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NATURAL RESOURCES DIVISION CITY OF NAPLES f^-S - 295 RIVERSIDECIRCLE NAPLES, FL 34102

Potential Impact of Septic Systems in the City of Naples

Improperly positioned or functioning septic systems can introduce contaminants such as nutrients and pathogens into the environment which poses human health and environmental concerns. Septic systems are prevalent throughout the state ofFlorida with an estimated2. 5 million septic systems used by one in every three households. 1' 2 Most septic systems consist of four primary components: a pipe from a household, a , a drainfield, and the soil. 3 The pipe connects the generated m a household to the underground septic tank. The septic tank allows the solids in the wastewater to settle to the bottom of the tank while the liquid wastewater known as effluent is released to the drainfield. The drainfield consists of a series of perforated underground pipes which release the effluent into the soil. The effluent percolates through the soil whereit is naturally treated, andbacteria, viruses, andnutrients are removed. Septic systems provide an effective method of when the septic systems are properly placed (e. g. soil type, water table depth, etc), and properly fanctioning and maintained. Thereby well-functioning septic systems protect human health and the environment from ground and contaminants such as nitrogen, phosphoms, and disease-causing bacteria and vimses. However, improperly functioning septic systems can result from: home-owners not maintaining their septic systems, high concentrations of septic systems in urban areas, and a high seasonal groundwatertable. For example, the groundwatertable in southwestFlorida can rise 2-4 feet between the low rainfall, dry season and the high rainfall, wet season. 4 If the groundwater table is at the same level or above the drainfield pipes, the wastewater effluent cannot percolate through the soil and may potentially contaminate the groundwater.5 Improperly functioning septic tanks have been reported in the Goodlette-Frank Rd ditch basin. However, a water sample obtained in August 2017 at Ridge Sti-eet after a flooding event was negative for a human fecal DNA marker. One sample is insufficient to detennine if septic tanks in the ditch basin are properly functioning or not. There is, however, a body of data that provides valuable information on the functioiiing and potential impacts of septic systems under similar conditions to Naples. Scientific studies in the Florida Keys andMarco Island, Florida found

Page 1 of 3 NATURALRESOURCES DIVISION CITY OF NAPLES 295 RIVERSIDECIRCLE NAPLES,FL 34102

contaminated waterways nearby areas with septic tanks as compared to minimal contamination near areas with sanity sewers. 4' 6 Florida soils, including those of Collier County are karst (limestone) and sandy and, thus, very porous, allowing rapid movement of contaminants. Field experiments conducted in the FloridaKeys showedthat fecal viruses injected into injection wells flowed out through the porous soils mto coastal waters within 10-53 hours. 7 A study in Charlotte County found the greatest abundances of fecal bacteria and vimses at low- to outgoing tides, because the action of outgoing tidal water on the saturated soils drew septic-system-polluted groundwater into the canal on the falling tide. 8 A further study of seven watersheds in the Charlotte Harbor system9, found that fecal microbes were concentrated m areas of low and high septic-system density. Another concern is the potential input of nutrients from septic systems into groundwater and surface waters. Excessive nutrients in surface waters can prolong naturally occurring algal blooms (e. g. red tide events), causeharmful algal blooms andother effects such as fishkills. The Gordon River Extension watershed has a Total Maximum Daily Load (TMDL) for dissolved oxygen impairment, but the causativepollutant was found to be total nitrogen. The TMDL calls for a 29%reduction of nitrogen loads to thewatershed. A shidyin the St. LucieEstuary in southeast Florida showed multiple lines of evidence that septic systems were contaminating the estuary. 10 This study provided evidence that septic systems are a major contributor ofnitrogen to ground and surface waters. Septic systems are now considered the second largest source of nitrogen to Florida's surface waters". Ideally homes in higher density areas, especially in coastal regions, should be connected to centralized sewer systems12 due to public health concerns and environmental concerns associated with contaminatedflood waterand movement ofcontaminants into ground and surfacewaters.

Page 2 of 3 NATURALRESOURCES DIVISION CITY OF NAPLES 295 RIVERSIDECIRCLE NAPLES,FL 34102

References: 1- Toor, G. S., Lusk, M., & Obreza, T. (201 1). Onsite sewagetreatment and disposal systems: Overview. University of Florida IFAS Extension, SL348. 2- MeerofF, D. E., Bloetscher, F., Bocca, T., & Morin, F. (2008). Evaluation of water quality impacts ofon-site treatment and disposal systems on urban coastal waters. Water, air, and soil pollution, 792(1-4), 11-24. 3- United States Environmental Protection Agency (USEPA). (2011). A Homeowner 's Guide to Septic Systems. U. S. Environmental Protection Agency. WashingtonD. C. 4- Bloetscher, F., & Van Cott, W. R. (1999). Impact of septic tanks on wellhead protection efforts. Florida Water Resources Journal, 51(2), 38-41. 5- Lipp, E. K., Farrah, S. A., & Rose, J. B. (2001). Assessment and impact ofmicrobial fecal pollution and human enteric pathogens in a coastal community. Marine pollution bulletin, 42(4), 286-293. 6- Griffin, D. W., Gibson, C. J., Lipp, E. K., Riley, K., Paul, J. H., & Rose, J. B. (1999). Detection of viral pathogens by reverse transcriptase PCR and ofmicrobial indicators by standard methods in the canals of the Florida Keys. Applied and Environmental Microbiology, 65(9), 4118-4125. 7- Paul JH, Rose JB, Jiang SC, Zhou X, Cochran P, Kellogg C, et al. Evidence for groundwater and surface marine water contamination by waste disposal wells in the Florida Keys. WaterRes 1997;31:1448-54. 8- Lipp EK, Rose JB, Vincent R, Kurz RC, Rodriguez-Palacios C. Diel variability ofmicrobial indicators of fecal pollution in a tidally influenced canal: Charlotte Harbor, Florida. Surface Water Improvement and Management Program, Southwest Florida Water ManagementDistrict, Brooksville, Florida, 1999. 9- Lipp EK, Kurz R, Vincent R, Rodriguez-Palacios C, Farrah SK, Rose JB. The effects of seasonal variability and weatheron microbial fecal pollution and enteric pathogens in a subtropical estuary. Estuaries 2001:24:266-76. 10- Lapointe, B. E., Herren, L. W., & Paule, A. L. (2017). Septic systems contribute to nutrient pollution and hannful algal blooms in the St. Lucie Estuary, Southeast Florida, USA. Hannful algae, 70, 1-22. 11- Badmzzaman, M., Pinzon, J., Oppenheimer, J., & Jacangelo, J. G. (2012). Sources of nutrients impacting surface waters in Florida: a review. Journal of Environmental Management, 109, 80-92. 12- Chanton, J. (2000). Accommodating coastal growth panel nonpoint source pollution. Testimony to U. S. Commission on Ocean Policy.

Page 3 of 3 Danette Kinaszczuk, Pollution Control Manager

Collier County. June 29, 2018

The Gordon River Extension (GRE) watershed had a Total Maximum Daily Load (TMDL) established in 2008. The TMDL is based on a dissolved oxygen impairment, but the causative pollutant was found to be total nitrogen. The TMDL calls for a 29% reduction of nitrogen loads to the watershed to meet a target concentration of total nitrogen in the surface waters of 0.74 mg/L.

Because groundwater can impact surface waters in Florida, the Florida Department of Environmental Protection [FDEP (2017)] began monitoring the shallow groundwater aquifer in 2014 in several TMDL watersheds in southwest Florida to determine sources of nutrients (nitrogen and phosphorus). This two-year study involved quarterly monitoring from areas of different land use types, including agriculture, golf courses, residential and commercial development areas. Sources of nutrients in the GRE included fertilizer, reuse water, and septic tanks. FDEP’s study found that average total nitrogen in the groundwater in the GRE to be 3.07 mg/L. This is above the TMDL required 0.74 mg/L target for surface waters within the GRE indicating groundwater nutrient loads are contributing surface water impairments.

FDEP does routine assessments to determine if a waterbody is meeting water quality standards. The most recent assessment (02/18/2018) indicates that Gordon River Extension, in addition to total nitrogen, is not meeting water quality standards for fecal coliform. The receiving waters downstream (Gordon River—Marine Segment) are not meeting water quality standards for total nitrogen, Enterococcus bacteria and chlorophyll-a (a Figure 1. Gordon River Extension and Gordon River Marine Segment watersheds plant pigment used to measure nutrient pollution). These waters will likely be declared as “impaired” in 2019. TMDLs will most likely follow.

Improperly functioning septic tanks have been reported in the Goodlette-Frank Rd. ditch basin. Additionally, septic tanks cannot function properly when the drainfield is flooded or the water table is too shallow. If septic tank failures result in release, flood waters could be contaminated with human pathogens potentially causing health impacts to anyone in contact with the flood waters. After a flooding event in August 2017, one sample was collected and tested only for human DNA in flood waters on Ridge St. This test was chosen in place of typical fecal coliform bacteria testing because fecal coliform bacteria are present in all natural waters and can grow in soils. Therefore, it is necessary to differentiate between human sources and natural (birds) or other (dogs) sources of coliform bacteria. The result indicated that no human fecal DNA was found in that sample of flood waters at that moment in time.

To determine if nutrients from septic tanks are entering the groundwater and surrounding surface waters in the GRE, a multi-year, mutli-faceted study of groundwater and surface water using human nutrient biomarkers would be required. One potential drawback is that much of the watershed is irrigated with reuse water and the human biomarkers are also typically present in the reuse water. FDEP found in their two-year study mentioned above that Sucralose (an artificial sweetener used as a wastewater biomarker) was prevalent throughout the groundwater and surface waters in the GRE. An alternative to an additional study is to utilize the multitude of existing studies that show properly working septic tanks contribute nutrients, specifically nitrogen, to groundwater (Lapointe 2017, Katz 2014, Chang 2011, EPA 2013, Toor 2011, FDOH 2009, FDOH 2007). EPA (2013) estimates that 40% of the total nitrogen load entering a septic tank can reach surface water via groundwater transport. It is these subsurface nutrient loads that are being recognized as major contributors to surface water pollutant loads. Further recognizing the contribution of septic tanks to nutrient pollution, FDEP offers grant funding for conversion of septic tanks to centralized sewer in watershed that are impaired for nutrients.

The current TMDL requires a 29% reduction in total nitrogen loads. This reduction must come from multiple sources to achieve this goal. The County constructed a water quality treatment wetland park (Freedom Park) to treat instream nutrient loads from the Goodlette- Frank Rd. ditch to the GRE and Naples Bay. This giant biofilter in the last 10 years has been removing 28-77% of the total nitrogen load coming from the Goodlette-Frank Rd. ditch. However, even with this removal, the total nitrogen levels leaving Freedom Park are still not meeting the TMDL target concentration. More nutrient removal in the watershed is needed. If the reduction is not met, it is likely that the FDEP will require a Basin Management Action Plan which have included septic to sewer conversions in other areas.

