Bacteriological Diseases
Bacteriological Diseases
CONTINUING EDUCATION
PROFESSIONAL DEVELOPMENT COURSE
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Printing and Saving Instructions
The best thing to do is to download this pdf document to your computer
desktop and open it with Adobe Acrobat DC reader.
You can complete the course by viewing the course materials on your
computer or you can print it out. Once you’ve paid for the course, we’ll
give you permission to print this document.
This course booklet does not have the assignment. Please visit our
website and download the assignment also.
Internet Link to Assignment…
http://www.tlch2o.com/PDF/BacterilogicalDiseasesAss.pdf
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pre-approved this course. Not all States are listed. Not all courses are
listed. Do not solely trust our list for it may be outdated. It is your sole
responsibility to ensure this course is accepted for credit. No refunds.
Professional Engineers; Most states will accept our courses for credit
but we do not officially list the States or Agencies.
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IDEXX’s SimPlate for HPC method is used for the quantification of heterotrophic plate
count (HPC) in water. It is based on the Multiple Enzyme Technology which detects viable
bacteria in water by testing for the presence of key enzymes known to be present in these
little organisms. This technique uses enzyme substrates that produce a blue fluorescence
when metabolized by waterborne bacteria.
The sample and media are added to a SimPlate Plate, incubated and then examined for
fluorescing wells. The number of wells corresponds to a Most Probable Number (MPN)
of total bacteria in the original sample. The MPN values generated by the SimPlate for
HPC method correlate with the Pour Plate method using the Total Plate Count Agar
incubated at 35oC for 48 hours as described in Standard Methods for the Examination of
Water and Wastewater, 19th Edition.
This course contains EPA’s federal rule requirements. Please be aware that
each state implements drinking water regulations that may be more stringent
than EPA’s regulations. Check with your state environmental agency for
more information.
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Contributing Editors
Joseph Camerata has a BS in Management with honors (magna cum laude). He retired
as a Chemist in 2006 having worked in the field of chemical, environmental, and industrial
hygiene sampling and analysis for 40 years. He has been a professional presenter at an
EPA analytical conference at the Biosphere in Arizona and a presenter at an AWWA
conference in Mesa, Arizona. He also taught safety classes at the Honeywell and City of
Phoenix, and is a motivational/inspirational speaker nationally and internationally.
Copyright Notice
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copyright infringements were made as soon as these issues are brought to the editor's
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accurate. All written, graphic, photographic or other material is provided for information
only. Therefore, Technical Learning College accepts no responsibility or liability
whatsoever for the application or misuse of any information included herein.
Information in this document is subject to change without notice. TLC is not liable for
errors or omissions appearing in this document.
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Some States and many employers require the final exam to be proctored.
Most of our students prefer to do the assignment in Word and e-mail or fax the
assignment back to us. We also teach this course in a conventional hands-on
class. Call us and schedule a class today.
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Technical Learning College’s Scope and Function
Welcome to the Program,
Technical Learning College (TLC) offers affordable continuing education for today’s
working professionals who need to maintain licenses or certifications. TLC holds several
different governmental agency approvals for granting of continuing education credit.
TLC’s delivery method of continuing education can include traditional types of classroom
lectures and distance-based courses or independent study. TLC’s distance based or
independent study courses are offered in a print- based format and you are welcome to
examine this material on your computer with no obligation. We will beat any other training
competitor’s price for the same CEU material or classroom training.
Our courses are designed to be flexible and for you do finish the material on your leisure.
Students can also receive course materials through the mail. The CEU course or e-manual
will contain all your lessons, activities and assignments. All of TLC’s CEU courses allow
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description for more information.)
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the necessary equipment before enrolling, i.e., printer, Microsoft Word and/or Adobe
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upon your state or employer requirements.
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At TLC, there are no scheduled online sessions or passwords you need contend with, nor
are you required to participate in learning teams or groups designed for the "typical"
younger campus based student. You will work at your own pace, completing assignments
in time frames that work best for you. TLC's method of flexible individualized instruction is
designed to provide each student the guidance and support needed for successful course
completion.
Course Structure
TLC's online courses combine the best of online delivery and traditional university
textbooks. You can easily find the course syllabus, course content, assignments, and the
post-exam (Assignment). This student friendly course design allows you the most flexibility
in choosing when and where you will study.
Classroom of One
TLC offers you the best of both worlds. You learn on your own terms, on your own time,
but you are never on your own. Once enrolled, you will be assigned a personal Student
Service Representative who works with you on an individualized basis throughout your
program of study. Course specific faculty members are assigned at the beginning of each
course providing the academic support you need to successfully complete each course.
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Satisfaction Guaranteed
We have many years of experience, dealing with thousands of students. We assure you,
our customer satisfaction is second to none. This is one reason we have taught more
than 20,000 students.
We welcome you to do the electronic version of the assignment and submit the answer
key and registration to us either by fax or e-mail. If you need this assignment graded and
a certificate of completion within a 48-hour turn around, prepare to pay an additional rush
charge of $50.
Contact Numbers
Fax (928) 468-0675
Email [email protected]
Telephone (866) 557-1746
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CEU Course Introduction
Bacteriological Diseases CEU Training Course
This short CEU Course will review commonly found water and wastewater diseases,
symptoms, and identification techniques. This course will cover water and wastewater
sampling techniques, waterborne disease identification ND control, general water quality
operations and definitions. It will also cover disease symptoms, disease diagnosis, history
of the disease, susceptibility, and disease sources of contamination.
This course will apply to all categories of water treatment/distribution and wastewater
treatment/collection. As water professionals, it is our responsibility to identify, stop, and
control all waterborne diseases.
This course was designed for the enhancement of laboratory technical abilities. This
course was intended for Water Laboratory Analysts, but can be utilized by Wastewater
Treatment, Collections, Water Distribution, Well Drillers, Pump Installers, and Water
Treatment Operators.
This course is also an excellent introduction for a person interested in working in the water
quality field, water/wastewater treatment or distribution or a collections facility and wishing
to maintain CEUs for a certification license or to learn how to do the job safely and
effectively, and/or to meet education needs for promotion. Every operator or customer
service person that has contact with the public should have this booklet accessible to help
answer water quality and waterborne disease related questions.
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To receive alternate credit for the course, please contact TLC to receive permission from
your Instructor.
Any fraud or deceit and the student will forfeit all fees and the appropriate agency will be
notified. A random test generator will be implemented to protect the integrity of the
assignment.
Grading Criteria
TLC will offer the student either pass/fail or a standard letter grading assignment. If TLC
is not notified, you will only receive a pass/fail notice. In order to pass your final
assignment, you are required to obtain a minimum score of 70% on your assignment.
Required Texts
The BACTERIOLOGICAL DISEASES CEU course comes complete with a short
summary of the EPA's Rules and Regulations and related drinking water standards. If you
need more information or a complete set of Rules, you can download them off the EPA’s
web page, www.epa.gov or contact your local state environmental agency. You may
need to contact a laboratory or state agency for certain sampling information.
ADA Compliance
TLC will make reasonable accommodations for persons with documented disabilities.
Students should notify TLC and their instructors of any special needs. Course content
may vary from this outline to meet the needs of this particular group. There is an option
course assignment available, please contact an Instructor for further assistance.
Mission Statement
Our only product is educational service. Our goal is to provide you with the best education
service possible. TLC will attempt to make your learning experience an enjoyable
opportunity.
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Educational Mission
The educational mission of TLC is:
To provide TLC students with comprehensive and ongoing training in the theory and skills
needed for the environmental education field,
To provide TLC student’s opportunities to apply and understand the theory and skills
needed for operator certification,
To provide opportunities for TLC students to learn and practice environmental educational
skills with members of the community for the purpose of sharing diverse perspectives and
experience,
To provide a forum in which students can exchange experiences and ideas related to
environmental education,
To provide a forum for the collection and dissemination of current information related to
environmental education, and to maintain an environment that nurtures academic and
personal growth.
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TABLE OF CONTENTS
Common Definitions................................................ 16
Federal Timeline…… ............................................. 17
Course Introduction................................................. 19
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Pyoverdin................................................................ 121
Pathogenesis........................................................... 122
Shigellosis............................................................... 123
Transmission........................................................... 125
Typhoid Fever ........................................................ 129
Tularemia................................................................ 131
MIB Geosmin.......................................................... 135
Arsenic.................................................................... 137
Methemoglobinemia..................................................139
References.............................................................. 141
Symbols.................................................................. 145
Glossary.................................................................. 149
Appendix................................................................. 219
Chlorine Charts...................................................... 281
Conversions............................................................ 293
Course References…………………………………… 297
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Water Quality Introduction
Water is basic to life and health. Over 1 billion people worldwide have no access to safe
drinking water. The United States is fortunate to have one of the best supplies of drinking
water in the world. Although tap water that meets federal and state standards is generally
safe to drink, threats to drinking water quality in the United States still exist. Outbreaks of
drinking water-associated illness and water restrictions during droughts demonstrate that
we cannot take our drinking water for granted.
Municipalities throughout the US - from the largest cities to the smallest towns - sometimes
fail to meet EPA standards. The EPA may fine the jurisdiction responsible for the violation,
but this does not always motivate the municipality to take corrective action. In such cases,
non-compliance with SEPA may continue for many months or years after the initial
violation.
This could result from the fact that the city simply doesn't have the financial resources
necessary to replace aging water pipes or upgrade their purification equipment.
In rare cases, the source water used by the municipality could be so polluted that water
purification processes can't do an adequate job. This can occur when a town is
downstream from a large sewage treatment plant or large-scale agricultural operations.
Citizens who live in such places - especially young children, the elderly, or people of any
age with autoimmune deficiencies - may suffer serious health complications as a long-
term result of drinking water from their own taps.
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Common Water Quality Definitions
Units of Measurement
mg/l = Milligrams per liter. One milligram per liter equals one packet of artificial sweetener
sprinkled into 250 gallons of iced tea.
μg/l = Micrograms per liter. One microgram per liter is equal to one packet of artificial
sweetener sprinkled into an Olympic-size swimming pool.
Acronyms
Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed
in drinking water.
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Timeline of Existing Federal Water and State Drinking Water
Quality Regulations
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Common Disinfectant Information
Sources of
MRDL1 MRDL1 Potential Health Effects
Contaminant Contaminant in
(mg/L)2 (mg/L)2 from Ingestion of Water
Drinking Water
Chloramines MRDLG=41 MRDL=4.01 Eye/nose irritation; Water additive used
(as Cl2) stomach discomfort, to control microbes
anemia
Chlorine (as MRDLG=41 MRDL=4.01 Eye/nose irritation; Water additive used
Cl2) stomach discomfort to control microbes
Chlorine MRDLG=0.81 MRDL=0.81 Anemia; infants & Water additive used
dioxide (as young children: nervous to control microbes
ClO2) system effects
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Waterborne Disease Introduction
Bacteria, viruses, and protozoans that cause disease are known as pathogens. Most
pathogens are generally associated with diseases that cause intestinal illness and affect
people in a relatively short amount of time, generally a few days to two weeks. They can
cause illness through exposure to small quantities of contaminated water or food, or from
direct contact with infected people or animals. Pathogens that may cause waterborne
outbreaks through drinking water have one thing in common: they are spread by the fecal-
oral, or feces-to-mouth, route.
Pathogens may get into water and spread when infected humans or animals pass the
bacteria, viruses, and protozoa in their stool. For another person to become infected, he
or she must take that pathogen in through the mouth.
Waterborne pathogens are different from other types of pathogens, such as the viruses
that cause influenza (the flu), or the bacteria that cause tuberculosis. Influenza virus and
tuberculosis bacteria are spread by secretions that are coughed or sneezed into the air by
an infected person.
Human or animal wastes in watersheds, failing septic systems, failing sewage treatment
plants, or cross-connections of water lines with sewage lines provide the potential for
contaminating water with pathogens. The water may not appear to be contaminated
because the feces has been broken up, dispersed, and diluted into microscopic particles.
These particles containing pathogens, may remain in the water and be passed to humans
or animals unless adequately treated.
Only proper treatment will ensure eliminating the spread of disease. In addition to water,
other methods exist for spreading pathogens by the fecal-oral route. The foodborne route
is one of the more common methods. A frequent source is a food handler who does not
wash his hands after a bowel movement and then handles food with unclean hands. The
individual who eats feces-contaminated food may become infected and ill. It is interesting
to note the majority of foodborne diseases occur in the home, not restaurants.
Day care centers are another common source for spreading pathogens by the fecal-oral
route. Here, infected children in diapers may get feces on their fingers, then put their
fingers in a friend’s mouth or handle toys that other children put into their mouths. You
will usually be asked to sample at these facilities for Giardia. The general public and some
of the medical community usually refer to diarrhea symptoms as stomach flu. Technically,
influenza is an upper respiratory illness and rarely has diarrhea associated with it;
therefore, stomach flu is a misleading description for foodborne or waterborne illnesses,
yet is accepted by the general public. So the next time you get the stomach flu, you may
want to think twice about what you’ve digested within the past few days.
