50 research outputs found

    Direct and indirect effects of climate change on the risk of infection by water-transmitted pathogens

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    Climate change is likely to affect the infectious disease burden from exposure to pathogens in water used for drinking and recreation. Effective intervention measures require quantification of impacts of climate change on the distribution of pathogens in the environment and their potential effects on human health. Objectives of this systematic review were to summarize current knowledge available to estimate how climate change may directly and indirectly affect infection risks due to Campylobacter, Cryptosporidium, norovirus, and Vibrio. Secondary objectives were to prioritize natural processes and interactions that are susceptible to climate change and to identify knowledge gaps. Search strategies were determined based on a conceptual model and scenarios with the main emphasis on The Netherlands. The literature search resulted in a large quantity of publications on climate variables affecting pathogen input and behavior in aquatic environments. However, not all processes and pathogens are evenly covered by the literature, and in many cases, the direction of change is still unclear. To make useful predictions of climate change, it is necessary to combine both negative and positive effects. This review provides an overview of the most important effects of climate change on human health and shows the importance of QMRA to quantify the net effects

    Quantitative microbial risk assessment for airborne transmission of sars-cov-2 via breathing, speaking, singing, coughing, and sneezing

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    Background: Evidence for indoor airborne transmission of SARS-CoV-2 is accumulating. Objectives: We assessed of the risk of illness due to airborne SARS-CoV-2 particles from breathing, speaking, singing, coughing, and sneezing in indoor environments. Methods: A risk assessment model, AirCoV2, for exposure to SARS-CoV-2 particles in aerosol droplets was developed. Previously published data on droplets expelled by breathing, speaking, singing, coughing, and sneezing by an infected person were used as inputs. Scenarios encompassed virus concentration, exposure time, and ventilation. Newly collected data of virus RNA copies in mucus from patients are presented. Results: The expelled volume of aerosols was highest for a sneeze, followed by a cough, singing, speaking, and breathing. After 20 min of exposure, at 107 RNA copies/mL in mucus, all mean illness risks were largely estimated to be below 0.001, except for the “high” sneeze scenario. At virus concentrations above 108 RNA copies/mL, and after 2 h of exposure, in the high and “low” sneeze scenarios, the high cough scenario and the singing scenario, risks exceeded 0.01 and may become very high, whereas the low coughing scenario, the high and low speaking scenarios and the breathing scenario remained below 0.1. After 2 h of exposure, singing became the second highest risk scenario. One air exchange per hour reduced risk of illness by about a factor of 2. Six air exchanges per hour reduced risks of illness by a factor of 8–13 for the sneeze and cough scenarios and by a factor of 4–9 for the other scenarios. Discussion: The large variation in the volume of expelled aerosols is discussed. The model calculations indicated that SARS-CoV-2 transmission via aerosols outside of the 1.5-m social distancing norm can occur. Virus concentrations in aerosols and/or the amount of expelled aerosol droplets need to be high for substantial transmission via this route. AirCoV2 is made available as interactive computational tool. https://doi.org/10.1289/EHP788

    Potentially human pathogenic vibrios in marine and fresh bathing waters related to environmental conditions and disease outcome

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    In 2009, four bathing sites in The Netherlands were monitored for potentially human pathogenic Vibrio species to observe possible associations with environmental conditions and health complaints. Three slightly different enrichment procedures were used to isolate Vibrio species with different growth requirements. Waters were generally positive for Vibrio from May until October; median Vibrio concentrations ranged from 4 to 383 MPN per litre (maximum 10(5) MPN per litre). Isolated Vibrio species included V. alginolyticus (50.6%) and V. parahaemolyticus (8.5%) from bathing sites with salinities ranging between 2.8 and 3.5% and V. cholerae non-O1/O139 (6.9%) from sites with salinities ranging between 0.007 and 0.08%. Although more samples were positive for Vibrio at elevated water temperatures, a quantitative relation between Vibrio numbers in water samples and the water temperature was not observed which may be explained by maximum water temperatures of 21 \ub0 C. Active surveillance yielded one case of a recreational water related Vibrio infection. V. cholerae non-O1/O139 was cultured from the patient's wound and the implicated recreational water; PFGE profiles of the water and patient isolates were not identical. The number of patients that contract a Vibrio infection through exposure to Dutch recreational waters seems low, but may be underestimated. The common occurrence of Vibrio species in these waters stresses the need for providing information on Vibrio to risk groups to prevent infections

