Secondary transmission of cryptosporidiosis associated with well water consumption: two case studies

Abstract: Cryptosporidiosis is a very prominent disease in the field of public health, and usually causes diarrhea. We describe two immunocompetent patients who presented with chronic diarrhea that was ultimately found to be caused by continuous exposure to well water contaminated with the microbial cysts (oocysts) of the Cryptosporidium spp parasite. We describe the patients' histories and possible explanations for their prolonged symptoms.

Prevalence, species differentiation, haemolytic activity, and antibiotic susceptibility of aeromonads in untreated well water

The use of untreated water for drinking and other activities have been associated with intestinal and extraintestinal infections in humans due to Aeromonas species. In the present study aeromonads were isolated from 48.7% of 1,000 water samples obtained from wells and other miscellaneous sources. Aeromonas species were detected in 45% of samples tested in spring, 34.5% in summer, 48% in autumn and 60% of samples tested in winter. Speciation of 382 strains resulted in 225 (59%) being A. hydrophila, 103 (27%) A. caviae, 42 (11%) A. sobria and 11 (3%) atypical aeromonads. Of 171 Aeromonas strains tested for their haemolytic activity, 53%, 49%, 40% and 37% were positive in this assay using human, horse, sheep and camel erythrocytes respectively. The results obtained indicate that potentially enteropathogenic Aeromonas species are commonly present in untreated drinking water obtained from wells in Libya (this may also apply to other neighbouring countries) which may pose a health problem to users of such water supplies. In addition, ceftriaxone and ciprofloxacin are suitable drugs that can be used in the treatment of Aeromonas-associated infections, particularly in the immunocompromised, resulting from contact with untreated sources of water.

Determination of heavy metals and genotoxicity of water from an artesian well in the city of Vazante- MG, Brazil

The city of Vazante-MG is of great socioeconomic and environmental interest because it is the most important zinc producer district of Brazil. The mineral processing and geochemical processes may determine high concentrations of heavy metals in water intended for human consumption. Thus, the present study aimed to quantify and evaluate the heavy metal genotoxicity of artesian water in the city by Atomic absorption spectrophotometer analysis and testing with the Allium cepa test, respectively. This study reveals a chemical contamination in well water in the city, caused by the presence of heavy metals. Therefore, it can be considered that the high levels of heavy metals found in water samples are correlated with the genotoxic events observed in root cells of A. cepa.

Update #3 : Crestwood public water supply groundwater modeling -- bedrock well installation /

"September 11, 2009"

Exposure to contaminated water: perceptions and practices in a neighborhood in the city of Manaus, Brazil

Objective. To investigate the modes of water supply and the perception concerning the problems caused by this water among residents of a neighborhood without public supply of water, settled in an area previously used as a garbage dump in the city of Manaus, Brazil. Methods. One hundred and sixty-two semi-structured household interviews were conducted. In addition, a focal group with teachers from a local public school and a meeting with residents were held. The instruments employed focused on the perception and modes of water use and on the process of exposure to chemical contaminants through water. Results. Untreated well water was used by most families. This water was considered to be ""good"" by 64.8% of the individuals interviewed. Most residents (88.3%) declared knowledge about the garbage dump. Of these, 77.6% stated that the garbage dump caused health and environmental problems. However, qualitative analysis of the responses revealed that the residents were not aware of contamination by chemical elements or of the consequences of such contamination. The activities carried out with teachers revealed that they were partially aware of the problem, but did not design interventions to address the issue. In a meeting with neighborhood residents, the presence of social activism concerning the problem was identified, but it did not extend beyond the neighborhood or reach governmental spheres. Conclusions. The study identified a situation of critical exposure that tends to be maintained as a result of misperceptions and lack of social mobilization. The dissemination of research results to teachers and residents was useful to empower subjects.

Effect of irrigation water and processing on the microbial quality of lettuces produced and sold on markets in Dakar (Senegal)

The aim of this survey is to assess the microbiological impact of irrigation water on lettuces produced on two urban agricultural sites and sold on markets; 6 and 7%, respectively, of lettuces coming from the sites of Pikine and Patte d'Oie were Salmonella spp. positive. Lettuces irrigated with shallow groundwater (''Ceanes'' water) were more contaminated (8% at both Pikine and Patte d'Oie sites) compared to those irrigated with wastewater (4% at Pikine) or well water (5% at Patte d'Oie). As for the lettuces in marketplaces, their contamination seems to depend on the type of treatment occurring before sale. Lettuces previously washed in the ``Ceanes'' were more contaminated than those rinsed with tap water at the marketplace. Salmonella spp. have been isolated from all marketplaces. However, the rates of contamination in markets surrounding Patte d'Oie are higher (9 and 11% at Grand Yoff and Dalifort) than those surrounding Pikine (4 and 2% at Zinc and Sham) or Rufisque, the control (2%). Our results confirm that the reuse of wastewater in irrigation is an alternative to animal manure. Its risk of microbial contamination can be significantly reduced by washing the vegetables with tap water before they are sold. Copyright (C) 2010 John Wiley & Sons, Ltd.

