ENVIRONMENTALLY

TRANSMITTED PATHOGENS
(CHAPTER 22)

Evy Novita Z
 TERMINOLOGY
• Pathogen: disease-causing microorganisms
▪ Primary (frank) pathogen: microbe or virus that causes disease in otherwise
healthy individual
▪ Opportunistic pathogen: microbe or virus causes disease only when body’s innate
or adaptive defenses are compromised or when introduced into unusual location

• Infection: the process in which the microorganism multiplies

or grows in or on the host, whether or not the host is harmed
• Disease: damage or injury to the host that impairs host
function
MODE OF TRANSMISSION
Waterborne Transmission
• Pathogenic microbes that can be directly spread through contaminated water

Foodborne Transmission
• Pathogenic microbes that can be directly spread through contaminated food

Person to person Transmission

• The spreading of pathogenic microbes through direct or indirect contact between hosts (person)

Airborne Transmission
• Pathogenic microbial agents which ride on either dust particles or small respiratory droplets and
can stay suspended in air and are capable of travelling distances on air currents

Vector-borne Transmission
• A biological association between an arthropod (insect or arachnid) and a pathogen acquired by
feeding on the blood of an infected vertebrate host.
 WATERBORNE INFECTIOUS DISEASES

Source: Ringenberg, 2015; https://www.mazzetti.com/paradigm-shift-ashrae-188-domestic-water-waterborne-pathogens/

 ORIGIN OF PATHOGENS IN WASTEWATER
• Faeces: contain the major amount of pathogens, enteric
infections
• Urine: only a few diseases transmitted through urine
• Greywater: laundry, washing diapers, from food stuffs
• Industry: abattoir, food industry (plant pathogens)
• Storm water: surface run-off – animal faeces
Source: Pepper et al., 2015
THE ”F-DIAGRAM - MAIN ROUTES TO SPREAD
DIARRHEA

The main ways diarrhoea is spread – by

faecal pathogens contaminating fingers,
flies, fields, food and fluids and then
eventually swallowed

(Esrey et al. 1998)

WATER RELATED ILLNESS ASSOCIATED WITH
MICROBES
Pathogens that originate in fecal material and are transmitted by ingestion.
Waterborne diseases Transmission particularly occurs by drinking contaminated water
• Cholera • Other diarrheal diseases: • Other diarrheal diseases:
• Thypoid fever ▪ Giardiasis (Protozoan) ▪ Shigellosis (Bacteria)
• Amoebic ▪ Cryptosporidiosis (Bacteria) ▪ Viral Gastroenteritis (Virus)
• Bacillary dysentery ▪ Campylobacteriosis (Bacteria) ▪ Cyclosporiasis (Parasite)

Organisms that originate in feces are transmitted through contact of

Water-washed diseases contaminated water because of inadequate sanitation or hygiene
• Scabies
• Trachoma
• Typhus
• Other flea, lice-borne diseases
WATER RELATED ILLNESS ASSOCIATED WITH
MICROBES
Organisms that originate in the water or spend part of their life cycle in aquatic animals (parasites
Water-based diseases found in intermediate aquatic organisms) and come in direct contact with human in water or by
inhalation
• Chistosomiasis
• Dracunculiasis
• Legionellossis

Water-related diseases
• Yellow fever
• Dengue
• Filariasis
• Malaria
• Onchocerciasis
• Trypanosomiasis
 OUTBREAKS
• Estimated 20.000.000 cases of illness per year due to drinking
contaminated water (Reynold, 2008 in Ian et al., 2015)
• In 1993, largest waterborne outbreak of disease in USA, when over
400.000 people (25% of population) became ill and around 100 died in
Milwaukee because of Cryptosporidiosis (Eisenberg et al., 2005 in Ian et al., 2015)
• Each year in USA, 128.000 people hospitalized and 3.000 death because of
eating contaminated food supplies (Ian et al., 2015)
• Campylobacter is the most common diarrheal illness in the US
 FOODBORNE INFECTIOUS DISEASES

