levulinic acid in combination with sodium dodecyl sulfate (SDS) in killing foodborne bacteria. Because of their innocuous properties, we studied the effects of levulinic acid and SDS at various concentrations appropriate for use in foods, on the viability of Cryptosporidium parvum and Encephalitozoon intestinalis. The viability of Cryptosporidium and E. intestinalis was determined by in vitro cultivation using the HCT-8 and RK-13 cell lines, respectively. Two Escherichia coli O157:H7 isolates were also used in the present study: strain 932 (a human isolate from a 1992 Oregon meat outbreak) and strain E 0018 (isolated from calf feces). Different concentrations and combinations of levulinic acid and SDS were tested for their ability to reduce infectivity of C. parvum oocysts (10(5)), E. intestinalis spores (10(6)), and E. coli O157:H7 (10(7)/ml) when in suspension. Microsporidian spores were treated for 30 and 60 min at 20 ± 2°C. None of the combinations of levulinic acid and SDS were effective at inactivating the spores or oocysts. When Cryptosporidium oocysts were treated with higher concentrations (3% levulinic acid-2% SDS and 2% levulinic acid-1% SDS) for 30, 60, and 120 min, viability was unaffected. E. coli O157:H7, used as a control, was highly sensitive to the various concentrations and exposure times tested. SDS and levulinic acid alone had very limited effect on E. coli O157:H7 viability, but in combination they were highly effective at 30 and 60 min of incubation. In conclusion, Cryptosporidium and microsporidia are not inactivated when treated for various periods of time with 2% levulinic acid-1% SDS or 3% levulinic acid-2% SDS at 20°C, suggesting that this novel sanitizer cannot be used to eliminate parasitic contaminants in foods.

Epidemiology of Cyclospora cayetanensis: A review focusing in endemic areas

Cyclospora cayetanensis is an intestinal coccidian protozoon that has emerged as an important cause of endemic or epidemic diarrhoeal illness in children and adults worldwide. Humans appear to be the only natural hosts. However, the role of animals as natural reservoirs is uncertain but of increasing concern. Human-to-human spread of the parasite occurs indirectly via the environment through oocysts in contaminated water, food or soil. In endemic areas, risk factors associated with the infection include contaminated water or food, contact with soil or animals, type of sanitation and low socioeconomic status. Infections linked to soil contact provide reasons to believe that this route of spread may be more common than realised in disadvantaged community settings. C. cayetanensis is an important cause of traveller's diarrhoea and numerous large foodborne outbreaks associated with the globalisation of the food supply and importation of fruits and vegetables from developing countries have occurred. Waterborne outbreaks have also been reported. Implementation of measures to prevent or control the spread of Cyclospora oocysts in the environment is critical. In endemic areas, the most important steps to prevent infection are improving environmental sanitation and health education. Significant gaps remain in our understanding of the epidemiology of human cyclosporiasis that highlight the need for continued research in several aspects of C. cayetanensis.

Update on Cyclospora cayetanensis, a food-borne and waterborne parasite

The coccidian parasite Cyclospora cayetanensis is recognized as an emerging pathogen that causes protracted diarrhea in humans. The first cases of Cyclospora infection were reported in the late 1970s and were observed among expatriates and travelers in regions where infections are endemic. Since then, Cyclospora has been considered a cause of traveler's diarrhea. Epidemiological investigations were reported and examined in areas of endemicity even before the true identity of Cyclospora was elucidated. Cyclospora was fully characterized in the early 1990s, but it was not until the 1995 Cyclospora outbreak in the United States and Canada that it caught the attention of the public and physicians. The biology, clinical presentation, epidemiology, diagnosis, treatment, and control of cyclosporiasis are reviewed, with a focus on diagnostic assays currently being used for clinical and environmental samples. Challenges and limitations in working with Cyclospora are also discussed.