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Book Details
Abstract
Infectious diseases caused by pathogenic bacteria, viruses and protozoa, are the most common and widespread health risk associated with drinking water. Most waterborne pathogens are introduced into drinking water supplies by human or animal faeces (enteric pathogens) but they can also exist naturally in water environments as indigenous aquatic micro-organisms. Controlling the risks related to these pathogens is a permanent challenge for the water industry. In addition to the constantly evolving range of pathogens to consider, assessing and managing such risks requires the integration of information issued by a wide range of disciplines. The necessary knowledge is however still sketchy and incomplete for most pathogens, and research efforts are necessary to fill the remaining gaps of knowledge.
The purpose of this study is to provide an updated, comprehensive review of current knowledge on a selection of pathogens of interest for the drinking water industry, and to identify the remaining gaps of knowledge and thus the necessary research to be conducted. Emphasis has been laid on the information needed to assess and manage the risks related to each of these pathogens in drinking water production and distribution.
The pathogens considered in this review were selected on the basis of:
- Their recognized or highly suspected transmission by drinking water through ingestion, inhalation, or contact
- Their recognized pathogenic character for humans
- The severity of their health effects
Visit the IWA WaterWiki to read and share material related to this title: http://www.iwawaterwiki.org/xwiki/bin/view/Articles/WaterbornePathogens
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Half title page | 1 | ||
Title page | 3 | ||
Copyright page | 4 | ||
Contents | 5 | ||
Foreword | 6 | ||
Acknowledgements | 7 | ||
Introduction | 9 | ||
Bacteria | 11 | ||
Campylobacter | 13 | ||
Microbiology | 13 | ||
General description | 13 | ||
Classification | 13 | ||
Human health effects | 13 | ||
Clinical features | 13 | ||
Dose – response data | 13 | ||
Target populations | 14 | ||
Diagnosis | 14 | ||
Treatment | 14 | ||
Geographical distribution | 14 | ||
Epidemiology | 14 | ||
Transmission routes | 14 | ||
Waterborne outbreaks | 14 | ||
Ecology | 15 | ||
Regrowth in distribution systems/biofilms | 15 | ||
Occurrence | 15 | ||
Reservoirs | 15 | ||
Survival | 15 | ||
Inactivation/removal | 16 | ||
Surrogates | 16 | ||
Environmental detection | 16 | ||
Research needs | 17 | ||
Analytical methods | 17 | ||
Route of transmission | 17 | ||
Occurrence | 17 | ||
Reservoirs | 17 | ||
Environmental survival | 17 | ||
Inactivation/removal | 17 | ||
Escherichia coli O157:H7 | 18 | ||
Microbiology | 18 | ||
General description | 18 | ||
Classification | 18 | ||
Human health effects | 18 | ||
Clinical features | 18 | ||
Dose – response data | 18 | ||
Target populations | 19 | ||
Diagnosis | 19 | ||
Treatment | 19 | ||
Geographical distribution | 19 | ||
Epidemiology | 19 | ||
Transmission routes | 19 | ||
Waterborne outbreaks | 19 | ||
Ecology | 20 | ||
Regrowth in distribution systems/biofilms | 20 | ||
Occurrence | 20 | ||
Reservoirs | 20 | ||