Source: M. Chan, WHO, 2015

DISEASES RELATED TO FOODBORNE
Diseases Pathogen agent Source (Transmission) Symptoms/Signs
Gastrointestinal Norovirus; Ingestion of contaminated raw Dhiarrhea
disease Caliciviridae family shellfish
Person to person through feces,
vomit
Diarrhea Campylobacter Raw or undercooked poultry Diarrhea, abdominal cramps,
Guillain-Barré jejuni, C. fetus, C. Non-chlorinated water fever, nausea
Syndrome coli Raw milk
Infected animal or human feces
(poultry, cattle, puppies, kittens,
pet birds)
Salmonellosis S. typhimurium Raw poultry and eggs Diarrhea, fever, cramps
S. enteritidis Raw milk
Raw beef
Unwashed fruit
Reptile pets: Snakes, turtles,
lizards
DISEASES RELATED TO FOODBORNE
Diseases Pathogen agent Source (Transmission) Symptoms/Signs

Diarrhea E. coli O157:H7 Ingestion of food/water Watery or bloody diarrhea, nausea,

Person to person through feces cramps

Botulism Clostridium home-canned foods, fermented meats Flaccid paralysis and cranial nerve
botulinum and honey deficits, and can lead to death
Double vision, drooping eyelids,
difficulty speaking and swallowing

Shigellosis (bacillary Shigella sonnei Human fecal contamination of food, Watery or bloody diarrhea, nausea,
dysentery) S. dysenteriae, S. beverages, vegetables, water vomiting, cramps, fever
flexneri and S. boydii

Toxoplasmosis Toxoplasma gondii Infected cats shedding in their feces, soil, Asymptomatic to fever, headache,
undercooked meat, and mechanical and swollen lymph nodes
vectors such as cockroaches and flies
 AIRBORNE INFECTIOUS DISEASES

Source: Pearson education Inc., 2012; http://www.microbiologybytes.com/dangers-microbes-found-hvac-systems/

DISEASES RELATED TO AIRBORNE TRANSMISSION
Diseases Pathogen agents Symptoms Transmission Properties
Streptococcal S. Pyogenes Respiratory symptoms Airborne Gram positive
disease S. Agalactiae Systemic symptoms Direct contact Cocci in chain
Enterococcus faecalis Scarlet fever Mildly to malignant
Immune related complications virulent
Diphtheria C. diphtheria Upper respiratory infection Airborne Gram positive Rod, non
May Spread into Bloodstream Droplet spore forming
Cardiovascular damage Direct contact
Pertussis Bordetella pertussis Upper respiratory tract infection Airborne Gram negative aerobic
Difficulty breathing Direct contact rod
Staccato cough
Meningococcal Neiserria meningitides Upper respiratory tract Airborne Gram-negative cocci in
infections Septicemia Direct contact pairs
Meningitis (headache, seizures,
coma, death)
DISEASES RELATED TO AIRBORNE TRANSMISSION
Diseases Pathogen agents Symptoms Transmission Properties
Haemophilus Haemophilus influenza Upper respiratory tract (Rhinitis and Airborne Gram-negative rod
influenzae (several strains) Sinusitis) Facultative anaerobic
Infections Haemophilus ducreyii Septicemia and Meningitis
Tuberculosis (TB) Mycobacterium Primary stage: Symptoms free Airborne Acid-fast rods
tuberculosis Flu-like illness Droplet (inhales)
Active stage: slight fever, night Direct contact
sweats, weight loss, fatigue
Vary depending on type of TB
Hansen’s disease Mycobacterium leprae Direct contact Acid-fast rods
(Leprosy) Respiratory routes
SARS (Severe Acute Coronavirus High fever, headache, body aches, Droplet (inhales)
Respiratory respiratory symptoms, diarrhea, Direct contact
Syndrome) cough, pneumonia Person to person
contact
OUTBREAKS
Name of pandemic Date Number of Deaths

