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1.
Waterborne Norovirus outbreak at a seaside resort likely originating from municipal water distribution system failure.
Giammanco, GM, Bonura, F, Urone, N, Purpari, G, Cuccia, M, Pepe, A, Li Muli, S, Cappa, V, Saglimbene, C, Mandolfo, G, et al
Epidemiology and infection. 2018;(7):879-887
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Abstract
In May 2016 a Norovirus (NoV) gastroenteritis outbreak involved a high school class visiting a seaside resort near Taormina (Mascali, Sicily). Twenty-four students and a teacher were affected and 17 of them showed symptoms on the second day of the journey, while the others got ill within the following 2 days. Symptoms included vomiting, diarrhoea and fever, and 12 students required hospitalisation. Stool samples tested positive for NoV genome by Real-Time polymerase chain reaction assay in all 25 symptomatic subjects. The GII.P2/GII.2 NoV genotype was linked to the outbreak by ORF1/ORF2 sequence analysis. The epidemiological features of the outbreak were consistent with food/waterborne followed by person-to-person and/or vomit transmission. Food consumed at a shared lunch on the first day of the trip was associated to illness and drinking un-bottled tap water was also considered as a risk factor. The analysis of water samples revealed the presence of bacterial indicators of faecal contamination in the water used in the resort as well as in other areas of the municipal water network, linking the NoV gastroenteritis outbreak to tap water pollution from sewage leakage. From a single water sample, an amplicon whose sequence corresponded to the capsid genotype recovered from patients could be obtained.
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Protozoan Parasites in Drinking Water: A System Approach for Improved Water, Sanitation and Hygiene in Developing Countries.
Omarova, A, Tussupova, K, Berndtsson, R, Kalishev, M, Sharapatova, K
International journal of environmental research and public health. 2018;(3)
Abstract
Improved water, sanitation and hygiene (WASH) are significant in preventing diarrhea morbidity and mortality caused by protozoa in low- and middle-income countries. Due to the intimate and complex relationships between the different WASH components, it is often necessary to improve not just one but all of these components to have sustainable results. The objective of this paper was to review the current state of WASH-related health problems caused by parasitic protozoa by: giving an overview and classification of protozoa and their effect on people's health, discussing different ways to improve accessibility to safe drinking water, sanitation services and personal hygiene behavior; and suggesting an institutional approach to ensure improved WASH. The findings indicate that Giardia and Cryptosporidium are more often identified during waterborne or water-washed outbreaks and they are less sensitive than most of the bacteria and viruses to conventional drinking water and wastewater treatment methods. There are various institutions of control and prevention of water-related diseases caused by protozoa in developed countries. Unfortunately, the developing regions do not have comparable systems. Consequently, the institutional and systems approach to WASH is necessary in these countries.
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Drinking water with consumption of a jelly filled doughnut has a time dependent effect on the postprandial blood glucose level in healthy young individuals.
Bipat, R, Toelsie, JR
Clinical nutrition ESPEN. 2018;:20-23
Abstract
An elevated postprandial glucose (PPG) level in plasma or blood is a risk factor for chronic disorders like obesity, diabetes mellitus type II and related cardiovascular conditions. Therefore, it is important to identify mechanisms that increase the value of postprandial glucose PPG levels. Hence in the present study we investigated the time dependent effect of drinking water during a meal on the level of PPG. Thirty-five volunteers were randomly assigned to five groups. Group A was given a jelly filled doughnut and group B, C, D and E had a similar doughnut in combination with a bottle of water along with the doughnut, thirty minutes before, thirty minutes after, and a second doughnut with water thirty minutes after the first one, respectively. Glucose was measured in capillary blood at intervals of 30 min up to 150 min (reg # FMeW 725B/17). PPG versus fasting glucose (Means ± SD, mmol/L) was for group A 5.4 ± 0.6 vs 4.6 ± 0.4, B 7.2 ± 0.7 vs 4.9 ± 0.4, C 5.5 ± 0.7 vs 4.4 ± 0.3, D 5.5 ± 0.6 vs 4.6 ± 0.3 and E 5.7 ± 0.5 vs 4.7 ± 0.2. The increase in group B was significantly higher than in all other groups (ANOVA, Dunnet's posttest). These results show that drinking water with consumption of a jelly-filled doughnut increases the postprandial blood glucose levels significantly compared to no drinking at all or thirty minutes before or after the consumption. It is therefore advisable that we should reconsider our eating and drinking habits to lower the PPG and consequently reduce the risks of abovementioned chronic disorders. Further assessment is necessary to evaluate this in more detail.
