Salivary Antibodies against Multiple Environmental Pathogens Found in Individuals Recreating at an Iowa Beach.

Swinburne A J Augustine,Kaneatra Simmons,Shannon M Griffin,Elizabeth Sams,Tim Wade,Kevin Oshima,Tarsha N Eason,Malini Ramudit,Alfred Dufour

doi:10.3390/ijerph18115797

Abstract

Detecting environmental exposures and mitigating their impacts are growing global public health challenges. Antibody tests show great promise and have emerged as fundamental tools for large-scale exposure studies. Here, we apply, demonstrate and validate the utility of a salivary antibody multiplex immunoassay in measuring antibody prevalence and immunoconversions to six pathogens commonly found in the environment. The study aimed to assess waterborne infections in consenting beachgoers recreating at an Iowa riverine beach by measuring immunoglobulin G (IgG) antibodies against select pathogens in serially collected saliva samples. Results showed that nearly 80% of beachgoers had prior exposures to at least one of the targeted pathogens at the beginning of the study. Most of these exposures were to norovirus GI.1 (59.41%), norovirus GII.4 (58.79%) and Toxoplasma gondii (22.80%) and over half (56.28%) of beachgoers had evidence of previous exposure to multiple pathogens. Of individuals who returned samples for each collection period, 6.11% immunoconverted to one or more pathogens, largely to noroviruses (GI.1: 3.82% and GII.4: 2.29%) and T. gondii (1.53%). Outcomes of this effort illustrate that the multiplex immunoassay presented here serves as an effective tool for evaluating health risks by providing valuable information on the occurrence of known and emerging pathogens in population surveillance studies.

Highlights

Waterborne, foodborne and environmentally transmitted infections continue to be a serious global concern for both developed and developing countries [1]
We described the development and utility of salivary antibody multiplex immunoassays in measuring symptomatic and asymptomatic infections, immunoprevalence, coinfections and incident infections associated with recreating in contaminated waters and other environmental and water-related exposures [13,14,15,16,17,18]
While previous studies concentrated on marine beachgoers, this study focuses on investigating the prevalence of exposure and incident infections in a riverine beachgoing community by examining the presence of immunoglobulin G (IgG) antibodies against six pathogens: norovirus genotypes GI.1 and GII.4, Helicobacter pylori, hepatitis A virus [HAV], Toxoplasma gondii and Campylobacter jejuni)

Summary

Introduction

Waterborne, foodborne and environmentally transmitted infections continue to be a serious global concern for both developed and developing countries [1]. A prominent area of concern is the well-documented association between fecal contamination and the risk of gastrointestinal (GI) illness for individuals recreating in oceans and lakes. Much less is known about the health risks associated with swimming in inland rivers [2]. Large inland rivers are a valuable source for recreation, but they receive discharges from numerous sources including treated and untreated sewage, wastewater and contaminated runoff that may cause acute health effects (e.g., infections). Since some infections present without observable symptoms, immunological responses can be used to identify the etiological agents and estimate both symptomatic and asymptomatic disease burden [3].

Methods

Results

Discussion

Conclusion