Investigation of the occurrence of pesticide residues in rural wells and surface water following application to tobacco

In this work the exposure of wells and surface water to pesticides, commonly used for tobacco cropping, was assessed. Water consumption wells and surface water flows were sampled at different times. After a preconcentration step with solid phase extraction (SPE), the selected pesticides were determined by gas chromatography with electron capture detection (GC-ECD) or high performance liquid chromatography with diode array detection (HPLC-DAD). No pesticides were detected in the well water samples and surface water flow in the winter season. However, in the spring and summer higher concentrations of chlorpyrifos and imidacloprid were found in the water source samples. Atrazine, simazine and clomazone were also found. The occurrence of pesticides in collected water samples was related with the application to tobacco.

Risk of Giardia infection for drinking water and bathing in a peri-urban area in Sao Paulo, Brazil

A high incidence of waterborne diseases is observed worldwide and in order to address contamination problems prior to an outbreak, quantitative microbial risk assessment is a useful tool for estimating the risk of infection. The objective of this paper was to assess the probability of Giardia infection from consuming water from shallow wells in a peri-urban area. Giardia has been described as an important waterborne pathogen and reported in several water sources, including ground waters. Sixteen water samples were collected and examined according to the US EPA (1623, 2005). A Monte Carlo method was used to address the potential risk as described by the exponential dose response model. Giardia cysts occurred in 62.5% of the samples (0.1-36.1 cysts/l). A median risk of 10-1 for the population was estimated and the adult ingestion was the highest risk driver. This study illustrates the vulnerability of shallow well water supply systems in peri-urban areas.

Determination of nitrite in meat products and water using dapsone with combined spot test/diffuse reflectance on filter paper

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

RB30-245 Water Supply and Sewage Disposal Systems for Farm Homes

When the well "goes dry" or when the windmill or pump breaks down, every one in the household immediately appreciates the value fo plenty of water. In other words, "You never miss the water until the well runs dry." Fortunately, in most sections of this state, plenty of pure water may be obtained by sinking wells of moderate depth, yet surprisingly few farm homes are supplied with running water in the kitchen even though the barn yards are equipped with hydrants and tanks. It is the purpose of this bulletin to present a number of water supply and sewage disposal systems which have been used in Nebraska and surrounding states and which add greatly to the comfort and convenience of the farm home.

Assessment of two arsenic-contaminated drinking water mitigation interventions in Bangladesh

Arsenic is a carcinogen. In Bangladesh, there are over 10 million tube-wells of which about 50% have arsenic concentrations exceeding the WHO recommended guideline value of 10 μg/L for drinking water. This study aimed to evaluate the efficacy of two relatively inexpensive mitigation interventions, three-pitcher filters and dug-wells. A randomised controlled field trial was conducted in Natore. Six Hundred and forty participants, 60 clusters of 47 villages were included in the trial. Two hundred and six participants were selected for the control group, 218 participants for the dug-wells, and 216 participants for the three-pitcher filters. The average arsenic in the drinking water was 128 μg/L in the three-pitcher trial. Twelve months post intervention, about 30% of the filtered water samples were >50 μg/L whereas dug-well water was

The relationship of E. coli and total coliform culture to the quantitative molecular detection of various fecal indicators, sources, and pathogens in private drinking water wells

Water remains a predominant vector for human enteric pathogens not just for developing countries but also developed nations, where numerous infectious disease outbreaks, linked to the contamination of drinking water have been documented. Private drinking water wells are a source of drinking water that is largely unstudied even though a significant percentage of the population in Ontario relies on wells as their primary water source. As there exists little to no systematic surveillance for enteric infections or outbreaks related to well water sources, these individuals may be at higher risk of waterborne infectious diseases. The relationships between various fecal indicators in the water of private drinking water wells, including E. coli, Total Coliforms (TC) and Bacteroides, and enteric pathogens, including Campylobacter jejuni, Salmonella spp., and Shiga toxin producing E. coli, were studied. Convenience private well water samples collected from various regions of interest during the summer of 2014 underwent membrane filtration and culture to determine quantities of E. coli and TC colony forming units. 289 E. coli positive and 230 TC-only waters were successfully analyzed by individual qPCR assays for the aforementioned enteric pathogens. Microbial source tracking methods targeted to specific Bacteroides were used to determine the source of fecal contamination as either human or bovine. The source of fecal contamination varied by geographic region and is thought to be due to such things as differences in septic tank density and underlying geology, among others. Fecal indicators, E. coli and Bacteroides, were significantly correlated. E. coli as measured by qPCR was more strongly correlated to both total and human-specific Bacteroides genetic markers than culturable E. coli. Lastly, 1.9% of samples showed molecular evidence of contamination with enteric pathogens. Although low, this finding is significant given the limited volume of water available for testing, and suggests a potential health risk to consumers. Knowing the extent of contamination, as well as the biologic source, can better inform risk assessment and the development of potential intervention strategies for private well water in specific regions of Ontario.

