Waterborne Infectious Diseases Research Articles

Monitoring coliphages to reduce waterborne infectious disease transmission in the One Water framework.

Coastal waters, surface waters, and groundwater are impacted by wastewater and stormwater discharges, as well as agricultural flows containing animal waste and nutrients. A One Water approach posits that components of the water system have overlapping and interactive impacts on other aspects of the system, for which a comprehensive approach to water management is needed to further inform public health decisions. Current frameworks for monitoring wastewater effluent and recreational surface waters include the measurement of fecal indicator bacteria. Although viral pathogens are likely to be transported further and can survive longer than bacterial pathogens, virus monitoring is not required for recreational waters. A scientific consensus is emerging that the use of bacterial indicators alone does not account for nor represent the health risks associated with viral pathogens due to the differences in the fate and transport of bacterial versus viral pathogens in wastewater treatment, surface water, and groundwater. Furthermore, it is likely that the public health risk associated with these waterborne pathogens is variable and diverse. For example, under drought conditions, effluents of urban water systems can comprise most of the dry weather flow in downstream waters, which are often used as sources of drinking water. This de facto reuse could increase viral risk for the end users of this water. A One Water approach will aid in protecting the health of the public from waterborne pathogens, regardless of where those pathogens entered the water system. In this review, we assert that monitoring for fecal indicator viruses can complement the monitoring of bacterial indicators, thereby improving public health protections. Bacteriophages have the strongest research foundation and correlation with viral pathogens along with some prediction power for risk to human health. Methods for detecting and quantifying coliphages are briefly summarized, as are challenges in the implementation of testing. Key knowledge gaps and research priorities are discussed so that the potential value and limitations of coliphage monitoring can be better addressed and understood.

Climate Precursors of Satellite Water Marker Index for Spring Cholera Outbreak in Northern Bay of Bengal Coastal Regions.

Cholera is a water-borne infectious disease that affects 1.3 to 4 million people, with 21,000 to 143,000 reported fatalities each year worldwide. Outbreaks are devastating to affected communities and their prospects for development. The key to support preparedness and public health response is the ability to forecast cholera outbreaks with sufficient lead time. How Vibrio cholerae survives in the environment outside a human host is an important route of disease transmission. Thus, identifying the environmental and climate drivers of these pathogens is highly desirable. Here, we elucidate for the first time a mechanistic link between climate variability and cholera (Satellite Water Marker; SWM) index in the Bengal Delta, which allows us to predict cholera outbreaks up to two seasons earlier. High values of the SWM index in fall were associated with above-normal summer monsoon rainfalls over northern India. In turn, these correlated with the La Niña climate pattern that was traced back to the summer monsoon and previous spring seasons. We present a new multi-linear regression model that can explain 50% of the SWM variability over the Bengal Delta based on the relationship with climatic indices of the El Niño Southern Oscillation, Indian Ocean Dipole, and summer monsoon rainfall during the decades 1997–2016. Interestingly, we further found that these relationships were non-stationary over the multi-decadal period 1948–2018. These results bear novel implications for developing outbreak-risk forecasts, demonstrating a crucial need to account for multi-decadal variations in climate interactions and underscoring to better understand how the south Asian summer monsoon responds to climate variability.

Interpersonal violence associated with hot weather

The anthropogenic climate change has numerous adverse health effects, such as heat-related morbidity and mortality, respiratory diseases from wildfire smoke, rise of prevailing and novel vector-borne and water-borne infectious diseases following a drought or flood, and death or injury due to storms or flooding.1,2 However, the potential effect of high temperature on increased interpersonal violence, in the context of climate change, has received much less attention.

Associations Between Environmental and Sociodemographic Data and Hepatitis-A Transmission in Pará State (Brazil).