Chain of Transmission
When water is contaminated with feces, this contamination may be of human or animal
origin. If the human or animal source is not infected with a pathogen disease-causing
bacteria, viruses or protozoa, no disease will result.
The pathogens must survive in the water. This depends on the temperature of the water
and the length of time the pathogens are in the water.
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Some pathogens will survive for only a short time in water. Others, such as Giardia or
Cryptosporidium, may survive for months.The pathogens in the water must enter the water
system’s intake and in numbers sufficient to infect people. The water is either not treated
or inadequately treated for the pathogens present. A susceptible person must drink the
water that contains the pathogen in order for illness (disease) to occur. This chain lists the
events that must occur for the transmission of disease via drinking water. By breaking the
chain at any point, the transmission of disease will be prevented.
The incubation period is 15-50 days and averages 28-30 days. Hepatitis A outbreaks have
been related to fecally contaminated water; food contaminated by infected food handlers,
including sandwiches and salads that are not cooked or are handled after cooking; and
raw or undercooked mollusks harvested from contaminated waters. Aseptic meningitis,
polio, and viral gastroenteritis (Norwalk agent) are other viral diseases that can be
transmitted through water. Most viruses in drinking water can be inactivated by chlorine
or other disinfectants.
Terrorism
Recent investigations have shown proof the terrorist organizations have been able to
reproduce most of these pathogens and have the technology and funding to attack our
public water supply system. You will need to know these diseases and how to deal with
these issues. Even diseases that we have not seen in years are easily and readily
available for a terrorist to backflow into our distribution system, or pour into a wellhead or
clearwell.
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The Main Players- History and Biology Chapter 1
Before we define the major waterborne diseases, let’s first examine the germs and other
creatures that cause the diseases. Most of the following information may be simple or
instruction that you already know. But to be safe, let’s review the basics.
History of Research
By the last half of the 19th century, the microbial world was known to consist of protozoa,
fungi, and bacteria, all visible with a light microscope. In the 1840s, the German scientist
Jacob Henle suggested that there were infectious agents too small to be seen with a light
microscope, but for the lack of direct proof, his hypothesis was not accepted. Although the
French scientist Louis Pasteur was working to develop a vaccine for rabies in the 1880s,
he did not understand the concept of a virus.
During the last half of the 19th century, several key discoveries were made that set the
stage for the discovery of viruses. Pasteur is usually credited for dispelling the notion of
spontaneous generation and proving that organisms reproduce new organisms. The
German scientist Robert Koch, a student of Jacob Henle, and the British surgeon Joseph
Lister developed techniques for growing cultures of single organisms that allowed the
assignment of specific bacteria to specific diseases.
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First Experiment
The first experimental transmission of a viral infection was accomplished in about 1880 by
the German scientist Adolf Mayer, when he demonstrated that extracts from infected
tobacco leaves could transfer tobacco mosaic disease to a new plant, causing spots on
the leaves. Because Mayer was unable to isolate a bacterium or fungus from the tobacco
leaf extracts, he considered the idea that tobacco mosaic disease might be caused by a
soluble agent, but he concluded incorrectly that a new type of bacteria was likely to be the
cause. The Russian scientist Dimitri Ivanofsky extended Mayer’s observation and reported
in 1892 that the tobacco mosaic agent was small enough to pass through a porcelain filter
known to block the passage of bacteria. He too failed to isolate bacteria or fungi from the
filtered material. But Ivanofsky, like Mayer, was bound by the dogma of his times and
concluded in 1903 that the filter might be defective or that the disease agent was a toxin
rather than a reproducing organism.
Unaware of Ivanofsky’s results, the Dutch scientist Martinus Beijerinck, who collaborated
with Mayer, repeated the filter experiment but extended this finding by demonstrating that
the filtered material was not a toxin because it could grow and reproduce in the cells of
the plant tissues. In his 1898 publication, Beijerinck referred to this new disease agent as
a contagious living liquid—contagium vivum fluid—initiating a 20-year controversy over
whether viruses were liquids or particles.
The conclusion that viruses are particles came from several important observations. In
1917 the French-Canadian scientist Félix H. d’Hérelle discovered that viruses of bacteria,
which he named bacteriophage, could make holes in a culture of bacteria. Because each
hole, or plaque, developed from a single bacteriophage, this experiment provided the first
method for counting infectious viruses (the plaque assay). In 1935 the American
biochemist Wendell Meredith Stanley crystallized tobacco mosaic virus to demonstrate
that viruses had regular shapes, and in 1939 tobacco mosaic virus was first visualized
using the electron microscope.
In 1898 the German bacteriologists Friedrich August Johannes Löffler and Paul F. Frosch
(both trained by Robert Koch) described foot-and-mouth disease virus as the first filterable
agent of animals, and in 1900, the American bacteriologist Walter Reed and colleagues
recognized yellow fever virus as the first human filterable agent. For several decades
viruses were referred to as filterable agents, and gradually the term virus (Latin for “slimy
liquid” or “poison”) was employed strictly for this new class of infectious agents. Through
the 1940s and 1950s many critical discoveries were made about viruses through the study
of bacteriophages because of the ease with which the bacteria they infect could be grown
in the laboratory. Between 1948 and 1955, scientists at the National Institutes of Health
(NIH) and at Johns Hopkins Medical Institutions revolutionized the study of animal viruses
by developing cell culture systems that permitted the growth and study of many animal
viruses in laboratory dishes.
In 1876, Robert Koch established an experimental procedure to prove the germ theory of
disease. This scientific procedure is known as Koch's postulates.
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Koch's Postulates
• the causative agent must be present in every case of the disease and must not be
present in healthy animals.
• the pathogen must be isolated from the diseased host animal and must be grown in pure
culture.
• the same disease must be produced when microbes from the pure culture are inoculated
into healthy susceptible animals.
• the same pathogen must be recoverable once again from this artificially infected animal
and it must be able to be grown in pure culture.
Koch’s postulates not only proved the germ theory, but also gave a tremendous boost to
the development of microbiology by stressing a laboratory culture and identification of
microorganisms.
Cells
Robert Hooke observed small empty chambers in the structure of cork with the help of his
crude microscope. He called them cells. With the help of advanced microscopes it is now
known that a cell is composed of many different substances and contains tiny particles
called organelles that have important functions.
Two German biologists, Matthias Schleiden and Thedore Schwann, proposed the "Cell
theory' in 1838. According to this theory, all living things are composed of cells.
Rudolph Virchow completed the cell theory with the idea that all cells must arise from
preexisting cells.
In biology, a cell is defined as the fundamental living unit of any organism and exhibits the
basic characteristics of life. A cell obtains food from the environment to produce energy
and nutrients for metabolism.
Metabolism
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Metabolism is a term that describes all the chemical reactions by which food is transformed
for use by the cells.
Through its metabolism, a cell can grow, reproduce, and it can respond to changes in its
environment. As a result of accidental changes in its environment, a cell can undergo
changes in its genetic material. This is called mutation.
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Bacteria
Bacteria consist of only a single cell, but don't let their small size and seeming simplicity
fool you. They're an amazingly complex and fascinating group of creatures. Bacteria have
been found that can live in temperatures above the boiling point and in cold that would
freeze your blood.
They "eat" everything from sugar and starch to sunlight, sulfur and iron. There's even a
species of bacteria—Deinococcus radiodurans—that can withstand blasts of radiation
1,000 times greater than would kill a human being.
“Bacteria” is a plural word. The singular for this word is “bacterium” (bacter = rod, staff).
Bacteria are prokaryotes (Kingdom Monera), which means that they have no true nucleus.
They do have one chromosome of double-stranded DNA in a ring.
They reproduce by binary fission. Most bacteria lack or have very few internal membranes,
which means that they don’t have some kinds of organelles (like mitochondria or
chloroplasts). Most bacteria are benign (benign = good, friendly, kind) or beneficial, and
only a few are “bad guys” or pathogens.
Kingdom Monera is a very diverse group. There are some bacteria relatives that can do
photosynthesis--they don’t have chloroplasts, but their chlorophyll and other needed
chemicals are built into their cell membranes.
These organisms are called Cyanobacteria (cyano = blue, dark blue) or bluegreen algae,
although they’re not really algae (real algae are in Kingdom Protista). Like us, some
kinds of bacteria need and do best in O2, while others are poisoned or killed by it.
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Prokaryotes
Bacteria and archaea are the only
prokaryotes. All other life forms are
Eukaryotes (you-carry-oats),
creatures whose cells have nuclei.
(Note: viruses are not considered
true cells, so they don't fit into either
of these categories; this will be
covered in the next few pages.)
Early Origins
Bacteria are among the earliest
forms of life that appeared on Earth
thousands of years ago.
Scientists think that bacteria helped shape and change the young planet's environment,
eventually creating atmospheric oxygen that enabled other, more complex life forms to
develop.
Many believe that more complex cells developed as once free-living bacteria took up
residence in other cells, eventually becoming the organelles in modern complex cells.
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The mitochondria (mite-oh-con-dree-uh) that make energy for your body cells is one
example of such an organelle.
There are thousands of species of bacteria, but all of them are basically one of three
different shapes. Some are rod - or stick-shaped and called bacilli (buh-sill-eye).
Others are shaped like little balls and called cocci (cox-eye).
Others still are helical or spiral in shape. Some bacterial cells exist as individuals while
others cluster together to form pairs, chains, squares or other groupings.
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Bacteria live on or in just about every material and environment on Earth, from soil to water
to air, and from your house to arctic ice, to volcanic vents. Each square centimeter of your
skin averages about 100,000 bacteria. A single teaspoon of topsoil contains more than a
billion (1,000,000,000) bacteria.
Peptidoglycan
Most bacteria secrete a covering for themselves which we call a cell wall.
However, bacterial cell walls are a totally different thing than the cell walls we talk about
plants having. Bacterial cell walls do NOT contain cellulose like plant cell walls do.
Bacterial cell walls are made mostly of a chemical called peptidoglycan (made of
polypeptides bonded to modified sugars), but the amount and location of the
peptidoglycan are different in the two possible types of cell walls, depending on the
species of bacterium.
Some antibiotics, like penicillin, inhibit the formation of the chemical cross linkages needed
to make peptidoglycan.
These antibiotics don’t kill the bacteria outright, just stop them from being able to make
more cell wall so they can grow.
That’s why antibiotics must typically be taken for ten days until the bacteria, unable to
grow, die of “old age”. If a person stops taking the antibiotic sooner, any living bacteria
could start making peptidoglycan, grow, and reproduce.
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Gram Stain
However, because one of the two possible types of bacterial cell walls has more
peptidoglycan than the other, antibiotics like penicillin are more effective against bacteria
with that type of cell wall and less effective against bacteria with less peptidoglycan in their
cell walls. Thus it is important, before beginning antibiotic treatment, to determine with
which of the two types of bacteria one is dealing. Dr. Hans Christian Gram, a Danish
physician, invented a staining process to tell these two types of bacteria apart, and in his
honor, this process is called Gram stain.
In this process, the amount of peptidoglycan in the cell walls of the bacteria under study
will determine how those bacteria absorb the dyes with which they are stained; thus,
bacterial cells can be Gram+ or Gram -. Gram+ bacteria have simpler cell walls with lots of
peptidoglycan, and stain a dark purple color. Gram- bacteria have more complex cell walls
with less peptidoglycan, thus absorb less of the purple dye used and stain a pinkish color
instead.
Also, Gram- bacteria often incorporate toxic chemicals into their cell walls, and thus tend
to cause worse reactions in our bodies. Because Gram- bacteria have less peptidoglycan,
antibiotics like penicillin are less effective against them. As we have discussed before,
taking antibiotics that don’t work can be bad for you, thus a good doctor should always
have a culture done before prescribing antibiotics to make sure the person is getting
something that will help.
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Two types of cells- Prokaryotes and Eukaryotes
A Prokaryotic cell exhibits all the characteristics of life but it lacks the complex system of
membranes and organelles. Example: Bacterial cells and cyanobacteria.
A Eukaryotic cell has a complex structure. It contains a true nucleus and many membrane
bound organelles. Example: Protozoa, fungi, algae, all plants and animal cells.
Nucleus
The Nucleus unifies, controls, and integrates the function of the entire cell. The nucleus is
enclosed in the nuclear membrane and contains chromosomes; the number and
composition of chromosomes and the number of genes on each chromosome are
characteristic of each species. Human cells have 46 (23 pairs) chromosomes.
Each chromosome consists of many genes. A gene is a coiled unit made up of DNA and
proteins that code for, or determine, a particular characteristic of an individual organism.