References

1. Chang, N.B., M. Wanielista, A. Daranpob, F. Hossain, and Z. Xuan et al. April 2011. Onsite and disposal systems evaluation for nutrient removal. Tallahassee, FL: Florida Department of Environmental Protection, Bureau of Watershed Restoration. Tallahassee, Florida. 2. Florida Department of Environmental Health (FDOH), June 2009. Florida Onsite Sewage Nitrogen Reduction Strategies Study: Literature Review of Nitrogen Reduction by Soils and Shallow Groundwater. Task C. Florida Department of Health, Tallahassee, Florida. 3. Florida Department of Environmental Protection (FDEP), February 2017. Everglades West Coast Final Update Lee and Collier Counties, Florida. SIS Site Number 686-1. Florida Department of Environmental Protection. Tallahassee, Florida. 4. Katz, Brian G. & Eller, Kirstin T., July 2014. Nitrogen Source Inventory of the BMAP Area for Wakulla Spring and River. Florida Department of Environmental Protection. Tallahassee, Florida. 5. Lapointe, Brian & Herren, Laura & Paule, Armelle. October 2017. Septic systems contribute to nutrient pollution and harmful algal blooms in the St. Lucie Estuary, Southeast Florida, USA. Harmful Algae. 70. 1-22. 10.1016/j.hal.2017.09.005. 6. Toor, Gurpal S., Lusk, M. & Obreza, T., June 2011. Onsite Sewage Treatment and Disposal Systems: Nitrogen. Department of Soil and Water Sciences Series SL348, University of Florida/IFAS Extension. Gainesville, Florida. 7. United States Environmental Protection Agency (USEPA), June 2013. A Model Program for Onsite System Management in the Chesapeake Bay Watershed. U.S. Environmental Protection Agency. Washington D.C. 8. Ye, Ming & Sun, Huaiwei & Hallas, Katie. January 2017. Numerical estimation of nitrogen load from septic systems to surface water bodies in St. Lucie River and Estuary Basin, Florida. Environmental Earth Sciences. 76. 10.1007/s12665-016-6358-y. EXECUTIVE SUMMARY Recommendation to award Bid No. 18-7322 to WPM-Southern, LLC, for construction of the West Goodlette-Frank Road Joint Stormwater-Sewer Project in the amount of $14,370,000 (of which $6,715,239 is the responsibility of the County and $7,654,761 is the responsibility of the City of Naples in accordance with the terms of an existing Interlocal Agreement), authorize the Chairman to execute the Contract, authorize the necessary budget amendments (Project No. 60142), contingent on the approval by the City of Naples within 120 days of the revised Notice of Recommendation, and authorize the Chairman to sign a letter to the City of Naples outlining Collier County’s commitment to the project. OBJECTIVE: To award solicitation No. 18-7322 for the construction of potable water, , and stormwater management facilities to serve properties in an area along Hollygate Lane to the north, US- 41 to the west, Rosemary Lane/Rosemary Court to the south, and Goodlette-Frank Road to the east, contingent on project approval from the City of Naples Council. CONSIDERATIONS: On September 14, 2015 a letter was provided to the City of Naples (City) from Collier County (County) formally requesting joint participation by the parties for a comprehensive solution to provide sanitary sewer and stormwater improvements in an area west of Goodlette-Frank Road and east of US-41 that is currently un-sewered and experiences significant flooding. On September 27, 2016 (Agenda Item 16A9), the Board of County Commissioners (Board) approved an Interlocal Agreement with the City of Naples for a joint project to design and construct stormwater and sanitary sewer facilities in the “West Goodlette” area, and on April 24, 2018 (Agenda Item 16A2), the Board approved the First Amendment to the Interlocal Agreement, which was also approved by the City. The engineering plans were prepared by Q. Grady Minor and Associates, a local consulting firm, selected in accordance with Request for Proposals No. 17-7103. The engineering contract was awarded by the Board on July 11, 2017 (Agenda Item 16A17). Additionally, on November 14, 2017 (Agenda Item 16A13), the Board approved the South Florida Water Management District/Big Cypress Basin (SFWMD/BCB) Agreement No. 4600003762 and authorized any necessary budget amendment to recognize grant funding in the amount of up to $800,000 for the West Goodlette-Frank Road Stormwater Improvement (Project No. 60142). The County advertised Invitation to Bid (ITB) No. 18-7322 for construction on April 13, 2018, in the Naples Daily News, and on the County’s web based bidding portal with BidSync (www.bidsync.com ). Eight bids were received by the May 14, 2018 due date. Three of the bidders were deemed non-responsive for failing to comply with the bid submittal requirements to return all required forms with signatures and are shown at the bottom of the list below. PWC, LLC would have been the lowest responsive bidder if they had correctly submitted all required information. Both City and County staff will continue to explore various options and grant opportunities to lower project costs. Contractor Bid Amount Responsive/Responsible 1 WPM Southern, LLC $13,353,480.00 Yes/Yes 2 Haskins, Inc. $14,428,152.50 Yes/Yes 3 Quality Enterprises USA, Inc. $14,883,331.50 Yes/Yes 4 Douglas N. Higgins, Inc. $15,668,435.00 Yes/Yes 5 Mitchell & Stark Construction Co., Inc. $17,544,550.00 Yes/Yes * PWC, LLC $11,205,115.00 No/Yes * Andrew Sitework, LLC $13,985,827.30 No/Yes 11.G Packet Pg. 364 07/10/2018 * Ric-Man Construction Florida, Inc. $14,889,266.00 No/Yes The Procurement Services staff and the design engineer tabulated and verified the bids received. WPM Southern, LLC, is the apparent lowest, responsive and responsible bidder. Staff and the design engineer performed a bid analysis to determine if there were any anomalies in the bids and found a math error in the subtotal lines of WPM Southern, LLC. This affected its final price but not the unit pricing for any of the line items. This mathematical error has been corrected by staff resulting in a decrease to WPM’s overall bid by $88,761.00, which is reflected in the bid amount in the above list. On May 18, 2018, WPM Southern, LLC provided an e-mail to Collier County Procurement Services acknowledging the math error and accepting the corrected sub-totals. The design engineer also completed reference checks and compared the bid amount to the engineer’s Opinion of Probable Construction Cost (OPCC). The bid amount is approximately 9% less than the design engineer’s OPCC of $14,347,350.00 for construction, prior to inclusion of contingencies. In accordance with the First Amendment to the Interlocal Agreement, the County and City are to enter into a three-party construction contract with the responsible, responsive and low bid contractor awarded the bid. The County is responsible for payment of construction costs set forth in Section 4 of the Contractor’s Bid Schedule: Stormwater System components and half of the Section 1: General components in its purchase order with the contractor. See Exhibit A-1 to the proposed Agreement. The City of Naples is responsible for payment of construction costs for the Sections 2 and 3 of the Contractor’s Bid Schedule: Water System components and Wastewater System components, respectively, and half of the Section 1: General components with its purchase order with the contractor. Id. A project of this size and complexity is likely to encounter unexpected underground conditions during construction. Section 5 of the Contractor’s Bid Schedule includes a contingency expenditure for this project, developed by City and County staff, should unexpected conditions result in additional expense. Therefore, staff recommends awarding ITBid No. 18-7322 to WMP Southern, LLC, the lowest, responsive and responsible bidder. On June 13, 2018, the City Council of the City of Naples voted to deny the Assessment proposed to be utilized to fund the majority of the City portion of the project, primarily due to the cost to the residents. This project, which represents nearly a 3-year partnership, is intended to address two significant issues: chronic flooding, which was significant during the 2017 rainy season, even pre-Hurricane Irma, and ongoing issues related to septic tank failures and drain field inundation and/or failures. The project is designed for the sewer and stormwater improvements to be constructed together and is the basis for the partnership agreement. Addressing Stormwater without the conversion from septic to sewer will not remedy the failure of existing drain fields. The Stormwater portion of the project will handle stormwater runoff and decrease depth and duration of roadway flooding. It will not lower the average peak level of the ground water table, which is what causes drain fields to be ineffective in treating waste water, and makes the installation of sanitary sewer an essential component of the project. There are numerous studies and publications that link nutrient impacts to groundwater and surrounding surface waters to septic tanks. Septic tanks are designed to remove bacteria, but not eliminate nutrients. Therefore, even properly functioning septic tanks discharge nutrients to the groundwater. The Gordon River Extension (GRE) watershed currently has a Total Maximum Daily Load (TMDL) that requires an overall total nitrogen reduction of 29% to the MS4. The TMDL requires that the surfaces waters in this watershed meet a total nitrogen concentration of 0.074 mg/L. The TMDL was established in 2008. The Florida Department of Environmental Protection (FDEP) performed a groundwater study in the GRE to investigate sources of nutrients from 2014-2016. They found that average total nitrogen in the groundwater in the GRE to be 3.07 mg/L. This is above the TMDL required 0.74 mg/L limit for surface waters within 11.G Packet Pg. 365 07/10/2018 the GRE. Therefore, staff would not recommend a stormwater project in this area that did not also include the needed conversion from septic to sewer as it would increase the pollutant load within the impaired receiving waters. (Water Quality exhibit attached) Since the denial of the proposed Assessment by the City, staff from the City, County and SFWMD/BCB have been working to identify possible alternatives to allow the project to move forward. These options include: 1) additional grant funding in Fiscal Year 2019, if approved by the SFWMD/BCB to assist with the cost of the sewer portion of the project and therefore the related Assessment; 2) a joint request for a Legislative Appropriation for the 2019 Legislative Session to provide funding for the sewer portion of the project and therefore the related Assessment; and 3) apply for a FDEP 319 Grant in the Spring of 2019 to address the private property costs of septic tank abandonment, installation of lateral sewer lines, etc., which would lessen additional costs that would otherwise be the responsibility of the affected property owners. Staff also recommends that the Board authorize the Chairman to sign a letter to the City of Naples outlining the County’s commitment to the West Goodlette-Frank Road Joint Stormwater-Sewer Project. FISCAL IMPACT: Separating the total project bid costs for the County and City results in the following amounts: Section No. County Responsibility City Responsibility 1 General $2,188,227.00 $2,188,227.00 2 Water Improve $0.00 $1,174,050.00 3 Wastewater $0.00 $3,795,526.00 4 Stormwater Imp $4,007,450.00 $0.00 5 Contingencies $519,562.00 $496,958.00 Totals: $6,715,239.00 $7,654,761.00 The County’s portion of the total cost of the project is $6,715,239.00. SFWMD grant funding in the amount of 40% of the stormwater component costs, up to a maximum of $800,000, is available in Growth Management Grant Fund (711) Project 60142. Budget amendments are required to appropriate the required 60% match of $1,200,000 within GMD Match Grant Fund (712). The source of the local match and excess expenditures above the grant reimbursement threshold is Stormwater Capital Improvement Fund (325). The project area is currently maintained by the Road Maintenance Division and is included in the maintenance schedule. Likewise, upon completion of the project, the Stormwater improvements will continue to be maintained by GMD as part of the Stormwater Utility. GROWTH MANAGEMENT IMPACT: The proposed construction project is consistent with the applicable sections of the Stormwater Management and Conservation and Coastal Management elements of the Collier County Growth Management Plan. This project has high prioritization due to the flooding experienced in the neighborhood and has been approved as part of the Annual Update and Inventory Report/Capital Improvement Element and the annual Stormwater Capital Budget. LEGAL CONSIDERATIONS: This item is approved as to form and legality, and requires majority vote for Board approval. -SRT RECOMMENDATION: To award ITB No. 18-7322 “West Goodlette-Frank Road Joint Stormwater- Sewer Project” construction contract to WPM-Southern, LLC, in the amount of $14,370,000.00 (County portion is $6,715,239.00); authorize the Chairman to execute the attached contract, contingent on approval by the City of Naples within 120 days of the revised Notice of Recommended Award; authorize the 11.G Packet Pg. 366 07/10/2018 Chairman to sign a letter to the City of Naples outlining the County’s commitment to the project; and authorize all budget amendments necessary to recognize and appropriate funds for the project. PREPARED BY: Amy Patterson, Director, Stormwater Management Section, Capital Project Planning, Impact Fees and Program Management Division ATTACHMENT(S) 1. [Linked] WGF 18-7322 WPM-Southern_VendSign Tri-Party Construction Services Agreement (PDF) 2. NORA (001) (PDF) 3. WGF 18-7322 Bid Recommendation Letter from EOR (QGM 5-21-18) (PDF) 4. County Manager Partner Letter to Bill Moss re- Illinois Drive (9-14-15) (PDF) 5. 06-29-18 Gordon River Extension WBID (PDF) 11.G Packet July 12, 2018

The following comments from environmental agencies and organizations was extracted from a “position paper” written by the Marco Island City Manager in December 2005. The paper was written to explain the initiative to install a centralized sanitary sewer collection system to serve a majority of single-family homes on Marco Island. The comments from the agencies and organizations are is deemed relevant to the decision to install a centralized sanitary sewer collection system in the Gulf Acres / Rosemary Heights area.

Bill Moss City Manager

Support Offered by Environmental Agencies and Organizations.

The negative influences of septic systems are the reasons the City has received letters of support from the Florida Department of Environmental Protection (acting under delegated authority from the U.S. E.P.A.), the Rookery Bay National Estuarine, the Florida Department of Health, the Big Cypress Basis/ South Florida Water Management District, the Conservancy of Southwest Florida, and the Florida Audubon Society. Their positions are summarized as follows:

Florida Department of Environmental Protection.

The Florida DEP is responsible for enforcement of environmental regulations in Florida. The U.S. Department of Environmental Protection has delegated to the Florida DEP its environmental review and enforcement authority. As such, the Florida DEP is the principal environmental review and enforcement authority. The Florida DEP has advised that:

“The quality of Marco Island’s waterways have reached a threshold of concern.”

“Septic tanks, when properly designed, constructed and maintained, perform well in sparsely populated rural areas where large tracts of lands are available for wastewater disposal.” “In urban and coastal areas, septic tanks and drain-field systems can have a significant impact on resources, particularly in residential communities interspersed with tidal canals.”

“In canal communities where septic systems are older or are not regularly maintained, the presence of fecal coliform bacteria and human pathogenic organisms within the canal systems and adjacent waters is commonly documented.”

“Central wastewater collection, treatment and disposal systems in communities with canal systems provide significantly greater water quality protection to the resource in a number of ways.”

“…it is the Department’s opinion that central wastewater collection and treatment systems offer a preferred environmental alternative for serving the utility needs of a community such as the City of Marco Island.”

Rookery Bay National Estuarine, Florida Department of Environmental Protection.

Based on a review of water quality testing since 1971, “on average, both total Nitrogen and fecal bacteria counts have increased from past to present day Marco.” “…all high fecal bacteria counts (>200 MPN) have occurred in the un-sewered or ½ sewered canals. If we combine the past dataset (all sewered) to the present dataset then there is a statistical difference associated with wastewater treatment category”.

The seasonal pattern in fecal bacteria counts suggest that septic tanks may be a significant contributor. As water level rise in the wet season there is more bacteria in the canal waters of present day Marco.”

