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This Article Appeared in a Journal Published by Elsevier. the Attached This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier’s archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright Author's personal copy Available online at www.sciencedirect.com New tools for the study and direct surveillance of viral pathogens in water Albert Bosch, Susana Guix, Daisuke Sano and Rosa M Pinto´ Half a century ago scientists attempted the detection of including viruses causing both symptomatic and asymp- poliovirus in water. Since then other enteric viruses responsible tomatic infections [2,3,4]. for gastroenteritis and hepatitis have replaced enteroviruses as the main target for detection. However, most viral outbreaks However, the tasks required to fulfil the aforementioned are restricted to norovirus and hepatitis A virus, making them goals are easier said than done. Main difficulties to over- the main targets in water.The inclusion of virus analysis in come for virus detection and characterisation in water regulatory standards for viruses in water samples must samples encompass viral diversity, occurrence of low overcome several shortcomings such as the technical particle numbers, particularly in drinking water, and difficulties and high costs of virus monitoring, the lack of the technical challenges of virus assays. harmonised and standardised assays and the challenge posed by the ever-changing nature of viruses. However, new Waterborne viruses tools are nowadays available for the study and direct A wide variety of different viruses may be found in human surveillance of viral pathogens in water that may contribute to sewage (Table 1). Some of these viruses are shed in fulfil these requirements. extremely high numbers, that is, patients suffering from diarrhoea or hepatitis may excrete up to 1013 and 1010 Addresses Enteric Virus Laboratory, Department of Microbiology, University of virus particles, respectively, per gram of stool [5,6,7 ]. Barcelona, Spain Since current water treatments do not ensure their com- plete removal they become contaminants of the water Corresponding author: Bosch, Albert ([email protected]), environment in numbers high enough to represent a Guix, Susana ([email protected]), public health threat, although low enough to pose serious Sano, Daisuke ([email protected]) and Pinto´ , Rosa M ([email protected]) difficulties for their detection. Figure 1 illustrates the possible routes of waterborne transmission of enteric Current Opinion in Biotechnology 2008, 19:295–301 viruses. Enteric viruses can be transmitted by a variety This review comes from a themed issue on of routes including person-to-person contact, zoonotic Environmental Biotechnology and/or vehicle transmission. Edited by Carla Pruzzo and Pietro Canepari Poor water quality continues to pose a major threat to Available online 26th May 2008 human health. Billions of cases of gastrointestinal illness 0958-1669/$ – see front matter occur annually worldwide. The World Health Organis- # 2008 Elsevier Ltd. All rights reserved. ation (WHO) declared that diarrhoeal disease alone con- tributes to an estimated 4.1% of the total DALY DOI 10.1016/j.copbio.2008.04.006 (disability adjusted life years) global burden of disease and is responsible for the deaths of 1.8 million people every year [8]. It was figured that 88% of that burden is Introduction attributable to unsafe water supply, sanitation and As stated by one of the seminal names in water virology, hygiene and it is mostly concentrated on children in WOK Grabow, virological analysis of water is required for developing countries. A significant amount of disease a number of purposes that include research on the inci- could be prevented especially in developing countries dence and behaviour of viruses in the water environ- through better access to safe water supply, adequate ments, assessment of the presence of viruses and the sanitation facilities and better hygiene practices. risk of infection, as well as evaluation of the efficiency of treatment and disinfection processes and routine quality Viruses are a major cause of water-related disease. It is monitoring to test the compliance of water quality with now well recognised that the most common viral gastro- guidelines and specifications [1] and in essence the intestinal illness are rotavirus and norovirus diarrhoea in public health impact of waterborne viral infections. the infantile and adult population, respectively. However, most well documented waterborne outbreaks of viral Additionally, identification