Cytoplasm
Cytoplasm is the cellular material outside the nucleus. It is composed of a semifluid
gelatinous nutrient matrix and cytoplasmic organelles including endoplasmic reticulum,
ribosomes, Golgi complex, mitochondria, centrioles, microtubules, lysosomes and
vacoules.
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Cell Wall
A cell wall is found as an external structure of plant cells, algae, and fungi. It consists of
cellulose, pectin, chitin, and some mineral salts. A rigid exterior cell wall defines the shape
of bacterial cells. It is different from the simple cell wall of plant cells and is made up of
macromolecular polymer-peptidoglycan (protein and polysaccharide chain). The thickness
and its exact composition varies with the species of bacteria.
Chromosome
The chromosome of a prokaryotic cell is not surrounded by a nuclear membrane, it has
no definite shape and no protein material associated with it. It usually consists of a single
circular DNA molecule and serves as the control center of the bacterial cell. A typical
bacterial chromosome contains approximately 10,000 genes.
Cytoplasm
Cytoplasm is a semi-liquid that surrounds the chromosome and is contained within the
plasma membrane. Located within the cytoplasm are several ribosomes, which are the
sites of protein synthesis. Cytoplasmic granules occur in certain species of bacteria which
can be specifically stained and used to identify the bacteria.
Cell Membrane
The Cell Membrane is similar to that of the eukaryotic cell membrane. It is selectively
permeable and controls the substances entering or leaving the cell. It is very thin and can
be seen by electron microscopes only.
Capsules
Some bacteria have a layer of material outside the cell wall. When highly organized and
firmly attached to the cell wall, this layer is called a capsule; or if it is not highly organized
and not firmly attached, a slime layer. Capsules consist of complex sugars or
polysaccharides combined with lipids and proteins. The composition of the capsule is
useful in differentiating between different types of bacteria. Capsules are usually detected
by negative staining, where the bacterial cell and the background become stained but the
capsule remains unstained.
Encapsulated bacteria produce colonies on nutrient agar that are smooth, mucoid and
glistening, whereas the noncapsulated bacteria produce rough and dry colonies. Capsules
enable the bacterial species to attach to mucus membranes and protect the bacteria from
phagocytosis.
Flagella
Flagella are thread-like proteins that enable the bacteria to move. Flagellated bacteria are
said to be motile while non-flagellated bacteria are generally non-motile. The number and
arrangement of flagella are species specific and can be used to classify bacteria.
Peritrichous bacteria- possess flagella over the entire surface.
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Lophotrichous bacteria-possess a tuft of flagella at one or both ends.
Amphitrichous bacteria-bacteria with one flagellum at each end.
Monotrichous bacteria-bacteria with a single polar flagellum.
Pili or Fimbriae
Pili or Fimbriae are thin hair-like structures observed on gram negative bacteria. They are
not associated with motility. They enable the bacteria to attach to other bacteria or to
membrane surfaces such as intestinal linings or RBC. They are also used to transfer
genetic material from one bacteria cell to another.
Spores
Some bacteria are capable of forming spores (also called endospore) as a means of
survival under adverse conditions. During sporulation the genetic material is enclosed in
several protein coats that are resistant to heat, drying and most chemicals. Spores have
been shown to survive in soil or dust. When the dried spore lands on a nutrient rich
surface, it forms a new vegetative cell. Spore formation is related to the survival of
bacterial cells, not reproduction.
Bacterial Nutrition
All life has the same basic nutritional requirements which include:
Energy. This may be light (the sun or lamps) or inorganic substances like sulfur, carbon
monoxide or ammonia, or preformed organic matter like sugar, protein, fats etc. Without
energy life cannot exist and quickly dies or becomes inactive.
Nitrogen. This may be nitrogen gas, ammonia, nitrate/nitrite, or a nitrogenous organic
compound like protein or nucleic acid.
Carbon. This can be carbon dioxide, methane, carbon monoxide, or a complex organic
material.
Oxygen. All cells use oxygen in a bound form and many require gaseous oxygen (air),
but oxygen is lethal to many microbes.
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Fastidious Bacteria
Many bacteria can synthesize every complex molecule they need from the basic minerals,
but others, said to be fastidious, require preformed organic molecules like vitamins, amino
acids, nucleic acids, carbohydrates; humans are fastidious. In general bacterial
pathogens need more preformed organic molecules than do nonpathogens, but that is not
always true. For example, some bacteria that are found in milk hardly make any of their
own basic organic molecule; that is, they let the cow (or more to the point the number of
microbes that live in the cow's gut) make these things for them. A simple rule of thumb is
"if humans can use something for food, many microbes will also love it". The reverse
is not always true, as microbes can "digest" some very strange substances including
cellulose, sulfur, some plastics, turkey feathers and asphalt, just to name a few.
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Eukaryote Section
Eukaryotes are organisms with complex cells, in which the genetic material is organized
into membrane-bound nuclei. They include the animals, plants, and fungi, which are
mostly multicellular, as well as various other groups called protists, many of which are
unicellular. In contrast, other organisms such as bacteria lack nuclei and other complex
cell structures, and are called prokaryotes. The eukaryotes share a common origin, and
are often treated formally as a superkingdom, empire, or domain. The name comes from
the Greek eus or true and karyon or nut, referring to the nucleus.
Eukaryotic Cells
Eukaryotic cells are generally much larger than prokaryotes, typically with a thousand
times their volumes. They have a variety of internal membranes and structures, called
organelles, and a cytoskeleton composed of microtubules and microfilaments, which plays
an important role in defining the cell's organization.
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Eukaryotic DNA is divided into several bundles called chromosomes, which are separated
by a microtubular spindle during nuclear division. In addition to asexual cell division, most
eukaryotes have some process of sexual reproduction via cell fusion, which is not found
among prokaryotes.
The nucleus is surrounded by a double membrane, with pores that allow material to move
in and out. Various tube- and sheet-like extensions of the nuclear membrane form what is
called the endoplasmic reticulum or ER, which is involved in protein transport. It includes
rough sections where ribosomes are attached, and the proteins they synthesize enter the
interior space or lumen. Subsequently, they generally enter vesicles, which bud off from
the smooth section. In most eukaryotes, the proteins may be further modified in stacks of
flattened vesicles, called Golgi bodies or dictyosomes.
Vesicles may be specialized for various purposes. For instance, lysosomes contain
enzymes that break down the contents of food vacuoles, and peroxisomes are used to
break down peroxide which is toxic otherwise.
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Contractile Vacuoles
Many protozoa have contractile vacuoles, which collect and expel excess water, and
extrusomes, which expel material used to deflect predators or capture prey. In multicellular
organisms, hormones are often produced in vesicles. In higher plants, most of a cell's
volume is taken up by a central vacuole or tonoplast, which maintains its osmotic pressure.
Many eukaryotes have slender motile projections, usually called flagella when long and
cilia when short. These are variously involved in movement, feeding, and sensation. These
are entirely distinct from prokaryotic flagella. They are supported by a bundle of microtu-
bules arising from a basal body, also called a kinetosome or centriole, characteristically
arranged as nine doublets surrounding two singlets. Flagella also may have hairs or
mastigonemes, scales, connecting membranes and internal rods. Their interior is
continuous with the cell's cytoplasm.
Centrioles
Centrioles are often present even in cells and groups that do not have flagella. They
generally occur in groups of one or two, called kinetids that give rise to various
microtubular roots. These form a primary component of the cytoskeletal structure, and are
often assembled over the course of several cell divisions, with one flagellum retained from
the parent and the other derived from it. Centrioles may also be associated in the formation
of a spindle during nuclear division.
Some protists have various other microtubule-supported organelles. These include the
radiolaria and heliozoa, which produce axopodia used in flotation or to capture prey, and
the haptophytes, which have a peculiar flagellum-like organelle called the haptonema.
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Bacteria Sampling
Water samples for Bacteria tests process must always be collected in a sterile
container.
Iron bacteria forms an obvious slime on the inside of pipes and fixtures. A water test is
not needed for identification. Check for a reddish-brown slime inside a toilet tank or
where water stands for several days.
Coliform bacteria are common in the environment and are generally not harmful, but the
presence of these bacteria in drinking water is usually a result of a problem with the
treatment system or the pipes which distribute water, and indicates that the water may
be contaminated with germs that can cause disease.
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Wastewater Treatment Biology Basics
Four groups of bugs do most of the “eating” in the activated sludge process. The first
group is the bacteria which eat the dissolved organic compounds. The second and third
groups of bugs are microorganisms known as the free-swimming and stalked
ciliates. These larger bugs eat the bacteria and are heavy enough to settle by gravity. The
fourth group is a microorganism, known as Suctoria, which feed on the larger bugs and
assist with settling.
The interesting thing about the bacteria that eat the dissolved organics is that they have
no mouth. The bacteria have an interesting property. Their “fat reserve” is stored on the
outside of their body. This fat layer is sticky and is what the organics adhere to.
Once the bacteria have “contacted” their food, they start the digestion process. A
chemical enzyme is sent out through the cell wall to break up the organic
compounds. This enzyme, known as hydrolytic enzyme, breaks the organic molecules
into small units which are able to pass through the cell wall of the bacteria.
Urostyla or Euplotes
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Wastewater Treatment Microlife
Euglypha sp.
Euglypha (70-100 æm) is a shelled (testate) amoeba. Amoebas have jelly-like bodies.
Motion occurs by extending a portion of the body
(pseudopodia) outward. Shelled amoebas have a
rigid covering which is either secreted or built
from sand grains or other extraneous materials.
The secreted shell of this Euglypha sp. consists
of about 150 oval plates. Its spines project
backward from the lower half of the shell.
Indicator: Shelled amoebas are common in soil, treatment plants, and stream bottoms
where decaying organic matter is present. They adapt to a wide range of conditions and
therefore are not good indicator organisms.
Euchlanis sp.
This microscopic animal is a typical rotifer. Euchlanis is a swimmer, using its foot and
cilia for locomotion. In common with other rotifers, it has a head rimmed with cilia, a
transparent body, and a foot with two strong swimming toes.
The head area, called the "corona," has cilia that
beat rhythmically, producing a strong current for
feeding or swimming.
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References
Bick, H. 1972. Ciliated protozoa. An illustrated guide to the species used as biological
indicators in freshwater biology. World Health Organization, Geneva. 198 pp.
Cairns, J., G.R. Lanza, and B.C. Parker. 1972. Pollution related structural and functional
changes in aquatic communities with emphasis on freshwater algae and protozoa.
Proceedings of the National Academy of Sciences 124:79-127.
Cairns, J., and J.A. Ruthven. 1972. A test of the cosmopolitan distribution of fresh-water
protozoans. Hydrobiologia 39:405-427.
Cairns, J., and W.H. Yongue. 1977. Factors affecting the number of species of freshwater
protozoan communities. Pages 257-303 in J. Cairns, ed. Aquatic microbial communities.
Garland, New York.
Curds, C.R. 1992. Protozoa and the water industry. Cambridge University Press, MA. 122
pp.
Fenchel, T. 1974. Intrinsic rate increase: the relationship with body size. Oecologia
14:317-326.
Fenchel, T., T. Perry, and A. Thane. 1977. Anaerobiosis and symbiosis with bacteria in
free-living ciliates. Journal of Protozoology 24:154-163.
Foissner, W. 1987. Soil protozoa: fundamental problems, ecological significance,
adaptations in ciliates and testaceans, bioindicators, and guide to the literature. Progress
in Protistology 2:69-212.
Foissner, W. 1988. Taxonomic and nomenclatural revision of Stádecek's list of ciliates
(Protozoa: Ciliophora) as indicators of water quality. Hydrobiologia 166:1-64.
Giese, A.C. 1973. Blepharisma. Stanford University Press, CA. 366 pp.
Kreier, J.P., and J.R. Baker. 1987. Parasitic protozoa. Allen and Unwin, Boston, MA. 241
pp.
Laybourn, J., and B.J. Finlay. 1976. Respiratory energy losses related to cell weight and
temperature in ciliated protozoa. Oecologia 44:165-174.
Lee, C.C., and T. Fenchel. 1972. Studies on ciliates associated with sea ice from
Antarctica. II. Temperature responses and tolerances in ciliates from Antarctica,
temperate and tropical habitats. Archive für Protistenkunde 114:237-244.
Montagnes, D.J.S., D.H. Lynn, J.C. Roff, and W.D. Taylor. 1988. The annual cycle of
heterotrophic planktonic ciliates in the
waters surrounding the Isles of Shoals,
Gulf of Maine: an assessment of their
trophic role. Marine Biology 99:21-30.
Niederlehner, B.R., K.W. Pontasch, J.R.