“It is difficult to be absolutely sure the septic systems are the source of the water quality decline but the data suggests that as water table levels rise in the rainy season there are increases in fecal bacteria and nitrogen in the canals. Additional research could be done to determine the source of the bacteria and nitrogen but given the density of Marco Island and the potential for rainy season ground saturation I feel that sewers are needed and the money is best spend moving forward.”

“As a research scientist I wish there were more Marco Island data to base the septic system versus central sewage treatment decision on, especially from some of the more specific genetically based bacterial and stable isotope techniques that are now available. You should however not limit your decision based sole (sp) on Marco Island specific datasets. There are many other coastal communities with similar densities as Marco that proactively made the decision to move to central sewage treatment without regret.”

Dr. Michael Shirley, a research scientist at Rookery Bay National Estuarine, compared water quality data collected since the 1970’s. He has stated that the results of his analysis indicate that water quality conditions have declined in the canals based on increase in both nitrogen and fecal bacteria. Areas with sewers had the lowest bacteria and nitrogen, areas with septic systems have the highest and the areas with mixed sewage treatment types fell in-between. He expressed his opinion that sewers are needed and that the money is best spent moving forward.

The Florida Department of Health.

“….supports your decision to move to a public sewer system for all City of Marco Island residents…”

“When public sewer is available it is always the desired way to serve the urban domestic waste needs of residents. Public sewers will provide the most flexibility for future development of the property and the assurance that the maintenance and operations of the system is regulated and monitored.”

“Many properties [unsewered] will require the use of performance based septic systems which can be very expensive, require annual inspection and maintenance agreements…”

“Septic systems are much more susceptible to misuse from residents not familiar with non urban waste treatment requirements.”

“The possible interaction with tidal areas, potential flooding and septic system failures make the public sewer system a more desirable option to protect public health in you island environment.”

“In short, migration to a standard central sewer system is a positive action by the City of Marco Island in the best interest of the public’s health”.

Big Cypress Basin, South Florida Water Management District

Resolution No. 05-8-4 commending the City of Marco Island for its efforts to protect and conserve the precious water resource of Collier County through is proactive seven year plan to build central sewers for the protection of the groundwater and nearby waterways.

Audubon of Florida

“On behalf of approximately 6,000 Audubon members in southwest Florida, I wish to commend the City of Marco Island for its proactive and politically courageous efforts to conserve our area’s precious water resources…”

“Audubon of Florida and Collier County Audubon Society recognize the City of Marco Island for committing to building central sewers for the protection of the groundwater and surrounding surface waters.”

Conservancy of Southwest Florida.

“…we applaud the City for taking steps to provide sewage treatment for more of Marco Island…”

In reference to the Estuaries Report Card for Southwest Florida dated December 8, 2005, “Marco Island is too far off shore and is completely excluded for the Rookery Bay and the 10,000 Islands Report Card. The Report Card has the overarching principal that it is imperative that throughout the watersheds, the dependency on septic systems to treat waste should be removed and municipal centralized waste systems are recommended”.

Centralized Wastewater Collection System vs. On-Site Septic Systems

Evaluation of Cost and Benefit of Centralized Wastewater Collection System City Council requested information that would demonstrate the cost and benefit of replacing individual septic systems with a sanitary sewer system.

Off-setting benefits should consider the following: • The life of a septic system is about 20 years, although property owners generally do not replace systems until they completely fail. Estimated replacement cost for a new system is $15,000 to $17,000.

• Collier County Health Department does not inspect septic systems unless a complaint regarding defective treatment is received. Usual observations are odor or physical evidence, such as flow from yards to sidewalks and streets if located in the front yard.

• The State of Florida allows septic systems for new construction unless sanitary sewer service is available. However, according to the Florida Department of Environmental Protection “Septic tanks, when properly designed, constructed and maintained, perform well in sparsely populated rural areas where large tracts of lands are available for wastewater disposal.” “In urban and coastal areas, septic tanks and drain-field systems can have a significant impact on resources, particularly in residential communities interspersed with tidal canals.”

• Larger homes (2,500 s.f. +) may not be able to accommodate the required drain field for a septic system. The Collier County Health Department then requires installation of an on-site aerobic treatment system. The annual permit an required maintenance contract is about $500. The system requires a source of power and will fail to treat waste when power is lost for a defined duration. The estimated cost of an on-site anaerobic system is $30,000 to $35,000

• Realtors will advise that, given the choice of similar properties, one with and one without centralized sanitary sewer systems, consumers prefer properties with sanitary sewers. Properties attractive to buyers will sell sooner and at a higher price than other properties.

In regards to other economic benefits, staff cannot quantify the amount of pollution generated by septic systems in coastal areas. There are ample studies that document that septic systems are adequate in rural areas where sufficient land exists and when properly maintained. The attached summary should provide sufficient documentation that septic systems in coastal areas near water bodies has a negative affect on the environment.

Septic Systems Are Not an Acceptable Alternative in Coastal Areas Many assume septic systems are an acceptable alternative to a central sewer system. Years of experience and research suggest otherwise. Because of our high density coastal development, extensive waterways, and a high water table, individual septic systems are not desirable for Naples. Scientific studies suggest that septic systems in coastal areas cannot adequately treat , including the removal of viruses, fecal matter, pharmaceuticals, and nutrients such as nitrogen and phosphates, all of which present health risks and degradation of our beaches and waterways. These reports support actions taken by other areas in Southwest Florida to remove septic systems when located near waterways (Naples, Collier County, Sanibel, Cape Coral, Monroe County, and Marco Island, to name a few).

Independent Studies and Articles on Septic Systems.

The following studies support installation of sanitary sewer systems. No scientific studies have been found to suggest that septic systems in coastal regions near bodies of water are an acceptable means of treating human waste.

Dr. Michael Shirley, Research

“The results (of my water quality data) indicate that water quality conditions have declined in the canals based on increasing both total nitrogen and fecal bacteria. Additional research could be done to determine the source of bacteria and nitrogen byt given the density of Marco Island and the potential for rainy season ground saturation I feel that sewers are needed.”

Bloetscher F. and Whitfield, R. Van Cott (1999) in an article titled "Impact of septic tanks on wellhead Protection Efforts" states:

" A brief study conducted on Marco Island several years ago indicated a perfect correlation between areas that has sanitary sewer and minimal fecal coliform counts in the adjoining waterways (less than 2 colony forming units/100ml), versus areas with septic tanks that consistently had bacteria counts classified as "too high to count". Similarly, the Naples Conservancy produced a report in the early 1980s that pointed to the high concentration of septic tanks in East Naples as the source of degradation and fecal coliform in Naples Bay. This report subsequently led to Collier County installing a sewer system.”

Arnade, L.J (1999) in an article titled "Seasonal Correlation of Well Contamination and Septic Tanks Distance" determined that there is a correlation between the density of septic tanks, porous sand, seasonal water table, distance of septic tank from water body and fecal coliform occurrence in ground water. The paper states:

"Ground water samples collected at all distances from septic tanks during the wet season contained twice as many fecal coliform and higher concentrations of nitrate and phosphates compared with samples collected during dry season."

“Many people do not realize or acknowledge the potential for septic tanks to contamination and the epidemiological effects that may be caused by this process. Fecal coliform, nitrates, and phosphorus present in septic tank effluent are responsible for such diseases as shigellosis, typhoide fever, gastroenteritis, blue baby syndrome (National Research Council 1998)."

"Fecal coliform counts were almost double during the wet season versus the dry season."

"The problem of ground water contamination via septic tanks is not an isolated problem in Palm Bay, but rather a nationwide problem."

Postma, et al. GW (1992), in an article titled “Nutrient and Microbial Movement from Seasonally-Used Septic Systems,” states:

“Unsewered season vacation communities present unique problems for on- site sewage disposal. Seasonal occupancy may promote the transmission of contaminants to groundwater due to incomplete formation of a biological clogging mat in the soil absorption system. Groundwater surrounding three seasonally-used septic systems was monitored to determine the movement and attenuation of nitrogen, phosphorus and two bacterial indicators of human fecal contamination, fecal coliforms and Clostridium perfringens. Nitrate-N concentrations were often three to four-fold greater than the drinking water standard at wells 6 m from the soil absorption systems. Minimal phosphorus migration occurred from these systems.”

DeBorde, et el (1998) in a study titled "Virus Occurrence and Transport in a School Septic System and Unconfined Aquifer" determined that 42% of all water associated disease outbreaks were a result of water impacted by septic tanks. They found that viruses had long survival times and low sorption rates.

Lipp, E.K, Farrah, S.A. and Rose, J.B. (2001) in a paper titled "Assessment and Impact of Microbial Fecal Pollution and Human Enteric Pathogens in a Coastal community" concluded that surface water bodies at risk are those with high concentrations of septic tanks. They state:

"Tracer studies demonstrate rapid movement of viruses from septic tanks into nearby coastal waters."

"Viruses may migrate under saturated conditions beyond current setback distance required between the drain field and wet weather water table."

"Under current regulations Florida soils may not be able to filter viral pathogens adequately."

“Infectious enteroviruses were detected throughout the study area, indicating a widespread contamination problem and a potential public health risk."

Cherry, John A. (1994), in an article titled “Biogeochemical Evolution of Domestic Waste Water in Septic Systems,” states:

“Recent findings raise issues beyond those of improved septic-system functioning and point to the possible need to diminish our reliance on conventional septic systems as a common means of waste-water disposal. The most compelling findings are those involving N[O.sub.3]-contamination. Nitrate-N has a maximum permissible drinking water concentration of 10 mg/l (Sayre, 1998; USEPA, 1992), but as explained below, properly designed and constructed septic systems cause [N[O.sub.3].sup.-]-N concentrations greater than 10 mg/l in the underlying ground water. Furthermore, septic systems also release other contaminants, such as [P[O.sub.4].sup.3-] (Sawhney and Starr, 1977), human pathogens (Hagedorn, 1984), and toxic organic chemical from household products (Kolega et al., 1987).”

Paul, J.H. et el (1997) in a paper titled "Evidence for groundwater and surface marine water contamination by waste disposal wells in the Florida Keys" states:

"Given known rates of travel of viruses in the subsurface, currently regulated setbacks distance will be ineffective at preventing micro-organisms, particularly viruses, from migrating to laterally to nearby surface waters."

Beaudoin, C.M. (1998) in a paper titled " Effects of sea water canals on fresh waste resources: an example from Big Pine Key, Florida" reported a substantial increase in nutrients in ground water near septic tanks (LaPoint et el (1990).

Kruczynski, W. (with USEPA), Florida Keys National Marine Sanctuary Water Quality Protection Program Report, dated September 1999, in an article titled “Water Quality Concerns in the Florida Keys: Source, Effects, Solutions” states:

“Properly functioning septic tank systems remove very little nutrients (only 4% N and only 15% P) from wastewater and effluent from septic tanks drainfields can rapidly migrate to surface waters.”

“Sewage discharged from septic tanks are a source of nutrients and human pathogens to ground and surface waters.”

“With septic tanks, the columns of many canals over six feet deep is stratified and bottom waters are usually in violation of Class III Surface Water Qualities Standards.”

Krucznski, W.L. in EPA study titled " Water Quality Concerns in Florida Keys: Sources, Effects, and Solutions, Water Protection Program", concluded that nutrients from wastewater are one of the major contributors to the decline of the water quality in the Florida Keys.

Paul, J.H., et al. (1995), in a paper titled “Viral Tracer Studies Indicate Contamination of Marine Waters by Sewage Disposal Practices in Key Largo, Florida,” states:

“Our work suggests that the on-site disposal practices employed in Key Largo lead to contamination of the marine surface waters. These practices could pose a health risk to the human population, when contact (swimming or diving) occurs, particularly in the canals, or from the consumption of seafood harvested from these canals.

Our work also is the first to link microbial contamination of the outstanding marine waters (station KLWC1) with on-site disposal practices. These data argue for changes in current waste disposal practices in the Florida Keys.”

Mcclure, Robert (2002) in an article titled “Septic systems an unseen danger up to a half-million exist in the region and many fail,” states:

“It reminds me of a harbor in a Third World country,” said commuter Lisa Jagunzy, who happens to work for the environmental group, People for Puget Sound. “It’s putrid, rotting, raw sewage. It’s disgusting.” Those failing tanks are one of the biggest reasons why one-fifth of the Sound’s commercial shellfish beds have seen harvest restrictions since 1980.”

P.R. Newswire (1998) in an article titled “Septic Tanks Pose Serious Threats to Health and Quality of Life for Millions,” states:

“The U.S. Environmental Protection Agency (EPA) says “leaking, malfunctioning, and worn out septic tanks are responsible for most of the in the U.S. today.”

“As reported in the Canter & Knox study “Septic Tank System Effects on Groundwater Quality” done for the EPA, an average of 40 percent (8 million) of these septic tanks do not function properly. The tanks fail eventually, dumping hundreds of millions of gallons of raw, untreated wastewater and other toxic materials into the ground, and at times into the nation’s water supply.”

