GRF 2nd One Health Summit 2013: Presentation by Professor Joan B. Rose, Michigan State University

1. GLOBAL ISSUES IN WATER QUALITY:
IMPLICATIONS FOR ONE HEALTH
2nd Global Risk Forum:
One Health Summit 2013
One Health - One Planet - One Future
Risks and Opportunities
17 - 20 November 2013 in Davos, Switzerland
Professor Joan B. Rose
rosejo@msu.edu
Homer Nowlin Chair
Center for Water Sciences

2. Chain of Life
THE BIOSPHERE
Nexus of Water, Land and Atmosphere
Natural &
Engineered Systems
Ecosystems
Rural & Urban
Systems
Agricultural
Systems
Human
Systems
molecular↔ cellular ↔species ↔ populations ↔ community ↔ systems

3. The United Nations Rio+20 Summit
in 2012 Began the Conversation on
the New Global Sustainable
Development Goals
“Protection of Earth’s Life Support System
including the atmosphere, oceans, forests,
waterways, biodiversity and biogeochemical
cycles is a prerequisite for a thriving global
society” Griggs, Nature, Mar, 2013, vol 495 p303

4. Water is at the core of the global goals for
sustainability and security

5. GLOBAL WATER QUALITY
IS DEGRADING
chemical and biological contaminants
Recreational
Irrigation
Seafood
Ecosystems
Drinking

6. GLOBAL TRENDS
IN THE ERA OF THE
ANTHROPOCENE
•
•
•
•
•
•
•
Urbanization
Population growth
Population Growth
Regional Growth
• HOW IS WATER QUALITY
CHANGING?
Travel and Tourism
Global Corporate Growth WHAT ARE THE SOURCES OF
•
THE CONTAMINANTS?
Global Food Market
Water Recycling, Reuse • HOW DOES ECOSYSTEM
HEALTH RELATE TO HUMAN
HEALTH?
• HOW DO WE RESTORE AND
PROTECT WATER SYSTEMS?

7. How do we solve the water pollution problem
and protect the biohealth of the planet?
ASSESSMENT
TECHNOLOGY
IMPROVED KNOWLEDGE

8. NATIONAL ACADEMY OF SCIENCES
RISK ASSESSMENT PARADIGM
 PROBLEM FORMULATION
 HAZARD IDENTIFICATION
 DOSE-RESPONSE
 EXPOSURE
 RISK CHARACTERIZATION
 RISK MANAGEMENT
Quantitative Microbial Risk Assessment

9. THE PROBLEM: THE
GREAT ACCELERATION
http://blogs.triplealearning.com/2011/03/dip
loma/dp_biology/world-water-day-3/
GLOBAL POPULATION TRENDS 1800S TO 2100
http://esa.un.org/wpp/unpp/panel_population.htm

10. Chickens
Eggs
Bovine
Milk
Pigs
Sheep and
Goats
Data from
FAO (2010)
.
19601970 1980 1990 2000 2010
YEAR
19601970 1980 1990 2000 2010
YEAR

11. Figure I. Cultivated areas of the world. Brown
regions indicate areas in which at least 30% of
the landscape is cultivated. Reproduced from
the Millennium Ecosystem Assessment 2005
(http://www.MAweb.org), UNEP.
LOSS OF WETLANDS
KM2
From 1950s to 1990s in
the US.
Verhoeven et al. TRENDS in Ecology
and Evolution Vol.21 No.2
February 2006

12. Knudsen
Et al.
2005. Global
Development of
Organic
Agriculture:
Challenges and
Promises (eds N.
Halberg, H.F.
Alrøe, M.T.
Knudsen and E.S.
Kristensen)

13. Water pollution from agriculture is
costing billions of dollars a year in
developed countries and is set to
rise in China and India as farmers
race to increase food production,
the Organization for Economic
Cooperation and Development said.
Agricultural Environments
contribute point and nonpoint pollution
Photos PROVIDED
BY DR. JEANETTE
THURSTON, USDA

14. Fecal contamination of water
Remains one of the largest threats to
the biological safety of water today.

15. World has 44% of the global population (7 billion people)
lives within 150 km (93 miles) of the coastline (that is 3 billion
people who flush or dispose daily and send fecal pollution
into the environment and eventually into waterways). The
world's rivers (ten of the longest rivers = 55,734 km or 34,629
miles) are so badly affected by human activity that the water
security of 5 billion people are impacted.