Survival | 20 | ||
Inactivation/removal | 20 | ||
Surrogates | 21 | ||
Environmental detection | 21 | ||
Research needs | 22 | ||
Analytical methods | 22 | ||
Ecology | 22 | ||
Environmental survival | 22 | ||
Treatment | 22 | ||
Helicobacter Pylori | 23 | ||
Microbiology | 23 | ||
General description | 23 | ||
Classification | 23 | ||
Human health effects | 23 | ||
Clinical features | 23 | ||
Dose – response data | 23 | ||
Target populations | 23 | ||
Diagnosis | 24 | ||
Treatment | 24 | ||
Geographical distribution | 24 | ||
Epidemiology | 24 | ||
Transmission routes | 24 | ||
Waterborne outbreaks | 24 | ||
Ecology | 24 | ||
Regrowth in distribution systems/biofilms | 24 | ||
Occurrence | 25 | ||
Reservoirs | 25 | ||
Survival | 25 | ||
Inactivation/removal | 25 | ||
Surrogates | 26 | ||
Environmental detection | 26 | ||
Research needs | 26 | ||
Analytical methods | 26 | ||
Route of transmission | 26 | ||
Occurrence | 27 | ||
Reservoirs | 27 | ||
Environmental survival | 27 | ||
Inactivation | 27 | ||
Salmonella | 28 | ||
Microbiology | 28 | ||
General description | 28 | ||
Classification | 28 | ||
Human health effects | 29 | ||
Clinical features | 29 | ||
Dose – response data | 29 | ||
Target populations | 29 | ||
Diagnosis | 29 | ||
Treatment | 29 | ||
Geographical distribution | 29 | ||
Epidemiology | 29 | ||
Transmission routes | 30 | ||
Waterborne outbreaks | 30 | ||
Ecology | 30 | ||
Regrowth in distribution systems/biofilms | 30 | ||
Occurrence | 30 | ||
Reservoirs | 30 | ||
Survival | 31 | ||
Inactivation/removal | 31 | ||
Surrogates | 31 | ||
Environmental detection | 31 | ||
Research needs | 32 | ||
Shigella | 33 | ||
Microbiology | 33 | ||
General description | 33 | ||
Classification | 33 | ||
Human health effects | 33 | ||
Clinical features | 33 | ||
Dose – response data | 33 | ||
Target populations | 34 | ||
Diagnosis | 34 | ||
Treatment | 34 | ||
Geographical distribution | 34 | ||
Epidemiology | 34 | ||
Transmission routes | 34 | ||
Waterborne outbreaks | 34 | ||
Ecology | 34 | ||
Regrowth in distribution systems/biofilms | 34 | ||
Occurrence | 35 | ||
Reservoirs | 35 | ||
Survival | 35 | ||
Inactivation/removal | 35 | ||
Surrogates | 35 | ||
Environmental detection | 36 | ||
Research needs | 36 | ||
Yersinia | 37 | ||
Microbiology | 37 | ||
General description | 37 | ||
Classification | 37 | ||
Human health effects | 37 | ||
Clinical features | 37 | ||
Dose – response data | 37 | ||
Target populations | 37 | ||
Diagnosis | 38 | ||
Treatment | 38 | ||
Geographical distribution | 38 | ||
Epidemiology | 38 | ||
Transmission routes | 38 | ||
Waterborne outbreaks | 38 | ||
Ecology | 38 | ||
Regrowth in distribution systems/biofilms | 38 | ||
Occurrence | 38 | ||
Reservoirs | 39 | ||
Survival | 39 | ||
Inactivation/removal | 39 | ||
Surrogates | 39 | ||
Environmental detection | 39 | ||
Research needs | 40 | ||
Transmission route | 40 | ||
Occurrence and distribution | 40 | ||
Survival | 40 | ||
Analytical methods | 40 | ||
Aeromonas | 41 | ||
RMicrobiology | 41 | ||
General description | 41 | ||
Classification | 41 | ||
Human health effects | 41 | ||
Clinical features | 41 | ||
Dose – response data | 41 | ||
Target populations | 42 | ||
Diagnosis | 42 | ||
Treatment | 42 | ||