“The major problem with septic tanks is they contain significant amounts of bacterial pathogens. The effluent also contains viral pathogens, which can and do pose a serious public health problem. Currently, no national enforcement standards exist for keeping viruses out of public and private water supplies, further exposing the public to increased risks of illness and death.”

Scandura and Sobsey (1997) in an article titled "Viral and Bacterial Contamination of groundwater from on-site sewage treatment systems" reported that the septic tank/soil absorption system that treat domestic wastewater have contaminated ground water with entric viruses, and other pathogens, causing waterborne disease outbreaks. They state "on-site septic wastewater treatment systems in sandy, coastal plains soils having seasonally high water tables can cause groundwater contamination with enteric viruses, bacteria and nutrients."

“Stoner, N. and Dorfman M. (July 2005) with the Natural Resources Defense Council, reported in a paper titled Testing the Waters 2005 – A Guide to Water Quality at Vacation Beaches” :

“Every year, more than 180 million Americans head to their favorite coastal and Great Lakes beach-vacation destinations to enjoy the sun, and the surf. Too often, however, they have to stay out of the water or risk getting sick. “

“Major causes of beach closings and advisories in 2004 were as follows:

• 85 percent were based on monitoring that detected bacteria levels exceeding beach water quality standards; • 13 percent were precautionary, due to rainfall known to carry pollution to swimming waters; • 3 percent were in response to known pollution events, such as sewage treatment plant failures or breaks in sewage pipes.”

“Because pathogens in sewage-contaminated waters can cause a wide range of diseases – including ear, nose, and throat problems, gastroenteritis, dysentery, hepatitis, and respiratory illnesses – beach water pollution threatens the public’s health. The consequences of these swimming-associated illnesses can be greater for children, elderly people, pregnant women, cancer patients and others with weakened immune systems.”

“Aside from the disease-causing organisms present in sewage, its high nutrient content acts as fertilizer that can spur massive blooms of microscopic organisms. In some cases, exposure to these organisms can cause illness through skin contact, inhalation, or ingestion. Toxic “red tides” outbreaks of such organisms such as Pfiesteria piscicida, have been found in recent years to be associated with fish kills in Atlantic and Gulf Coast marine and estuarine waters. Pfiesteria piscicida and other species of algae contain neurotoxins that may affect fishermen, swimmers, and other recreational users of nearshore marine and riverine waters. Exposure to these toxic blooms may result in short-term memory loss, dizziness, muscle aches, peripheral tingling, vomiting, skin lesions, and abdominal pain. Several leading scientists believe that the number and frequency of outbreaks such as these toxic blooms are increasing around the world and that these blooms may be attributed in part to coastal pollution.”

“Preliminary research from scientists working southwest Florida’s Lee County on both red tides and red-drift algae (a nontoxic micro algae whose blooms are also triggered by the presence of nutrients in water), suggests the occurrence of such blooms are worsening, tied to wastewater discharges as well as other nutrient sources, and are initiated near shore (closer to sources of human-made pollution) rather than offshore as previously thought.”

• “Water pollution has a significant economic effect on coastal states. Failing to invest in clean water costs coastal states jobs, job productivity, tourism, property-tax dollars, and economic growth.”

• “Polluted waters also cause economic losses both from swimming- related illnesses and from beachgoers’ lost use of the beach.”

• “Beaches are the top vacation destination in the country. Coastal tourism, dependent in part on clean beaches, generates substantial revenues for state and local governments. According to the Report of the U.S. Commission on Ocean Policy, ocean-related tourism and recreation contributed roughly $29 billion and 1.67 million jobs to the U.S. economy in 2000.”

Dale W. Griffin, et al. (1999), in an article titled “Detection of Viral Pathogens by Reverse Transcriptase PCR and of Microbial Indicators by Standard Methods in the Canals of the Florida Keys,” states:

“In order to assess the microbial water quality in canal waters throughout the Florida Keys, a survey was conducted to determine the concentration of microbial fecal indicators and the presence of human pathogenic microorganisms. A total of 19 sites, including 17 canal sites and 2 nearshore water sites, were assayed for total coliforms, fecal coliforms, Escherichia coli, Clostridium perfringens, enterococci, coliphages, F- specific (F+) RNA coliphages, Giardia lamblia, Cryptosporidium parvum, and human enteric viruses (polioviruses, coxsackie A and B viruses, echoviruses, hepatitis A viruses, Norwalk viruses, and small round- structured viruses). Numbers of coliforms ranged from <1 to 1,410, E. coli organisms from <1 to 130, Clostridium spp. from <1 to 520, and enterococci from <1 to 800 CFU/100 ml of sample.”

“Seventy-nine percent of the sites were positive for the presence of enteroviruses by reverse transcriptase PCR (polioviruses, coxsackie A and B viruses, and echoviruses). Sixty-three percent of the sites were positive for the presence of hepatititis A viruses. Ten percent of the sites were positive for the presence of Norwalk viruses. Ninety-five percent of the sites were positive for at least one of the virus groups. These results indicate that the canals and nearshore waters throughout the Florida Keys are being impacted by human fecal material carrying human enteric viruses through current wastewater treatment strategies such as septic tanks. Exposure to canal waters through recreation and work may be contributing to human health risks.”

D. Reide Corbett, et al. (2001), in an article titled “The spatial variability of nitrogen and phosphorus concentration in a sand aquifer influenced by onsite sewage treatment and disposal systems: a case study on St. George Island, Florida” states:

“Nutrient concentrations monitored downgradient from wastewater disposal systems show significant attenuation before discharge into surface waters. Silicate was used as a natural conservative tracer, providing insight to the extent of the wastewater plume and dilution of other nutrients. Total nitrogen, ammonia, and total phosphate were all attenuated relative to silicate, indicating non-conservative removal of these nutrients in the subsurface. Estimates of the total nitrogen flux into Apalachicola Bay from groundwater originating on St. George Island ranged between 1.5 and 65.7 mg N m¯² year¯¹ and the total phosphate flux ranged between 1.2 and 24.2 mg P m¯² year¯¹, based on estimated groundwater discharge rates and groundwater pore water nutrient concentrations measured near surface waters. However, current setback distances (23m) are insufficient to reduce nutrient concentrations to natural levels. By increasing the setback distance to approximately 50 m, most nutrient concentrations will be reduced to natural levels.“

Lapointe, B.E. et al. (2004) in a paper titled “Anthropogenic nutrient enrichment of seagrass and coral reef communities in the lower Florida Keys: Discrimination of local vs. regional nitrogen sources” states:

“Local sewage discharge from the Florida Keys is significant.” Nitrogen source supporting eutrophication and algae blooms in seagrass and coral reef communities in the lower Florida Keys.”

“Most of these OSDSS (septic tanks) are located adjacent to constructed canal systems that were designed to provide boating access to coastal waters that contain nutrient sensitive seagrass and coral reef communities.

They concluded that “high groundwater tables and transmissive substrata, OSDS (septic tanks) in the Florida Keys rapidly contaminated groundwater with high concentrations of dissolved inorganic nitrogen, and to a lesser extent, soluble reactive phosphorous.”

In their conclusions, they state:

“Results of this study support the hypothesis that land-based nutrient enrichment (from septic tanks) is a primary factor in seasonal development of phytoplankton, macrogalgae and seagrass epiphyte blooms in the inshore, nearshore and offshore waters.”

Chanton, J., in a paper titled “Accommodating Coastal Growth Panel Nonpoint Source Pollution” states:

“Florida’s coastal environment is especially vulnerable to nonpoint source pollution for two reasons. One, the extent of the karst nature of the platform allows great interaction between ground and surface waters. Second, the low gradient of the land results in high water tables. Both of these factors result in poor attenuation of contaminants in the subsurface, and the release of nutrients and pathogens to surface waters.” Dr. Chanton recommends:

“Onsite sewage disposal systems such as septic systems don’t work well in karst areas like the Florida Keys or in areas where the water table is high. Water can wick up into mounded septic systems, reducing their efficiency.”

“Homes in coastal areas should be connected to centralized sewer systems as much as possible.”

“Increase setbacks of septic systems from the shoreline to 150 feet.”

Quirolo, D.V. (2001) an article titled “Clean Water Protects Coral Reefs” states:

“This past September in Florida, Key West city officials held a ribbon- cutting ceremony to inaugurate one of the most advanced wastewater treatment facilities in the southern United States and Caribbean. The effort is the culmination of an accelerated $67.3 million dollar project to replace the island’s 46 miles of main sewer lines and 27 miles of lateral sewage collection pipelines with new PVC pipe. Some of the iron, steel, and clay pipes date to the 1800’s. In addition, almost all of Key West’s septic tanks and have been eliminated. The plant improves the biological treatment process by adding to remove nutrients. “

“Sewage contains nutrients, such as nitrates and phosphates, as well as viruses and pathogens that are a public health threat to humans. Once released into the aquatic environment, increased nutrients, chemical toxins, and biological pathogens from sewage effluent can be responsible for algae blooms, coral reef and fish diseases, genetic defects in fish and wildlife, beach closings, and general environmental degradation.”

Nurse, Doug, Staff (2001) in an article titled “Gwinnett officials target septic tanks as potential polluters under scrutiny: County plans project to detect failing systems and decide where sewers can have most impact on streams,” states:

“Gwinett County has about 90,000 septic tanks, thousands of which are nearing the end of their 20-year lifespan with potentially dire consequences for the environment. County officials suspect that the aging septic systems- --and newer ones, too---are contributing to pollution of streams with disease-carrying fecal coliform. The county has between 120 and 144 miles of fishing streams that exceed the state and federal standards for fecal coliform, a bacterium that lives inside of the bowels of warm-blooded animals, including humans.”

Tankersley, Claude (1996) in an article titled “Small Waterfront Community Faces a Big Sewer Challenge. (Suwannee, Florida)” states:

“Located at the end of a narrow, two-lane road and surrounded by wilderness, the coastal community of Suwannee, Florida is an unincorporated town in Dixie County with fewer than 1,000 fulltime residents. Nearly every lot in the community has direct canal access , and wastewater treatment and disposal is currently provided by septic tanks. The combination of these two factors caused major problems for Suwannee in recent years.”

“In 1990, the Florida Department of Health and Rehabilitative Services (HRS) declared that the town’s failing septic tanks were linked to the contamination of local shellfish beds. As a result, the state closed the oyster fishing industry in Suwannee Sound.”

Meehan, Mary (2002) in an article titled “Lack of Sewers Poses a Health Risk for Many” states:

“But some 207,000 people living in 17 Central Kentucky counties don’t have the comparative luxury of an absent-minded flush. They depend on often poorly maintained septic systems or privately operated package plants. In about half of those counties, more than 50 percent of homes are not on public sewers. In an unfiltered, undiluted form, sewage mingles with groundwater and eventually makes its way into creeks and rivers. That helps give Kentucky waterways the dubious distinction of having one of the highest rates of fecal coliform in the country, said Mike Davis, Director of the Kentucky On-Site Wastewater Training Center in Anderson County. Fecal coliform is a bacteria that can signal the presence of untreated sewage and other disease-causing bacteria.”

Paul, J.H., et al. (1995), states:

“Using viral tracers found that the wastewater transport from septic tanks into adjacent surface water (a 70 foot horizontal distance) occurred in as little as 11 hour.

Memo Natural Resources Division Management ● Science ● Restoration● Outreach

TO: A. William Moss, City Manager FROM: Mike Bauer, Natural Resources Manager DATE: March 12, 2010 SUBJECT: Bembury Sewer Project

The City of Naples water quality sampling program, designed and implemented by the Natural Resources Division, involves sampling 16 water quality sites--8 one month and then 8 the next month--in Naples Bay and the Gordon River. In addition, 4 sites are sampled monthly in Moorings Bay. Over 20 parameters are analyzed for each site— some requiring lab analysis and others that are measured on site using water quality instrumentation. In Naples Bay, these sites range from Gordon Pass to the Gordon River with some sites located in the wide canals of Port Royal, others at the mouths of canals, but most located in the open bay or river. All data collected are entered into a database as well as sent to the Florida Department of Environmental Protection for inclusion in STORET—the statewide repository for water quality data that is used for determining impairments and Total Maximum Daily Loads (TMDLs). Preparation for sampling (calibration of instruments, organization of sampling bottles, data sheets, lab coordination), entering data into the state database, ensuring proper quality assurance and control of the data, addressing possible errors, formatting the data for inclusion into STORET (which involves running the data through their quality control software), and analysis are time consuming activities that can require 10-15 hours per month in addition to the time it takes to collect the samples (between 11-12 hours per month). The City has three water quality stations in the Gordon River between the US41 bridge and Anthony Park. The County samples further to the north including the Gordon River Extension and in the Golden Gate Canal. The County has a water quality sampling site at the mouth of the canal behind the post office where residents currently have septic tanks. The County site is consistently higher in bacteria levels than the sites further down the river. This is not enough information, however, to quantify effects, if any, that these septic tanks are having on the adjacent waterway. Investigating the septic tanks themselves and performing simple dye tests to show whether or not they are functioning properly would be the best way to determine any potential impacts they may be having.

