Viruses in recreational water‐borne disease outbreaks: a review

Viruses are believed to be a significant cause of recreationally associated water‐borne disease. However, they have been difficult to document because of the wide variety of illnesses that they cause and the limitations in previous detection methods. Noroviruses are believed to be the single largest cause of outbreaks, which have been documented in the published literature 45% (n = 25), followed by adenovirus (24%), echovirus (18%), hepatitis A virus (7%) and coxsackieviruses (5%). Just under half of the outbreaks occurred in swimming pools (49%), while the second largest outbreak occurred in lakes or ponds (40%). The number of reported outbreaks associated with noroviruses has increased significantly in recent years probably because of better methods for virus detection. Inadequate disinfection was related to 69% (n = 18) of swimming pool outbreaks. A lack of required reporting and nonuniform water quality and chlorination/disinfection standards continues to contribute to water‐borne recreational disease outbreaks.     

First report of geosmin and 2-methylisoborneol (2-MIB) in Dolichospermum and Oscillatoria from Vietnam

Limnology - Cyanobacteria are the major producers of the taste and odour compounds geosmin and 2-methylisoborneol (2-MIB) in drinking water and fish worldwide. In recent years, the outbreaks of...     

Climate change and outbreaks of the geometrids Operophtera brumata and Epirrita autumnata in subarctic birch forest: evidence of a recent outbreak range expansion

1. Range expansions mediated by recent climate warming have been documented for many insect species, including some important forest pests. However, whether climate change also influences the eruptive dynamics of forest pest insects, and hence the ecological and economical consequences of outbreaks, is largely unresolved. 2. Using historical outbreak records covering more than a century, we document recent outbreak range expansions of two species of cyclic geometrid moth, Operophtera brumata Bkh. (winter moth) and Epirrita autumnata L. (autumnal moth), in subarctic birch forest of northern Fennoscandia. The two species differ with respect to cold tolerance, and show strikingly different patterns in their recent outbreak range expansion. 3. We show that, during the past 15-20 years, the less cold-tolerant species O. brumata has experienced a pronounced north-eastern expansion into areas previously dominated by E. autumnata outbreaks. Epirrita autumnata, on the other hand, has expanded the region in which it exhibits regular outbreaks into the coldest, most continental areas. Our findings support the suggestion that recent climate warming in the region is the most parsimonious explanation for the observed patterns. 4. The presence of O. brumata outbreaks in regions previously affected solely by E. autumnata outbreaks is likely to increase the effective duration of local outbreaks, and hence have profound implications for the subarctic birch forest ecosystem.     

Cholera caused by Vibrio cholerae O1 ctxAB- tcpA+

Results of analysis of cholera outbreak during which V. cholerae O1 biovar El-Tor ctxAB- tcpA+ was isolated from 2 patients and 30 carriers are presented. Epidemic was caused by contamination of water source and water route of transmission. Strains identical to ones detected in humans were isolated from water of surface well in zone of water intake. Genome and VNTR-analysis of ctxAB- tcpA+ vibrios that caused outbreak in Rostov region in 2005 showed that they differed from ctxAB- tcpA- and ctxAB- tcpA+ vibrios isolated previously during and beyond of outbreaks from patients, carriers and environment and formed separate group with certain genotype. These results confirms conclusions of epidemiological analysis about imported cause of recent outbreak.     

Use of immunofluorescence and phase-contrast microscopy for detection and identification of Giardia cysts in water samples.

A method was developed in which indirect immunofluorescence and phase-contrast microscopy are used for rapid detection and identification of Giardia cysts in raw and finished water supplies. When anti-Giardia cyst antiserum and fluorescein conjugate were applied to known Giardia cysts on membrane filters, the cysts fluoresced bright green when they were illuminated by UV light. This procedure permitted individual cysts to be quickly located even in samples heavily contaminated with other microorganisms and debris. The identity of presumptive Giardia cysts located in this way could then be confirmed by observing characteristic internal morphological features with phase-contrast microscopy. With this method, Giardia cysts were detected and their identities were confirmed in samples taken from raw and finished surface water supplies during several recent outbreaks.     