Geographical distribution | 42 | ||
Epidemiology | 42 | ||
Transmission routes | 42 | ||
Waterborne outbreaks | 42 | ||
Ecology | 42 | ||
Regrowth in distribution systems/biofilms | 42 | ||
Occurrence | 43 | ||
Reservoirs | 43 | ||
Survival | 43 | ||
Inactivation/removal | 43 | ||
Surrogates | 44 | ||
Environmental detection | 44 | ||
Research needs | 44 | ||
Burkholderia pseudomallei | 46 | ||
Microbiology | 46 | ||
General description | 46 | ||
Classification | 46 | ||
Human health effects | 46 | ||
Clinical features | 46 | ||
Dose – response data | 46 | ||
Target populations | 46 | ||
Diagnosis | 47 | ||
Treatment | 47 | ||
Geographical distribution | 47 | ||
Epidemiology | 47 | ||
Transmission routes | 47 | ||
Waterborne outbreaks | 47 | ||
Ecology | 47 | ||
Regrowth in distribution systems/biofilms | 47 | ||
Occurrence | 47 | ||
Reservoirs | 47 | ||
Survival | 48 | ||
Inactivation/removal | 48 | ||
Surrogates | 48 | ||
Environmental detection | 48 | ||
Research needs | 48 | ||
Cyanobacteria | 49 | ||
Microbiology | 49 | ||
General description | 49 | ||
Classification | 49 | ||
Human health effects | 49 | ||
The cause | 49 | ||
Clinical features | 50 | ||
Dose – response data | 50 | ||
Target populations | 50 | ||
Diagnosis | 50 | ||
Treatment | 50 | ||
Geographical distribution | 51 | ||
Epidemiology | 51 | ||
Transmission routes | 51 | ||
Waterborne outbreaks | 51 | ||
Ecology | 51 | ||
Regrowth in distribution systems/biofilms | 51 | ||
Occurrence | 51 | ||
Reservoirs | 51 | ||
Survival/growth | 52 | ||
Inactivation/removal | 52 | ||
Surrogates | 52 | ||
Environmental detection | 52 | ||
Research needs | 53 | ||
Legionella | 55 | ||
Microbiology | 55 | ||
General description | 55 | ||
Classification | 55 | ||
Human health effects | 55 | ||
Clinical features | 55 | ||
Dose – response data | 55 | ||
Target populations | 56 | ||
Diagnosis | 56 | ||
Treatment | 56 | ||
Geographical distribution | 56 | ||
Epidemiology | 56 | ||
Transmission routes | 56 | ||
Waterborne outbreaks | 56 | ||
Ecology | 57 | ||
Regrowth in distribution systems/biofilms | 57 | ||
Occurrence | 57 | ||
Reservoirs | 58 | ||
Survival | 58 | ||
Inactivation/removal | 58 | ||
Surrogates | 59 | ||
Environmental detection | 59 | ||
Research needs | 60 | ||
Analytical methods | 60 | ||
Ecology | 61 | ||
Occurrence: | 61 | ||
Epidemiology | 61 | ||
Treatment | 61 | ||
Non-tuberculosis mycobacteria (NTM) | 62 | ||
Microbiology | 62 | ||
General description | 62 | ||
Classification | 62 | ||
Human health effects | 62 | ||
Clinical features | 62 | ||
Dose – response data | 63 | ||
Target populations | 63 | ||
Diagnosis | 63 | ||
Treatment | 63 | ||
Geographical distribution | 63 | ||
Epidemiology | 63 | ||
Transmission routes | 63 | ||
Waterborne outbreaks | 63 | ||
Ecology | 64 | ||
Regrowth in distribution systems/biofilms | 64 | ||
Occurrence | 64 | ||
Reservoirs | 64 | ||
Survival | 64 | ||
Inactivation/removal | 65 | ||
Surrogates | 65 | ||
Environmental detection | 65 | ||
Research needs | 66 | ||
Analytical methods | 66 | ||
Virulence factors | 66 | ||
Epidemiology | 67 | ||
Biofilm | 67 | ||
Waterborne transmission | 67 | ||
Inactivation | 67 | ||
Risk assessment | 67 | ||
Viruses | 69 | ||
Adenovirus | 71 | ||