    Quantitative microbial risk assessment for airborne transmission of sars-cov-2 via breathing, speaking, singing, coughing, and sneezing

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    Background: Evidence for indoor airborne transmission of SARS-CoV-2 is accumulating. Objectives: We assessed of the risk of illness due to airborne SARS-CoV-2 particles from breathing, speaking, singing, coughing, and sneezing in indoor environments. Methods: A risk assessment model, AirCoV2, for exposure to SARS-CoV-2 particles in aerosol droplets was developed. Previously published data on droplets expelled by breathing, speaking, singing, coughing, and sneezing by an infected person were used as inputs. Scenarios encompassed virus concentration, exposure time, and ventilation. Newly collected data of virus RNA copies in mucus from patients are presented. Results: The expelled volume of aerosols was highest for a sneeze, followed by a cough, singing, speaking, and breathing. After 20 min of exposure, at 107 RNA copies/mL in mucus, all mean illness risks were largely estimated to be below 0.001, except for the “high” sneeze scenario. At virus concentrations above 108 RNA copies/mL, and after 2 h of exposure, in the high and “low” sneeze scenarios, the high cough scenario and the singing scenario, risks exceeded 0.01 and may become very high, whereas the low coughing scenario, the high and low speaking scenarios and the breathing scenario remained below 0.1. After 2 h of exposure, singing became the second highest risk scenario. One air exchange per hour reduced risk of illness by about a factor of 2. Six air exchanges per hour reduced risks of illness by a factor of 8–13 for the sneeze and cough scenarios and by a factor of 4–9 for the other scenarios. Discussion: The large variation in the volume of expelled aerosols is discussed. The model calculations indicated that SARS-CoV-2 transmission via aerosols outside of the 1.5-m social distancing norm can occur. Virus concentrations in aerosols and/or the amount of expelled aerosol droplets need to be high for substantial transmission via this route. AirCoV2 is made available as interactive computational tool. https://doi.org/10.1289/EHP788

    Hepatitis E Virus RNA in Commercial Porcine Livers in The Netherlands

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    Human hepatitis E virus (HEV) infections by genotype 3 strains in industrialized countries are hypothesized to be caused by pigs. To examine this hypothesis, the potential health risks of transmission routes should be examined. Possible foodborne transmission was studied by quantifying the presence and infectivity of HEV in commercial porcine livers in The Netherlands. A comparison of four tissue disruption and seven RNA extraction methods revealed that mechanical disruption followed by silica-based RNA extraction gave the highest RNA yields and was therefore employed on commercial porcine livers. Four (6.5%) of 62 porcine livers were HEV RNA positive by reverse transcriptase PCR and Southern blot hybridization. Each positive liver was estimated to contain ~65 PCR-detectable units per g. Sequences were obtained for three of four positive livers and classified as HEV genotype 3. Ninety-three percent similarity to Dutch human HEV sequences and 97% similarity to Dutch swine HEV sequences were observed. To determine whether positive livers contained infectious HEV particles, extracts from livers with known HEV RNA sequences were inoculated intravenously in pigs. Two control pigs were included: one was inoculated with a high dose known to result in infection (104 PCR-detectable units of HEV RNA), and the other was inoculated with a lower concentration of virus that equaled the concentration of PCR-detectable units in commercial livers (~20 PCR-detectable units). Infection was observed in the high-dose control, but not in other pigs, suggesting a dose-dependent response in pigs. Hence, the implications of HEV RNA in commercial porcine livers in The Netherlands are unknown. However, HEV RNA is present in commercial porcine livers, and sufficient heating of porcine livers before consumption as precautionary measure is recommended
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