Quantitative Detection of Human Adenoviruses in Wastewater and Combined Sewer Overflows Influencing a Michigan River

Enteric viruses are important pathogens found in contaminated surface waters and have previously been detected in waters of the Great Lakes. Human adenoviruses were monitored because of their high prevalence and persistence in aquatic environments. In this study, we quantified adenoviruses in wastewater, surface water, and combined sewer overflows (CSOs) by real-time PCR. Between August 2005 and August 2006, adenovirus concentrations in raw sewage, primary-treated effluent, secondary-treated effluent, and chlorinated effluent from a wastewater treatment plant in Michigan were examined. CSO samples (n = 6) were collected from a CSO retention basin in Grand Rapids, MI. Adenoviruses were detected in 100% of wastewater and CSO discharge samples. Average adenovirus DNA concentrations in sewage and CSOs were 1.15 × 10⁶ viruses/liter and 5.35 × 10⁵ viruses/liter, respectively. Adenovirus removal was <2 log₁₀ (99%) at the wastewater treatment plant. Adenovirus type 41 (60% of clones), type 12 (29%), type 40 (3%), type 2 (3%), and type 3 (3%) were isolated from raw sewage and primary effluents (n = 28). Six of 20 surface water samples from recreational parks at the lower Grand River showed virus concentrations above the real-time PCR detection limit (average, 7.8 × 10³ viruses/liter). This research demonstrates that wastewater effluents and wastewater-impacted surface waters in the lower Grand River in Michigan contain high levels of viruses and may not be suitable for full-body recreational activities. High concentrations of adenovirus in these waters may be due to inefficient removal during wastewater treatment and to the high persistence of these viruses in the environment.Enteric viruses are important waterborne pathogens. They are frequently isolated from feces-contaminated water and have been linked to numerous waterborne outbreaks (9, 34, 42, 61). This group of pathogens includes adenoviruses, enteroviruses, hepatitis A virus, noroviruses, and rotavirus. In the Great Lakes region, enteric viruses were isolated from recreational beaches and groundwater for municipal usage, indicating an elevated public health risk in consuming or coming into contact with these waters (15, 69). Although recent developments in molecular detection assays substantially increase the detection of viruses from waters, from a management standpoint it is impractical to test all viruses when determining the microbial quality of water. Here we propose that adenovirus monitoring can be used to examine wastewater impacts on surface water quality.Adenoviruses, which have a high prevalence in water, have been suggested as preferred candidates as index organisms for viral pathogens because they fit most criteria for an ideal indicator (19, 33, 38, 54). It is estimated that more than 90% of the human population is seropositive for one or more serotypes of adenoviruses (11, 68). Human adenoviruses (HAdVs) are present at a higher frequency in sewage than are other enteric viruses (54) and are excreted in high concentrations from infected patients (up to 10¹¹ viral particles per gram of feces) (68).Adenoviruses were first isolated from humans and identified as the causative agent of epidemic febrile respiratory disease among military recruits in the 1950s (30, 55). Human adenoviruses are the second most important viral pathogen of infantile gastroenteritis, after rotavirus (3, 10, 44, 51, 58, 62, 65). Serotypes of adenoviruses have been found to cause symptomatic infections in several organ systems, including the respiratory system (pharyngitis, acute respiratory disease, and pneumonia), eye (conjunctivitis), gastrointestinal tract (gastroenteritis), central nervous system (meningoencephalitis), and genitalia (urethritis and cervicitis) (8, 37). Human adenovirus types 40 and 41 have been associated with gastroenteritis in children, while human adenovirus type 4 is linked to persistent epidemics of acute respiratory disease in the United States (10, 49). It was estimated that 2 to 7% of all lower respiratory tract illnesses in children may be caused by adenoviruses (5, 17).Transmission routes of adenoviruses include the fecal-oral route and inhalation of aerosols. Adenoviruses have been associated with outbreaks in different settings, including military camps (7, 36, 40), hospitals (6, 28, 32), day care centers (1, 38), and schools (27). Waterborne outbreaks due to adenoviruses have also involved swimming pools (53, 64).It is hypothesized that combined sewer overflows (CSOs; where storm water and untreated sewage are combined) may contribute high concentrations of waterborne pathogens, especially viruses, which in turn may pose an adverse risk to human health. In older cities of Michigan, such as Detroit, East Lansing, and Grand Rapids, major contributors to microbial contamination of surface water during high-rainfall events include discharges from sanitary sewer systems and combined sewer systems. The federal government''s effort to control CSOs started in 1994, when the U.S. EPA published the CSO Control Policy as the national framework. In Michigan, the first CSO policy was drafted by the Department of Environmental Quality in 1983. However, the first noncontested permit requiring a long-term CSO correction program was issued to the Grand Rapids wastewater treatment plant (WWTP) only in Fall 1988, following a large CSO event in the city that affected water quality downstream, in Grand Haven (50). To date, Michigan communities have eliminated 75% of the 613 untreated CSO outfalls that existed in the year 1988, and the remaining 25% are scheduled for correction/elimination through implementation of long-term control plans. However, water quality after CSO or any sewage spill remains a public health concern to individuals via recreational water exposure at recreational parks and beaches downstream of discharge sites.The aim of this study was to evaluate the presence and concentration of adenoviruses in sewage and in the Grand River in the state of Michigan. Raw sewage, wastewater effluent, CSO discharges, and surface water in the lower Grand River were surveyed for the occurrence and concentration of human adenoviruses. Real-time PCR was used for quantification. Predominant adenovirus genotypes in sewage were determined, and the efficiency of virus removal during wastewater treatment was evaluated.