16. There are 16,000 publicly owned wastewater treatment plants, 100,000
major pumping stations, 600,000 miles of sanitary sewers, and 200,000
miles of storm sewers in the US.
Wastewater Grades
1988 C
1998 D+
2012 D
INFRASTRUCTURE IS
NOT KEEPING UP
discharge billions of gallons of
untreated sewage into U.S. surface
waters each year. The EPA estimates
that the nation must invest $390
billion over the next 20 years to
replace existing systems and build
new ones to meet increasing
demands.
ASCE

17. Risk Frameworks: Interfacing with Water
Safety Plans and Water Management
The Exposure
The Hazards
The Risk Characterization
The Dose-response
CAMRA:EPA-DHS
Center of Excellence on
Microbial Risk
Assessment
http://camra.msu.edu/

18. THE HAZARDS
Viruses
Bacteria
Parasites
THE DISEASES: diarrhea, respiratory illness, liver damage,
kidney failure, heart disease, cancer, nervous system disorders;
birth defects, death.

19. Outbreak of Polio
Spreading in Syria
Oct 26th, 2013 ·
Queensland Health struggling to contain legionella outbreaks
in two towns
Updated Tue 6 Aug 2013, 2:39pm AEST
Wild type Polio virus
Circulating in sewage
In Israel.
In Syria, twenty-two people or
more, mostly babies and
toddlers, are said to have
contracted polio,
announced the World Health
Organization. Doctors in Syria
have also reported a rise in
diseases such a typhoid,
hepatitis, and the flesh-eating
parasite leishmaniasis
About 83%
diseases in
Mumbai are
water borne:
Hand, foot, mouth disease patientsIST
PTI | Aug 19, 2013, 09.18 PM top
130,000 in Japan JIJI, Aug 7, 2013
“The number of lakes at r isk
of har mf ul algal blooms will
incr ease by 20 per cent in t he

20. An Emerging Waterborne Virus: Found as
Part of the sewage viral biome (Aw and Rose, 2013)
Circoviridae
•a virus family that comprises two genera,
Circovirus that includes porcine circoviruses,
pigeon circovirus, and psittacine beak and
feather disease virus, and Gyrovirus that
includes chicken anemia virus.
•
A cyclovirus - has been isolated
from the cerebrospinal fluid of
25 Vietnamese patients with
CNS infections of unknown
aetiology (2013)
The same virus has been isolated from the
faeces of healthy children and also from
pigs and chickens. This suggests a oral
faecal route of transmission with a
possible animal reservoir.
Tan le V, et al (2013) Identification of a new cyclovirus in cerebrospinal fluid of patients
with acute central nervous system infections. MBio 4(3). pii: e00231-13. doi:
10.1128/mBio.00231-13x

21. Waterborne Guillain Barré Investigation Update
August 5th, 2011 AZ
• a rare cluster of Guillain-Barré Syndrome (GBS)
along the US-Mexico border near Yuma, AZ has
been identified 8 more cases for a total of 24.
Clostridium difficile contamination of public tap water distribution system during a waterborne
outbreak in Finland 2007 (KOTILA et al. Scandinavian Journal of Public Health, 2013; 0: 1–5)
• 8000 people ill multiple etiological agents
including12 toxin producing C. difficile isolated
from sewage contaminated drinking water in a
large gastroenteritis outbreak town of Nokia,
Finland.

22. Parasite Cyclospora Outbreak
June to Sept 2013
.
linked to a salad mix produced by Taylor Farms de Mexic o
• Fecal oral, spread by
an oocyst
• Only found in
humans.
• Spread to produce by
contaminated water.
• Case Count: 643
• States: 25
• Deaths: 0
• Hospitalizations: 45

23. •Human-Animal Diseases – Global Hotspots for zoonoses by
the International Livestock Research Institute (ILRI), the Institute of Zoology
(UK) and the Hanoi School of Public Health in Vietnam, 13 zoonotic
pathogens were associated with 2.4 billion cases of human
illness and 2.2 million deaths every year. A 99% correlation
between the burden of zoonoses and country levels of proteinenergy malnutrition was found. (Grace et al.2012)
•HEV, gastrointestinal agents, Leptospira, Toxoplasma
Protozoan Parasites
Enteric Viruses?
Photos BY DR. JEANETTE THURSTON, ARS,
NEBRASKA
Bacteria
Antibiotic Resistance
Other Pathogens
Microsporidia

24. Antibiotic Resistance
1999
2008

25. Multistate Outbreak of Multidrug-Resistant Salmonella
Heidelberg Infections Linked to Foster Farms Brand Chicken
October 18, 2013 04:00 PM ET
•Case Count: 338
•States: 20
•Hospitalizations: 40%
•Recall: Yes
•As of October 17, 2013, a total of 338 persons infected with seven outbreak
strains of Salmonella Heidelberg have been reported from 20 states and Puerto
Rico. 40% of ill persons have been hospitalized, and no deaths have been
reported. Most ill persons (75%) have been reported from California.
Antonito water may have Salmonella contamination
Modified: Thursday, Nov 14th, 2013
By Jesse Medina