Naples Bay is impaired for fecal coliform per the Florida Department of Environmental Protection Impaired Waters Rule. The City is working to address water quality in relation to stormwater runoff so that Naples Bay can be removed from the impaired waters list before Total Maximum Daily Loads are determined for the bay.

On September 5, 2008 staff presented to City Council the Master Sewer Plan developed in 2006. While City Council seemed intent on eventually extending sewer service to those areas outside the city that have individual septic systems, they stopped short of directing such Ethics above all else... Service to others before self... Quality in all that we do. Page 2 extension at this time. They preferred opening a dialog with property owners, beginning with properties adjacent to the Gordon River. The highest priority area is the Bembury Subdivision containing 50 parcels with an estimated construction cost of $1,035,000.

Ethics above all else... Service to others before self... Quality in all that we do. Fecal Coliform

Fecal Coliform in Naples Bay Fecal Coliform Naples Bay 2005-2009

GORDJOE GORDPK GORDPT GPASS6 NBAY21 NBAY33 600 NBAYKF NBAYTC NBAYWS State Standard (10%) 500

400

300

200

100 Fecal Coliform (cfu/100ml) 0

FEB 05 DEC 05FEB 06 DEC 06FEB 07 DEC 07FEB 08 DEC 08FEB 09 APR 05J UNE 05AUG 05OCT 05 J UNE 06AUG 06OCT 06 APR 07J UNE 07AUG 07OCT 07 APR 08J UNE 08AUG 08OCT 08 APR 09J UNE 09AUG 09OCT 09

Fecal Coliform Naples Bay 2006-2009 GORDPK NBAY13 NBAY29 NBAYBV 250 NBA Y CC NBA Y HC NBAYLLO 200 NBA Y NL State Standard (10%) 150

100

50

Fecal Coliform (cfu/100ml) 0

JAN 07 JAN 09 MA R 06MAY 06J UL Y 06SEPT 06NOV 06 MA R 07MAY 07J UL Y 07SEPT 07NOV 07MA R 08MAY 08J UL Y 08SEPT 08NOV 08 MA R 09MAY 09J UL Y 09SEPT 09NOV 09 Fecal Coliform values from 2000-2009 collected by Collier County

Gordon River: Station BC3 Fecal Coliform 3070 1800 1600 BC3 1400 1200 State Standard Not to 1000 exceed value 800 10% of samples not 600 CFU/100ml to exceed 400 200 Not to exceed monthly 0 avg. 10/18/2000 04/18/2001 10/18/2001 04/18/2002 10/18/2002 04/18/2003 10/18/2003 04/18/2004 10/18/2004 04/18/2005 10/18/2005 04/18/2006 10/18/2006 04/18/2007 10/18/2007 04/18/2008 10/18/2008 04/18/2009

Station is located near the post office Research

Massive Microbiological Groundwater Contamination Associated with a Waterborne Outbreak in Lake Erie, South Bass Island, Ohio Theng-Theng Fong,1 Linda S. Mansfield,2 David L. Wilson,3,4 David J. Schwab,5 Stephanie L. Molloy,6 and Joan B. Rose1,6 1Department of Crop and Soil Science, 2Department of Microbiology and Molecular Genetics, 3National Food Safety and Toxicology Center, and 4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA; 5National Oceanic and Atmospheric Administration Great Lake Environmental Research Laboratory, Ann Arbor, Michigan, USA; 6Department of Fisheries and Wildlife, Michigan State University, East Lansing, Michigan, USA

During the time of the outbreak, South BACKGROUND: A groundwater-associated outbreak affected approximately 1,450 residents and visitors Bass Island used three main types of waste- of South Bass Island, Ohio, between July and September 2004. water disposal systems: a) the village of Put- OBJECTIVES: To examine the microbiological quality of groundwater wells located on South Bass in-Bay operated a publicly owned treatment Island, we sampled 16 wells that provide potable water to public water systems 15–21 September works (POTWs) that served the village; 2004. b) some of the businesses on the island were METHODS: We tested groundwater wells for fecal indicators, enteric viruses and bacteria, and pro- served by small package wastewater treatment tozoa (Cryptosporidium and Giardia). The hydrodynamics of Lake Erie were examined to explore works with aeration; and c) on-site waste- the possible surface water–groundwater interactions. water treatment works, such as septic tanks, RESULTS: All wells were positive for both total coliform and Escherichia coli. Seven wells tested mound systems, subsurface sand filters, and positive for enterococci and Arcobacter (an emerging bacterial pathogen), and F+-specific coliphage holding tanks served most of the unincorpo- was present in four wells. Three wells were positive for all three bacterial indicators, coliphages, and rated areas of the island. The small package Arcobacter; adenovirus DNA was recovered from two of these wells. We found a cluster of the most (or semipublic) wastewater treatment plants contaminated wells at the southeast side of the island. (WWTPs) are privately owned facilities that CONCLUSIONS: Massive groundwater contamination on the island was likely caused by transport of are regulated the same as POTWs by the microbiological contaminants from wastewater treatment facilities and septic tanks to the lake and the Ohio EPA. All POTWs on South Bass Island subsurface, after extreme precipitation events in May–July 2004. This likely raised the water table, discharge treated effluent to Lake Erie and are saturated the subsurface, and along with very strong Lake Erie currents on 24 July, forced a surge in water levels and rapid surface water–groundwater interchange throughout the island. Landsat images regulated by the Ohio EPA under a National showed massive influx of organic material and surrounding the island before the peak of the Pollutant Discharge Elimination System outbreak. These combinations of factors and information can be used to examine vulnerabilities in (NPDES) permit. Under Ohio NPDES per- other coastal systems. Both wastewater and drinking water issues are now being addressed by the mits (Ohio EPA 2005), sanitary sewage treat- Ohio Environmental Protection Agency and the Ohio Department of Health. ment systems are allowed to discharge with a KEY WORDS: Arcobacter, groundwater, microbiological contamination, outbreak, viruses, waterborne. daily fecal coliform bacteria limit of 2,000 Environ Health Perspect 115:856–864 (2007). doi:10.1289/ehp.9430 available via http://dx.doi.org/ colony-forming units (CFU)/100 mL with a [Online 6 February 2007] design flow of < 5,000 gal/day if they do not discharge directly into an Ohio river. Description of the outbreak. On 2 August Contaminated groundwater is the most com- which is the largest community on the island; 2004, the Ottawa County Health Department monly reported source of waterborne disease in Put-in-Bay has a permanent population of 350 (OCHD) in Ohio received several telephone the United States, associated with 64% of the and up to 25,000 visitors/day during the calls from persons reporting gastrointestinal ill- drinking water outbreaks between 1989 and tourist season. Potable water on the island is ness after visiting South Bass Island. A food- 2002. In recent national figures (2001–2002), provided through a number of public and pri- borne disease outbreak investigation was groundwater sources constituted 92% of the vate water systems. A public water system was initiated by the OCHD and the Ohio outbreaks, which often occurred in small defined by the Ohio EPA (2005) as a system Department of Health (ODH). On 12 August communities (Blackburn et al. 2004). A large that has at least 15 service connections or regu- 2004 the Ohio EPA was informed about a groundwater-associated outbreak in the larly serves an average of at least 25 individuals possible waterborne outbreak and began an Great Lakes basin occurred between June daily at least 60 days of the year. and September 2004 on South Bass Island, The village of Put-in-Bay is served by a Address correspondence to J.B. Rose, Department of Ohio, affecting approximately 1,450 individ- municipal public water system that uses pri- Fisheries and Wildlife, 15 Natural Resources, Michigan uals (both residents and visitors) [Ohio marily treated surface water from Lake Erie. State University, East Lansing, MI 48824-1222 USA. Environmental Protection Agency (EPA) However, many businesses and the majority Telephone: (517) 432-4412. Fax: (517) 432–1699. 2005]. The present study was undertaken to of residents on the island use untreated E-mail: [email protected] investigate the groundwater quality on the groundwater pumped from wells on their We thank J. Linz for providing guidance in the island and the factors associated with the premises as their primary source of potable culturing of Campylobacter and Arcobacter; the Ohio Environmental Protection Agency for their funding contamination event. water. There are approximately 13 transient and assistance in sampling; and R. Ives, T. Jenkins, South Bass Island is located in Ottawa noncommunity public water systems and and M. Wong for assisting with samples processing. County, Ohio, off the southern coast of Lake small businesses on the island that use wells to This study was supported by the NOAA Center of Erie, and approximately 5 mi from the meet their water needs. According to the Ohio Excellence for Great Lakes and Human Health Canadian border (Figure 1). South Bass Island EPA (2005), transient noncommunity public (CA4/III-08) and the Centers for Emerging Infectious is one of the main tourist destinations in the water systems are water systems that do not Diseases and Microbial Pathogenesis at Michigan State University. Midwest and has the nickname “Key West of regularly serve at least 25 of the same persons The authors declare they have no competing the Midwest.” Most bars and restaurants on the over 6 months of the year (e.g., restaurants, financial interests. island are located in the village of Put-in-Bay, campgrounds, gas stations). Received 16 June 2006; accepted 6 February 2007.

856 VOLUME 115 | NUMBER 6 | June 2007 • Environmental Health Perspectives Contaminated groundwater and waterborne disease investigation of the drinking and wastewater During 23–31 August 2004, the Ohio Materials and Methods systems. On 16 August 2004 the ODH EPA and the CDC performed another study Sampling sites. A total of 16 wells at Put-in- reported to the Foodborne and Diarrheal sampling for total coliform, Escherichia coli, Bay were selected by the Ohio EPA sampling Diseases Branch at the Centers for Disease and other enteric pathogens such as Campylo- team (15–21 September 2004) for study. Control and Prevention (CDC; Atlanta, GA) bactor at locations identified during the previ- Figure 3 shows the layout of the island and that there were 70 cases of gastroenteritis with ous epidemiologic investigation (O’Reilly the sampling sites. The 16 wells were labeled illness onsets between 1 June and 16 August et al. 2007). They also performed macro- according to the Ohio EPA labeling system 2004, including two confirmed cases of scopic particulate analysis from those wells. (PB-1, PB-2, PB-3, PB-4, PB-5, PB-6A, campylobacteriosis. All cases had a common During 8–10 September 2004, the ODH PB-6B, PB-6C, PB-7A, PB-7B, PB-8, PB-9, history of visiting South Bass Island before conducted an extensive environmental assess- PB-11, PB-12, PB-14, PB-19). Water sam- contracting gastroenteritis. The number of ment and water quality monitoring investiga- ples were collected from various types of busi- cases reported per day peaked around tion of private wells on the island. ness including cottages/home rentals (n = 6), 15 August 2004 when 75 cases were reported The present study was initiated to assist the parks (n = 3), food services (n = 2), an apart- (O’Reilly et al. 2007). On 26 August 2004 Ohio EPA, following the CDC’s initial investi- ment building, a public pool, a campground, the ODH and the OCHD advised island resi- gation, to further examine the extent of micro- a research facility, and a water treatment dents with private well water to boil their biological quality of the groundwater wells plant. Wells were not disinfected before the drinking water or use bottled water, and the located on South Bass Island. Approximately outbreaks but some were chlorinated after the Ohio EPA began ordering water-use advi- 1 month after the peak of the outbreak, sam- outbreak. At 12 of the sites, semipublic facili- sories for public water systems with an indica- ples were collected from 16 wells that provide ties (package WWTPs) were used for waste- tion of contamination. potable water to public and private water sys- water treatment. Most of the unincorporated By 5 September 2004, approximately tems on the island in order to examine the areas of South Bass Island are served by on- 1,450 gastroenteritis cases had been reported. ongoing risk to the population and residual site wastewater treatment works. On-site sys- Figure 2 shows those cases based on the epi- distribution of the contamination on the tems typically consist of a septic tank and demiologic study undertaken (O’Reilly et al. island. Groundwater analyses included conven- leach field. Two sites (PB-9 and PB-19) were 2007). The majority of cases occurred between tional indicators used for water, such as coli- served by on-site systems: PB-9 (airport) used 25 July and 17 August. The CDC detected a form bacteria (including total coliform and a mounded system, and PB-19 [ODNR mixture of pathogens, including Campylobacter E. coli), and the alternative indicators entero- (Ohio Department of Natural Resources) spp., Norovirus, Giardia spp., and Salmonella cocci, coliphage, and Clostridium perfringens. Oak Point picnic area] used a subsurface sand typhimurium in human fecal specimens The wells were also tested for Campylobacter, filter. One site (PB-5; Horny Toad) was (O’Reilly et al. 2007). Giardia, Cryptosporidium, and human enteric served by the village of Put-in-Bay full-scale A case–control study was conducted by viruses. The U.S. EPA standards for drinking publicly owned sewage treatment plant (Ohio the CDC and the ODH between 30 August water for total coliform bacteria are < 1/100 EPA 2005). A septage disposal site was and 7 September 2004. A significant associa- mL (U.S. EPA 1986, 2001d). Other fecal indi- located in the middle of the island, between tion between gastroenteritis symptoms and cators (E. coli, enterococci, and coliphage) and Catawba Rd. and Put-in-Bay Rd. tap water consumption, as well as the pathogens should not be present. In addition, Bacterial indicators and coliphage analyses. amount of tap water consumed, on the island we explored the factors associated with the Grab samples were collected using sterile was reported both from wells and the munic- microbial contaminants and their transport bottles; sodium thiosulfate was added to neu- ipal system (O’Reilly et al. 2007). Whereas using climate and satellite data as well as a tralize water samples with detectable chlorine recreational exposure (i.e., direct contact hydrodynamics model of Lake Erie. residuals. Samples were processed within with the lake, swimming or wading in the lake water, swimming in any pool on the 80 3.5 Cases May monthly rainfall Precipitation island) was not shown to be statistically asso- event is 200% above ciated with illness, direct exposure to Lake 70 50-year average 3 Erie did show an increased odds ratio (OR), with 13% of the cases and 8% of the controls 60 showing illness [matched OR = 6.0; p = 0.1; 2.5 95% confidence interval (CI), 0.7–276] 50 Lake Erie current (O’Reilly 2005). event, 7/24 2