Hepatitis‐A is a waterborne infectious disease transmitted by the eponymous hepatitis‐A virus (HAV). Due to the disease's sociodemographic and environmental characteristics, this study applied public census and remote sensing data to assess risk factors for hepatitis‐A transmission. Municipality‐level data were obtained for the state of Pará, Brazil. Generalized linear and nonlinear models were evaluated as alternative predictors for hepatitis‐A transmission in Pará. The Histogram Gradient Boost (HGB) regression model was deemed the best choice (RMSE= 2.36, and higher R2 = 0.95) among the tested models. Partial dependence analysis and permutation feature importance analysis were used to investigate the partial dependence and the relative importance values of the independent variables in the disease transmission prediction model. Results indicated a complex relationship between the disease transmission and the sociodemographic and environmental characteristics of the study area. Population size, lack of sanitation, urban clustering, year of notification, insufficient public vaccination programs, household proximity to open‐air dumpsites and storm‐drains, and lack of access to healthcare facilities and hospitals were sociodemographic parameters related to HAV transmission. Turbidity and precipitation were the environmental parameters closest related to disease transmission. Based on HGB model, a hepatitis‐A risk map was built for Pará state. The obtained risk map can be thought of as an auxiliary tool for public health strategies. This study reinforces the need to incorporate remote sensing data in epidemiological modelling and surveillance plans for the development of early prevention strategies for hepatitis‐A.

Trends in recent waterborne and foodborne disease outbreaks in South Korea, 2015-2019.

ObjectivesThis study analyzed trends in foodborne and waterborne diseases in South Korea between 2015 and 2019.MethodsThe data consisted of information on outbreaks of waterborne and foodborne infectious diseases reported through the Korea Centers for Disease Control and Prevention (KCDC) system. We analyzed the trends and epidemiological aspects of outbreaks by month, place of occurrence, and causative pathogens in this observational study.ResultsThe number of outbreaks has steadily increased over the last 5 years, but the number of cases per outbreak has followed a decreasing trend. Incidence at daycare centers and preschools has been steadily increasing over consecutive years.ConclusionThe steady number of patients and decreasing number of cases per outbreak, even as the number of outbreaks has been increasing, suggest that the KCDC’s professional management system is operating effectively. It is necessary to continue improving the objectivity and efficiency of the management system and to carefully examine the increasing number of outbreaks in smaller-scale group catering facilities, such as daycare centers and preschools. Outbreaks can be prevented by closely examining those caused by unidentified pathogens and group outbreaks caused by other diseases, identifying problems, and supplementing the management system.

Coliphages as a Complementary Tool to Improve the Management of Urban Wastewater Treatments and Minimize Health Risks in Receiving Waters

Even in countries with extensive sanitation systems, outbreaks of waterborne infectious diseases are being reported. Current tendencies, such as the growing concentration of populations in large urban conurbations, climate change, aging of existing infrastructures, and emerging pathogens, indicate that the management of water resources will become increasingly challenging in the near future. In this context, there is an urgent need to control the fate of fecal microorganisms in wastewater to avoid the negative health consequences of releasing treated effluents into surface waters (rivers, lakes, etc.) or marine coastal water. On the other hand, the measurement of bacterial indicators yields insufficient information to gauge the human health risk associated with viral infections. It would therefore seem advisable to include a viral indicator—for example, somatic coliphages—to monitor the functioning of wastewater treatments. As indicated in the studies reviewed herein, the concentrations of somatic coliphages in raw sewage remain consistently high throughout the year worldwide, as occurs with bacterial indicators. The removal process for bacterial indicators and coliphages in traditional sewage treatments is similar, the concentrations in secondary effluents remaining sufficiently high for enumeration, without the need for cumbersome and costly concentration procedures. Additionally, according to the available data on indicator behavior, which is still limited for sewers but abundant for surface waters, coliphages persist longer than bacterial indicators once outside the gut. Based on these data, coliphages can be recommended as indicators to assess the efficiency of wastewater management procedures with the aim of minimizing the health impact of urban wastewater release in surface waters.

Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States.

Provision of safe drinking water in the United States is a great public health achievement. However, new waterborne disease challenges have emerged (e.g., aging infrastructure, chlorine-tolerant and biofilm-related pathogens, increased recreational water use). Comprehensive estimates of the health burden for all water exposure routes (ingestion, contact, inhalation) and sources (drinking, recreational, environmental) are needed. We estimated total illnesses, emergency department (ED) visits, hospitalizations, deaths, and direct healthcare costs for 17 waterborne infectious diseases. About 7.15 million waterborne illnesses occur annually (95% credible interval [CrI] 3.88 million–12.0 million), results in 601,000 ED visits (95% CrI 364,000–866,000), 118,000 hospitalizations (95% CrI 86,800–150,000), and 6,630 deaths (95% CrI 4,520–8,870) and incurring US $3.33 billion (95% CrI 1.37 billion–8.77 billion) in direct healthcare costs. Otitis externa and norovirus infection were the most common illnesses. Most hospitalizations and deaths were caused by biofilm-associated pathogens (nontuberculous mycobacteria, Pseudomonas, Legionella), costing US $2.39 billion annually.