Pratt, and J. Cairns. 1990. Field
evaluation of predictions of
environmental effects from multispecies
microcosm toxicity test. Archives of
Environmental Contamination and
Toxicology 19:62-71.
Taylor, W., and R. Sanders. 1991.
Protozoa. Pages 37-93 in J.H. Thorp
and A.P. Covich, eds. Ecology and
classification of North American
freshwater invertebrates. Academic
Press, New York.
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Microorganisms
MCL Sources of
MCLG1 Potential Health Effects from
Contaminant or TT1 Contaminant in
(mg/L)2 Ingestion of Water
(mg/L)2 Drinking Water
Giardia lamblia zero TT3 Gastrointestinal illness (e.g., Human and animal
diarrhea, vomiting, cramps) fecal waste
Total Coliforms zero 5.0%4 Not a health threat in itself; it is Coliforms are
(including fecal used to indicate whether other naturally present in
coliform and E. potentially harmful bacteria the environment; as
Coli) may be present5 well as feces; fecal
coliforms and E. coli
only come from
human and animal
fecal waste.
Viruses (enteric) zero TT3 Gastrointestinal illness (e.g., Human and animal
diarrhea, vomiting, cramps) fecal waste
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Giardiasis Giardia lamblia Chapter 2
Giardia lamblia (intestinalis) is a single celled animal, i.e., a protozoon, that moves with
the aid of five flagella. In Europe, it is sometimes referred to as Lamblia intestinalis.
Giardiasis is the most frequent cause of non-bacterial diarrhea in North America. Giardia
duodenalis, cause of giardiasis (GEE-are-DYE-uh-sis), is a one-celled, microscopic
parasite that can live in the intestines of animals and
people. It is found in every region throughout the
world and has become recognized as one of the
most common causes of waterborne (and
occasionally foodborne) illness often referred to as
"Beaver Fever." It is commonly known as "traveler's
diarrhea", and referred to as "Montezuma's Revenge"
by those who travel to third world countries in the
Western Hemisphere.
It is possible to experience some, not all, of the symptoms, yet still shed cysts and pass
the parasite onto others. Typically, the disease runs its course in a week or two, although
in some cases, the disease may linger for months, causing severe illness and weight loss.
Nonetheless, the basic biology of this parasite--including how it ravages the digestive
tract--is poorly understood.
The organism exists in two different forms--a hardy, dormant cyst that contaminates water
or food and an active, disease-causing form that emerges after the parasite is ingested.
National Institute of General Medical Sciences grantee Dr. Frances Gillin of the University
of California, San Diego and her colleagues cultivated the entire life cycle of this parasite
in the lab and identified biochemical cues in the host's digestive system that trigger
Giardia's life cycle transformations. They also uncovered several tricks the parasite uses
to evade the defenses of the infected organism. One of Giardia's techniques is to alter the
proteins on its surface, which confounds the ability of the infected animal's immune system
to detect and combat the parasite. This work reveals why Giardia infections are extremely
persistent and prone to recur. In addition, these insights into Giardia's biology and survival
techniques may enable scientists to develop better strategies to understand, prevent, and
treat Giardia infections.
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The microaerophilic Giardia uses these mitosomes in the maturation of iron-sulfur proteins
rather than in ATP synthesis as is the case in mitochondria-possessing eukaryotes.
Nature of Disease
Organisms that appear identical to those that cause human illness have been isolated
from domestic animals (dogs and cats) and wild animals (beavers and bears). A related
but morphologically distinct organism infects rodents, although rodents may be infected
with human isolates in the laboratory. Human giardiasis may involve diarrhea within 1
week of ingestion of the cyst, which is the environmental survival form and infective stage
of the organism.
Normally illness lasts for 1 to 2 weeks, but there are cases of chronic infections lasting
months to years. Chronic cases, both those with defined immune deficiencies and those
without, are difficult to treat.
The disease mechanism is unknown, with some investigators reporting that the organism
produces a toxin while others are unable to confirm its existence. The organism has been
demonstrated inside host cells in the duodenum, but most investigators think this is such
an infrequent occurrence that it is not responsible for disease symptoms. Mechanical
obstruction of the absorptive surface of the intestine has been proposed as a possible
pathogenic mechanism, as has a synergistic relationship with some of the intestinal flora.
Giardia can be excysted, cultured and encysted in vitro; new isolates have bacterial,
fungal, and viral symbionts. Classically, the disease was diagnosed by demonstration of
the organism in stained fecal smears.
Several strains of G. lamblia have been isolated and described through analysis of their
proteins and DNA; type of strain, however, is not consistently associated with disease
severity. Different individuals show various degrees of symptoms when infected with the
same strain, and the symptoms of an individual may vary during the course of the disease.
A commercial fluorescent antibody kit is available to stain the organism. Organisms may
be concentrated by sedimentation or flotation; however, these procedures reduce the
number of recognizable organisms in the sample. An enzyme linked immunosorbant
assay (ELISA) that detects excretory secretory products of the organism is also available.
So far, the increased sensitivity of indirect serological detection has not been consistently
demonstrated.
Giardiasis is most frequently associated with the consumption of contaminated water. Five
outbreaks have been traced to food contamination by infected or infested food handlers,
and the possibility of infections from contaminated vegetables that are eaten raw cannot
be excluded. Cool moist conditions favor the survival of the organism.
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Relative Frequency of Disease
Giardiasis is more prevalent in children than in adults, possibly because many individuals
seem to have a lasting immunity after infection. This organism is implicated in 25% of the
cases of gastrointestinal disease and may be present asymptomatically. The overall
incidence of infection in the United States is estimated at 2% of the population. This
disease afflicts many homosexual men, both HIV-positive and HIV-negative individuals.
This is presumed to be due to sexual transmission. The disease is also common in child
day care centers, especially those in which diapering is done.
Acute outbreaks appear to be common with infants and is not usually associated with
water but is related to child care and diaper changing hygiene procedures. When I worked
for a major water provider, I would receive 2-3 calls a week about infants diagnosed with
Giardiasis. The problem lies with the water provider in that we are obligated to investigate
and analyze all water customer complaints and make sure that our water is safe.
This is an example of infectious diarrhea due to Giardia lamblia infection of the small
intestine. The small pear-shaped trophozoites live in the duodenum and become infective
cysts that are excreted. They produce a watery diarrhea. A useful test for diagnosis of
infectious diarrheas is stool examination for ova and parasites.
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Chronic cases of giardiasis in immunodeficient and normal individuals are frequently
refractile to drug treatment. Flagyl is normally quite effective in terminating infections. In
some immune deficient individuals, giardiasis may contribute to a shortening of the life
span.
Target Populations
Giardiasis occurs throughout the population, although the prevalence is higher in children
than adults. Chronic symptomatic giardiasis is more common in adults than children.
Major Outbreaks
Major outbreaks are associated with contaminated water systems that do not use sand
filtration or have a defect in the filtration system.
In April 1988, the Albuquerque Environmental Health Department and the New Mexico
Health and Environment Department investigated reports of giardiasis among members
of a church youth group in Albuquerque. The first two members to be affected had onset
of diarrhea on March 3 and 4, respectively; stool specimens from both were positive for
Giardia lamblia cysts. These two persons had only church youth group activities in
common.
On August 8, 1983, the Utah Department of Health was notified by the Tooele County
Health Department (TCHD) of an outbreak of diarrheal illness in Tooele, Utah, possibly
associated with a contaminated public water supply that resulted from flooding during
Utah's spring thaw.
References
Hetsko ML, McCaffery JM, Svard SG, Meng TC, Que X, Gillin FD. Cellular
and transcriptional changes during excystation of Giardia lamblia in vitro. Exp.
Parasitol. 1998;88(3):172-83.
Svard SG, Meng TC, Hetsko ML, McCaffery JM, Gillin FD. Differentiation-
driven surface antigen variation in the ancient eukaryote. Molec. Microbiol.
1998;30:979-89.
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Giardia Images
Above: Differential interference contrast (DIC) image of Giardia lamblia cysts, purified from
Mongolian gerbil fecal material. Cysts are ovoidal or elipsoidal objects, usually 11-14
microns in length. Cysts may contain as many as 4 nuclei, and residual structures from
their trophozoite or vegetative form. These residua include central axonemes, remnants
of the striated disk, and remnant median bodies. In some cysts these structures will be
indistinct. Scale bar is 10 microns.
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Photo Credit: H.D.A Lindquist, U.S. EPA
Above: Fluorescence image of Giardia lamblia cysts, purified from Mongolian gerbil fecal
material. (Same field of view) Cysts were stained with 4,6-diamidino 2-phenyl-indole
dihydrochloride (DAPI). DAPI interacts with nucleic acids and stains the nuclei within the
cyst.
There should be 4 nuclei in each cyst. Cysts that appear to have fewer than 4 stained
nuclei, may have 4 nuclei with the others not visible in this plane of focus.
Cysts with no nuclei visible, may be dead, may be resistant to DAPI staining, or may be
organisms other than G. lamblia.
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Introduction
Until 1993, when over 400,000 people in Milwaukee became ill with diarrhea after drinking
water contaminated with the parasite, few people had heard of Cryptosporidium parvum,
or the disease it causes, cryptosporidiosis. Today, however, public health and water utility
officials are increasingly called on to provide information and make decisions about the
control of this protozoan found in public water supplies, recreational water and other areas.
Other diseases besides AIDS can cause immunosuppression severe enough to lead to
chronic cryptosporidiosis. Persons with these diseases should also be concerned about
becoming infected. These diseases include congenital agammaglobulinemia, congenital
IgA deficiency and cancer. Persons taking corticosteroids, for cancer and bone marrow or
organ transplants, also need to be concerned about becoming infected. Even though
persons who are taking immunosuppressive drugs may develop chronic and/or severe
cryptosporidiosis, the infection usually resolves when these drugs are decreased or
stopped. Persons taking immunosuppressive drugs need to consult with their healthcare
provider if they believe they have cryptosporidiosis.
Persons at increased risk for contracting cryptosporidiosis include child care workers;
diaper-aged children who attend child care centers; persons exposed to human feces by
sexual contact; and caregivers who might come in direct contact with feces while caring
for a person infected with cryptosporidiosis.
Transmission is by an oral-fecal route, including hand contact with the stool of infected
humans or animals or with objects contaminated with stool. Transmission is also common
from ingestion of food or water contaminated with stool, including water in the recreational
water park and swimming pool settings.
AIDS
Patients with AIDS can have a large number of stools per day for months or even years.
There is currently no cure for cryptosporidiosis, though drug research is continuing.
Patients who suspect they may have cryptosporidiosis should drink extra fluids and may
wish to drink oral rehydration therapy liquid, to avoid dehydration.
49
They should also avoid close contact with anyone who has a weakened immune system.
Individuals with diarrhea should not swim in public bathing areas while they have diarrhea
and for at least 2 weeks after each attack of diarrhea.
Prevention
Washing hands is the most effective means of preventing cryptosporidiosis transmission.
For the immunocompromised, sex, including oral sex, that involves possible contact with
stool should be avoided. Immunocompromised individuals should also avoid the stool of
all animals and wash their hands thoroughly after any contact with animals or the living
areas of animals. Immunocompromised persons may also wish to wash, peel, or cook all
vegetables and to take extra measures, such as boiling or filtering their drinking water, to
ensure its safety.
50
In: Strickland GT, editor. Hunter’s Tropical Medicine and Emerging Infectious Diseases,
8th ed. Philadelphia: WB Saunders; 2000. Originally adapted from the life cycle that
appears in Current WL, Garcia LS. Cryptosporidiosis. Clinc Microbiol Rev 1991;4:325-58.
Sporulated oocysts, containing 4 sporozoites, are excreted by the infected host through
feces and possibly other routes such as respiratory secretions.
Occasionally food sources, such as chicken salad, may serve as vehicles for transmis-
sion. Many outbreaks in the United States have occurred in waterparks, community
swimming pools, and day care centers. Zoonotic and anthroponotic transmission of C.
parvum and anthroponotic transmission of C. hominis occur through exposure to infected
animals or exposure to water contaminated by feces of infected animals.
Following ingestion (and possibly inhalation) by a suitable host, excystation occurs. The
sporozoites are released and parasitize epithelial cells of the gastrointestinal tract or other
tissues such as the respiratory tract.
In these cells, the parasites undergo asexual multiplication (schizogony or merogony) and
then sexual multiplic-ation (gametogony) producing microgamonts (male) and
macrogamonts (female).
Oocysts are infective upon excretion, thus permitting direct and immediate fecal-oral
transmission.
Note that oocysts of Cyclospora cayetanensis, another important coccidian parasite, are
unsporulated at the time of excretion and do not become infective until sporulation is
completed.