1889–1890 flu pandemic 1889–1890 1 million

(Asiatic or Russian Flu)
1918 flu pandemic 1918–1920 20 to 100 million
(Spanish flu)
Asian Flu 1957–1958 1 to 1.5 million

Hong Kong Flu 1968–1969 0.75 to 1 million

Russian flu 1977–1978 no accurate count

2009 flu pandemic 2009–2010 18,000

INCUBATION TIME
Agent Incubation Mode of transmission Illness Duration of illness
Period
Adenovirus 8-10 days Fecal-oral-respiratory Respiratory diseases, 8 days
gastroenteritris, (see Table
22.11)
Campylobader jejuni 3-5 days Food ingestion, direct contact Diarrhoea 2-10 days

Cryptosporidium 2-14 days Food/water ingestion, direct & indirect contact Diarrhoea weeks to months

E. Coli ETEC 16-72 h Food/water ingestion Diarrhoea 3-5 days

EPEC 16-48 h Food/water ingestion, direct & indirect contact Diarrhoea 5-12 days

EHEC 72-120 h Food/ingestion, direct/indirect contact Diarrhoea 2-15 days

Giardia lamblia 7-14 days Food/water ingestion, direct & indirect contact Diarrhoea weeks to months

Norovirus 24-48 h Food/water ingestion, direct & indirect contact Gastroenteritris 1-2 days

Rotavirus 24-72 h Direct/indirect contact Diarrhoea, gastroenteritris 4-6 days

Hepatitis A virus 30-60 days Fecal-oral, fomites Hepatitis A 2-4 weeks

Salmonella 16-72 h Food ingestion, direct & indirect contact Thypoid fever, parathypoid 2-7 days
fever
Shigella 16-72 h Food ingestion, direct & indirect contact Dysentri (shigellosis) 2-7 days

Yersinia enterocolitica 3-7 days Food ingestion, direct contact Fever & diarrhoea 1-3 weeks
INFECTIOUS DOSE
Agent Infectious dose Unit
Hepatitis A virus 10-100 Virus particle
Norovirus 10-100 Virus particle
Rotavirus 10-100 Virus particle
Salmonella < 101-109 CFU
Shigella sonnei <500 CFU
Shigella dysenteriae 200
Shigella flexneri < 140
Strepcoccus pyogenes < 103 CFU
Campylobacter 500-800 CFU
E. coli 106-108 CFU
Vibrio parahaemolyticus < 103 CFU
Vibrio cholerae Virus particle
O1 serotype < 103
O139 serotype < 104
Yersinia enterocolitica 106-109 CFU
Legionella 1 CFU
ENVIRONMENTAL FACTORS INFLUENCING SURVIVAL OR
PROLIFERATION OF INFECTIOUS AGENTS
• Physical: temperature, relative humidity, sunlight, moisture content or
water activity, climate and weather, etc.

• Chemical and Nutritional: Antimicrobial chemicals, nutrients for

microbial proliferation.

• Biological: Antagonistic activity by other organisms: antimicrobial

agents, parasitism, etc.; presence and state of a vector
ENVIRONMENTAL FACTORS INFLUENCING SURVIVAL OR
PROLIFERATION OF INFECTIOUS AGENTS
No. Environmental Remarks
Factors
1 Temperature The most important factor, longer survival at lower temperatures, freezing
kils bacteria & protozoan parasites, but prolong virus survival
2 Moisture Low moisture content in soil can reduce bacterial population
3 Light UV sunlight is harmful to bacteria & protozoa
4 pH Most are stable at pH values of natural waters. Enteric bacteria are less stable
at pH>9 and pH<6
5 Salts Some viruses are protected against heat inactivation by the presence of
certain cations
6 Organic matter The presence of sewage usually results in longer survival
7 SS or sediment Association with solids prolongs survival of enteric bacteria & virus
8 Biological factors Native microflora is usually antagonistics
HOMEWORK
• Read chapter 22
• Make a summary on Chapter 22 (minimum 4 pages)
• Answer all the questions and problems on the page 546
(Chapter 22)
• Collected on May 17, 2018