Asymptomatic transmission shifts epidemic dynamics.

Asymptomatic transmission of infectious diseases has been recognized recently in several epidemics or pandemics. There is a great need to incorporate asymptomatic transmissions into traditional modeling of infectious diseases and to study how asymptomatic transmissions shift epidemic dynamics. In this work, we propose a compartmental model with asymptomatic transmissions for waterborne infectious diseases. We conduct a detailed analysis and numerical study with shigellosis data. Two parameters, the proportion $p$ of asymptomatic infected individuals and the proportion $k$ of asymptomatic infectious individuals who can asymptomatically transmit diseases, play major rules in the epidemic dynamics. The basic reproduction number $\mathscr{R}_{0}$ is a decreasing function of parameter $p$ when parameter $k$ is smaller than a critical value while $\mathscr{R}_{0}$ is an increasing function of $p$ when $k$ is greater than the critical value. $\mathscr{R}_{0}$ is an increasing function of $k$ for any value of $p$. When $\mathscr{R}_{0}$ passes through 1 as $p$ or $k$ varies, the dynamics of epidemics is shifted. If asymptomatic transmissions are not counted, $\mathscr{R}_{0}$ will be underestimated while the final size may be overestimated or underestimated. Our study provides a theoretical example for investigating other asymptomatic transmissions and useful information for public health measurements in waterborne infectious diseases.

OPD Management Of General Surgical Patient In Covid-19 Situation – Ayurvedic And Modern Perspective

Abstract
 
 On 11th March 2020, the World Health Organization declared Severe Acute Respiratory Syndrome COVID-19 as a pandemic and hence lockdown imposed in India resulted in a significant depletion in surgical practices even after unlock down. There were some guidelines for patient care in general surgical practice have been published, overall, publications focusing exclusively on guidelines on starting surgical outpatient departments (OPD) after the COVID-19 lockdown amidst the on-going pandemic are lacking. We hereby propose the evolving knowledge in changes in OPD management practices for general surgeons in the COVID- 19 era. The priority on online registration (e-registration) should be given impetus and become the new norm supplemented by telephonic and spot registration for the uneducated patients. 
 The article also mentions the duties of the help desk, OPD hall supervisor and the new norms of air conditioning, ventilation, safe use of elevators, sanitization of OPD premises and biomedical waste disposal. The optimum and safe utilization of human & material resources DO’s and DON’Ts for patients & health staff have also been proposed. 
 In Ayurveda, a concept similar to the epidemic is narrated by Acharya Charak under a broad heading ‘Janapadodhwamsa’. The word ‘Janapadodhwamsa’ comprises of two words Janapada (large population) & Udhvamsa (destruction) which means the diseases affecting & causing damage of a large number of people. Factors which are familiar to the people under a particular community like air (Vayu), water (Jala), habitat (Desha) and seasons (Kala), Sinful acts (Adharma) in the form of war, affliction by attacks of monsters, demon, alliants (Rakshas) etc. & curses (Abhishap) are responsible for ‘Janapadodhwamsa. . These diseases can be considered as either airborne or waterborne infectious diseases or diseases occurring due to soil contamination or conditions arising due to weather or seasonal hazards. Further, under the heading of Adidaivika Bala Pravritta Vyadhi (diseases arising due to such causes that cannot be controlled by human intelligence), terms such as Sansargaja and Upsragaja are mentioned which indicate that there are certain diseases which can be transmitted directly from infected persons to healthy persons such as contagious diseases or certain diseases can be transmitted by respiration/air borne
 Keywords: COVID 19, Outpatient, general surgery, Corona virus, OPD, Janapadodhwamsa’

A data-driven optimization approach for multi-period resource allocation in cholera outbreak control