Sampling 40 area Michigan 1.5

No. of cases Boil order, 8/26 Pennsyl- Isle St. George vania 30 Ohio Middle Bass Island Indiana South Bass Island 1 (Put-in-Bay)

20 daily precipitation (cm) Average Kelleys Island

Catawba Island 0.5 10

Port Clinton Sandusky Bay 0 0 5/1 5/8 5/15 5/22 5/29 6/5 6/12 6/19 6/26 7/3 7/10 7/17 7/24 7/31 8/78/14 8/21 8/28 9/4 9/11 9/18 Miles 510 15 Date Figure 1. Map showing South Bass Island in Lake Figure 2. Gastroenteritis cases by date in 2004, average daily rainfall (cm), and key events over the duration Erie and in relation to the State of Ohio (U.S. of the outbreak. Index cases were reported on 30 May 2004 (n = 1,450); the estimated number of cases was Geological Survey 2006). obtained from O’Reilly et al. (2007).

Environmental Health Perspectives • VOLUME 115 | NUMBER 6 | June 2007 857 Fong et al.

24 hr of collection. Total coliform and E. coli An enrichment step was performed on MI) at each sampling site. Filtration, elution, were analyzed by a filtration/agar method samples that were negative by DAL procedure and recovery of parasites from filters were per- (American Public Health Association et al. to amplify the number of coliphage in the sam- formed following U.S. EPA method 1623 1995) and by the Colilert Presence/Absence ples. A 1-L sample was supplemented with (U.S. EPA 2001c). Parasite oocysts/cysts were test kit (IDEXX Laboratories, Inc., Westbrook, 12.5 mL 4 M MgCl2 and 5 mL host organism then concentrated into a pellet by the Dynal ME). Aliquots of each water sample (300 mL) (E. coli C3000 or E. coli F amp) in log phase Immunomagnetic Separation Technique were filtered through a membrane filter and and 50 mL 10X TSB. For enrichment with (IMS; Dynabeads CG-combo Kit; Dynal enumerated on mENDO (total coliform) E. coli C3000, we also added 10 mL/L 1% Biotech, Inc., Lake Success, NY). The concen- media (catalog no. 273620) and EC-MUG nalidixic acid solution. For E. coli F+amp as the trated pellet was resuspended with MilliQ (E. coli) media (catalog no. 222200), both host organism, enrichments were supple- water [obtained from a Nanopure Diamond from Difco Laboratories, (Detroit, MI). mented with 10 mL streptomycin/ampicillin Analytical Ultrapure water system (Barnstead Enterococci were enumerated by membrane solution. Enrichments were then incubated for International, Dubuque, IA)] into 20 mL and filtration and cultured on mEI agar (catalog 16–24 hr at 37°C. Phage presence in the split into two. One portion was screened for no. 214885; Difco Laboratories) following enrichments was confirmed via plaque forma- the presence of Cryptosporidium oocysts and U.S. EPA Method 1600 (U.S. EPA 2002). tion using the overlay method described above. Giardia cysts under Carl Zeiss Axioskop 2 MCP medium (catalog no. 7477A; Acumedia, Arcobacter/Campylobacter spp. analysis. fluorescence microscope (Zeiss, Thornwood, Baltimore, MD) was used for C. perfringens Four liters of grab samples were collected from NY) after staining with monoclonal antibodies analysis (Bisson and Cabelli 1979). After incu- each well initially for analysis of Campylobacter (EasyStain; Biotechnology Frontiers, North bation, yellow colonies that turned red or dark spp. Concentrated Maximum Recovery Ryde, Australia) tagged with fluorescein isoth- pink after being exposed to ammonium Diluent (Oxoid, Basingstoke, UK) was then iocyanate. The pellet was also stained with a hydroxide were counted as C. perfringens. Each added to each water sample at a ratio of 1:10. 0.4-μg/mL 4´6-diamidino-2-phenyl indole sample was analyzed in triplicate. Samples were filtered through 0.45-μm mem- (DAPI) solution. Before staining, IMS con- We analyzed coliphages using the double brane filters (Gelman Sciences, Ann Arbor, centrates were applied to Dynal Spot-On agar layer (DAL) method or enrichment MI). After filtration, the membranes were then slides (Dynal Biotech, Oslo, Norway) and air method as described in U.S. EPA Methods placed on Bolton Selective Enrichment Agar dried. After air-drying and fixing in methanol, 1601 and 1602 (U.S. EPA 2001a, 2001b). We (BSEA; Oxoid) and flooded with 10 mL all samples were stained with 50 μL EasyStain, used hosts E. coli F-amp (ATCC no. 700891; Bolton broth supplemented with 5% defibri- followed by 1 mL DAPI and were examined American Type Culture Collection, Manassas, nated sheep’s blood, cefoperazone (20 μg/mL), by fluorescence microscopy. The remaining VA) for detecting F+-specific coliphage and vancomycin (10 μg/mL), and amphotericin B pellet suspensions were stored for further E. coli C3000 (ATCC no. 15597) for total (2 μg/mL). The plates (and all other incuba- analysis [i.e., cell culture if a (oo)cyst was (somatic and F+-specific) coliphages. In brief, tions) were placed in an anaerobic jar and incu- detected by microscopy]. we prefiltered 20 mL of each water sample bated at 37°C with 40 rpm agitation under an Human enteric virus analyses. Approxi- through a 0.22-μm filter to remove debris and atmosphere of 10% CO2, 10% H2, and 80% mately 1,000 L of water at each site was filtered bacteria: 0.5 mL host and 2 mL filtered sample N2. After 48 hr incubation, turbid broth cul- through a 1 MDS cartridge filter (CUNO Inc., were then added to 3 mL trypticase soy broth tures were diluted serially, plated onto BSEA, Meriden, CT, USA). Virus elution and con- (TSB) containing 1.5% agar before mixing and and incubated as above without agitation. Five centration was carried out by organic floccula- pouring onto a tryptic soy agar plate. Five isolated colonies from the enrichment cultures tion as described by Fout et al. (1996). Viruses replicates were assayed for a total of 10 mL. that produced growth were passaged onto were desorbed from the filters by two rounds Overlays were incubated at 37°C for 24 hr and BSEA to produce pure culture. of reverse passage of 1 L 1.5% beef extract then assessed for plaque formation. We performed C. jejuni–specific poly- solution (1.5% wt/vol beef extract, 0.05 M merase chain reaction (PCR) analysis to rapidly glycine, pH 9.0–9.5). Viruses were flocculated screen colonies isolated on BSEA (Wilson et al. by the addition of ferric (III) chloride to a final

8 2000). Colonies were transferred by sterile concentration of 2.5 mM and by lowering the 19 toothpicks to PuReTaq Ready-To-Go PCR pH to 3.5 (Payment et al. 1984). Viral concen- beads (Amersham Biosciences, Bucks, UK). trates were centrifuged at 2,500 × g for 15 min, Bayview PCR was performed with primer concentra- and the pellet was resuspended in 30 mL of Mitchell Delaware tions at 1 pmol/μL. Chromosomal DNA was 0.15 M sodium phosphate (final pH 9.0). West Shore Road extracted with Easy DNA (Invitrogen, Viruses were purified by centrifugation at 5 Carlsbad, CA) from selected BSEA isolates. 10,000 × g for 10 min; brought to a neutral PCR-restriction fragment length polymor- pH; supplemented with 100 U penicillin, 14 1 Catawba phism (PCR-RFLP) was then used to distin- 100 μg streptomycin, and 0.25 μg ampho- 7a, 7b guish between Campylobacter, Helicobacter, and tericin B; and stored at –80°C until analysis. 4 Put-in-Bay2 Road Arcobacter spp. (Marshall et al. 1999). This Culturable viruses were assayed on 11 6a, 12 PCR amplifies a 1,004-bp fragment within the Buffalo Green Monkey cells with Eagle mini- 6b, 6c 3 coding region of the 16S rRNA gene in mum essential medium supplemented with 9 Campylobacter, Arcobacter, and Helicobacter 2% fetal bovine serum and incubated at spp. Thereafter, all of these genera can be iden- 36.5 ± 1°C for 14 days. Samples were exam- Lang Ram Sampling locations tified to the genus level with one restriction ined daily for the development of cytopathic Roads enzyme. effects. All samples underwent a secondary Cryptosporidium spp. and Giardia spp. passage after freeze-thaw. We used U.S. EPA analysis. For parasite analysis (Cryptosporidium MPN (Most Probable Number) software Figure 3. Wells sampled on South Bass Island spp. and Giardia spp.), approximately 100 L (U.S. EPA, Cincinnati, OH) to calculate the 15–21 September 2004; map reproduced with per- water was filtered through an Envirochek HV MPN/100 L values and confidence limits for mission from the Ohio EPA (2005). filter (Pall Gelman Laboratories, Ann Arbor, viruses.

858 VOLUME 115 | NUMBER 6 | June 2007 • Environmental Health Perspectives Contaminated groundwater and waterborne disease

Enteric viruses were also detected by PCR. integrated currents for 8 days during the out- of < 1 NTU (U.S. EPA 1975). Ten of 16 wells Concentrated water samples (6 mL) were fur- break period in 2004. Average monthly precip- (PB-1, PB-3, PB-4, PB-5, PB-6B, PB-6C, ther purified, concentrated, and desalted with itation data for 2004 was obtained from the PB-7B, PB-8, PB-11, and PB-19) were found Centriprep YM-50 concentrator columns ODH (2005). True-color LandSat 7 images of to have TDS levels that exceeded the National (Millipore). The final volume of concentrated western Lake Erie were obtained from Secondary Drinking Water Regulations of eluate recovered was approximately 750 μL. OhioLINK (2004) during the period of sus- 500 mg/L (U.S. EPA 1991). Concentrates were stored at –80°C until analy- pected contamination. Table 3 shows the results of the micro- sis. We extracted and purified viral RNA from biological analyses arranged from the most concentrates using a QIAamp Viral RNA Mini Results contaminated wells to the least contaminated. Kit (Qiagen, Valencia, CA) following the Groundwater quality. Four water samples were Total coliforms, E. coli, enterococci, C. per- manufacturer’s protocol. Purified viral RNA collected on 15, 16, 20, and 21 September fringens, total coliphages, and F±-specific coli- was eluted in 60 μL of RNase-free water. Each 2004 for a total of 16 samples. The dates and phages were monitored as evidence of fecal concentrated and purified sample was serially the physical and chemical analyses of ground- contamination. Eleven wells were positive for –1 diluted to a concentration of 10 and stored at water samples, including free Cl2, total Cl2, total coliforms (range, 2.2–90 CFU/100 mL; –20°C. Both concentrations were assayed to pH, turbidity, and (TDS), mean, 12.55 CFU/100 mL) and eight wells examine inhibition. We performed PCR ampli- are shown in Table 2. Four samples (PB-3, were positive for E. coli (range, 0.1–4 fication for norovirus (NV), human enterovirus PB-4, PB-11, and PB-14) had free Cl2 and total CFU/100 mL; mean, 0.64 CFU/100 mL) by (HEntV), and human adenovirus (HAdV) Cl2 ranging from 0.08 to 0.49 mg/L and from the membrane filtration method. All wells using the primer sets shown in Table 1. HEntV 0.04 to 1.00 mg/L, respectively. The pH was were positive for both total coliform and primer sets were able to detect at least 25 differ- fairly consistent, ranging from 6.8 to 7.4. High E. coli by the Colilert Presence/Absence test ent HEntVs; echovirus 22 was not detected. levels of turbidity were found in PB-8, PB-9, kit. Seven wells tested positive for enterococci, We used a nested primer set designed by Allard and PB-19, with turbidity of 6.5, 4.1, and 3.9 with counts ranging from 0.1 CFU/100 mL to et al. (1992) to amplify HAdV. The primers nephelometric turbidity units (NTU), respec- 6.6 CFU/100 mL (mean, 1.38 CFU/100 mL). were able to identify 47 HAdV serotypes, tively. The National Primary Drinking Water C. perfringens was not detected in any well. including the more common HAdV types 2, Regulations require a maximum turbidity level Overall, five wells (PB-3, PB-9, PB-6B, 40, and 41 (Allard et al. 1992; Puig et al. 1994). Reverse transcriptase (RT)-PCR for Table 1. Primer sets for virus detection. The equivalent original volume of water analyzed for each sample noroviruses and enteroviruses was performed ranged between 4.58 L and 6.46 L for NV, between 1.37 L and 1.94 L for HAdV and between 2.29 L and 3.23 L using GeneAmp Gold RNA PCR Core Kit for HEntV. (Applied Biosystems, Foster City, CA) accord- Virus group, primer Sequence (5´ to 3´) Amplicon (bp) Reference ing to manufacturer’s recommendations (Le NV Guyader et al. 1996). Primers NVp110 and NVp110 AC(A/T/G)AT(C/T)TCATCATCACCATA 398 Le Guyader et al. 1996 NVp36 were used. Noroviruses G1 and G2 NVp36 ATAAAAGTTGGCATGAACA were used as positive controls (courteously pro- HAdV vided by J. Massey, Michigan Department of AV-A1 GCCGCAGTGGTCTTACATGCACATC Community Health, Lansing, MI). We per- AV-A2 CAGCACGCCGCGGATGTCAAAGT 300 Allard et al. 1992 AV-B1a GCCACCGAGACGTACTTCAGCCTG formed RT-nested-PCR for HEntV following a AV-B2a TTGTACGAGTACGCGGTATCCTCGCGGTC 143 Allard et al. 1992 modified protocol by Fong et al. (2005). The HEntV final amplicon size was 154 bp. Poliovirus 1, ENT-up-1 GTAGATCAGGTCGATGAGTC Fong et al. 2005 LSc strain (ATCC no. VR-59) was used as a ENT-down-1 AC(T/C)GG(A/G)TGGCCAATC 330 De Leon et al. 1990 positive control; MilliQ water was used as a ENT-up-2a CCTCCGGCCCCTGAATG De Leon et al. 1990 a negative control for all PCR assays. ENT-down-2 ATTGTCACCATAAGCAGCC 154 Fong et al. 2005 Lake Erie hydrodynamic modeling. We aPrimers used for the second round of PCR. used a coastal ocean circulation model (Princeton Ocean Model; Blumberg and Table 2. Physical and chemical data of groundwater collected in September 2004.