52
Cryptosporidium oocysts
Genus Cryptosporidium
Members of the genus Cryptosporidium are parasites of the intestinal tracts of fishes,
reptiles, birds, and mammals. It seems that members of this genus do not display a high
degree of host specificity, so the number of species in this genus remains a matter of
some discussion. Cryptosporidium isolated from humans is now referred to as C. parvum.
Cryptosporidium infections have been reported from a variety of wild and domesticated
animals, and in the last six or seven years literally hundreds of human infections have
been reported, including epidemics in several major urban areas in the United States.
Cryptosporidiosis is now recognized as an important opportunistic infection, especially in
immunocompromised hosts.
Cryptosporidium is a small parasite, measuring about 3-5 µm. It lives on (or just under)
the surface of the cells lining the small intestine, reproduces asexually, and oocysts are
passed in the feces. Transmission of the infection occurs via the oocysts. Many human
infections have been traced to the contamination of drinking water with oocysts from
agricultural "run-off" (i.e., drainage from pastures), so it is considered a zoonosis.
In most patients infected with cryptosporidiosis the infection causes a short term, mild
diarrhea. Since such symptoms are associated with a number of ailments, infected
individuals may not seek medical treatment, and the infection may subside on its
own. Thus, it is difficult to say how many people are infected. On the other hand, in
persons with compromised immune systems, this parasite can cause a pronounced,
chronic diarrhea; in severe cases the infected individual may produce up to 15 liters/day
of stools, and this may go on for weeks or months. Needless to say, such an infection, if
not fatal unto itself, can exacerbate other opportunitistic infections common in
immunocompromised hosts.
53
An electron micrograph showing several stages of Cryptosporidium (two are marked with
asterisks) on the intestinal epithelium of a sheep. (From: Gardiner et al., 1988, An Atlas
of Protozoan Parasites in Animal Tissues, USDA Agriculture Handbook No. 651.)
54
Consequently, Cryptosporidium is found in soil, food, water, or surfaces that have been
contaminated with infected human or animal feces. If a person swallows the parasite they
become infected. You cannot become infected through contact with blood. The parasite
can be spread by:
Accidentally putting something into your mouth or swallowing something that has
come into contact with feces of a person or animal infected with Cryptosporidium.
Note: Cryptosporidium can survive for days in swimming pools with adequate
chlorine levels.
55
57
However, even if symptoms disappear, cryptosporidiosis is usually not curable and the
symptoms may return if the immune status worsens. See your health care provider to
discuss anti-retroviral therapy used to improve your immune status.
58
If you are unable to avoid using or drinking water that might be contaminated,
then you can make the water safe to drink by doing one of the following:
Heat the water to a rolling boil for at least 1 minute.
OR
Use a filter that has an absolute pore size
For information on choosing a
of at least 1 micron or one that has been
water filter, see the CDC fact
NSF rated for "cyst removal."
sheet entitled "Preventing
Cryptosporidiosis: A Guide to
Do not rely on chemicals to disinfect water and
Water Filters and Bottled Water,"
kill Cryptosporidium. Because it has a thick outer
available by visiting
shell, this particular parasite is highly resistant to
http://www.cdc.gov/ncidod/dpd/
disinfectants such as chlorine and iodine.
parasites/cryptosporidiosis/
factsht_crypto_prevent_water.htm.
59
60
There are two types of these - "absolute 1 micron" filters and "nominal 1 micron" filters.
The absolute 1 micron filter will more consistently remove Cryptosporidium than a nominal
filter. Some nominal 1 micron filters will allow 20% to 30% of 1 micron particles to pass
through.
NSF-International
NSF-International (NSF) does independent testing of filters to determine if they remove
Cryptosporidium. To find out if a particular filter is
certified to remove Cryptosporidium, you can look
for the NSF trademark plus the words "cyst
reduction" or "cyst removal" on the product label
information. You can also contact the NSF at 789
N. Dixboro Road, Ann Arbor, MI 48105 USA, toll
free1-877-867-3435, fax 313-769-0109, email
[email protected], or visit their Web site at
www.nsf.org/certified/DWTU/.
61
Carbon filter
Water purifier
Activated carbon
Removes chlorine
Ultraviolet light
Pentiodide resins
Water softener
Note: Filters collect germs from water, so someone who is not HIV infected or immune
impaired should change the filter cartridges.
62
If you drink bottled water, read the label and look for this information:
Water so labeled may not
Water so labeled has been
have been processed by
processed by method
method effective against
effective against crypto
crypto
Distilled Micro-filtered
Multimedia-filtered
Ozonated
Ozone-treated
Ultraviolet light-treated
Activated carbon-treated
Carbon dioxide-treated
Ion exchange-treated
Deionized
Purified
Chlorinated
Bottled water labels reading "well water," "artesian well water," "spring water," or "mineral
water" do not guarantee that the water does not contain crypto. However, water that
comes from protected well or protected spring water sources is less likely to contain crypto
than bottled water or tap water from less protected sources, such as rivers and lakes.
63
Other drinks: Soft drinks and other beverages may or may not contain crypto. You need
to know how they were prepared to know if they might contain crypto.
If you consume prepared beverages, look for drinks from which crypto has been
removed:
Crypto killed or removed in Crypto may not be killed or
preparation removed in preparation
Steaming hot (175 degrees F Fruit drinks you mix with tap
or hotter) tea or coffee water from frozen concentrate
Juices made from fresh fruit can also be contaminated with crypto. Several people became
ill after drinking apple cider made from apples contaminated with crypto. You may wish to
avoid unpasteurized juices or fresh juices if you do not know how they were prepared.
64
Vibrio cholerae
Cholera, which is derived from a Greek term meaning “flow of bile,” is caused by Vibrio
cholerae and is the most feared epidemic diarrheal disease because of its severity.
Dehydration and death can occur within a matter of hours of infection.
In 1883, Robert Koch discovered V cholerae during a cholera outbreak in Egypt. The
organism is a comma-shaped, gram-negative aerobic bacillus whose size varies from 1-3
mm in length by 0.5-0.8 mm in diameter. Its antigenic structure consists of a flagellar H
antigen and a somatic O antigen. The differentiation of the latter allows for separation into
pathogenic and nonpathogenic strains. V cholerae O1 or O139 are associated with
epidemic cholera. V cholerae O1 has 2 major biotypes: classic and El Tor.
Currently, El Tor is the predominant cholera pathogen. Organisms in both biotypes are
subdivided into serotypes according to the structure of the O antigen, as follows:
Serotype Inaba - O antigens A and C
Serotype Ogawa - O antigens A and B
Serotype Hikojima - O antigens A, B, and C
The cholera bacterium may also live in the environment in brackish rivers and coastal
waters. Shellfish eaten raw have been a source of cholera, and a few persons in the United
States have contracted cholera after eating raw or undercooked shellfish from the Gulf of
Mexico. The disease is not likely to spread directly from one person to another; therefore,
casual contact with an infected person is not a risk for becoming ill.
65
* About one million Vibrio cholerae bacteria must be ingested to cause cholera in
normally healthy adults, although increased susceptibility may be observed in
those with a weakened immune system, individuals with decreased gastric acidity
(as from the use of antacids), or those who are malnourished.
* 1,099,882 cases and 10,453 deaths were reported in the Western Hemisphere
between January 1991 and July 1995.
* On average, one case of cholera is reported in the United States every week.
Vibrio cholerae causes disease by producing a toxin that disables the GTPase
function of G proteins which are part of G protein-coupled receptors in intestinal
cells. This has the effect that the G proteins are locked in the "on position" binding
GTP (normally, the G proteins quickly return to "off" by hydrolyzing GTP to GDP).
The G proteins then cause adenylate cyclases to produce large amounts of cyclic
AMP (cAMP) which results in the loss of fluid and salts across the lining of the gut.
The resulting diarrhea allows the bacterium to spread to other people under unsanitary
conditions.
Although cholera can be life-threatening, it is easily prevented and treated. In the United
States, because of advanced water and sanitation systems, cholera is not a major threat.
The last major outbreak of cholera in the United States was in 1911. However, everyone,
especially travelers, should be aware of how the disease is transmitted and what can be
done to prevent it.
66
A simple rule of thumb is "Boil it, cook it, peel it, or forget it."
Treatment
The objective of treatment is to replace fluid and electrolytes lost through diarrhea.
Depending on the condition of the person, oral or intravenous fluid will be given.
Tetracycline and other antibiotics may shorten the duration of the symptoms.
Note: Tetracycline is usually not prescribed for children until after all the permanent teeth
have come in, because it can permanently discolor teeth that are still forming.
The World Health Organization (WHO) has developed an oral rehydration solution that is
cheaper and easier to use than the typical intravenous fluid. This solution of sugar and
electrolytes is now being used internationally.
Expectations (prognosis)
Severe dehydration can cause death. Given adequate fluids, most people will make a full
recovery.
Complications
Severe dehydration.
Call your health care provider if signs of dehydration occur, including rapid pulse (heart
rate), dry skin, dry mouth, thirst, "glassy" eyes, lethargy, sunken eyes, no tears, reduced
or no urine, and unusual sleepiness or tiredness.
Susceptibility
Recent genetic research has determined that a person's susceptibility to cholera and other
diarrheas) is affected by their blood type. Those with type O blood are the most
susceptible. Those with type AB are the most resistant, virtually immune. Between these
two extremes are the A and B blood types, with type A being more resistant than type B.
Carriers of the cystic fibrosis gene are protected from the severe effects of cholera
because they don't lose water as quickly. This explains the high incidence of cystic fibrosis
among populations which were formerly exposed to cholera.
67
Limited stocks of two oral cholera vaccines that provide high-level protection for several
months against cholera caused by V. cholerae O1 have recently become available in a
few countries. Both are suitable for use by travelers but they have not yet been used on a
large scale for public health purposes. Use of this vaccine to prevent or control cholera
outbreaks is not recommended because it may give a false sense of security to vaccinated
subjects and to health authorities, who may then neglect more effective measures.
Two recently developed vaccines for cholera are licensed and available in other countries
(Dukoral®, Biotec AB and Mutacol®, Berna). Both vaccines appear to provide a somewhat
better immunity and fewer side-effects than the previously available vaccine. However,
neither of these two vaccines are recommended for travelers nor are they available in the
United States.
The first long-distance spread of cholera to Europe and the Americas began in 1817 and
by the early 20th century, six waves of cholera had spread across the world in devastating
epidemic fashion. Since then, until the 1960s, the disease contracted, remaining present
only in southern Asia.
68
There are several characteristics of the El Tor strain that confer upon it a high degree of
"epidemic virulence" allowing it to spread across the world as previous strains have done.
First, the ratio of cases to carriers is much less than in cholera due to classic biotypes (1:
30-100 for El Tor vs. 1: 2 - 4 for "classic" biotypes). Second, the duration of carriage after
infection is longer for the El Tor strain than the classic strains. Third, the El Tor strain
survives for longer periods in the extraintestinal environment. Between 1969 and 1974, El
Tor replaced the classic strains in the heartland of endemic cholera, the Ganges River
Delta of India.
El Tor broke out explosively in Peru in 1991 (after an absence of cholera there for 100
years), and spread rapidly in Central and South America, with recurrent epidemics in 1992
and 1993. From the onset of the epidemic in January 1991 through September 1, 1994, a
total of 1,041,422 cases and 9,642 deaths (overall case-fatality rate: 0.9%) were reported
from countries in the Western Hemisphere to the Pan American Health Organization. In
1993, the numbers of reported cases and deaths were 204,543 and 2362, respectively.
So far, the United States has been spared except for imported cases, or clusters of
infections from imported food. In the United States during 1993 and 1994, 22 and 47
cholera cases were reported to CDC, respectively. Of these, 65 (94%) were associated
with foreign travel.
In 1982, in Bangladesh, a classic biotype resurfaced with a new capacity to produce more
severe illness, and it rapidly replaced the El Tor strain which was thought to be well-
entrenched. This classic strain has not yet produced a major outbreak in any other country.
In December, 1992, a large epidemic of cholera began in Bangladesh, and large numbers
of people have been involved. The organism has been characterized as V. cholerae O139
"Bengal". It is derived genetically from the El Tor pandemic strain but it has changed its
antigenic structure such that there is no existing immunity and all ages, even in endemic
areas, are susceptible. The epidemic has continued to spread. and V. cholerae O139 has
affected at least 11 countries in southern Asia. Specific totals for numbers of V. cholerae
O139 cases are unknown because affected countries do not report infections caused by
O1 and O139 separately.
69
70
The toxin has been characterized and contains 5 binding (B) subunits of 11,500 daltons,
an active (A1) subunit of 23,500 daltons, and a bridging piece (A2) of 5,500 daltons that
links A1 to the 5B subunits. Once it has entered the cell, the A1 subunit enzymatically
transfers ADP ribose from NAD to a protein (called Gs or Ns), that regulates the adenylate
cyclase system which is located on the inside of the plasma membrane of mammalian
cells.