Microbiology | 71 | ||
General description | 71 | ||
Classification | 71 | ||
Human health effects | 71 | ||
Clinical features | 71 | ||
Dose – response data | 72 | ||
Target populations | 72 | ||
Diagnosis | 72 | ||
Treatment | 72 | ||
Geographical distribution | 72 | ||
Epidemiology | 72 | ||
Transmission routes | 72 | ||
Waterborne outbreaks | 72 | ||
Ecology | 73 | ||
Regrowth in distribution systems/biofilms | 73 | ||
Occurrence | 73 | ||
Survival | 73 | ||
Reservoirs | 73 | ||
Inactivation/removal | 73 | ||
Surrogates | 74 | ||
Environmental detection | 74 | ||
Calicivirus | 75 | ||
Microbiology | 75 | ||
General description | 75 | ||
Classification | 75 | ||
Human health effects | 75 | ||
Clinical features | 75 | ||
Dose – response data | 76 | ||
Target populations | 76 | ||
Diagnosis | 76 | ||
Treatment | 76 | ||
Geographical distribution | 76 | ||
Epidemiology | 76 | ||
Transmission routes | 76 | ||
Waterborne outbreaks | 76 | ||
Ecology | 77 | ||
Regrowth in distribution systems/biofilms | 77 | ||
Occurrence | 77 | ||
Reservoirs | 77 | ||
Survival | 77 | ||
Inactivation/removal | 77 | ||
Surrogates | 78 | ||
Environmental detection | 78 | ||
Enterovirus | 79 | ||
Microbiology | 79 | ||
General description | 79 | ||
Classification | 79 | ||
Human health effects | 79 | ||
Clinical features | 79 | ||
Dose – response data | 80 | ||
Target populations | 80 | ||
Diagnosis | 80 | ||
Treatment | 80 | ||
Geographical distribution | 80 | ||
Epidemiology | 80 | ||
Transmission routes | 80 | ||
Waterborne outbreaks | 80 | ||
Ecology | 81 | ||
Regrowth in distribution systems/biofilms | 81 | ||
Occurrence | 81 | ||
Reservoirs | 81 | ||
Survival | 81 | ||
Inactivation/removal | 82 | ||
Surrogates | 82 | ||
Environmental detection | 82 | ||
Concentration: | 82 | ||
Purification: | 82 | ||
Detection: | 82 | ||
Hepatitis A | 84 | ||
Microbiology | 84 | ||
General description | 84 | ||
Classification | 84 | ||
Human health effects | 84 | ||
Clinical features | 84 | ||
Dose – response data | 84 | ||
Target populations | 84 | ||
Diagnosis | 85 | ||
Treatment | 85 | ||
Geographical distribution | 85 | ||
Epidemiology | 85 | ||
Transmission routes | 85 | ||
Waterborne outbreaks | 85 | ||
Ecology | 86 | ||
Regrowth in distribution systems/biofilms | 86 | ||
Occurrence | 86 | ||
Survival | 86 | ||
Reservoirs | 86 | ||
Inactivation/removal | 86 | ||
Surrogates | 87 | ||
Environmental detection | 87 | ||
Hepatitis E | 89 | ||
Microbiology | 89 | ||
General description | 89 | ||
Classification | 89 | ||
Human health effects | 89 | ||
Clinical features | 89 | ||
Dose – response data | 89 | ||
Target populations | 90 | ||
Diagnosis | 90 | ||
Treatment | 90 | ||
Geographical distribution | 90 | ||
Epidemiology | 90 | ||
Transmission routes | 90 | ||
Waterborne outbreaks | 90 | ||
Ecology | 91 | ||
Regrowth in distribution systems/biofilms | 91 | ||
Occurrence | 91 | ||
Reservoirs | 91 | ||
Survival | 91 | ||
Inactivation/removal | 91 | ||
Surrogates | 91 | ||
Environmental detection | 91 | ||
Rotavirus | 93 | ||
Microbiology | 93 | ||
General description | 93 | ||
Classification | 93 | ||
Human health effects | 93 | ||
Clinical features | 93 | ||
Dose – response data | 93 | ||
Target populations | 93 | ||