of strains isolated from the gastroenteritis are related to noroviruses [9,10]. Other water environment may also be used as a tool for the study gastro enteric viruses, such as rotaviruses [11] and astro- of the epidemiology of waterborne viruses providing an viruses [12] have also occasionally been implicated in overview of all the viruses circulating in the community, waterborne outbreaks. www.sciencedirect.com Current Opinion in Biotechnology 2008, 19:295–301 Author's personal copy 296 Environmental Biotechnology Table 1 Human viruses documented to be found in the water environment Genus Popular name Disease caused (genome) Enterovirus Poliovirus Paralysis, meningitis, fever (ssRNA) Coxsackie A, B virus Herpangina, meningitis, fever, respiratory disease, hand-foot-and-mouth disease, myocarditis, heart anomalies, rush, pleurodynia, diabetes Echovirus Meningitis, fever, respiratory disease, rush, gastroenteritis Hepatovirus Hepatitis A virus Hepatitis (ssRNA) Reovirus Human reovirus Unknown (segmented dsRNA) Rotavirus Human rotavirus Gastroenteritis (segmented dsRNA) Norovirus Norovirus Gastroenteritis (ssRNA) Sapovirus Sapporo-like virus Gastroenteritis (ssRNA) Hepevirus Hepatitis E virus Hepatitis (ssRNA) Mamastrovirus Human astrovirus Gastroenteritis (ssRNA) Coronavirus Human coronavirus Gastroenteritis, respiratory disease, SARS (ssRNA) Orthomyxovirus Influenza virus Influenza, respiratory disease (segmented ssRNA) Parvovirus Human parvovirus Gastroenteritis (ssDNA) Mastadenovirus Human adenovirus Gastroenteritis, respiratory disease, conjunctivitis (dsDNA) Polyomavirus Polyomavirus Progressive multifocal leucoencephalopathy, (dsDNA) diseases of urinary tract Circovirus TT (Torque Teno) virus Unknown, hepatitis (ssDNA) Another major waterborne disease is hepatitis that can be a ered or appear to re-emerge as important human patho- serious debilitating disease progressing from a non-specific gens. One example of an emerging disease is the severe illness with fever, headache, nausea and malaise to vomit- acute respiratory syndrome or SARS, reported in Novem- ing, diarrhoea, abdominal pain and jaundice. Hepatitis A ber 2002. Although several coronaviruses are known to be represents worldwide around 50% of the total hepatitis spread by the faecal–oral route, there is no current evi- cases and although is self-limiting and rarely causing death dence that this mode of transmission plays a key role in may incapacitate patients for several months. The causa- the transmission of SARS in spite of the considerable tive agent is the hepatitis A virus that has been linked to shedding of the virus in stools [15]. Another important several waterborne outbreaks [13]. Hepatitis E, although zoonotical issue is the case of influenza viruses. Despite less frequent than hepatitis A, has a higher mortality rate, human influenza viruses replicate primarily in the respir- particularly in pregnant women. It is the most important or atory tract, avian influenza viruses, such as the highly the second most important cause of acute clinical hepatitis pathogenic H5N1, cause generalised infection in birds in adults throughout Asia, the Middle East and Africa. By with replication in the gastrointestinal duct and virus contrast, hepatitis E is rare in industrialised countries, but shedding in faeces. However, their potential waterborne antibody (anti-HEV) is found worldwide. Hepatitis E is transmission remains controversial [16,17]. principally the result of a waterborne infection in devel- oping countries and is thought to be spread zoonotically Water-related diseases are associated with exposure to (principally from swine) in industrialised countries [14]. water environments in many ways. These include not only waters used for drinking and recreation purposes but The significance to human health of many of the non- also those used for agricultural purposes such as crop human animal viruses present in environmental samples irrigation, and food processing, eventually resulting in is less well understood although it is remarkable that foodborne outbreaks [18,19]. Additionally, shellfish zoonotic viruses infecting humans continue to be discov- grown and harvested in polluted waters is a well-docu- Current Opinion in Biotechnology 2008, 19:295–301 www.sciencedirect.com Author's personal copy Virus detection in water Bosch et al. 297 Figure 1 Possible routes of waterborne transmission of enteric viruses. Viruses are shed in extremely high numbers in the faeces and vomit of infected individuals.
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