71
The lost H2O and electrolytes in mucosal cells are replaced from the blood. Thus, the
toxin-damaged cells become pumps for water and electrolytes, causing the diarrhea, loss
of electrolytes, and dehydration that are characteristic of cholera.
Last Word
E. coli produces a toxin, heat labile toxin (LT) that is very similar to the cholera toxin in
structure and mode of action. The DNA that encodes the LT toxin is on a plasmid that can
be transferred to other E. coli strains and probably to other enteric bacteria, as well. Close
relationships between the genetic code for LT toxin and the cholera toxin un-doubtedly
exist but have not been documented as yet.
The genetic information for the toxin in V. cholerae is located on the bacterial chromo-
some. Other bacterial enterotoxins related to cholera toxin have been reported in non-
group O Vibrio strains and a strain of Salmonella.
Enterotoxins, toxins which act in the GI tract, are produced by a wide variety of bacteria.
The family of heat-stable (ST) enterotoxins of E. coli, which activate guanylate cyclase,
are unrelated to LT toxin or cholera toxin. Other enterotoxins, which elicit cytotoxic effects
on intestinal epithelial cells, have been described from Escherichia, Klebsiella,
Enterobacter, Citrobacter, Aeromonas, Pseudomonas, Shigella, V. parahaemolyticus,
Campylobacter, Yersinia enterocolitica, Bacillus cereus, Clostridium perfringens, C.
difficile, and Staphylococcus aureus.
.
72
Legionella may multiply to high numbers in cooling towers, evaporative condensers, air
washers, humidifiers, hot water heaters, spas, fountains, and plumbing fixtures.
73
Once high numbers of Legionella have been found, a relatively simple procedure for
disinfecting water systems with chlorine and detergent is available. This procedure is not
part of a routine maintenance program because equipment may become corroded.
Property owners have been sued for the spread of Legionella, resulting in expensive
settlements. Regular monitoring with a battery of DFA monoclonal antibodies for several
serogroups and species of Legionella morphologically intact bacteria provides a means
for exercising 'reasonable care' to deter potential litigation.
Most labs will provide a quantitative epifluorescence microscopic analysis of your cooling
tower and potable water samples for 14 serogroups of Legionella pneumophila and 15
other Legionella species (listed below).
Culture methods are good during outbreaks for biotyping; but culture methods lack
sensitivity for routine, quantitative monitoring. Many factors will inhibit growth or
identification of legionella on BCYE with or without antimicrobial agents, heat or acid
treatment.
Culture methods will not identify non-culturable legionella that can still cause outbreaks
(non-culturable, viable legionella have been reported in several peer-reviewed
journals). Only DFA tests performed by trained laboratory personnel can identify these
legionella.
74
Legionella species of bacteria cause Legionnaire's disease. They are gram negative (but
stain poorly), strictly aerobic rods.
The U.S. Environmental Protection Agency and the U.S. Occupational Safety and Health
Administration recommend routine maintenance of water-containing equipment. Most
State health departments recommend monthly testing for Legionella as part of a routine
maintenance program.
As far as we know, there are no federal or state certification programs for laboratories that
perform Legionella testing of environmental samples. Therefore, care must be taken
when selecting a testing laboratory.
Most cases are caused by L. pneumophila, serogroup 1. Legionella species are small (0.3
to 0.9 μm in width and approximately 2 μm in length) faintly staining Gram-negative rods
with polar flagella (except L. oakridgensis).
They generally appear as small coccobacilli in infected tissue or secretions. They are
distinguished from other saccharolytic bacteria by their requirement for L-cysteine and iron
salts for primary isolation on solid media and by their unique cellular fatty acids and
ubiquinones.
They grow well on buffered charcoal yeast extract agar, but it takes about five days to get
sufficient growth. When grown on this medium, Legionella colonies appear off-white in
color and circular in shape.
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L. pneumophila
L. pneumophila is the bacterium associated with Legionnaires' disease and Pontiac fever.
Respiratory transmission of this organism can lead to infection, which is usually
characterized by a gradual onset of flu-like symptoms.
Patients may experience fever, chills, and a dry cough as part of the early symptoms.
Patients can develop severe pneumonia which is not responsive to penicillins or
aminoglycosides. Legionnaires' disease also has the potential to spread into other organ-
systems of the body such as the gastrointestinal tract and the central nervous system.
Accordingly, patients with advanced infections may experience diarrhea, nausea,
disorientation, and confusion.
The 1200 or so cases of Legionnaires' disease per year in the United States usually
involve middle-aged or immunosuppressed individuals. Pontiac fever is also caused by L.
pneumophila but does not produce the severity of the symptoms found in Legionnaires'
disease.
77
Laboratory Indications
Beta-lactamase +
Hippurate hydrolysis +
L. micdadei
L. micdadei is the second most commonly isolated member of Legionella. This bacterium
can cause the same flu-like symptoms and pneomonia which characterize an L.
pneumophila infection. Unlike its relative, L. micdadei is sensitive to the penicillins
because it does not produce beta-lactamase.
Laboratory Indications
Beta-lactamase -
Hippurate hydrolysis -
Acid fast
78
79
Because it is so much more expensive and tedious to do so, actual pathogens are virtually
never tested for. Over the course of a professional lifetime pouring over indicator tests, in
a context where all standards are based on indicators, water workers tend to forget that
the indicators are not the things we actually care about.
The more closely related the animal, the more likely pathogens excreted with their feces
can infect us.
Human feces are the biggest concern, because anything which infects one human could
infect another. There isn't currently a quantitative method for measuring specifically
human fecal bacteria (expensive genetic studies can give a presence/absence result).
Ingesting a human stranger's feces via contaminated water supply is a classic means for
infections to spread rapidly. The more pathogens an individual carries, the more
hazardous their feces. Ingesting feces from someone who is not carrying any pathogens
may gross you out, but it can't infect you. Infection rates are around 5% in the US, and
approach 100% in areas with poor hygiene and contaminated water supplies.
Keep in the back of your mind that the ratio of indicators to actual pathogens is not
fixed. It will always be different, sometimes very different. Whenever you are trying to form
a mental map of reality based on water tests, you should include in the application of your
water intuition an adjustment factor for your best guess of the ratio between indicators and
actual pathogens.
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Clonal Reference
Class Comments
Group Strain
0 N/A TW08017 Undefined Clonal Group
atypical
1 TW08889 cluster within E. coli with Boydii 13 (B13 ) antigen
B13
2 STEC 13 TW08045 includes STEC R:H18 strain
3 EPEC 3 TW06584 O86:H34 strains from infant diarrhea
4 H51 TW08260 cluster with H51 antigen
5 NT-1 TW08997 no common traits
6 EPEC 1 TW06375 Classical EPEC with H6
7 EPEC 4 TW03173 O119:H6 strains, basal to EPEC 1
8 NT-2 TW08983 no common traits
9 NT-3 TW08990 no common traits
Shigella Reeves Shigella Group 3 including serotypes F1a,
10 TW08837
3 F2a, F3a, F3b, F4, F5a FY
O157:H7 and relatives including atypical EPEC
11 EHEC 1 TW08264
O55:H7
12 STEC 12 TW00964 STEC O145 strains
13 ETEC P TW00601 ETEC from pigs including O157:H43 clone
14 EHEC 2 TW00970 O26:H11 and O111:H8 and relatives including RDEC
15 NT-4 TW09177 no common traits
16 EIEC 2 TW01095 Invasive strains with O type 29, 124, 152, 164
17 EPEC 2 TW01120 Classical EPEC with H2 antigen
Serotype O104:H21, includes Montana outbreak strain
18 STEC 8 TW04909
G5506
19 STEC 9 TW08580 Serotype O174:H8
20 STEC 10 TW07618 Various serotypes
21 STEC 11 TW07613 Serotype O111:H28
22 EIEC 1 TW01116 Invasive strains with O types 29, 124, 152, 164
23 ECOR A TW00073 Includes atypical EPEC O111:H12
24 STEC 3 TW08023 Serotype O121:H19
Reeves Shigella Group 1 including serotypes F6, D3,
Shigella
25 TW07572 D6, D7, D9, D11, D12, B1, B2, B3, B4, B8, B10, B14,
1
B15, B18
Shigella Reeves Shigella Group 2 including serotypes D2, D4,
26 TW02615
2a B9, B15
Shigella Reeves Shigella Group 2 including serotypes B5, B11,
27 TW01151
2b B17
Atypical EPEC with serotype O111:H9, includes
28 EPEC 5 TW04892
Finland outbreak strain 921
29 Sonnei TW01150 Shigella sonnei
30 STEC 2 TW01391 Includes serotype O113:H21 and ECOR 30
31 NT-5 TW00676 no common traits
81
82
Reed, Craig A. and B. Kaplan. 1996. S.O.S. ... HELP prevent E. coli 0157:H7 ... et al!
Journal of the American Veterinary Medical Association 209:1213.
83
The covert release of a biologic agent may not have an immediate impact because of the
delay between exposure and illness onset, and outbreaks associated with intentional
releases might closely resemble naturally occurring outbreaks. Indications of intentional
release of a biologic agent include 1) an unusual temporal or geographic clustering of
illness (e.g., persons who attended the same public event or gathering) or patients
presenting with clinical signs and symptoms that suggest an infectious disease outbreak
(e.g., >2 patients presenting with an unexplained febrile illness associated with sepsis,
pneumonia, respiratory failure, or rash or a botulism-like syndrome with flaccid muscle
paralysis, especially if occurring in otherwise healthy persons); 2) an unusual age
distribution for common diseases (e.g., an increase in what appears to be a chickenpox-
like illness among adult patients, but which might be smallpox); and 3) a large number of
cases of acute flaccid paralysis with prominent bulbar palsies, suggestive of a release of
botulinum toxin.
CDC defines three categories of biologic agents with potential to be used as weapons,
based on ease of dissemination or transmission, potential for major public health impact
(e.g., high mortality), potential for public panic and social disruption, and requirements for
public health preparedness.
Agents of highest concern are Bacillus anthracis (anthrax), Yersinia pestis (plague),
variola major (smallpox), Clostridium botulinum toxin (botulism), Francisella tularensis
(tularemia), filoviruses (Ebola hemorrhagic fever, Marburg hemorrhagic fever); and
arenaviruses (Lassa [Lassa fever], Junin [Argentine hemorrhagic fever], and related
viruses). The following summarizes the clinical features of these agents.
Anthrax
A nonspecific prodrome (i.e., fever, dyspnea, cough, and chest discomfort) follows
inhalation of infectious spores. Approximately 2--4 days after initial symptoms, sometimes
after a brief period of improvement, respiratory failure and hemodynamic collapse ensue.
Inhalational anthrax also might include thoracic edema and a widened mediastinum on
chest radiograph.
Gram-positive bacilli can grow on blood culture, usually 2--3 days after onset of illness.
Cutaneous anthrax follows deposition of the organism onto the skin, occurring particularly
on exposed areas of the hands, arms, or face. An area of local edema becomes a pruritic
macule or papule, which enlarges and ulcerates after 1--2 days. Small, 1--3 mm vesicles
may surround the ulcer. A painless, depressed, black eschar, usually with surrounding
local edema, subsequently develops. The syndrome also may include lymphangitis and
painful lymphadenopathy.
Plague
Clinical features of pneumonic plague include fever, cough with muco-purulent sputum
(gram-negative rods may be seen on gram stain), hemoptysis, and chest pain. A chest
radiograph will show evidence of bronchopneumonia.
85
Smallpox (variola)
The acute clinical symptoms of smallpox resemble other acute viral illnesses, such as
influenza, beginning with a 2--4 day nonspecific prodrome of fever and myalgias before
rash onset. Several clinical features can help clinicians differentiate varicella (chickenpox)
from smallpox.
The rash of varicella is most prominent on the trunk and develops in successive groups of
lesions over several days, resulting in lesions in various stages of development and
resolution. In comparison, the vesicular/pustular rash of smallpox is typically most
prominent on the face and extremities, and lesions develop at the same time.
Inhalational tularemia
Inhalation of F. tularensis causes an abrupt onset of an acute, nonspecific febrile illness
beginning 3--5 days after exposure, with pleuropneumonitis developing in a substantial
proportion of cases during subsequent days.
Laboratory Personnel
Although unidentified gram-positive bacilli growing on agar may be considered as
contaminants and discarded, CDC recommends that these bacilli be treated as a "finding"
when they occur in a suspicious clinical setting (e.g., febrile illness in a previously healthy
person).
The laboratory should attempt to characterize the organism, such as motility testing,
inhibition by penicillin, absence of hemolysis on sheep blood agar, and further biochemical
testing or species determination.
