The Role of Environmental Reservoirs in Human Campylobacteriosis

UV disinfection technology is of growing interest in the water industry since it was demonstrated that UV radiation is very effective against (oo)cysts of Cryptosporidium and Giardia, two pathogenic micro-organisms of major importance for the safety of drinking water. Quantitative Microbial Risk Assessment, the new concept for microbial safety of drinking water and wastewater, requires quantitative data of the inactivation or removal of pathogenic micro-organisms by water treatment processes. The objective of this study was to review the literature on UV disinfection and extract quantitative information about the relation between the inactivation of micro-organisms and the applied UV fluence. The quality of the available studies was evaluated and only high-quality studies were incorporated in the analysis of the inactivation kinetics. The results show that UV is effective against all waterborne pathogens. The inactivation of micro-organisms by UV could be described with first-order kinetics using fluence-inactivation data from laboratory studies in collimated beam tests. No inactivation at low fluences (offset) and/or no further increase of inactivation at higher fluences (tailing) was observed for some micro-organisms. Where observed, these were included in the description of the inactivation kinetics, even though the cause of tailing is still a matter of debate. The parameters that were used to describe inactivation are the inactivation rate constant k (cm(2)/mJ), the maximum inactivation demonstrated and (only for bacterial spores and Acanthamoeba) the offset value. These parameters were the basis for the calculation of the microbial inactivation credit (MIC="log-credits") that can be assigned to a certain UV fluence. The most UV-resistant organisms are viruses, specifically Adenoviruses, and bacterial spores. The protozoon Acanthamoeba is also highly UV resistant. Bacteria and (oo)cysts of Cryptosporidium and Giardia are more susceptible with a fluence requirement of <20 mJ/cm(2) for an MIC of 3 log. Several studies have reported an increased UV resistance of environmental bacteria and bacterial spores, compared to lab-grown strains. This means that higher UV fluences are required to obtain the same level of inactivation. Hence, for bacteria and spores, a correction factor of 2 and 4 was included in the MIC calculation, respectively, whereas some wastewater studies suggest that a correction of a factor of 7 is needed under these conditions. For phages and viruses this phenomenon appears to be of little significance and for protozoan (oo)cysts this aspect needs further investigation. Correction of the required fluence for DNA repair is considered unnecessary under the conditions of drinking water practice (no photo-repair, dark repair insignificant, esp. at higher (60 mJ/cm(2)) fluences) and probably also wastewater practice (photo-repair limited by light absorption). To enable accurate assessment of the effective fluence in continuous flow UV systems in water treatment practice, biodosimetry is still essential, although the use of computational fluid dynamics (CFD) improves the description of reactor hydraulics and fluence distribution. For UV systems that are primarily dedicated to inactivate the more sensitive pathogens (Cryptosporidium, Giardia, pathogenic bacteria), additional model organisms are needed to serve as biodosimeter.

Campylobacter species cause a high proportion of bacterial gastroenteritis cases and are a significant burden on health care systems and economies worldwide; however, the relative contributions of the various possible sources of infection in humans are unclear. National-scale genotyping of Campylobacter species was used to quantify the relative importance of various possible sources of human infection. Multilocus sequence types were determined for 5674 isolates obtained from cases of human campylobacteriosis in Scotland from July 2005 through September 2006 and from 999 Campylobacter species isolates from 3417 contemporaneous samples from potential human infection sources. These data were supplemented with 2420 sequence types from other studies, representing isolates from a variety of sources. The clinical isolates were attributed to possible sources on the basis of their sequence types with use of 2 population genetic models, STRUCTURE and an asymmetric island model. The STRUCTURE and the asymmetric island models attributed most clinical isolates to chicken meat (58% and 78% of Campylobacter jejuni and 40% and 56% of Campylobacter coli isolates, respectively), identifying it as the principal source of Campylobacter infection in humans. Both models attributed the majority of the remaining isolates to ruminant sources, with relatively few isolates attributed to wild bird, environment, swine, and turkey sources. National-scale genotyping was a practical and efficient methodology for the quantification of the contributions of different sources to human Campylobacter infection. Combined with the knowledge that retail chicken is routinely contaminated with Campylobacter, these results are consistent with the view that the largest reductions in human campylobacteriosis in industrialized countries will come from interventions that focus on the poultry industry.