Mellor 1987) to simulate the currents in Lake Date Free Cl2 Total Cl2 Turbidity TDS Erie during 2004. The model uses observed Site Sample ID collected (mg/L) (mg/L) pH (NTU) (ppm) winds from weather stations around the lakes Put-in-Bay well PB-1 16 Sep ND 0.04 7.12 0.08 (0.32) 410 and buoys in the lake to estimate currents and Bird’s Nest Resorta PB-2 15 Sep ND ND 7.2 0.1 480 thermal structure on a horizontal grid with Clinsters PB-3 21 Sep 0.1 0.39 7.4 0.01 630 2-km grid spacing. This model has been used Fox’s Dena PB-4 15 Sep 0.08 0.1 6.8 0.12 520 extensively in the Great Lakes for operational Horny Toad PB-5 16 Sep ND ND 6.8 0 (0.37) 490 Island Club well 1 PB–6A 21 Sep ND ND 7 0.05 370 coastal forecasting (Kelley et al. 1998; Schwab Island Club well 2 PB–6B 21 Sep ND ND 7.4 0.01 560 and Bedford 1999) and has generally proven to Island Club well 3 PB–6C 21 Sep ND ND 7.07 0 620 be quite accurate (Beletsky and Schwab 2001; ODNR State Park well 1 PB-7A 20 Sep ND ND 7.11 0.05 (0.31) 510 Beletsky et al. 2003). Storm surges in Lake Erie ODNR State Park well 2 PB-7B 20 Sep ND ND 6.92 0.05 (0.07) 820 have previously been shown to influence water OSU Stone Lab PB-8 20 Sep ND ND 7.1 6.48 (5.53) 1,370 a levels (O’Connor et al. 1999). Currents were Airport PB-9 15 Sep ND ND 6.92 4.14 500 Saunders South PB-11 20 Sep 0.13 0.2 7.4 0.26 (0.31) 570 calculated on an hourly basis and show consid- Skyway Loungea PB-12 16 Sep ND ND 7.2 0.25 (0.43) 490 erable hour-to-hour and day-to-day variability, Victory Park Resortb PB-14 15 Sep 0.49 1 7 0.08 960 mainly due to variability in the wind field. As ODNR Oak Point PB-19 16 Sep ND ND 7.09 3.86 (10.74) 600 an example of current variability around the ND, not detected. The turbidity of all samples was measured in the field by the Ohio EPA; the turbidity readings taken at South Bass Island area, we developed and the Michigan State University laboratory are shown in parentheses. examined plots of daily averaged, vertically aChlorinator was turned off before sampling. bBleach was added directly into the well by the owner for decontamination.

Environmental Health Perspectives • VOLUME 115 | NUMBER 6 | June 2007 859 Fong et al.

PB-7A, and PB-12) were positive for three the presence of enteric virus DNA or RNA via moderately contaminated with coliform bac- bacterial indicators (total coliform, E. coli, and PCR. Adenovirus DNA was detected at two teria and E. coli. PB-19 was also positive for enterococci), and PB-3 had the highest counts sites, PB-9 and PB-12. The HAdV primers enterococci. for all three indicators. used were able to identify 47 HAdV serotypes, Hydrodynamic modeling. We examined Three wells were positive for total coli- including both respiratory and enteric HAdV the hydrodynamics of Lake Erie during the phages (PB-5, PB-6B, and PB-12) and four (Allard et al. 1992). Neither enterovirus nor outbreak to explore the possible surface water– samples were positive for F+-specific coli- norovirus was detected in any of the samples. ground water interactions. Water levels forced phages (PB-6A, PB-6B, PB-6C, and PB-9) Relative microbial contamination. by observed winds (O’Connor et al. 1999) and when analyzed by the two-step enrichment Table 3 shows contamination of sites in the storm surges in the lake are likely to influence method. One well (PB-6B) was positive for order of contamination level. PB-9, PB-12, the subsurface aquifers. Figure 5 shows the both somatic and F+-specific coliphages. PB-5, and PB-6B were the most contami- daily averaged, vertically integrated modeled PB-6B was also positive for all three bacterial nated, followed by PB-3, PB-6A, and PB-6C; currents in the South Bass Island area plotted indicators. Although both types of phage are then PB-19 and PB-7A; and PB-11 and for 8 days during the 2004 outbreak period. indicators of fecal contamination, it has been PB-8. PB-14, PB-2, PB-4, PB-1, and PB-7B On the south side of the island, currents were suggested that the F+-specific coliphages may were the least contaminated. They had only most commonly westward with moderated represent the transport and survival of the some evidence of coliform and E. coli conta- speeds ranging from 5 to 10 cm/sec (30 May, RNA human enteric viruses more adequately mination via Colilert test. Although the cont- 25 June, 11 July, and 15 August 2004). There (International Association on Water Pollution amination was widespread across the island were also two examples of eastward flow Research and Control Study Group on Health (Figure 3), the most contaminated sites were (1 August and 9 September 2004), one of Related Water Microbiology 1991). along the southeast side of the island. The strong (> 20 cm/sec) westward flow (24 July A preliminary investigation of about cleaner sites were all north of these, with the 2004), and one of almost stagnant flow 50% of the pure cultures isolated on the exception of PB-5. All (100%) of the wells (22 August 2004). Currents are almost always Campylobacter-selective media recovered were positive for both total coliform and weakly southward on the east side of the Arcobacter spp., which genetically and morpho- E. coli by the Colilert method, but in spite of island. On the west side, currents are about logically resembles Campylobacter. Arcobacter some chlorine residual, only about 65% and evenly divided between northward and south- spp. were detected in seven wells (PB-3, PB-5, 47% were positive, respectively, when culti- ward on these particular days. On 24 July PB-6A, PB-6B, PB-6C, PB-9, and PB-12). vated by membrane filtration. Enterococci 2004, immediately before the beginning of the The morphology of these cells was confirmed and Arcobacter were found in 41% of the largest peak in cases during the outbreak, the under a darkfield microscope. Arcobacter spp. wells, whereas phage and HAdV DNA were current pattern shows clockwise circulation has now been identified as an emerging cause found in 37% and 12% of the wells, respec- around the island, with current speeds exceed- of diarrhea in humans and is closely related to tively. Three of the five cleanest sites all car- ing 20 cm/sec on the south shore. Water Campylobacter (Wesley 1997). Species-specific ried chlorine residuals and had low turbidity. movement was almost stagnant on 22 August PCR screening for C. jejuni DNA from pre- Interestingly, site PB-3, despite having chlo- 2004, around the time of the sudden decrease sumptive Campylobacter isolates was negative rine residuals, was moderately contaminated; (Figure 4). this site is located between the two most cont- We detected no parasites in the 16 water aminated sites: PB-9 and PB-12. No chlorine samples collected. The volume of water ana- residual was found in the four most contami- lyzed for parasites ranged between 40 and nated sites, and PB-9 had high turbidity. 75 L. No cultivatable viruses were detected in PB-8 and PB-19 both produced water with the approximately 500 L of groundwater high . These sites were located at assayed. The samples were also analyzed for the far northern tip of the island and were

Table 3. Contamination in samples shown in order from the highest to the lowest bacterial indicator and virus counts. Bacteria (CFU 100/mL) Total Total Coliphages Enteric coliform coliform E. coli E. coli (enrichment/L) viruses Sample ID (MF) (Colilert) (MF) (Colilert) Enterococci Arcobacter Total F-specific HAdV PB-9 7.8 + 1.3 + 1.9 + < 1 + + PB-12 7.7 + 0.3 + 0.6 + + < 1 + PB-6B 38 + 0.4 + 0.1 + + + – PB-5 3.4 + < 0.1 + 2 + + < 1 – PB-3 90 + 4 + 6.6 + < 1 < 1 – PB-6C 26 + 0.1 + < 0.1 + < 1 + – PB-6A 5.9 + < 0.1 + < 0.1 + < 1 + – PB-19 12.8 + < 0.1 + 5.9 < 0.1 < 1 < 1 – PB-7A 3.7 + 0.7 + 5 < 0.1 < 1 < 1 – Figure 4. 16S rDNA PCR-RFLP patterns of chromo- PB-11 2.2 + 0.9 + < 0.1 < 0.1 < 1 < 1 – somal extracts from bacterial isolates recovered in PB-8 3.3 + 2.6 + < 0.1 < 0.1 < 1 < 1 – South Bass Island groundwater after DdeI digest. PB-14 < 0.1 + < 0.1 + < 0.1 < 0.1 < 1 < 1 – Lane 1, 100-bp marker; lane 2, C. jejuni control PB-2 < 0.1 + < 0.1 + < 0.1 < 0.1 < 1 < 1 – (ATCC no. 11168); lanes 3–9, samples isolated from PB-4 < 0.1 + < 0.1 + < 0.1 < 0.1 < 1 < 1 – South Bass Island groundwater sites PB-5, PB-12, PB-1 < 0.1 + < 0.1 + < 0.1 < 0.1 < 1 < 1 – PB-3, PB-6A, PB-6B, and PB-6C, respectively. DdeI PB-7B < 0.1 + < 0.1 + < 0.1 < 0.1 < 1 < 1 – restriction fragments of 421, 353, and 183 bp are Abbreviations: +, positive; –, negative; MF, membrane filtration. All samples were negative for C. perfringen, indicative of Arcobacter as specified by Marshall Cryptosporidium spp., Giardia spp., noroviruses, and human enteroviruses. et al. (1999).

