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Water Microbiology/Microbial Contaminants Gwy-Am Shin Office: Suite 2335, 4225 Roosevelt Phone: 206-543-9026 Email: [email protected] Microbiological Contaminants • Most benign, “normal” • Some are frank pathogens • Microbial pathogens usually are not “normal flora” of humans; Oppurtunisitic pathogens – Some are “normal flora” of animals: • Salmonella enteriditis and Campylobacter jejuni in poultry – “Normal flora” for local populations may be pathogenic for visitors and transient populations: • “Traveller’s diarrhea” due to local strains of E. coli – Some “normal flora” are pathogenic for sensitive populations, such as immunocompromised persons Occurrence of Enteric Microbial Pathogens in Humans and Pathogen Shedding • Enteric (gastrointestinal) illnesses are second only to respiratory illnesses in the population • Most people get 1 enteric illness per year: – Annual illness rates are even higher in infants, children, the elderly, child caregivers, health professionals, the poor, male homosexuals and other high risk groups • Not all enteric infections produce illness (asymptomatic or sub-clinical infections) – So, rates of infection are even higher (by perhaps 2 to 100 times) • People (and animals) with enteric infections fecally excrete high concentrations of pathogens for days, weeks, months or longer. • Pathogen concentrations can be >106 to >109 per gram of feces. • Community pathogen shedding is often 1-10% at any time. Transmission of enteric pathogens Incidence and concentration of enteric pathogens in feces (USA) Pathogen Enteric virus Hepatitis A Rotavirus Salmonella Giardia Cryptosporidium Incidence (%) 10-40 0.1 10-29 0.5 3.8 18-54 0.6-20 27-50 Concentration(/gram) 103-108 108 1010-1012 104-1010 106 106 106-107 106-107 Viruses: smallest (0.02-0.3 µm diameter); simplest: nucleic acid + protein coat (+ lipoprotein envelope) Bacteria: 0.5-2.0 µm diameter; prokaryotes; cellular; simple internal organization; binary fission. Protozoa: most >2 µm- 2 mm; eucaryotic; uni-cellular; non-photosynthetic; flexible cell membrane; no cell wall; wide range of sizes and shapes; hardy cysts Groups: flagellates, amoebae, ciliates, sporozoans (complex life cycle) and microsporidia. , rigid cell wall, most eukaryotic Algae: wide range of sizes and shapes; photosynthetic. Helminths (Worms): multicellular animals; some are parasites; eggs are small enough (25-150 µm) to pose health risks from human and animal wastes in water. THE MICROBIAL WORLD: SIZES OF MICROBES Parasites are visible by light microscopy Viruses • Smallest (0.02 – 0.3 µm) • Simplest – Nucleic acids (DNA or RNA) – Protein capsid Human enteric viruses Bacteria • Size: 0.5 –2.0 µm • Simple internal organization • Envelope: cytoplasmic membrane, cell wall, and capsule • Appendages: flagella and/or pili • Spores: environmentally resistant form Human pathogenic bacteria Human pathogenic bacteria Procaryotic Cell (left) and Eucaryotic Cell (right) Protozoa • Size: 2 – 2000 µm • Complex internal organization (nucleus, mitochondria, etc) • Very complex life cycle (inside and outside of their hosts) • Flagellates, amoeba, ciliates, and sporozoans • (Oo)cysts: environmentally resistant form Human protozoan parasites Algae • Photosynthetic • Rigid cell wall • Wide range of sizes and shapes Nostoc – 2 micrometers and larger Anabaena and Aphanocapsa Helminths (Worms) • Multicellular animals • Some are human and/or animal parasites • Eggs are small enough to pose environmental health problems from human and animal excreta in water, food, soil, etc. • Several major groups: – Nematodes (roundworms): ex. Ascaris – Trematodes (flukes; flatworms): ex. Schistosomes – Cestodes (tapeworms): pork and beef tapeworms Helminths • Multicellualr animals • Size: up to 30 cm • Highly differentiated