Reclaimed wastewater: Effects on citrus nutrition

The effects of irrigation with reclaimed wastewater (RWW) were compared with well water (WW) on citrus (Citrus paradisi Macfad. X Citrus aurantium L) nutrition. The deviation from the optimum percentage (DOP) index of macro- and micro-nutrients were used to evaluate the nutritional status: optimal (DOP = 0), deficiency (DOP < 0) or excess (DOP > 0). After 11 years of RWW irrigation the influence on nutrient concentration in plants decreased in the order: B > Zn > Mn = Ca > Cu > Mg > P > K. Reclaimed wastewater irritation positively affected citrus nutrition as it rendered the concentration of macronutrients, i.e. P, Ca, and K. closer to their optimum levels (Sigma DOP(macro) = 7). However micro-nutrients tended to be excessive in plants (EDOP(micro) = 753) due to imbalanced supply of these elements in the RWW, particularly, for B and Cu. Citrus groves with long-term RWW irrigation may exercised caution in monitoring concentrations of B and Cu to avoid plant toxicity and soil quality degradation. (C) 2011 Elsevier B.V. All rights reserved.

Environmental Risk Factors for Parkinson's Disease

Parkinson’s disease (PD) is a progressive, degenerative, neurological disease. The progressive disability associated with PD results in substantial burdens for those with the condition, their families and society in terms of increased health resource use, earnings loss of affected individuals and family caregivers, poorer quality of life, caregiver burden, disrupted family relationships, decreased social and leisure activities, and deteriorating emotional well-being. Currently, no cure is available and the efficacy of available treatments, such as medication and surgical interventions, decreases with longer duration of the disease. Whilst the cause of PD is unknown, genetic and environmental factors are believed to contribute to its aetiology. Descriptive and analytical epidemiological studies have been conducted in a number of countries in an effort to elucidate the cause, or causes, of PD. Rural residency, farming, well water consumption, pesticide exposure, metals and solvents have been implicated as potential risk factors for PD in some previous epidemiological studies. However, there is substantial disagreement between the results of existing studies. Therefore, the role of environmental exposures in the aetiology of PD remains unclear. The main component of this thesis consists of a case-control study that assessed the contribution of environmental exposures to the risk of developing PD. An existing, previously unanalysed, dataset from a local case-control study was analysed to inform the design of the new case-control study. The analysis results suggested that regular exposure to pesticides and head injury were important risk factors for PD. However, due to the substantial limitations of this existing study, further confirmation of these results was desirable with a more robustly designed epidemiological study. A new exposure measurement instrument (a structured interviewer-delivered questionnaire) was developed for the new case-control study to obtain data on demographic, lifestyle, environmental and medical factors. Prior to its use in the case-control study, the questionnaire was assessed for test-retest repeatability in a series of 32 PD cases and 29 healthy sex-, age- and residential suburb-matched electoral roll controls. High repeatability was demonstrated for lifestyle exposures, such as smoking and coffee/tea consumption (kappas 0.70-1.00). The majority of environmental exposures, including use of pesticides, solvents and exposure to metal dusts and fumes, also showed high repeatability (kappas >0.78). A consecutive series of 163 PD case participants was recruited from a neurology clinic in Brisbane. One hundred and fifty-one (151) control participants were randomly selected from the Australian Commonwealth Electoral Roll and individually matched to the PD cases on age (± 2 years), sex and current residential suburb. Participants ranged in age from 40-89 years (mean age 67 years). Exposure data were collected in face-to-face interviews. Odds ratios and 95% confidence intervals were calculated using conditional logistic regression for matched sets in SAS version 9.1. Consistent with previous studies, ever having been a regular smoker or coffee drinker was inversely associated with PD with dose-response relationships evident for packyears smoked and number of cups of coffee drunk per day. Passive smoking from ever having lived with a smoker or worked in a smoky workplace was also inversely related to PD. Ever having been a regular tea drinker was associated with decreased odds of PD. Hobby gardening was inversely associated with PD. However, use of fungicides in the home garden or occupationally was associated with increased odds of PD. Exposure to welding fumes, cleaning solvents, or thinners occupationally was associated with increased odds of PD. Ever having resided in a rural or remote area was inversely associated with PD. Ever having resided on a farm was only associated with moderately increased odds of PD. Whilst the current study’s results suggest that environmental exposures on their own are only modest contributors to overall PD risk, the possibility that interaction with genetic factors may additively or synergistically increase risk should be considered. The results of this research support the theory that PD has a multifactorial aetiology and that environmental exposures are some of a number of factors to contribute to PD risk. There was also evidence of interaction between some factors (eg smoking and welding) to moderate PD risk.