Waterborne cryptosporidiosis

Awareness of the importance of Cryptosporidium as a gastrointestinal parasite of developed countries not only stems from its prevalence in AIDS patients but also from its recent recognition as a possible contaminant of drinking water supplies. The importance of Cryptosporidium to public health has recently been revealed by a series of major epidemics of diarrhoeal disease in the USA and UK. In this review, Huw Smith and Joan Rose document what is known of the causes of some of these outbreaks and explain why this parasite can escape the battery of treatment processes normally used for drinking water supplies in these countries.     

Use of immunofluorescence and phase-contrast microscopy for detection and identification of Giardia cysts in water samples

A method was developed in which indirect immunofluorescence and phase-contrast microscopy are used for rapid detection and identification of Giardia cysts in raw and finished water supplies. When anti-Giardia cyst antiserum and fluorescein conjugate were applied to known Giardia cysts on membrane filters, the cysts fluoresced bright green when they were illuminated by UV light. This procedure permitted individual cysts to be quickly located even in samples heavily contaminated with other microorganisms and debris. The identity of presumptive Giardia cysts located in this way could then be confirmed by observing characteristic internal morphological features with phase-contrast microscopy. With this method, Giardia cysts were detected and their identities were confirmed in samples taken from raw and finished surface water supplies during several recent outbreaks.     

Qualitative Risk Assessment of Surface Water Contamination with Cryptosporidium Sp. Oocysts: A Case Study of Three Agricultural Catchments

In recent years there have been a number of waterborne outbreaks of cryptosporidiosis in some major urban centers in Ireland. The Irish Environmental Protection Agency has adapted and modified the qualitative “Scottish Water Directions” to help prevent such outbreaks. When this risk assessment method was applied to three small agricultural river catchments in Ireland, the results suggested an equal risk of water contamination for each catchment. A survey was conducted in each catchment focusing on agricultural activity and surface waters. Fecal samples were collected from 1–8-week-old calves along with associated slurry and dung from beef and dairy farms and water samples were collected monthly at the outlet of the three catchments. Two of the catchments had much higher infection rates among neonatal calves as well as higher oocyst contamination of surface waters than the remaining one. It was concluded that the qualitative risk assessment could be more robust if cognizance was taken of the temporal and epidemiological aspects of cryptosporidiosis in beef and dairy herds.     

Botulism among Alaska Natives. The role of changing food preparation and consumption practices.

Alaska Natives have one of the highest rates of food-borne botulism worldwide. All outbreaks have been associated with the consumption of native foods, but in recent years outbreaks have occurred in previously unaffected areas and have involved new food items. Five botulism outbreaks occurred between 1975 and 1985 in an area of southwestern Alaska without previous confirmed outbreaks and among one ethnic group, the Yupik Eskimo. Of the 5 outbreaks, 3 were associated with fermented beaver tail, a nontraditional native food recently introduced into the region. Preparation techniques vary widely within villages and among ethnic groups. Traditional fermentation techniques have changed over the past 50 years; current preparation methods used by some families and ethnic groups may be more favorable for Clostridium botulinum growth. Prevention efforts should be targeted at high-risk subgroups of Alaska Natives who appear to have modified traditional practices and increased their risk of food-borne botulism.     

Seasonal abundance of total and pathogenic Vibrio parahaemolyticus in Alabama oysters

