Sydney 1998 - lessons from a drinking water crisis

From July to September 1998, high concentrations of Cryptosporidium and Giardia were detected episodically in the water supply and distribution systems of Sydney, Australia. The resulting drinking water crisis triggered three consecutive boil-water advisories and a government inquiry into the management of the water supply. The episodic nature of the detections focused attention on the veracity of the laboratory results and triggered an investigation of the transport of these pathogens in Sydney's water supply system. This article provides information submitted to the Sydney Water Inquiry that explains the episodic occurrence of pathogens in the reticulated water supply, attributing it to rapid fluctuations in the quality of the water reaching the water treatment plant

The epidemiology of cryptosporidiosis in New Zealand, 1997-2006

Aims New Zealand has a high incidence of cryptosporidiosis compared to other developed countries. This study aimed to describe the epidemiology of this disease in detail and to identify potential risk factors.

Methods We analysed anonymous cryptosporidiosis notification (1997–2006) and hospitalisation data (1996–2006). Cases were designated as “urban” or “rural” and assigned a deprivation level based on their home address. Association between disease rates and animal density was studied using a simple linear regression model, at the territorial authority level.

Results Over the 10-year period 1997–2006, the average annual rate of notified cryptosporidiosis was 22.0 cases per 100,000 population. The number of hospitalisations was equivalent to 3.6% of the notified cases. There was only 1 reported fatality. The annual incidence of infection appeared fairly stable, but showed marked seasonality with a peak rate in spring (September–November in New Zealand). The highest rates were among Europeans, children 0–9 years of age, and those living in low deprivation areas. Notification rates showed large geographic variations, with rates in rural areas 2.8 times higher than in urban areas, and with rural areas also experiencing the most pronounced spring peak. At the territorial authority (TA) level, rates were also correlated with farm animal density.

Conclusions Most transmission of Cryptosporidium in New Zealand appears to be zoonotic: from farm animals to humans. Prevention should focus on reducing transmission in rural setting, though more research is needed to identify which strategies are likely to be most effective in that environment.

A tale of two parasites : the comparative epidemiology of cryptosporidiosis and giardiasis

New Zealand has a higher reported incidence of cryptosporidiosis and giardiasis than most other developed countries. This study aimed to describe and compare the epidemiology of these infections in New Zealand, to better understand their impact on public health and to gain insight into their probable modes of transmission. We analysed cryptosporidiosis and giardiasis notification data for a 10-year period (1997–2006). Highest rates for both diseases were in Europeans, children aged 0–5 years, and those living in low-deprivation areas. Cryptosporidiosis distribution was consistent with mainly farm animal (zoonotic) reservoirs. There was a dose–response relationship with increasing grades of rurality, marked spring seasonality, and positive correlation with farm animal density. Giardiasis distribution was consistent with predominantly human (anthroponotic) reservoirs, with an important contribution from overseas travel. Further research should focus on methods to reduce transmission of Cryptosporidium in rural areas and on reducing anthroponotic transmission of Giardia.

Protozoa lectins and their role in host-pathogen interactions

Lectins are proteins/glycoproteins of non-immune origin that agglutinate red blood cells, lymphocytes, fibroblasts, etc., and bind reversibly to carbohydrates present on the apposing cells. They have at least two carbohydrate binding sites and their binding can be inhibited by one or more carbohydrates. Owing to carbohydrate binding specificity of lectins, they mediate cell-cell interactions and play role in protozoan adhesion and host cell cytotoxicity, thus are central to the pathogenic property of the parasite. Several parasitic protozoa possess lectins which mediate parasite adherence to host cells based on their carbohydrate specificities. These interactions could be exploited for development of novel therapeutics, targeting the adherence and thus helpful in eradicating wide spread of protozoan diseases. The current review highlights the present state knowledge with regard to protozoal lectins with an emphasis on their haemagglutination activity, carbohydrate specificity, characteristics and also their role in pathogenesis notably as adhesion molecules, thereby aiding the pathogen in disease establishment.