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Review of Zoonotic Pathogens in Ambient Waters

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Review of Zoonotic Pathogens in Ambient Waters EPA 822-R-09-002 REVIEW OF ZOONOTIC PATHOGENS IN AMBIENT WATERS U.S. Environmental Protection Agency Office of Water Health and Ecological Criteria Division February 2009 [this page intentionally left blank] U.S. Environmental Protection Agency DISCLAIMER This document has been reviewed in accordance with U.S. Environmental Protection Agency policy and approved for publication. Mention of trade names or commercial products does not constitute endorsement or recommendation for use. February 2009 i [this page intentionally left blank] U.S. Environmental Protection Agency ACKNOWLEDGMENTS Questions concerning this document or its application should be addressed to the EPA Work Assignment Manager: John Ravenscroft USEPA Headquarters Office of Science and Technology, Office of Water 1200 Pennsylvania Avenue, NW Mail Code: 4304T Washington, DC 20460 Phone: 202-566-1101 Email: [email protected] This literature review was managed under EPA Contract EP-C-07-036 to Clancy Environmental Consultants, Inc. The following individuals contributed to the development of the report: Lead writer: Audrey Ichida ICF International Leiran Biton ICF International Alexis Castrovinci ICF International Jennifer Clancy Clancy Environmental Consultants Mary Clark ICF International Elizabeth Dederick ICF International Kelly Hammerle ICF International Walter Jakubowski WaltJay Consulting Margaret McVey ICF International Michelle Moser ICF International Jeffery Rosen Clancy Environmental Consultants Tina Rouse ICF International Jennifer Welham ICF International Kerry Williams ICF International February 2009 iii [this page intentionally left blank] U.S. Environmental Protection Agency TABLE OF CONTENTS ACKNOWLEDGMENTS ................................................................................................................................................. iii TABLES AND FIGURES ................................................................................................................................................. vii ACRONYMS ................................................................................................................................................................... ix EXECUTIVE SUMMARY ................................................................................................................................................. 1 I. BACKGROUND AND INTRODUCTION .................................................................................................................... 5 I.1 Background: Context and Purpose ............................................................................................................ 5 I.2 Introduction ................................................................................................................................................ 6 II. KEY WATERBORNE ZOONOTIC PATHOGENS OF CONCERN ............................................................................... 8 II.1 Bacteria ...................................................................................................................................................... 8 II.1.1 Escherichia coli ............................................................................................................................. 8 II.1.2 Campylobacter ............................................................................................................................ 12 II.1.3 Salmonella ................................................................................................................................... 14 II.1.4 Leptospira .................................................................................................................................... 17 II.2 Protozoa ................................................................................................................................................... 19 II.2.1 Cryptosporidium .......................................................................................................................... 19 II.2.2 Giardia ........................................................................................................................................ 26 II.3 Viruses Zoonotic Potential ....................................................................................................................... 33 III. PATHOGEN INTERACTIONS WITH THEIR ENVIRONMENT ................................................................................. 37 III.1 Water Environment Affects Pathogen Survivability and Phenotype ....................................................... 37 III.1.1 Pathogenic E. coli Survival in the Environment .......................................................................... 38 III.1.2 Campylobacter Survival in the Environment .............................................................................. 39 III.1.3 Salmonella Survival in the Environment ..................................................................................... 39 III.1.4 Leptospira Survival in the Environment ...................................................................................... 39 III.1.5 Cryptosporidium Survival in the Environment ............................................................................ 40 III.1.6 Giardia Survival in the Environment .......................................................................................... 43 III.1.7 Virus Survival in the Environment .............................................................................................. 44 III.2 Host Animals Can Influence Pathogen Characteristics and Mechanisms of Rapid Evolution ................ 44 IV. SUMMARY ........................................................................................................................................................... 49 V. REFERENCES ...................................................................................................................................................... 50 APPENDIX A: WATERBORNE PATHOGENS .............................................................................................................. A-1 APPENDIX B: LITERATURE SEARCH STRATEGY AND RESULTS ............................................................................. B-1 APPENDIX C: INCIDENTAL INGESTION OF AMBIENT WATER DURING RECREATIONAL ACTIVITIES ................... C-1 February 2009 v [this page intentionally left blank] U.S. Environmental Protection Agency TABLES AND FIGURES Table II.1.1-1. Outbreaks of E. coli Associated with Recreational Waters in the United States. ........................ 12 Table II.2.1-1. Cryptosporidium Species ............................................................................................................. 20 Table II.2.1-2. Outbreaks of Cryptosporidiosis Associated with Recreational Waters in the United States. ...... 27 Table II.2.2-1. Giardia Taxonomy ...................................................................................................................... 28 Table II.2.2-2. Giardia Infection Occurrence in U.S. Populations ...................................................................... 32 Table II.2.2-3. Outbreaks of Giardiasis Associated with Recreational Waters in the United States. .................. 34 Table III.1.1-1. Survival of E. coli O157:H7 in Ambient Waters ......................................................................... 38 Figure II.2.1-1. Reported Cryptosporidium infections in the United States, 1999 to 2005. ................................. 26 Figure II.2.2-1. Reported Giardia cases in the 50 states plus Washington DC, 1992 to 2005. ............................ 32 February 2009 vii [this page intentionally left blank] U.S. Environmental Protection Agency ACRONYMS AEC attaching E. coli AIDS Acquired Immune Deficiency Syndrome AWQC ambient water quality criteria BEACH Act Beaches Environmental Assessment and Coastal Health Act of 2000 CDC U.S. Centers for Disease Control and Prevention CPV C. parvum virus CWA Clean Water Act DAEC diffuse adherent E. coli DEC diarrheagenic E. coli EAggEC enteroaggregative E. coli EEC effacing E. coli EHEC enterohemorrhagic E. coli EPA U.S. Environmental Protection Agency EPEC enteropathogenic E. coli ETEC enterotoxigenic E. coli GI gastrointestinal GLV Giardia lamblia virus GBS Guillain-Barré Syndrome HC hemorrhagic colitis HEV hepatitis E virus HUS hemolytic uremic syndrome IPSID immunoproliferative small intestinal disease MALT mucosa-associated lymphoid tissue NA not available or not applicable PCR polymerase chain reaction POTW Publicly Owned Treatment Works ppt parts per thousand (salinity) RFLP restriction fragment length polymorphism SPE serial passage experiment STEC Shiga toxin-producing E. coli U.S. United States U.K. United Kingdom USDA U.S. Department of Agriculture UV ultraviolet (light) VTEC verocytotoxin-producing E. coli WHO World Health Organization (United Nations) February 2009 ix [this page intentionally left blank] U.S. Environmental Protection Agency EXECUTIVE SUMMARY Introduction The overall goal of the current Clean Water Act (CWA) §304(a) ambient water quality criteria (AWQC) for bacteria in the United States is to provide public health protection from gastrointestinal (GI) illness (gastroenteritis) associated with exposure to fecal contamination during recreational water contact. Water quality criteria are specified throughout the world in terms of concentrations of fecal indicator organisms because fecal matter can be a major source of pathogens in
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