An unusually high number of samples, particularly from the same biologic medium (e.g.,
blood and stool cultures), may alert laboratory personnel to an outbreak. In addition,
central laboratories that receive clinical specimens from several sources should be alert
to increases in demand or unusual requests for culturing (e.g., uncommon biologic
specimens such as cerebrospinal fluid or pulmonary aspirates).
86
After the terrorist attacks of September 11, state and local health departments initiated
various activities to improve surveillance and response, ranging from enhancing
communications (between state and local health departments and between public health
agencies and health-care providers) to conducting special surveillance projects.
These special projects have included active surveillance for changes in the number of
hospital admissions, emergency department visits, and occurrence of specific syndromes.
Activities in bioterrorism preparedness and emerging infections over the past few years
have better positioned public health agencies to detect and respond to the intentional
release of a biologic agent. Immediate review of these activities to identify the most useful
and practical approaches will help refine syndrome surveillance efforts in various clinical
situations.
87
88
89
Trophozoites
The trophozoites can be carried out in the feces. As the feces pass through the colon they
dehydrate. The dehydration of the feces causes the trophozoites to begin the process of
encystment. Undigested food is discharged, and the trophozoite condenses and forms a
spherical shape to form what is called the pre-cyst, and the cyst wall is secreted. Within
the cyst there are two nuclear divisions resulting in 2 nuclei in the immature cyst and 4
nuclei within the mature cyst.
The cyst can resist desiccation for 1-2 weeks. When the cyst is ingested by another host
the parasite excysts in the intestine and undergoes cytoplasmic division to produce 4
trophozoites. In some cases the trophozoites secrete proteolytic enzymes which destroy
the intestinal epithelium allowing the trophozoiute to enter the host tissue.
Trophoziotes in diarrheic feces are not stimulated to encyst because the feces are not
dehydrating. If they are not encysted they cannot long survive in the external environment.
Secondary bacterial infection can complicate an already severe pathology.
Symptoms of Amoebiasis
In most infected humans the symptoms of "amoebiasis" (or "amebiasis") are intermittent
and mild (various gastrointestinal upsets, including colitis and diarrhea). In more severe
cases the gastrointestinal tract hemorrhages, resulting in dysentery. In some cases the
trophozoites will enter the circulatory system and infect other organs, most often the liver
(hepatic amoebiasis), or they may penetrate the gastrointestinal tract resulting in acute
peritonitis; such cases are often fatal.
90
Naegleria fowleri trophozoite in spinal fluid. Trichrome stain. Note the typically large
karyosome and the monopodial locomotion. Image contributed by Texas SHD.
Although the ameba is commonly found in the environment, PAM is very rare. In the last
30 years, only a few hundred cases have been reported worldwide.
93
94
Residents of the Arizona towns of Peoria and Glendale have been shocked by the deaths
of two five-year old boys from amoebic meningitis caused by Naegleria fowleri. The source
of the infections has not been positively established but suspicion has fallen on a small
unchlorinated ground water supply operated by a private company.
This supply was taken off-line on 3 November, a boil water notice was issued and 6,000
consumers were warned not to use unboiled tap water for drinking, cooking or bathing.
Schools and restaurants in the suspect area were also closed, and residents were advised
to drain and clean spas and hyperchlorinate swimming pools.
Supply to the affected area was switched to a chlorinated surface water source, and a
flushing program with hyperchlorinated water was carried out to remove possible
contamination from the water distribution system.
One of the victims lived in Peoria and the other in the neighboring town of Glendale, some
four miles away. They attended separate schools, however the Glendale boy frequently
visited his grandparents' home a few blocks from the other boy's residence in Peoria. Both
boys became ill on 9 October and died a few days later on 12 and 13 October respectively.
Health authorities then began investigating possible common sources of Naegleria
exposure including drinking water, pools, bathtubs, spas and fountains.
About 100,000 of Peoria's 120,000 residents receive chlorinated drinking water from the
municipal supply. This supply is predominantly drawn from surface water sources but is
supplemented by groundwater in times of high demand. As Arizona state law prevents
counties from supplying water to areas outside the incorporated municipal zones, the
remaining 20,000 residents in the rapidly growing town are served by private water
companies which mainly rely on groundwater sources. Some of these companies
chlorinate their groundwater supplies and some do not.
The suspect water supply is drawn from a deep aquifer and is not routinely chlorinated,
although periodic chlorination has been used after new connections, line breaks or
incidents that might allow ingress of microbial contamination.
Tests by the Centers for Disease Control and Prevention have detected N. fowleri
in three samples:
ꞏ one pre-chlorination water sample from a municipal well that was routinely chlorinated.
ꞏ one tank water sample from the suspect unchlorinated groundwater system.
ꞏ the refrigerator filter from the home of the grandparents of one of the boys.
Naegleria fowleri is a free living amoeba which is common in the environment and grows
optimally at temperatures of 35 to 45 degrees C. Exposure to the organism is believed to
95
Most reported cases of N. fowleri meningitis are associated with swimming in natural
surface freshwater bodies, and infection occurs through introduction of the organism into
the nasal cavities. Cases are often reported to be associated with jumping or falling into
the water, providing conditions where water is forced into the nose at pressure. The
amoeba may then penetrate the cribiform plate, a semiporous barrier, and spread to the
meninges (the membrane surrounding the brain) and often to the brain tissue itself. The
cribiform plate is more permeable in children, making them more susceptible to infection
than adults. People with immune deficiencies may also be more prone to infection.
The incubation period is usually 2 to 5 days, and the infection cannot be transmitted from
person to person. In early studies, transmission by contaminated dust was suspected as
an infection route but this has since been discounted as the organism does not survive
desiccation.
Cases of disease have also been associated with swimming pools where disinfection
levels were inadequate, and inhalation of tap water from surface water supplies that have
been subject to high temperatures.
The involvement of tap water supplies was first documented in South Australia, where a
number of cases occurred in the 1960s and 70s in several towns served by unchlorinated
surface water delivered through long above-ground pipelines. About half of the cases in
the state did not have a recent history of freshwater swimming, but had intra-nasal
exposure to tap water through inhaling or squirting water into the nose.
Investigators found N. fowleri in the water supply pipelines, and concluded that the high
water temperatures reached in summer provided a suitable environment for growth of the
organism. Tap water may also have been the primary source of infections attributed to
swimming pools in these towns. The incidence of disease was greatly reduced by
introduction of reliable chlorination facilities along the above-ground pipelines and
introduction of chloramination in the 1980s led to virtual elimination of N. fowleri from the
water supplies. Cases of disease have also been recorded in Western Australia,
Queensland and New South Wales, and N. fowleri has been detected in water supplies in
each of these states as well as the Northern Territory.
Warm water conditions and the absence of free chlorine may then allow it to proliferate in
the system. Local health authorities in Arizona are continuing their investigation into the
two deaths with assistance from CDC personnel. Plans are also underway to install a
continuous chlorination plant on the groundwater supply, and some residents have called
for the municipality to purchase the private water company and take over its operations.
96
Note the 'Star of David' image exhibited by individual virus particles. This is distinct from
the star-like images exhibited by astrovirus particles. Bar = 50 nanometers.
Source: Stool sample from an individual with gastroenteritis.
Method: Negative-stain Transmission Electron Microscopy
Rotovirus
Note the wheel-like appearance of some of the rotavirus particles. The observance of such
particles gave the virus its name ('rota' being the Latin word meaning wheel). Bar = 100
nanometers.
Source: Cell culture.
Method: Negative-stain Transmission Electron Microscopy
Photographs and information courtesy from the U.S. EPA and F.P. Williams, U.S.
EPA
97
A Flatworm that spends part of its life in a freshwater snail host causes schistosomiasis.
Multiplying in the snail, a microscopic infective larval stage is released that can penetrate
human skin painlessly in 30 to 60 seconds. The larvae grow to adulthood and migrate to
the veins around the intestines or bladder, where mating occurs. The eggs produced may
lodge in these tissues and cause disease, or they are passed out in urine or feces, where
they reach fresh water and hatch to infect snails.
Cercariae
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Host Defenses
Host defenses against schistosomiasis include antibody or complement-dependent
cellular cytotoxicity and modulation of granulomatous hypersensitivity. The defenses
against hermaphroditic flukes are unknown.
Epidemiology
Most infected individuals show no overt disease. In a relatively small proportion of
individuals, heavy infections due to repeated exposure to parasitic larvae will lead to the
development of clinical manifestations. The distribution of flukes is limited by the
distribution of their snail intermediate host. Larvae from snails infect a human by
penetrating the skin (schistosomes) or by being eaten (encysted larvae of other
trematodes).
Diagnosis
Diagnosis is suggested by clinical manifestations, geographic history, and exposure to
infective larvae. The diagnosis is confirmed by the presence of parasite eggs in excreta.
Control
As a control measure, exposure to parasite larvae in water and food should be prevented.
Treatment with praziquantel is effective.
Clinical Manifestations
Signs and symptoms are related largely to the location of the adult worms. Infections with
Schistosoma mansoni and S japonicum (mesenteric venules) result in eosinophilia,
hepatomegaly, splenomegaly, and hematemesis. Schistosoma haematobium (vesical
venules) causes dysuria, hema turia, and uremia.
Fasciola hepatica, Clonorchis sinensis, and Opisthorchis viverrini (bile ducts) cause fever,
hepatomegaly, abdominal pain, and jaundice. Infections with Paragonimus westermani
(lungs, brain) result in cough, hemoptysis, chest pain, and epilepsy. Fasciolopsis buski
(intestines) causes abdominal pain, diarrhea, and edema.
Structure
Trematodes are multicellular eukaryotic helminths.
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101
102
Follow the written directions on the ORS package, and use clean or boiled water.
Medications, including antibiotics (which have no effect on viruses) and other treatments,
should be avoided unless specifically recommended by a physician.
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The Virus
A rotavirus has a characteristic wheel-like appearance when viewed by electron
microscopy (the name rotavirus is derived from the Latin rota, meaning "wheel").
Rotaviruses are nonenveloped, double-shelled viruses. The genome is composed of 11
segments of double-stranded RNA, which code for six structural and five nonstructural
proteins. The virus is stable in the environment.
Epidemiologic Features
The primary mode of transmission is fecal-oral, although some have reported low titers of
virus in respiratory tract secretions and other body fluids. Because the virus is stable in
the environment, transmission can occur through ingestion of contaminated water or food
and contact with contaminated surfaces. In the United States and other countries with a
temperate climate, the disease has a winter seasonal pattern, with annual epidemics
occurring from November to April. The highest rates of illness occur among infants and
young children, and most children in the United States are infected by 2 years of age.
Adults can also be infected, though disease tends to be mild.
Diagnosis
Diagnosis may be made by rapid antigen detection of rotavirus in stool specimens. Strains
may be further characterized by enzyme immunoassay or reverse transcriptase
polymerase chain reaction, but such testing is not commonly done.
Treatment
For persons with healthy immune systems, rotavirus gastroenteritis is a self-limited illness,
lasting for only a few days. Treatment is nonspecific and consists of oral rehydration
therapy to prevent dehydration. About one in 40 children with rotavirus gastroenteritis will
require hospitalization for intravenous fluids.
Prevention
In 1998, the U.S. Food and Drug Administration approved a live virus vaccine (Rotashield)
for use in children. However, the Advisory Committee on Immunization Practices (ACIP)
recommended that Rotashield no longer be recommended for infants in the United States
because of data that indicated a strong association between Rotashield and
intussusception (bowel obstruction) among some infants during the first 1-2 weeks
following vaccination.
More information about rotavirus vaccine is available from the National Immunization
Program.
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Norwalk Virus
The Gila County Department of Health is currently investigating an outbreak of viral gastroenteritis
in the Globe / Miami area. The outbreak has been laboratory confirmed by the Arizona State
Laboratory as Norwalk virus. Please be aware of the following symptoms and recommendations.
Norwalk Symptoms
Usually a mild to moderate infection that often occurs in outbreaks with clinical symptoms of
nausea, vomiting, diarrhea, abdominal pain, low grade fever, or any combination of these
symptoms. Gastrointestinal symptoms will characteristically last 24 to 48 hours, resolving on their
own.
If you are experiencing symptoms consistent with this disease, please exclude yourself from school,
work, or any group activity. Hand washing and disinfection are essential to stop the spread of this
virus. Anyone experiencing severe complications from this ailment should seek medical attention.
Please report all suspected group outbreaks to the Gila County Department of Health by phone
immediately. (928) 425-3189
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Persons working in day-care centers or nursing homes should pay special attention to
children or residents who have norovirus illness. This virus is very contagious and can
spread rapidly throughout such environments.
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Norovirus illness is usually brief in healthy individuals. When people are ill with vomiting
and diarrhea, they should drink plenty of fluids to prevent dehydration. Dehydration among
young children, the elderly, and the sick can be common, and it is the most serious health
effect that can result from norovirus infection. By drinking oral rehydration fluids (ORF),
juice, or water, people can reduce their chance of becoming dehydrated. Sports drinks do
not replace the nutrients and minerals lost during this illness.