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Heterogeneity in the Relationship between Disinfection By-Products in Drinking Water and Cancer: A Systematic Review.
Benmarhnia, T, Delpla, I, Schwarz, L, Rodriguez, MJ, Levallois, P
International journal of environmental research and public health. 2018;(5)
Abstract
The epidemiological evidence demonstrating the effect of disinfection by-products (DBPs) from drinking water on colon and rectal cancers is well documented. However, no systematic assessment has been conducted to assess the potential effect measure modification (EMM) in the relationship between DBPs and cancer. The objective of this paper is to conduct a systematic literature review to determine the extent to which EMM has been assessed in the relationship between DBPs in drinking water in past epidemiological studies. Selected articles (n = 19) were reviewed, and effect estimates and covariates that could have been used in an EMM assessment were gathered. Approximately half of the studies assess EMM (n = 10), but the majority of studies only estimate it relative to sex subgroups (n = 6 for bladder cancer and n = 2 both for rectal and colon cancers). Although EMM is rarely assessed, several variables that could have a potential modification effect are routinely collected in these studies, such as socioeconomic status or age. The role of environmental exposures through drinking water can play an important role and contribute to cancer disparities. We encourage a systematic use of subgroup analysis to understand which populations or territories are more vulnerable to the health impacts of DBPs.
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Impact of biofilm formation and detachment on the transmission of bacterial antibiotic resistance in drinking water distribution systems.
Zhang, J, Li, W, Chen, J, Qi, W, Wang, F, Zhou, Y
Chemosphere. 2018;:368-380
Abstract
There is growing awareness of the antibiotic-resistance crisis and its implications for public health among clinicians, researchers, politicians, and the public. We studied bacterial antibiotic resistance transition and the role of biofilms in a drinking water distribution system (DWDS). We tracked several different antibiotic resistant bacteria (ARB) with resistance to tetracycline, sulfamethoxazole, clindamycin, and norfloxacin for one year in a DWDS. The results indicated that the amount of ARB increased in tap water, presumably due to biofilm detachment. The effect of biofilm detachment on the transmission of antibiotic resistance from biofilms to tap water was explored by using a bacterial annular reactor. The percentage of ARB of inlet water, outlet water, and biofilms ranged from 0.26% to 9.85%, 1.08%-16.29%, and 0.52%-29.97%, respectively in a chlorinated system, and from 0.23% to 9.89%, 0.84%-16.84%, and 0.35%-17.77%, respectively, in a chloraminated system. The relative abundances of antibiotic resistance Acinetobacter, Sphingomonas, and Bradyrhizobium were higher in outlet water than in inlet water, as determined by high throughout sequencing. The amount of ARB percentage varied with the concentration of viable but non-culturable (VBNC) cells (r = 0.21, n = 160, P < 0.05) in biofilm, suggesting a higher antibiotic resistance mutation rate in VBNC cells. Our results suggest that biofilm detachment was promoted by disinfectant and affected the overall bacterial antibiotic resistance of microbes in tap water.
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Trace lithium in Texas tap water is negatively associated with all-cause mortality and premature death.
Fajardo, VA, LeBlanc, PJ, Fajardo, VA
Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2018;(4):412-414
Abstract
Lithium in tap water was previously found to have life-extending effects across 18 Japanese municipalities. Using a larger dataset with several Texas counties, our study shows that lithium concentrations in tap water are negatively associated with all-cause mortality (r = -0.18, p = 0.006, 232 counties) and years of potential life lost (r = -0.22, p = 0.001, 214 counties). Thus, our present findings extend and reinforce lithium's purported life-prolonging effect in humans.
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High Content of Lead Is Associated with the Softness of Drinking Water and Raised Cardiovascular Morbidity: A Review.
Bjørklund, G, Dadar, M, Chirumbolo, S, Aaseth, J
Biological trace element research. 2018;(2):384-394
Abstract
Daily ingestion of lead (Pb), even through piped drinking water, has long time been an important issue of concern, attracting for decades research in environmental science and toxicology, and again comes to prominence because of recent high-profile cases of exposure of populations in several countries to Pb-contaminated water. Numerous studies have reported an association between Pb in water and the risk of cardiovascular pathologies. Low levels of magnesium and calcium, i.e., low degree of hardness of the drinking water, may accentuate Pb leaching from water pipes and furthermore increase Pb absorption. This review evaluates the evidence for an association between Pb exposure from drinking water and cardiovascular end points in human populations.
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Impact of intensive care unit relocation and role of tap water on an outbreak of Pseudomonas aeruginosa expressing OprD-mediated resistance to imipenem.