Recent Vibrio parahaemolyticus outbreaks associated with consumption of raw shellfish in the United States focused attention on the occurrence of this organism in shellfish. From March 1999 through September 2000, paired oyster samples were collected biweekly from two shellfish-growing areas in Mobile Bay, Ala. The presence and densities of V. parahaemolyticus were determined by using DNA probes targeting the thermolabile hemolysin (tlh) and thermostable direct hemolysin (tdh) genes for confirmation of total and pathogenic V. parahaemolyticus, respectively. V. parahaemolyticus was detected in all samples with densities ranging from <10 to 12,000 g(-1). Higher V. parahaemolyticus densities were associated with higher water temperatures. Pathogenic strains were detected in 34 (21.8%) of 156 samples by direct plating or enrichment. Forty-six of 6,018 and 31 of 6,992 V. parahaemolyticus isolates from enrichments and direct plates, respectively, hybridized with the tdh probe. There was an apparent inverse relationship between water temperature and the prevalence of pathogenic strains. Pathogenic strains were of diverse serotypes, and 97% produced urease and possessed a tdh-related hemolysin (trh) gene. The O3:K6 serotype associated with pandemic spread and recent outbreaks in the United States was not detected. The efficient screening of numerous isolates by colony lift and DNA probe procedures may account for the higher prevalence of samples with tdh(+) V. parahaemolyticus than previously reported.     

Prepared salads and public health

In recent years the importance of prepared salads as potential vehicles of gastrointestinal infection has been highlighted by several large outbreaks both nationally and across international boundaries. Between 1992 and 2006, 2274 foodborne general outbreaks of infectious intestinal disease were reported in England and Wales, of which 4% were associated with the consumption of prepared salads. In total, 3434 people were affected, with 66 hospitalizations and one death reported. The attribution of prepared salad types and pathogens among prepared salad associated outbreaks are presented and discussed. Findings from UK studies on salad vegetables, fruit and mixed salads from 1995 to 2007 (21 247 samples) indicate that most bacteria of concern with regard to human health are relatively rare in these products (98.6% of satisfactory quality); however, outbreaks of salmonellosis were uncovered associated with bagged salad leaves and fresh herbs during two such studies. Although it is known that fresh salad vegetables, herbs or fruit may become contaminated from environmental sources, only in recent years has the association of foods of nonanimal origin, such as salad vegetables, with foodborne illness become evident and recurrent, demonstrating that major health problems can arise from consumption of contaminated prepared salads if hygiene practices breakdown.     

Stand‐replacing fires reduce susceptibility of lodgepole pine to mountain pine beetle outbreaks in Colorado

Aim As climate change is increasing the frequency, severity and extent of wildfire and bark beetle outbreaks, it is important to understand how these disturbances interact to affect ecological patterns and processes, including susceptibility to subsequent disturbances. Stand‐replacing fires and outbreaks of mountain pine beetle (MPB), Dendroctonus ponderosae, are both important disturbances in the lodgepole pine, Pinus contorta, forests of the Rocky Mountains. In the current study we investigated how time since the last stand‐replacing fire affects the susceptibility of the stand to MPB outbreaks in these forests. We hypothesized that at a stand‐scale, young post‐fire stands (< c. 100–150 years old) are less susceptible to past and current MPB outbreaks than are older stands. Location Colorado, USA. Methods We used dendroecological methods to reconstruct stand‐origin dates and the history of outbreaks in 23 lodgepole pine stands. Results The relatively narrow range of establishment dates among the oldest trees in most sampled stands suggested that these stands originated after stand‐replacing or partially stand‐replacing fires over the past three centuries. Stands were affected by MPB outbreaks in the 1940s/1950s, 1980s and 2000s/2010s. Susceptibility to outbreaks generally increased with stand age (i.e. time since the last stand‐replacing fire). However, this reduced susceptibility of younger post‐fire stands was most pronounced for the 1940s/1950s outbreak, less so for the 1980s outbreak, and did not hold true for the 2000s/2010s outbreak. Main conclusions Younger stands may not have been less susceptible to the most recent outbreak because: (1) after stands reach a threshold age of > 100–150 years, stand age does not affect susceptibility to outbreaks, or (2) the high intensity of the most recent outbreak reduces the importance of pre‐disturbance conditions for susceptibility to disturbance. If the warm and dry conditions that contribute to MPB outbreaks concurrently increase the frequency and/or extent of severe fires, they may thereby mitigate the otherwise increased landscape‐scale susceptibility to outbreaks. Potential increases in severe fires driven by warm and dry climatic trends may lead to a negative feedback by making lodgepole pine stands less susceptible to future MPB outbreaks.     