860 VOLUME 115 | NUMBER 6 | June 2007 • Environmental Health Perspectives Contaminated groundwater and waterborne disease in cases of the disease; the boil order was not and 31% of the wells were positive for total investigation (15–21 September); 100% were initiated until 26 August 2004. The pattern of coliform and E. coli, respectively. About 63% positive for E. coli in our analysis using the the current on 9 September 2004 before our of the 22 wells at depths between 0–50 feet Colilert method, which has been known to sampling shows the strong (> 20 cm/sec) cur- and 18.5% of 54 wells at depths of 51–162 ft recover chlorine-injured bacteria (McFeters rents that can occur during fall storms. tested positive for E. coli. Some of the wells et al. 1993). The monthly rainfall in 2004 was on were sampled approximately 1 month after the Campylobacter was isolated from 16 stool average greater than the 50-year monthly outbreak during our more intensive microbial samples and one well sample during the averages for the area (Figure 6) and in fact was > 200% for May and 120% for June. 9 Three true-color LandSat images of western Monthly precipitation data Lake Erie from 10 May 2004, 27 June 2004, Monthly average precipitation data (1951–2000) and 15 September 2004 are shown in 8 Figure 7 (OhioLINK 2004). Biological activity (greenish color) is indicated on the northeast of the Island in the Figure 7A (10 May), but most 7 of the turbidity appears to be inorganic (white and gray). By 27 June 2004 (Figure 7B), the reddish colors in the lake indicate a dramatic 6 increase in biological activity or suspended inorganic material (clay). Finally, by 5 15 September 2004 (Figure 7C), the activity (or turbidity) diminished considerably except in Sandusky Bay. 4

Discussion Precipitation (inches)

The South Bass Island waterborne outbreak, 3 which took place between June and August 2004, is one of the largest documented in the Great Lakes in the last decade. Our investiga- 2 tion indicated that the fecal contamination was massive and widespread throughout the groundwater on South Bass Island. The multi- 1 tude of pathogens detected in the population, including Camplylobacter and norovirus, sug- 0 gests that human wastes were the source of the Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec contamination originating from wastewater 2004 facilities, septic tank effluent discharges, or pos- Figure 6. Monthly precipitation (inches) in 2004 and monthly average precipitation data (based on 1951–2000) sibly septage. The ODH reported that 78% for the North Central Climatic region of Ohio in 2004. Reproduced with permission from ODH (2005).

A B C D

5/30/04 6/25/04 7/11/04 7/24/04

10 cm/sec 10 cm/sec 10 cm/sec 10 cm/sec

E F G H

8/1/04 8/15/04 8/22/04 9/9/04

10 cm/sec 10 cm/sec 10 cm/sec 10 cm/sec

Figure 5. Modeled currents around South Bass Island in Lake Erie before [(A) 30 May, (B) 25 June], during [(C) 11 July, (D) 24 July, (E) 1 August, (F) 15 August, (G) 22 August], and after [(H) 9 September] the outbreak in 2004.

Environmental Health Perspectives • VOLUME 115 | NUMBER 6 | June 2007 861 Fong et al. investigation by the CDC in late August (> 90%) remove the bacteria and viruses. may have inactivated the viruses. Chlorinators (O’Reilly et al. 2007) but not in our well sam- Interestingly O’Reilly et al. (2007) reported no were turned off just before collection of sam- ples. In our study, seven water samples that significant difference between attack rates for ples. Adenovirus DNA was detected in wells were presumptively positive for Campylobacter residents using well water or municipal water PB-9 and PB-12, which shows that these wells spp. were identified as being contaminated (treated Lake Erie water). Although not statisti- were vulnerable to human wastes (both wells with Arcobacter. Arcobacter spp. can be differ- cally significant, an increased OR was found by were < 51 ft deep) and that the use of multiple entiated from other Campylobacter-like bacte- O’Reilly (2005) for cases with any contact with cell lines may be necessary in cell culture analy- ria by two distinctive features: They grow at Lake Erie (13% of the cases and 8% of the sis (ODH 2005). The presence of human 15°C, and they are aerotolerant (Wesley controls showed illness, with a matched OR of adenoviral DNA indicated that groundwater 1997). Recent studies suggest that Arcobacter, 6.0; p = 0.1; 95% CI, 0.7–276). on South Bass Island was affected by human especially Arcobacter butzleri, is associated with Cell culture analysis showed no culturable sewage. The indicator viruses, in this case persistent, watery diarrhea and bacteremia in virus; chlorination of the wells before sampling coliphages, were also detected (in 37.5% of infected patients (Vandenberg the wells) and are highly indica- 2004). Little is known about the A tive of sewage contamination. mechanisms of pathogenicity, They are also useful as viral indi- potential virulence factors, or clini- cators of groundwater contami- cal importance of Arcobacter spp. nation because of their colloidal because these organisms are often nature and ability to move misidentified as a Campylobacter through the subsurface. spp. if specific testing to species Overall, wells PB-5 (Horny level is not performed (Diergaardt Toad), PB-6B (Island Club et al. 2004). It is uncertain how well 2), PB-9 (airport), and PB-12 frequently Arcobacter can be (Skyway Lounge) were among the found in sewage, surface water, or most contaminated sites; these groundwater. The high prevalence wells were positive for all three of Arcobacter in these water sam- bacterial indicators, coliphages, ples and the ability of the bacteria and Arcobacter spp. PB-9 and to grow at cool temperatures fur- PB-12 were positive for adeno- ther support its potential as a virus DNA. At PB-9, an on-site waterborne pathogen. Arcobacter septic system was used for waste- spp. should be considered as one B water treatment; this could have of the emerging waterborne bac- been the possible source of the terial pathogens, and waters contamination in the well. Both should be further monitored for PB-12 and PB-6B were connected this bacterium. to a privately owned treatment We did not detect Crypto- facility with discharge to Lake sporidium oocysts or Giardia cysts Erie. in the present study using U.S. The possible sources of human EPA method 1623 (U.S. EPA fecal wastes on this island included 2001c). These organisms are gen- 149 household sewage treatment erally detected in surface waters systems, 81 of which discharge to and in drinking waters with inade- the subsurface and 68 of which quate filtration (Betancourt and discharge to Lake Erie. Also, sep- Rose 2004). This suggests that the tage was also applied to the land groundwater on South Bass Island in the center of the western por- was not under the direct influence tion of the island, between of surface water because the pres- C Catawba and Put-in-Bay Rd.; the ence of these parasites in water is application was discontinued dur- normally the result of surface ing this outbreak. On-site waste- runoff (Hancock et al. 1998). The water disposal systems, which microscopic particulate analysis discharge to the subsurface, have test run by the Ohio EPA also cor- been shown to readily contami- roborated these results, returning a nate ground and surface waters. low risk of groundwater under the Virus transport in karst and “direct” influence of surface porous aquifers can be rapid, waters. Although a few cases of ranging from 8 to 54 m/day (Paul parasitic infections were reported et al. 1997). Viruses, bacteria, and (three cases of giardiasis), these parasites have been reported at could have been acquired from concentrations of 102–105/L in contact with the lake. The sewage depending on the treat- hydraulic conductivity between the ment scheme (type of secondary lake and the groundwater, as well treatment) and level of disinfec- as the type of glacial geology in Figure 7. Landsat satellite images of Lake Erie around South Bass Island 10 May tion (National Research Council this area, would not effectively 2004 (A), 27 June 2004 (B), and 15 September 2004 (C) (OhioLINK 2004). 1998; Rose et al. 2001). The high

862 VOLUME 115 | NUMBER 6 | June 2007 • Environmental Health Perspectives Contaminated groundwater and waterborne disease

concentrations of bacteria allowed as a part of 25 July and 17 August 2004 (Figure 2). Rapid associated with drinking water—United States, 2001–2002. the NPDES in sewage effluent discharges transport and interchange likely occur between MMWR Surveill Summ 53(8):23–45. Blumberg, AF, Mellor GL. 1987. A description of a three-dimen- (2,000 CFU/100 mL) suggest that disinfection the lake and groundwater as the water levels sional coastal ocean circulation model. In: Three- of the wastewater was limited (Ohio EPA rise as a result of storm surges.These combi- Dimensional Coastal Ocean Models, Coastal Estuarine 2005). The porous aquifer on the island pro- nations of factors and information can be Science, Vol 5 (Heaps NS, ed). Washington, DC:American Geophysical Union, 1–16. vided little to no natural filtration that might used to examine vulnerabilities in other Curriero FC, Patz JA, Rose JB, Lele S. 2001. The association normally occur during water movement coastal systems. between extreme precipitation and waterborne disease out- through the soil. In addition, fractures in the Since the outbreak, the current goal has breaks in the United States, 1948–1994. Am J Public Health 91(8):1194–1199. limestone aquifer would have allowed for the been to supply the entire island with fully De Leon R, Shieh C, Baric RS, Sobsey MD. 1990. Detection of transport of bacteria and viruses throughout treated drinking water from Lake Erie. To enteroviruses and hepatitis A virus in environmental sam- the subsurface. Many existing on-site septic protect public health, routine monitoring and ples by gene probes and polymerase chain reaction. In: Proceedings of the 1990 Water Quality Technology systems were installed in areas of thin to absent disinfection of groundwater for potable use Conference, 11–15 November, San Diego, CA. Washington, soils, whereas other wastewater systems dis- on the island was made mandatory and sep- DC:American Water Works Association, 833–853. charge to Lake Erie (Ohio EPA 2005). tage disposal was discontinued. Although lit- Diergaardt SM, Venter SN, Spreeth A, Theron J, Brozel VS. Moreover, the microscopic particulate analysis tle attention is often given to wastewater 2004. The occurrence of campylobacters in water sources in South Africa. Water Res 38(10):2589. test performed by the Ohio EPA on three of discharges and septic drainfield effects, these Fong T-T, Griffin DW, Lipp EK. 2005. Molecular assays for target- the island wells found no surface water indica- issues are being addressed by the health ing human and bovine enteric viruses in coastal waters and tors, suggesting that groundwater contamina- department and the Ohio EPA; an island- their application for library-independent source tracking. Appl Environ Microbiol 71(4):2070–2078. tion through the infiltration of lake water and wide sewer is also a goal. In spite of having Fout GS, Schaefer FW III, Messer JW, Dahling DR, Stetler RE. poorly installed sewage systems is a more likely fully treated and disinfected water, the 1996. ICR Microbial Laboratory Manual. EPA/600/R-95/178. source of contamination (Ohio EPA 2005). multiple-barrier concept should be used for Washington, DC:U.S. Environmental Protection Agency. Available: http://www.epa.gov/nerlcwww/icrmicro.pdf Extreme precipitation events have also all waters. Source protection is still needed for [accessed 20 June 2006]. been shown to be related to waterborne out- both groundwater and surface water in order Hancock CM, Rose JB, Callahan M. 1998. Cryptosporidium and breaks (Curriero et al. 2001; Morris and Levin to fully protect both drinking and recreational Giardia in US groundwater. J Am Water Works Assoc 90(3):58–61. 1995; Rose et al. 2000). Curriero et al. (2001) waters. International Association on Water Pollution Research and observed a 2-month lag statistical association Outbreaks represent observable epidemics Control Study Group on Health Related Water Microbiology. between extreme rainfall events and disease and are generally considered to be under- 1991. Bacteriophages as model viruses in water quality control. Water Res 25:529–545. outbreaks from groundwater. This is likely due reported. Endemic waterborne disease may still Kelley JGW, Hobgood JS, Bedford KW, Schwab DJ. 1998. to the transport time for pathogen movement be occurring without being appropriately Generation of three-dimensional lake model forecasts for from the source (i.e., sewage) to the exposure documented. Because of the multitude of Lake Erie. Weather Forecasting 13(3):659–687. site (i.e., groundwater wells) and the time pathogens involved and infection with bacteria Le Guyader F, Neill FH, Estes MK, Monroe SS, Ando T, Atmar RL. 1996. Detection and analysis of a small round-structured required for disease incubation and disease such as Campylobacter (associated with Guillain virus strain in oysters implicated in an outbreak of acute reporting. The average monthly precipitation Barré disease) (Mishu et al. 1993), the possible gastroenteritis. Appl Environ Microbiol 62(11):4268–4272. in the north central region of Ohio was at a chronic outcomes should be followed in the Marshall SM, Melito PL, Woodward DL, Johnson WM, Rodgers FG, Mulvey MR. 1999. Rapid identification of record high in late May 2004 (ODH 2005). population exposed in this outbreak. In addi- Campylobacter, Arcobacter, and Helicobacter isolates by Suspected disease cases were first noted by tion, the role of Arcobacter as a waterborne PCR-restriction fragment length polymorphism analysis of 30 May, followed by a small increase in June; pathogen should be further evaluated. The pre- the 16S rRNA Gene. J Clin Microbiol 37(12):4158–4160. McFeters GA, Pyle BH, Gillis SJ, Acomb CJ, Ferrazza D. 1993. by July (2 months later) a 4-fold increase in sent study supports the use of remote-sensing Chlorine injury and the comparative performance of cases was reported. The rainfall probably con- information, climatic data, and hydrodynamic ColisureTM, ColiLertTM and ColiQuikTM for the enumeration tributed to a higher water table, as well as modeling to examine high-risk water contami- of coliform bacteria and E. coli in drinking water. Water Sci Technol 27(3–4):261–265. increased run-off and flushing of contaminants nation periods, particularly for islands and Mishu B, Ilyas AA, Koski CL, Vriensendorf F, Cook SD, into the subsurface and Lake Erie. coastal systems in the Great Lakes. Mithen FA, et al. 1993. Serological evidence of previous We suggest that massive groundwater con- Campylobacter jejuni infection in patients with the Guillain REFERENCES Barré Syndrome. 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864 VOLUME 115 | NUMBER 6 | June 2007 • Environmental Health Perspectives