Tran-Dinh, A, Neulier, C, Amara, M, Nebot, N, Troché, G, Breton, N, Zuber, B, Cavelot, S, Pangon, B, Bedos, JP, et al
The Journal of hospital infection. 2018;(3):e105-e114
Abstract
BACKGROUND To assess the impact of the incidental relocation of an intensive care unit (ICU) on the risk of colonizations/infections with Pseudomonas aeruginosa exhibiting OprD-mediated resistance to imipenem (PA-OprD). AIM: The primary aim was to compare the proportion of PA-OprD among P. aeruginosa samples before and after an incidental relocation of the ICU. The role of tap water as a route of contamination for colonization/infection of patients with PA-OprD was assessed as a secondary aim. METHODS A single-centre, observational, before/after comparison study was conducted from October 2013 to October 2015. The ICU was relocated at the end of October 2014. All P. aeruginosa-positive samples isolated from patients hospitalized ≥48 h in the ICU were included. Tap water specimens were collected every three months in the ICU. PA-OprD strains isolated from patients and tap water were genotyped using pulse-field gel electrophoresis. FINDINGS A total of 139 clinical specimens of P. aeruginosa and 19 tap water samples were analysed. The proportion of PA-OprD strains decreased significantly from 31% to 7.7% after the relocation of the ICU (P = 0.004). All PA-OprD clinical specimens had a distinct genotype. Surprisingly, tap water was colonized with a single PA-OprD strain during both periods, but this single clone has never been isolated from clinical specimens. CONCLUSION Relocation of the ICU was associated with a marked decrease in P. aeruginosa strains resistant to imipenem. The polyclonal character of PA-OprD strains isolated from patients and the absence of tap-water-to-patient contamination highlight the complexity of the environmental impact on the endogenous colonization/infection with P. aeruginosa.
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9.
Potable Water Reuse: What Are the Microbiological Risks?
Nappier, SP, Soller, JA, Eftim, SE
Current environmental health reports. 2018;(2):283-292
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Abstract
PURPOSE OF REVIEW With the increasing interest in recycling water for potable reuse purposes, it is important to understand the microbial risks associated with potable reuse. This review focuses on potable reuse systems that use high-level treatment and de facto reuse scenarios that include a quantifiable wastewater effluent component. RECENT FINDINGS In this article, we summarize the published human health studies related to potable reuse, including both epidemiology studies and quantitative microbial risk assessments (QMRA). Overall, there have been relatively few health-based studies evaluating the microbial risks associated with potable reuse. Several microbial risk assessments focused on risks associated with unplanned (or de facto) reuse, while others evaluated planned potable reuse, such as indirect potable reuse (IPR) or direct potable reuse (DPR). The reported QMRA-based risks for planned potable reuse varied substantially, indicating there is a need for risk assessors to use consistent input parameters and transparent assumptions, so that risk results are easily translated across studies. However, the current results overall indicate that predicted risks associated with planned potable reuse scenarios may be lower than those for de facto reuse scenarios. Overall, there is a clear need to carefully consider water treatment train choices when wastewater is a component of the drinking water supply (whether de facto, IPR, or DPR). More data from full-scale water treatment facilities would be helpful to quantify levels of viruses in raw sewage and reductions across unit treatment processes for both culturable and molecular detection methods.
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Effect of pre-donation fluid intake on fluid shift from interstitial to intravascular compartment in blood donors.
Deepika, C, Murugesan, M, Shastry, S
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis. 2018;(1):54-57
Abstract
BACKGROUND Fluid shifts from interstitial to intravascular space during blood donation helps in compensating the lost blood volume. We aimed to determine the volume of fluid shift following donation in donors with and without pre-donation fluid intake. METHODS We studied the fluid shift in 325 blood donors prospectively. Donors were divided in groups- with no fluid intake (GI) and either water (GII) or oral rehydrating fluids (GIII) before donation. Fluid shift following donation was calculated based on the difference between the pre and post donation blood volume. The influence of oral fluid intake, age, gender and body mass index (BMI) on volume of fluid shift was analyzed. RESULTS The fluid shift was significant between donors without fluids (GI: 127 ± 81 ml) and donors with fluid intake (GII & III: 96 ± 45 ml) (p < 0.05). The difference was not significant between donors with water intake (GII: 106 ± 52 ml) and oral rehydrating fluid intake (GIII: 87 ± 41 ml). The shifted fluid volume increased with increasing BMI and decreased with increasing age in females. The fluid shift increased in females than in males. CONCLUSION The age, gender, BMI and VVR did not significantly contribute to the volume of fluid shift following donation. As per our observation, the oral fluids before donation might not contribute to increase in fluid shift in blood donors after donation.