structures • Very complex life cycle (inside and outside of their hosts) • Nematodes, Trematodes, and Cestodes • Eggs: environmentally resistant form Human helminth parasites Bacteria Shigella spp. • Elongated and straight rods • Size: 0.5-1 µm • Four species: dysenteriae, flexneri, sonnei, and boydii • Watery or bloody diarrhea, abdominal pain, fever, and malaise • fatality may be as high as 10-15% with some strains Shigella spp.: Epidemiology • Involved in 44 drinking water outbreaks with 9,196 cases and 34 recreational water outbreaks with 2,329 cases in USA (1971-2000) • Incidence – 14,000 (lab-confirmed) and 448,240 (estimated) cases in USA – 164.7 million (estimated) case (163.2 in developing countries and 1.5 in developed countries) and 1.1 million death worldwide – 580,000 cases in travelers • • • • Reservoirs: humans and primates Infectious dose: ~ 10 cells Incubation period: typically 1-3 days Duration of illness: 2-7 days • Mode of transmission: Direct (person-to-person) and indirect (fomites, water, and food) Escherichia coli O157: H7 • Elongated and straight rods • Size: 0.5-1 µm • ~8,000 serotypes • Acute bloody diarrhea and abdominal cramps with little or no fever • 3-5% fatality. Escherichia coli O157: H7 : Epidemiology • Involved in 11 drinking water outbreaks with 529 cases and 15 recreational water outbreaks with 387 cases in USA (1971-2000) • Incidence – 730,000 (estimated) cases (USA) – 210 million cases and 300,000 deaths worldwide – Many different serotypes: enterotoxigenic (ETEC); enteropathogenic (EPEC); enteroinvasive (EIEC); and enteroaggregative (EAgg EC) – All pathogenic E. coli: 1.5 billion (estimated) case and 3 million death worldwide • • • • Reservoirs: humans and animals (cattle, goats, sheep, deer, ….) Infectious dose: ~ 100 cells Incubation period: typically 1-3 days Duration of illness: 2-12 days • Mode of transmission: Direct (person-to-person) and indirect (fomites, water, and food) Salmonella spp. • Elongated and straight rods • >2,000 serotypes • Diarrhea, fever, headache, constipation, malaise, chills, and myalgia • 12% - 30% mortality Salmonella spp. : Epidemiology • Involved in 12 drinking water outbreaks with 2,370 cases in USA (1971-1992) • Incidence – An estimated1.4 million cases with 500 death in the United States – An estimated 21 million cases of typhoid fever and 200,000 deaths occur worldwide. • • • • Reservoirs: humans and animals (cattle, chicken, turkey…) Infectious dose: ~100 cells Incubation period: typically 1-3 days Duration of illness: 2-7 days • Mode of transmission: Direct (person-to-person) and indirect (fomites, water, and food) Vibrio cholerae • Straight or curved rods • Motile with flagella • 0.5-0.8 µm in width and 1.4-2.6 µm in length • Serogroup O1 or O139 • Profuse watery diarrhea, vomiting, circulatory collapse and shock. • 40 - 60 % of typical cases are fatal if untreated Vibrio spp. : Epidemiology • Involved in 2 drinking water outbreaks with 28 cases in the USA (1971-2000) • Incidence – 0-5 cases per year in the United States. – A major cause of epidemic diarrhea throughout the developing world. – Ongoing global pandemic in Asia, Africa and Latin America for the last four decades. • Reservoirs: humans, environmental reservoirs - waters may be associated with copepods or other zooplankton Infectious dose: ~100 cells • • Incubation period: a few hours to 5 days; usually 2-3 days • Duration of illness: several days • Mode of transmission: Indirect (water and food) Campylobacter spp. • Curved rod • Size: 1.5-3 microns • C. jejuni and C. coli • fever, nausea, abdominal cramps, (seldom) vomiting, and bloody diarrhea Campylobacter spp. : Epidemiology • Involved in 16 drinking water outbreaks with 5473 cases in the USA (1971-2000) • Incidence – An estimated 2.4 million persons are affected each year. • • • • Reservoirs: humans and animals (cattle, chicken, birds, …) Infectious dose: ~100 cells Incubation period: 3-5 days Duration of illness: 2-10 days • Mode of transmission: Direct (animal contact) and indirect (food and water) Other Important Bacterial Pathogens • Fecal origin – Aeromonas spp. – Plesomonas spp. – Yersinia spp. • Environmental origin – Legionella spp. (esp. L. pneumophila) – Pseudomonas spp. (esp. P. aeruginosa) – Mycobacterium Avium Complex (MAC) Nuisance Bacteria • Acintomycetes/Streptomycetes – Thin filamentous, gram postive rods – Taste and odor • Iron Bacteria – E.g. Leptothrix, Thiobacillus, Clonothrix, Sphaerotilus, Caulobacter, Hyphomicrobium – Main corrosion – Increase oxidant demand • Sulfur Bacteria – E.g. Desulfovibrio, Thiothrix, Chlorobium, Chromatium, Thiobacillus – Formation of tubercles; pipe corrosion; increase oxidant demand – Reduce Sulfur compounds to H2Sa • Nitrifying bacteria – E.g. Nitrosomonas, Nitrobacter, Nitrospira, Nitrococcus – Increased oxygen demand (Nitrite); Protozoan Pathogens Waterborne Outbreaks in the United States, 1989-1994 Etiologic Agent No. Outbreaks Acute GI (unknown) 44 Cryptosporidium parvum 8 Giardia lamblia 16 Hepatitis A virus 4 Norwalk-like viruses 1 E. coli O157:H7 1 Cyclospora cayatenensis 1 Shigella spp. 7 Salmonella sp. 1 Vibrio cholerae (non-01) 1 Chemicals: Pb, NO3, F and Cu 13 No. Cases 16,264 406,822 1,205 81 900 243 21 570 625 11 TOTAL 427,256 87 394 Protozoa • Size – Usually 10-50 µm • smallest: 1-10 µm, largest: 150 µm (Balantidium coli) • Many organells – Nucleus (or nuclei) – Cytosome (cell mouth), food vacuoles, contractile vacuoles (osmoregulation), Golgi apparatus, mitochondria, lysosomes,… – Locomotive structures: pseudopodia, flagella, cilia • Cell cycle and reproduction – Asexual (binary fission) and sexual (various life stages) Prokaryotic Cell (left) and Eukaryotic Cell (right) Enteric Protozoans: Taxonomy Protozoans (single-celled): • Sarcodina: Amoebas: ex.: Entamoeba histolytica • Mastigophora: Flagellates: ex.: Giardia lamblia • Sporozoa: Coccidians: Cryptosporidium parvum • Ciliophora: Ciliates: ex.: Balantidium coli • Microsporidia: ex.: Enterocytozoon beinusi Entamoeba histolytica • Ameba • Cyst – 10-20 μm – 4 nuclei – chromatoidal bars • Trophozoite – 12-50 μm – 1 nucleus – actively mobile • Mild GI symptoms (abdominal pain, cramps, colitis and diarrhea), bloody diarrhea (amoebic dysentery) Entamoeba histolytica: Epidemiology • Involved in 1 drinking water outbreaks with 4 cases and 40 recreational water outbreaks with 11,707 cases in USA (1971-2000) • Incidence – 4 % prevalence in USA – 50 % prevalence with 100,000 deaths per year worldwide • Reservoir: human is the only host • Infectious dose: unknown; however, theoretically, the ingestion of one viable cyst can cause infection • Incubation period: 1-4 weeks • Transmission: Direct transmission (sexually transmission), fecal-oral route, waterborne, foodborne • High risk groups: travelers, recent immigrants, male homosexuals, institutioned populations Giardia lamblia • • Flagellate Cyst – – – • Trophozoite – – – – • 8-14 μm 2-4 nuclei thick oocyst wall (0.3 μm) Heart-shaped, symmetric 10-18 μm long, 6-8 μm wide 2 nuclei 8 flagella abdominal cramps, nausea, vomiting, anorexia, low-grade fever, flu-like headache, general malaise, weakness, weight loss, distension, and profuse, greasy, bulky and foul-smelling diarrhea Giardia lamblia: Epidemiology • Involved in 126 drinking water outbreaks with 28,426 cases and 16 recreational water outbreaks with 684 cases in USA (1971-2000) • 500,000 estimated cases (200 millions?) worldwide • Reservoir: Human and animals (dogs, beaver, muskrat, elk, deer, voles, mice, horses, sheep, …) • Infectious dose: ~10 cysts • Incubation period: 1-14 days • Duration of illness: 1-3 weeks • Transmission: Fomites, waterborne, foodborne • High risk groups: children (in day-care centers), immunosuppressed people, and institutioned populations Cryptosporidium parvum • • Coccidia Oocyst • Sporozoite – 4 - 6 m – 4 sporozoites – Thick oocyst wall – No locomotive structure • • Immunocompetent people: similar to giardiasis Immunocompromised people: lifethreating • Fluid loss: 2-6liter/day (17 liters/day) • Extra-intestinal infection: respiratory cryptosporidiosis (intestitial pneumonia) Cryptosporidium parvum: Epidemiology • Involved in 15 drinking water outbreaks with 421,473 cases and 40 recreational water outbreaks with 11,707 cases in USA(1971-2000) • Incidence – 1 – 3 % prevalence in USA – 5 % (Asia) and 10 % (Africa) prevalence • Reservoir: Human and animals (calves, lambs, goats,horses, pigs, deer, squirrel, beaver, muskrat,woodchuck,rabbit, dogs, fox, cat, skunk, raccon, bear, …) • Infectious dose: < 10 cysts • Incubation period: 7 days • Duration of illness: 1-4 weeks • Transmission: Fomites, waterborne, foodborne • High risk groups: children, immunosuppressed people, institutioned populations Emerging Protozoan Parasites • Toxoplasma gondii • Microsporidia spp. Toxoplasma gondii (oocysts) • Apicomplexa (Coccidia) • Oocyst – Two phases • A: unsporulated • B: sporulated – – – – 10 – 13 m two sporocysts four sporozoites distinctive cell walls • two or three layers • scatter UV • highly persistent in the environment – soil (months) – moist conditions (years) Toxoplasma gondii (other infectious forms) • Tachyzoite – – – – Crescent-shaped 2X6 m Rapidly multiflying Transmitted through placenta • Bradyzoite – Slowly multiplying – Tissues in intermediate hosts • Reproduction – Both asexual (intermediate hosts) and sexual (definitive hosts: cats) Transmission of Toxoplasma gondii Toxoplasma gondii: Epidemiology • Worldwide – – 22.5 % prevalence (general population) in USA between 1988-1994 Half billion people in the world • • • Symptoms – – – • • • • • Unusually high prevalence in France (65-85%): raw or undercooked meat High prevalence in Central America: large number of stray cats Immunocompetent people: mostly asymptomatic, some flu-like symptoms (swollen lymph glands, muscle aches and pains) Immunocompromised people: life-threating • central nerve system disease (encephalitis) • blindness, myocarditis, pneumonia Congenital infected children • impaired vision and mental retardation Reservoir: Definitive hosts are cats; intermediate hosts are sheep, goats, rodents, swine, cattle, chicken, and birds Infectious dose: Not known Incubation period: 10-23 days Transmission: Indirect (water and food) and transplacental High risk groups: infants born to infected mothers, immunosuppressed people Microsporidia spp. • New Phylum – 143 genera, >1200 species – 14 identified human pathogens • Produce very resistant spores – Usuaually small (1-4 m) • A unique organalle (polar tubule) – Coiled inside the spores – Inject infective spore contents into the host cells Life cycle of Microsporidia spp. Microsporidia spp.: Epidemiology • Worldwide – Both developed and developing countries • Symptoms: – Immunocompetent people: asymptomatic or self-limiting diarrhea – Immunocompromised people: • Chronic diarrhea • Disseminated diseases (keraconjunctivitis, bronchitis, pnuemonia, hepatitis, …) • Reservoirs: human and animals (rabbits, mice, dogs, pigs, cats, cattle, wild birds (parrots), insects?) • Infectious dose: Not known • Incubation period: Not known • Transmission: uncertain – Airborne transmission? – Waterborne transmission?? – Transplacental transmission? (Encephalitozoon spp.) Other Important Protozoa • Trypanosomes- Sleeping Sickness – African (Tsetse flies) – American (kissing bugs) “Chaga’s” • • • • Acanthamoeba spp. (GAE) Balamuthia mandrillaris (GAE) Naeglaria fowlerii (PAM) Pneumocystis carinii (now P. jiroveci a fungus)