26. Tap water associated amoeba infections increasing.
DHH: St. Bernard child dead
after infection by rare
amoeba
Thursday, September 12, 2013 8:47 PM EST</em>
A CDC microscope image of
Naegleria fowleri
CONTRIBUTOR: FOX8LIVE.COM STAFF
Biofilms are known to contribute to Legionaires disease,
harboring Legionella bacteria.
AND
recently suspected to be
associated with the support
of the deadly free-living amoeba
Naegleria infection.
microbewiki.kenyon.edu
Risks from the built water environment

27. Water-associated infectious diseases reported outbreak
events from 1991 to 2008 (extracted from the Global
Infectious Disease and Epidemiology Network).
Yang K, LeJeune J, Alsdorf D, Lu B, Shum CK, et al. (2012) Global Distribution of Outbreaks of WaterAssociated Infectious Diseases. PLoS Negl Trop Dis 6(2): e1483. doi:10.1371/journal.pntd.0001483

28. Identification of hazards, hazardous events, evaluation
of risks

29. Growth Based Methods: Common Fecal Indicator
Organisms for measuring water quality
Filtering 100
ml water
samples
Fecal coliforms
Agar and colonies
Total coliforms E.coli
MPN and colonies
MPN

30. Water Diagnostics
Polymerase chain reaction
(PCR):
Small amount of DNA amplified
in a thermal cycler
Amplified products are measured
at the end point of amplification
by agarose gel electrophoresis
Quantitative PCR (qPCR):
Amplified PCR products are
detected real-time during the early
phases of the reaction.
30

31. Microbial Source Tracking
•Tools are now
available to determine
the molecular
fingerprint of the fecal
pollution.
•Health risks
•Remediation
•Prioritization
•Responsibility

33. Wells Sampled in Nicaragua
Diagnostic Tools using qPCR
No Human sewage marker found.
simple
34.37
rope-pump
12.34
15% of the samples (+) for Bovine
markers
Simple Well
Rope Pump Well

34. The distribution of the human
sewage marker Bacteroides

35. AN INTERNATIONAL COLLABORATION
FOR TESTING MARKERS
Dr. Asli Aslan Director of IC Sewage
Dr. Andreas
Farnleitner, Austria
is undertaking a
global assessment of
the new MST
technology.
Build Capacity
Train
Map pollution
http://www.cws.msu.edu/ic-sewage/

36. Mapping waterborne pathogens in surface waters
worldwide
Results of first exploration: total emissions
Hofstra, Bouwman, Beusen and Medema, STOTEN 2013

37. PROBLEM FORMULATION
ANALYSIS
Address HAZARDS
Exposure
Pathways
Dose-Response
Human
Health Effects
RISK CHARACTERIZATION
Uncertainty Analysis
RISK MANAGEMENT OPTIONS

38. 35 pathogens on
QMRAWiki with DoseResponse Models
• Exponential
•
•
•
•
Analyzed
~70 DR datasets
Inhalation & ingestion
Human & animal data
p = 1− exp(−kd)
• Approximate Beta
Poisson
 d( −1)
2

p =1− 1+
N 50 



1/ α
www.camra.msu.edu
−α

39. 10-4 (1/10,000) GOAL FOR WATER SAFETY
Development of
treatment
standards for
drinking water
treatment to
remove
pathogens from
water

40. Coupled Water, Food and Human Systems
Oceans
Lakes
Irrigation
Fertilization
WATER
SYSTEMS
Ground
Water
rc
ou
s
Re
ov
ec
eR
Animal &
Human Feces
nts
rie
ut
,N
r
Recreational
ate
& ,W
rgyDrinking
e Water
En
:
ery
Immunocompromised
Elderly
Children
HUMAN SYSTEMS
COMMUNITY
Fish
FOOD
SYSTEMS
Agricultural
Runoff
Streams
Rivers
Produce
Poultry
Pork
Beef
Handling
Preparation
Consumption

41. Recommendations
• To achieve a global understanding of water
quality and “Safe Water” to address the
biohealth of the planet.
– Use QMRA frameworks
– Use new water diagnostic molecular tools
– Mobilize the international water quality resources
and laboratories
– Address the distribution of fecal pollution and
sources under different climate regimes at regional
scales
– Map global water quality

42. Thank You!
Any Questions??

43. WPL for DIN in 1970
Water pollution levels (WPL) for
dissolved inorganic nitrogen (DIN),
from 1970 to estimates from the
Millennium Ecosystem Assessment
WPL for DIN in 2000
(MA) global orchestration (GO)
scenario.
C. Liu et al. / Ecological Indicators 18 (2012) 42–49

44. WPL for DIP in 1970
Water pollution levels (WPL) for
dissolved inorganic phosphorous
(DIP), from 1970 to estimates from
the Millennium Ecosystem
WPL for DIP in 2000
Assessment (MA) global
orchestration (GO) scenario.
C. Liu et al. / Ecological Indicators 18 (2012) 42–49