Cholera, a water-borne bacteria infectious disease, shows clear spatial variation in its transmission pattern. It is thus important to incorporate understanding on the spatial variability of its transmission when making transmission prediction and intervention decisions. However, for an emerging cholera outbreak, transmission dynamics models are often uncertain as model parameters are indeterminate and epidemic state can only be partially observed. Hence, ensuing intervention decisions have to be made under uncertainty and thus the resultant optimization problem is challenging. In this paper, we study a multi-period location-specific resource allocation problem for cholera outbreak intervention with periodically acquired state information from different locations and increasingly understood transmission parameters over time. We formulate the problem as a nonlinear optimization model on a set of ordinary-differential-equations governing location-specific disease transmission dynamics. We propose a data-driven optimization approach to determine the optimal strategy of intervention resource allocation at each period and each community in a rolling-horizon manner. At each period, we integrate single-period model parameter fitting and scenario-based stochastic programming to make decisions under uncertainty with newly acquired system understanding. We conduct comparative studies to assess the performance of our data-driven optimization approach and offer insights into intervention resource allocation policy development. We conclude that our data-driven optimization approach is effective to multi-period decision problems under system dynamics with indeterminate parameters.

The assessment of environmental health status in the route of Arbaeen pilgrims at Shalamcheh border in southwestern Iran

The negligence of health regulations in the preparation of the foods, services, and sanitary and welfare facilities provided in religious borders could increase the risk of waterborne infectious intestinal diseases. Therefore, the continuous monitoring and control of health indicators is essential in mourning borders. This descriptive, cross-sectional study was conducted on the Mawkebs of Shalamcheh border (n=267). In total, 186 samples were evaluated in terms of the microbial quality of water, and 66 samples were evaluated in terms of the microbial quality of food. The studied parameters in drinking water included the residual free chlorine, pH, turbidity, total coliform, and fecal coliform, and the studied parameters in foodstuffs included the total count and fecal coliform (Escherichia coli). According to the findings, these indicators were appropriate in terms of accommodation hygiene and preparation and distribution of crew hygiene by 99.9%. On the other hand, there were zero cases where the food sampling results were undesirable for the measurement of the total count and fecal coliform. The number of the contaminated water samples was 46 (24.7%) out of 186 water samples. Therefore, the proper implementation and continuous control of health instructions seem critical for these borders, and it is suggested that special regulations and indicators be enacted for the crew in charge, so that they would attend training courses, obtain medical examination cards, and practice personal hygiene.

Effects of bacterial community composition and structure in drinking water distribution systems on biofilm formation and chlorine resistance

Community-intrinsic properties affect the composition and function of a microbial community. Understanding the microbial community-intrinsic properties in drinking water distribution systems (DWDS) could help to select disinfection strategies and aid in the prevention of waterborne infectious diseases. In this study, we investigated the formation of multi-species biofilms in six groups, each consisting of four or five mixed bacterial strains isolated from a simulated DWDS, at different incubation times (24, 48, and 72 h). We then evaluated the chlorine resistance of the 72-h multi-species biofilms in the presence of 0.3, 0.6, 1, 2, 4, and 10 mg/L residual chlorine. Microbacterium laevaniformans inhibited the formation of multi-species biofilms, Sphingomonas sp., Acinetobacter sp. and A. deluvii had the effect of promoting their growth, and B. cereus has little effect on the growth of multi-species biofilms. However, these inhibition and promotion effects were weak and inadequate to completely control the growth of multi-species biofilms. All multi-species produced strong biofilms after 72 h incubation, which could be due to microbial community-intrinsic properties. Community-intrinsic properties could maintain high EPS production and cell-to-cell connections in multi-species biofilms, and could affect the formation of multi-species biofilms. The chlorine resistance of multi-species biofilms was significantly improved by B. cereus, but significantly reduced by M. laevaniformans. These results indicated that the microbial community-intrinsic properties were influenced by the environment. At a relatively low disinfectant concentration (<2 mg/L residual chlorine), the community-intrinsic properties were maintained; however, when the disinfectant concentration was increased to 2–4 mg/L residual chlorine, the community-intrinsic properties weakened, and significantly affected the resistance of the microbial communities to the disinfectant. With further increases in concentration, to >4 mg/L residual chlorine, no significant difference was observed in the disinfectant resistance of the microbial community.