An assessment of the geological evidence for previous Acanthaster outbreaks

Much debate has surrounded the notion that outbreaks of the crown-of-thorns starfish (Acanthaster planci) have occurred in the geological past and hence are natural phenomena. As this debate has recently been renewed, we have reassessed statistically data presented by Frankel (1977, 1978) as evidence for the occurrence of past outbreaks. This was done using Frankel's data as well as those from extensive starfish surveys conducted prior to the commencement of his research. Our analysis of these data indicates that the occurrence of A. planci remains in recent sediments is independent of whether or not the reef from which the sample was collected had experienced a recent outbreak. Based on this premise, it is not possible to infer from Frankel's data the occurrence of past outbreaks from similar material in much older sediments. Thus while the data presented by Frankel (1977, 1978) may show that A. planci has existed within the Great Barrier Reef for at least several thousand years it does not demonstrate that outbreaks of this starfish have occurred in the geological past.     

Do leafy green vegetables and their ready-to-eat [RTE] salads carry a risk of foodborne pathogens?

Over the past 10 years, there is an increasing demand for leafy green vegetables and their ready-to-eat (RTE) salads since people changed their eating habits because of healthier lifestyle interest. Nevertheless fresh leafy green vegetables and their RTE salads are recognized as a source of food poisoning outbreaks in many parts of the world. However, this increased proportion of outbreaks cannot be completely explained by increased consumption and enhanced surveillance of them. Both in Europe and in the USA, recent foodborne illness outbreaks have revealed links between some pathogens and some leafy green vegetables such as mostly lettuces and spinaches and their RTE salads since fresh leafy green vegetables carry the potential risk of microbiological contamination due to the usage of untreated irrigation water, inappropriate organic fertilizers, wildlife or other sources that can occur anywhere from the farm to the fork such as failure during harvesting, handling, processing and packaging. Among a wide range of pathogens causing foodborne illnesses, Escherichia coli O157:H7, Salmonella spp., and Listeria monocytogenes are the most common pathogens that contaminate leafy green vegetables. Children, the elderly, pregnant women and immunocompromised people are the most at risk for developing complications from foodborne illness as a result of eating contaminated leafy greens or their RTE salads. These outbreaks are mostly restaurant associated or they sometimes spread across several countries by international trade routes. This review summarizes current observations concerning the contaminated leafy green vegetables and their RTE salads as important vehicles for the transmission of some foodborne pathogens to humans.     

Geological evidence for recurring outbreaks of the crown-of-thorns starfish: a reassessment from an ecological perspective

The abundance and distribution of Acanthaster planci skeletal elements in reef sediments have been presented as evidence that population outbreaks of the crown-of-thorns starfish on the Great Barrier Reef are not a new occurrence, but have been an integral part of the ecosystem for at least 7000 years on some reefs (Walbran et al. 1989a). Reassessment of the evidence shows that these claims are not justified and challenges the validity of several assumptions that are crucial to their thesis that outbreaks have been a recurrent phenomenon on the Great Barrier Reef. These are: (i) that the majority of starfish from outbreak populations remain and die on the host reef and that their skeletal elements add to the reef sediment, (ii) that reefs which have had recent A. planci outbreaks can be discriminated from those which have not by the abundance of starfish skeletal remains in recent sediments, (iii) that outbreaks will significantly increase the number of skeletal elements in reef sediments above normal background levels and, (iv) that the age of individual skeletal elements can be predicted from the age of their surrounding sediment or their depth in the sediment pile. We conclude that Walbran et al. do not have sufficient data to infer the outbreak history of A. planci from the sediment recored and that there are alternative interpretations of their findings. The possibility cannot be discounted that destructive population outbreaks of A. planci witnessed on the Great Barrier Reef since 1960 are unprecedented. The question of whether A. planci outbreaks are a naturally recurring phenomena or a novel, more recent development remains unanswered.     

