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Risk assessment and control of waterborne giardiasis

Author

Listed:
  • Rose, J.B.
  • Haas, C.N.
  • Regli, S.

Abstract

Background: Waterborne giardiasis has been increasing in the United States with 95 outbreaks reported over the last 25 years. The Safe Drinking Water Act has mandated control of this pathogen. Methods: A risk assessment model was developed to estimate risk of infection after exposure to treated waters containing varying levels of Giardia cysts. The model was defined by a dose-response curve developed from human feeding studies for Giardia and assumed 2L of water consumption per day. Data on concentrations and distribution of the organism in source waters were used to assess exposure after varying reductions achieved through treatment. Results: In surveys reporting prevalence and levels of Giardia cyst contamination, average levels of cysts in surface waters ranged from 0.33 to 104/100L; from pristine watersheds (protected from all human activity) 0.6 to 5/100L. Yearly risks were 4.8 x 10-3 for systems using polluted waters and 1.3 x 10-4 for pristine waters with a 10-3 treatment reduction. Conclusion: Public Health officials will need to work with the water industry to ensure a risk of less than 1/10,000 for source waters with 0.7 to 70 cysts per 100 liters through treatment achieving reduction of 10-3 to 10-5, respectively, of Giardia cysts.

Suggested Citation

  • Rose, J.B. & Haas, C.N. & Regli, S., 1991. "Risk assessment and control of waterborne giardiasis," American Journal of Public Health, American Public Health Association, vol. 81(6), pages 709-713.
    • Handle: RePEc:aph:ajpbhl:1991:81:6:709-713_9
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    Cited by:

    1. Charles N. Haas, 2002. "On the Risk of Mortality to Primates Exposed to Anthrax Spores," Risk Analysis, John Wiley & Sons, vol. 22(2), pages 189-193, April.
    2. Miao Guo & Abhinav Mishra & Robert L. Buchanan & Jitender P. Dubey & Dolores E. Hill & H. Ray Gamble & Jeffrey L. Jones & Xianzhi Du & Abani K. Pradhan, 2016. "Development of Dose‐Response Models to Predict the Relationship for Human Toxoplasma gondii Infection Associated with Meat Consumption," Risk Analysis, John Wiley & Sons, vol. 36(5), pages 926-938, May.
    3. Charles N. Haas, 2002. "Conditional Dose‐Response Relationships for Microorganisms: Development and Application," Risk Analysis, John Wiley & Sons, vol. 22(3), pages 455-463, June.
    4. Frank J. Loge & Elisabetta Lambertini & Mark A. Borchardt & Hakan Başağaoğlu & Timothy R. Ginn, 2009. "Effects of Etiological Agent and Bather Shedding of Pathogens on Interpretation of Epidemiological Data Used to Establish Recreational Water Quality Standards," Risk Analysis, John Wiley & Sons, vol. 29(2), pages 257-266, February.
    5. Tucker Burch, 2019. "Validation of Quantitative Microbial Risk Assessment Using Epidemiological Data from Outbreaks of Waterborne Gastrointestinal Disease," Risk Analysis, John Wiley & Sons, vol. 39(3), pages 599-615, March.
    6. Régis Pouillot & Véronique Goulet & Marie Laure Delignette‐Muller & Aurélie Mahé & Marie Cornu, 2009. "Quantitative Risk Assessment of Listeria monocytogenes in French Cold‐Smoked Salmon: II. Risk Characterization," Risk Analysis, John Wiley & Sons, vol. 29(6), pages 806-819, June.
    7. Thu Le-Thi & Phuc Pham-Duc & Christian Zurbrügg & Toan Luu-Quoc & Huong Nguyen-Mai & Tu Vu-Van & Hung Nguyen-Viet, 2017. "Diarrhea risks by exposure to livestock waste in Vietnam using quantitative microbial risk assessment," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(1), pages 83-91, February.
    8. Philip J. Schmidt & Katarina D. M. Pintar & Aamir M. Fazil & Edward Topp, 2013. "Harnessing the Theoretical Foundations of the Exponential and Beta‐Poisson Dose‐Response Models to Quantify Parameter Uncertainty Using Markov Chain Monte Carlo," Risk Analysis, John Wiley & Sons, vol. 33(9), pages 1677-1693, September.
    9. David L. Holcomb & Mary A. Smith & Glenn O. Ware & Yen‐Con Hung & Robert E. Brackett & Michael P. Doyle, 1999. "Comparison of Six Dose‐Response Models for Use with Food‐Borne Pathogens," Risk Analysis, John Wiley & Sons, vol. 19(6), pages 1091-1100, December.
    10. Joseph N. Eisenberg & Edmund Y. W. Seto & Adam W. Olivieri & Robert C. Spear, 1996. "Quantifying Water Pathogen Risk in an Epidemiological Framework," Risk Analysis, John Wiley & Sons, vol. 16(4), pages 549-563, August.
    11. S. R. Petterson, 2016. "Application of a QMRA Framework to Inform Selection of Drinking Water Interventions in the Developing Context," Risk Analysis, John Wiley & Sons, vol. 36(2), pages 203-214, February.
    12. Tucker R. Burch, 2020. "Outbreak‐Based Giardia Dose–Response Model Using Bayesian Hierarchical Markov Chain Monte Carlo Analysis," Risk Analysis, John Wiley & Sons, vol. 40(4), pages 705-722, April.

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