Health-related publications on people living in fragile states in the alert zone: a bibliometric analysis

BackgroundFragile states pose a global challenge. Assessing health research activity on people living in these states can help identify neglected health domains in fragile settings. The objective of the current study was to assess and describe health research activity on people living in fragile states in the alert zone.MethodA bibliometric method was applied using SciVerse Scopus. Research articles published on people in fragile states in the alert zone were retrieved and analyzed. The Fragile State Index (FSI) score was used for selection of states in the alert zone. The analysis was limited to 1 year; 2018.ResultsThe search query found 2299 research articles giving an average of 2 research articles per one million population per year in the selected fragile states. The number of research articles per one million population was not significantly correlated (p = 0.053; r = − 0.349) with FSI scores. However, it was significantly correlated with the extent of international research collaboration (p < 0.01, r = 065). Research on communicable diseases was the largest research domain (763 articles; 33.2%) followed by maternal/women’s health (430 articles; 18.7%), non-communicable diseases (291 articles; 12.7%), health system/policy (271 articles; 11.8%) and psychosocial and mental health (89; 3.9%). There were three research themes in the research domain of infectious diseases: HIV/AIDS; water-borne infectious diseases; and miscellaneous infectious diseases such as tuberculosis and malaria. The top ten cited articles were mainly on infectious diseases, particularly on malaria and Lassa fever. Of all the retrieved documents, 727 (31.6%) research articles appeared in national/regional journals while the remaining appeared in international journals. The World Health organization was the most active funding organization for research on fragile states. Top ten active institutions were mainly based in fragile states with the lowest FSI score, specifically Ethiopia, Uganda, Nigeria, and Pakistan.ConclusionResearch on fragile states was relatively low. Research on mental health and health system/policy should be encouraged. Collaboration and funding might help academic institutions in fragile states to make health problems in these countries more visible.

MAY SCHISTOSOMIASIS HAEMATOBIUM AND MANSONI LEAD TO INFERTILITY IN THE HOST?

Schistosomiasis is worldwide water-borne infectious risky disease. Steroid hormones are synthesizedfrom cholesterol in adrenal glands and gonads. They include corticosteroids, androgens,estrogens and progestogens. The present study evaluated the effect of Schistosoma mansoni andS. haematobium infections on the hamsters’ fertility as indicated by the changes of steroid sexhormones levels. Eighteen Mesocricetus auratus clear laboratory bred hamsters (9 males & 9females) were divided into 3 groups. G1: was infected with S. mansoni cercariae, G2: was infectedwith S. haematobium cercariae, and G3: was not infected (negative control). The resultsshowed that testosterone level increased in all infected hamsters but markedly increased in thoseinfected with schistosomiasis haematobium (7.52 & 0.78nmol/L) as compared to control (2.41 &0.341nmol/L). Progesterone level decreased in all infected hamsters especially in S. mansoni andS. haematobium females (5.732 & 11.13nmol/L) in comparison to control (86.34 &64.7nmol/L). Estradiol E2 level markedly decreased in female hamsters infected with either S.mansoni or S. haematobium (247.54 & 463.8pmol/L) as compared to control (1658pmol/L) butnot detected in male hamsters.

MAY SCHISTOSOMIASIS HAEMATOBIUM AND MANSONI LEAD TO INFERTILITY IN THE HOST

Schistosomiasis is worldwide water-borne infectious risky disease. Steroid hormones are synthesizedfrom cholesterol in adrenal glands and gonads. They include corticosteroids, androgens,estrogens and progestogens. The present study evaluated the effect of Schistosoma mansoni andS. haematobium infections on the hamsters’ fertility as indicated by the changes of steroid sexhormones levels. Eighteen Mesocricetus auratus clear laboratory bred hamsters (9 males & 9females) were divided into 3 groups. G1: was infected with S. mansoni cercariae, G2: was infectedwith S. haematobium cercariae, and G3: was not infected (negative control). The resultsshowed that testosterone level increased in all infected hamsters but markedly increased in thoseinfected with schistosomiasis haematobium (7.52 & 0.78nmol/L) as compared to control (2.41 &0.341nmol/L). Progesterone level decreased in all infected hamsters especially in S. mansoni andS. haematobium females (5.732 & 11.13nmol/L) in comparison to control (86.34 &64.7nmol/L). Estradiol E2 level markedly decreased in female hamsters infected with either S.mansoni or S. haematobium (247.54 & 463.8pmol/L) as compared to control (1658pmol/L) butnot detected in male hamsters.