Infection of Mice,Ferrets, and Rhesus Macaques with a Clinical Mumps Virus Isolate

In recent years, many mumps outbreaks have occurred in vaccinated populations worldwide. The reasons for these outbreaks are not clear. Animal models are needed to investigate the causes of outbreaks and to understand the pathogenesis of mumps virus (MuV). In this study, we have examined the infection of three animal models with an isolate of mumps virus from a recent outbreak (MuV-IA). We have found that while both ferrets and mice generated humoral and cellular immune responses to MuV-IA infection, no obvious signs of illness were observed in these animals; rhesus macaques were the most susceptible to MuV-IA infection. Infection of rhesus macaques via both intranasal and intratracheal routes with MuV-IA led to the typical clinical signs of mumps 2 weeks to 4 weeks postinfection. However, none of the infected macaques showed any fever or neurologic signs during the experimental period. Mumps viral antigen was detected in parotid glands by immunohistochemistry (IHC). Rhesus macaques represent the best animal model for the study of mumps virus pathogenesis.     

Endotoxins from Cyanobacteria and Gram-negative Bacteria as the Cause of an Acute Influenza-like Reaction after Inhalation of Aerosols

Endotoxins (lipopolysaccharides) in aerosols, originating from cyanobacteria and gram-negative bacteria, were the likely etiological agent behind outbreaks of a transient, flu-like syndrome, described from four Scandinavian towns and Harare, Zimbabwe. The syndrome with fever, malaise, muscle pains, tightness of the chest and respiratory-tract symptoms, also known as toxic pneumonitis, occurred 1.5–6 hours after taking a bath or shower. The outbreaks were associated with mass developments of cyanobacteria in the drinking water reservoirs. Cyanobacterial cells and elevated levels of endotoxins were detected in the Harare tap water when human subjects reported symptoms. In a field study of 21 water bodies, the concentrations of endotoxins were much higher in water dominated by cyanobacteria, compared to water with dominance of eukaryotic algae. This observation may partially be explained by the fact that cyanobacteria possess endotoxins and partially by our findings that endotoxin-possessing bacteria inhabit the mucilage of several mass developing cyanobacterial taxa.     

Factors in the spread of diseases caused by nonagglutinating vibrios studied by using the data from strain serotyping

The method of the serotyping of strains was used for the epidemiological evaluation of the role of different factors in the transfer of infective agents in 147 cases of diseases and carrier state, caused by NAG vibrios, in Karakalpakia. Out of 150 NAG vibrio strains, 136 strains were serotyped and classified with 26 serovars. The strains were found to belong mostly to serovars 47, 37, 5 and 6 (42.0%). Most of the infected persons (58.5%) used water from open water bodies for household purposes. The role of water factor in the spread of infection was confirmed by a wide spectrum of serologic variants, a low index of the focal outbreaks (1.02), and sporadic pattern of infection. No group morbidity or toxinfection-type outbreaks were recorded.     

A statistical model of Rift Valley fever activity in Egypt

Rift Valley fever (RVF) is a viral disease of animals and humans and a global public health concern due to its ecological plasticity, adaptivity, and potential for spread to countries with a temperate climate. In many places, outbreaks are episodic and linked to climatic, hydrologic, and socioeconomic factors. Although outbreaks of RVF have occurred in Egypt since 1977, attempts to identify risk factors have been limited. Using a statistical learning approach (lasso‐regularized generalized linear model), we tested the hypotheses that outbreaks in Egypt are linked to (1) River Nile conditions that create a mosquito vector habitat, (2) entomologic conditions favorable to transmission, (3) socio‐economic factors (Islamic festival of Greater Bairam), and (4) recent history of transmission activity. Evidence was found for effects of rainfall and river discharge and recent history of transmission activity. There was no evidence for an effect of Greater Bairam. The model predicted RVF activity correctly in 351 of 358 months (98.0%). This is the first study to statistically identify risk factors for RVF outbreaks in a region of unstable transmission.