Diagnosis | 94 | ||
Treatment | 94 | ||
Geographical distribution | 94 | ||
Epidemiology | 94 | ||
Transmission routes | 94 | ||
Waterborne outbreaks | 94 | ||
Ecology | 95 | ||
Regrowth in distribution systems/biofilms | 95 | ||
Occurrence | 95 | ||
Survival | 95 | ||
Reservoirs | 95 | ||
Inactivation/removal | 95 | ||
Surrogates | 96 | ||
Environmental detection | 96 | ||
Virus research needs | 96 | ||
Analytical methods | 96 | ||
Occurrence | 97 | ||
Epidemiology | 97 | ||
Ecology | 97 | ||
Reservoirs: | 97 | ||
Environmental survival and transport: | 97 | ||
Treatment | 98 | ||
Indicators | 98 | ||
Cyclospora | 116 | ||
Microbiology | 116 | ||
General description | 116 | ||
Classification | 116 | ||
Human health effects | 116 | ||
Clinical features | 116 | ||
Dose – response data | 117 | ||
Target populations | 117 | ||
Diagnosis | 117 | ||
Treatment | 117 | ||
Geographical distribution | 117 | ||
Epidemiology | 117 | ||
Transmission routes | 117 | ||
Waterborne outbreaks | 117 | ||
Ecology | 118 | ||
Regrowth in distribution systems/biofilms | 118 | ||
Occurrence | 118 | ||
Reservoirs | 118 | ||
Survival | 118 | ||
Inactivation/removal | 118 | ||
Surrogates | 119 | ||
Environmental detection | 119 | ||
Research needs | 119 | ||
Environmental survival | 119 | ||
Epidemiology | 120 | ||
Transmission to humans: | 120 | ||
Treatment | 120 | ||
Analytical method | 120 | ||
Microsporidia | 121 | ||
Microbiology | 121 | ||
General description | 121 | ||
Classification | 121 | ||
Human health effects | 121 | ||
Clinical features | 121 | ||
Dose – response data | 122 | ||
Target populations | 122 | ||
Diagnosis | 122 | ||
Treatment | 122 | ||
Geographical distribution | 122 | ||
Epidemiology | 122 | ||
Transmission routes | 122 | ||
Waterborne outbreaks | 122 | ||
Ecology | 123 | ||
Occurrence | 123 | ||
Reservoirs | 123 | ||
Survival | 123 | ||
Inactivation/removal | 123 | ||
Surrogates | 124 | ||
Environmental detection | 124 | ||
Research needs | 125 | ||
Acanthamoeba | 126 | ||
Microbiology | 126 | ||
General description | 126 | ||
Classification | 126 | ||
Human health effects | 126 | ||
Clinical features | 126 | ||
Dose – response data | 127 | ||
Target populations | 127 | ||
Diagnosis | 127 | ||
Treatment | 127 | ||
Geographical distribution | 127 | ||
Epidemiology | 127 | ||
Transmission routes | 127 | ||
Waterborne outbreaks | 128 | ||
Ecology | 128 | ||
Regrowth in distribution systems/biofilms | 128 | ||
Occurrence | 128 | ||
Reservoirs | 128 | ||
Survival | 128 | ||
Inactivation/removal | 128 | ||
Surrogates | 129 | ||
Environmental detection | 129 | ||
Research needs | 129 | ||
Ecology | 130 | ||
Acanthamoeba-bacteria interaction: | 130 | ||
Occurrence: | 130 | ||
Epidemiology | 130 | ||
Treatment | 130 | ||
Environmental detection method | 130 | ||
Conclusions | 131 | ||
References | 133 | ||
Annex 1 | 173 | ||
Annex 1: Treatment data | 174 | ||
Treatment data: clarification/rapid filtration | 174 | ||
Treatment data: disinfection–chlorine | 177 | ||
Treatment data: disinfection–chloramines | 183 | ||
Treatment data: disinfection–chlorine dioxide | 186 | ||
Treatment data: disinfection–ozone | 189 | ||
Treatment data: disinfection–UV | 192 | ||
Treatment data: References | 197 |