Changing climate: A ‘threat multiplier’ for foodborne and waterborne infectious diseases and antibiotic resistance

Changing climate: A ‘threat multiplier’ for foodborne and waterborne infectious diseases and antibiotic resistance

Risk factors for viral hepatitis A infection in Gampaha District, Sri Lanka: an unmatched case control study

BackgroundHepatitis A virus (HAV) is one of the commonest food and water borne infectious diseases. The objective of the study was to determine the risk factors of HAV infection in the Gampha District in Sri Lanka.MethodsThis was an unmatched case control study conducted between January 2015 and November 2016 comprising of 504 participants with a case control ratio of 1:1. The study population included individuals of age 1 year and above who were permanent residents of the district. Cases included participants admitted to four secondary care state hospitals with an acute HAV diagnosed by detecting serum anti-HAV IgM antibodies. Controls were randomly selected individuals from the community with serum negative for Anti-HAV IgM and IgG. An interviewer administered questionnaire was used for the data collection and multiple logistic regression was applied to determine the independent risk factors. The results are expressed as adjusted odds ratios (AOR) and 95% confidence intervals (CI).ResultsRisk factors for HAV infection were poor knowledge regarding hepatitis (AOR;3.98, 95% CI = 1.97–8.05), unhygienic sanitary practices (OR = 2.73; 95% CI = 1.42–5.23), unhygienic practices related to drinking water (OR = 2.67; 95% CI = 1.37–5.21), residing in urban areas (OR = 5.94; 95% CI = 2.98–11.86) and lower family income (OR = 2.83; 95% CI = 1.30–6.13).ConclusionsThe independent modifiable risk factors for HAV infection were poor knowledge regarding hepatitis, unhygienic sanitary practices, and unhygienic practices related to drinking water. Community awareness must be raised on hygienic practices and safe water drinking practices. Inequities of social determinates of health must be addressed.

Health risk assessment of drinking water in correlation with water-related diseasess

Healthy and safe drinking water in sufficient quantities provided to consumers improves living conditions, raises health culture at a higher level and promotes the environment as a whole. The aim is to see if there is a correlation between irregular water samples with intestinal infectious diseases related to drinking water. Materials and method. The preparation of the Republic Computer Program (1996) for issuing laboratory findings (RCP) from the analyses of samples of drinking water (physico-chemical and bacteriological), in accordance with the methodology for application of ID numbers in the computer system in the Public Health Centers has created the possibility of complete health records of drinking water supply facilities under health surveillance for the territory of the entire Republic. Evaluation has been made of the results of basic physicо-chemical and bacteriological analyses of drinking water in the settlements of the Republic of North Macedonia and the water-related diseases – waterborne intestinal infectious diseases in the period 2014-2018. Results. Drinking water from city water supply in the examined period in terms of physico-chemical analysis ranged 2.9-4.3%, while in relation to bacteriological analysis 0.9-2.6%.. Waterborne intestinal infectious diseases show a decline in their incidence in 2018. Conclusion. The registered data from the physicо-chemical and bacteriological analysis showed that the drinking water from the city water supply systems in the period 2014-2018 was safe. According to the processed data, access to safe drinking water for the population was 97% by 2018, which ranks the country in the group of countries in the world with the highest access to safe drinking water, and there is no significant connection with drinking water related diseases.

Stability Analysis of a Waterborne Infectious Disease Model with Infectious Saturation Effect on Bacterial Disease Transmission

Stability Analysis of a Waterborne Infectious Disease Model with Infectious Saturation Effect on Bacterial Disease Transmission

Access to drinking water and sewage treatment in Brazil: a challenge for the control of waterborne infectious diseases

Access to drinking water and sewage treatment in Brazil: a challenge for the control of waterborne infectious diseases