Persons who are infected with norovirus should not prepare food while they have
symptoms and for 3 days after they recover from their illness. Food that may have been
contaminated by an ill person should be disposed of properly.
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Scientists have identified six hepatitis viruses, but three - known as A, B and C - cause
about 90 percent of acute hepatitis cases in the United States. People infected with
hepatitis can experience effects ranging from mild illness to serious liver damage. Many
recover completely from an infection, while others become carriers of the disease and can
spread it to others unknowingly. It is especially important for women who are pregnant or
are trying to become pregnant to get tested for hepatitis.
Hepatitis A virus found in human feces; shellfish grown in polluted waters. Yellowed skin,
enlarged liver, fever, vomiting, weight loss, and abdominal pain — low mortality, lasts up
to four months.
Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). Hepatitis A can affect
anyone. In the United States, hepatitis A can occur in situations ranging from isolated
cases of disease to widespread epidemics.
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Where and how does hepatitis A virus get into drinking water?
Hepatitis A is found in every part of the United States and throughout the world. When
water sources such as private wells are contaminated with feces from infected humans,
the water will spread the hepatitis A virus. The virus can enter the water through various
ways, including sewage overflows or broken sewage systems.
The food preparer or cook is the individual most often contaminating the food. He or she
is generally not ill: the peak time of infectivity (i.e., when the most virus is present in the
stool of an infectious individual) is during the 2 weeks before illness begins.
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Such “outbreaks are usually associated with contamination of food during preparation by
an HAV-infected food handler.”
Indeed, “[v]iral gastroenteritis was reported as the most common food-borne illness in
Minnesota from 1984 to 1991, predominantly associated with poor personal hygiene of
infected food handlers.”
Although ingestion of contaminated food is the most common means of spread for
Hepatitis A, it may also commonly be spread by household contact among families or
roommates, sexual contact, by the ingestion of contaminated water, by the ingestion of
raw or undercooked fruits and vegetables or shellfish (like oysters), and by direct
inoculation from persons sharing illicit drugs. Children often have asymptomatic or
unrecognized infections and can pass the virus through ordinary play, unknown to their
parents, who may later become infected from contact with their children.
Hepatitis B: is a serious disease caused by a virus that attacks the liver. The virus, which
is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the
liver, liver cancer, liver failure, and death.
Hepatitis C: is a liver disease caused by the hepatitis C virus (HCV), which is found in the
blood of persons who have the disease. HCV is spread by contact with the blood of an
infected person.
Hepatitis D: is a liver disease caused by the hepatitis D virus (HDV), a defective virus that
needs the hepatitis B virus to exist. Hepatitis D virus (HDV) is found in the blood of persons
infected with the virus.
Hepatitis E: is a liver disease caused by the hepatitis E virus (HEV) transmitted in much
the same way as hepatitis A virus. Hepatitis E, however, does not occur often in the United
States.
Medical Testing
Hepatitis virus tests require a blood sample. It is not necessary for the patient to withhold
food or fluids before any of these tests, unless requested to do so by the physician.
Risks
Risks for these tests are minimal for the patient, but may include slight bleeding from the
blood-drawing site, fainting or feeling lightheaded after venipuncture, or hematoma (blood
accumulating under the puncture site).
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Hepatitis B: High levels of HBsAg that continue for three or more months after onset of
acute infection suggest development of chronic hepatitis or carrier status. Detection of
anti-HBs signals late convalescence or recovery from infection. This antibody remains in
the blood to provide immunity to re-infection.
References
Cahill, Mathew. Handbook of Diagnostic Tests. Springhouse, PA: Springhouse
Corporation, 1995.
Jacobs, David S. Laboratory Test Handbook, 4th ed. Hudson, OH: Lexi-Comp Inc.,
1996.
Pagana, Kathleen Deska. Mosby's Manual of Diagnostic and Laboratory Tests. St.
Louis: Mosby, Inc., 1998.
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Pathogenesis
Leptospira enters the host through mucosa and broken skin, resulting in bacteremia. The
spirochetes multiply in organs, most commonly the central nervous system, kidneys, and
liver. They are cleared by the immune response from the blood and most tissues but
persist and multiply for some time in the kidney tubules. Infective bacteria are shed in the
urine. The mechanism of tissue damage is not known.
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Epidemiology
Leptospirosis is a worldwide zoonosis affecting many wild and domestic animals. Humans
acquire the infection by contact with the urine of infected animals. Human-to-human
transmission is extremely rare.
Diagnosis
Clinical diagnosis is usually confirmed by serology. Isolation of spirochetes is possible, but
it is time-consuming and requires special media.
Control
Animal vaccination and eradication of rodents are important. Treatment with tetracycline
and penicillin G is effective. No human vaccine is available.
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117
P. aeruginosa is widely studied by scientists who are interested in not only its ability to
cause disease and resist antibiotics, but also its metabolic capability and environmental
versatility. Analysis of its genome sequence has identified genes involved in locomotion,
attachment, transport and utilization of nutrients, antibiotic efflux, and systems involved in
sensing and responding to environmental changes.
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--P. aeruginosa possesses the metabolic versatility for which pseudomonads are so
renowned. Organic growth factors are not required, and it can use more than seventy-five
organic compounds for growth.
--Its optimum temperature for growth is 37°C, and it is able to grow at temperatures as
high as 42°C.
These natural properties of the bacterium undoubtedly contribute to its ecological success
as an opportunistic pathogen. They also help explain the ubiquitous nature of the organism
and its prominance as a nosocomial pathogen.
P. aeruginosa isolates may produce three colony types. Natural isolates from soil or water
typically produce a small, rough colony. Clinical samples, in general, yield one or another
of two smooth colony types. One type has a fried-egg appearance which is large and
smooth, with flat edges and an elevated appearance. Another type, frequently obtained
from respiratory and urinary tract secretions, has a mucoid appearance, which is attributed
to the production of alginate slime. The smooth and mucoid colonies are presumed to play
a role in colonization and virulence.
Pseudomonas aeruginosa is notorious for its resistance to antibiotics and is, therefore, a
particularly dangerous and dreaded pathogen. The bacterium is naturally resistant to
many antibiotics due to the permeability barrier afforded by its outer membrane LPS. Also,
its tendency to colonize surfaces in a biofilm form makes the cells impervious to
therapeutic concentrations antibiotics. Since its natural habitat is the soil, living in
association with the bacilli, actinomycetes and molds, it has developed resistance to a
variety of their naturally-occurring antibiotics. Moreover, Pseudomonas maintains
antibiotic resistance plasmids, both R-factors and RTFs, and it is able to transfer these
genes by means of the bacterial processes of transduction and conjugation.
Diagnosis
Diagnosis of P. aeruginosa infection depends upon isolation and laboratory identification
of the bacterium. It grows well on most laboratory media and commonly is isolated on
blood agar or eosin-methylthionine blue agar. It is identified on the basis of its Gram
morphology, inability to ferment lactose, a positive oxidase reaction, its fruity odor, and its
ability to grow at 42° C. Fluorescence under ultraviolet light is helpful in early identification
of P. aeruginosa colonies. Fluorescence is also used to suggest the presence of P.
aeruginosa in wounds.
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Most Pseudomonas infections are both invasive and toxinogenic. The ultimate
Pseudomonas infection may be seen as composed of three distinct stages: (1) bacterial
attachment and colonization; (2) local invasion; (3) disseminated systemic disease.
However, the disease process may stop at any stage. Particular bacterial determinants of
virulence mediate each of these stages and are ultimately responsible for the
characteristic syndromes that accompany the disease.
Colonization
Although colonization usually precedes infections by Pseudomonas aeruginosa, the exact
source and mode of transmission of the pathogen are often unclear because of its
ubiquitous presence in the environment. It is sometimes present as part of the normal flora
of humans, although the prevalence of colonization of healthy individuals outside the
hospital is relatively low (estimates range from 0 to 24 percent depending on the
anatomical locale).
The fimbriae of Pseudomonas will adhere to the epithelial cells of the upper respiratory
tract and, by inference, to other epithelial cells as well. These adhesions appear to bind to
specific galactose, mannose, or sialic acid receptors on epithelial cells. Colonization of the
respiratory tract by Pseudomonas requires fimbrial adherence and may be aided by
production of a protease enzyme that degrades fibronectin in order to expose the
underlying fimbrial receptors on the epithelial cell surface. Tissue injury may also play a
role in colonization of the respiratory tract since P. aeruginosa will adhere to tracheal
epithelial cells of mice infected with Influenza virus but not to normal tracheal epithelium.
This has been called opportunistic adherence, and it may be an important step in
Pseudomonas keratitis and urinary tract infections, as well as infections of the respiratory
tract. The receptor on tracheal epithelial cells for Pseudomonas pili is probably sialic acid
(N-acetylneuraminic acid). Mucoid strains, which produce an exopolysaccharide (alginate)
have an additional or alternative adhesion which attaches to the tracheobronchial mucin
(N-acetylglucosamine). Besides pili and the mucoid polysaccharide, there are possibly two
other cell surface adhesions utilized by Pseudomonas to colonize the respiratory
epithelium or mucin. Also, it is likely that surface-bound exoenzyme S could serve as an
adhesion for glycolipids on respiratory cells. The mucoid exopolysaccharide produced by
P. aeruginosa is a repeating polymer of mannuronic and glucuronic acid referred to as
alginate. Alginate slime forms the matrix of the Pseudomonas biofilm which anchors the
cells to their environment and, in medical situations; it protects the bacteria from the host
defenses such as lymphocytes, phagocytes, the ciliary action of the respiratory tract,
antibodies and complement. Biofilm mucoid strains of P. aeruginosa are also less
susceptible to antibiotics than their planktonic counterparts. Mucoid strains of P.
aeruginosa are most often isolated from patients with cystic fibrosis and they are usually
found in post mortem lung tissues from such individuals.
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Shigella dysenteriae type 1(or bacillary dysentery) is the only cause of epidemic
dysentery. This organism is generally found in the stool of infected individuals, as well as
in contaminated water supplies. It is known to be able to survive on soiled linens for up to
seven weeks, in water supplies for 5-11 days, and in kitchen waste for 1-4 days. Shigella
can even survive in dust particles for six weeks at room temperature.
Infected humans act as host for this particular organism, as well as primates. The
infections caused by this organism are generally seen in developing countries and areas
of poor sanitation. Transmission occurs via direct or indirect contact with individuals who
are infected by ingesting contaminated water or food, as well as contact with fecal material.
Microbial Characteristics
Shigella dysenteriae is a Gram (-), non-spore forming bacillus that survives as a facultative
anaerobe. It is part of the family Enterobacteriaceae. When testing for it in the laboratory,
you can help identify it by the fact that it is non-motile, and lactose and lysine (-). This
organism, unlike some enterics, does not produce gas when breaking down
carbohydrates.
Shigella dysenteriae is the organism responsible for bacillary dysentery. This disease is
most often associated with areas of overcrowding and poor sanitation (developing
countries). Illness does, however, tend to be seasonal, happening when it is hot, and wet.
Symptoms of dysentery due to this organism include mild to severe diarrhea, which is
sometimes bloody or watery.
There is also fever and nausea that accompany the diarrhea. Some people, however, also
suffer from vomiting and cramping, and some show no symptoms at all. The symptoms of
the disease will generally show between 12-96 hours (1-3 days) after becoming infected.
During this incubation period, the organism will penetrate the mucosal epithelial cells of
the intestine through use of an intestinal adherence factor. This penetration causes severe
irritation, which is responsible for the cramps and watery, bloody diarrhea. Dehydration
can become a complication.
Persons with mild infections will usually recover quickly without antibiotic treatment.
Therefore, when many persons in a community are affected by shigellosis, antibiotics are
sometimes used selectively to treat only the more severe cases. Antidiarrheal agents such
as loperamide (Imodium*) or diphenoxylate with atropine (Lomotil*) are likely to make the
illness worse and should be avoided.
Once someone has had shigellosis, they are not likely to get infected with that specific
type again for at least several years. However, they can still get infected with other types
of Shigella.
This happens when basic hygiene and handwashing habits are inadequate. It is
particularly likely to occur among toddlers who are not fully toilet-trained. Family members
and playmates of such children are at high risk of becoming infected.
Shigella infections may be acquired from eating contaminated food. Contaminated food
may look and smell normal. Food may become contaminated by infected food handlers
who forget to wash their hands with soap after using the bathroom. Vegetables can
become contaminated if they are harvested from a field with sewage in it. Flies can breed
in infected feces and then contaminate food. Shigella infections can also be acquired by
drinking or swimming in contaminated water. Water may become contaminated if sewage
runs into it, or if someone with shigellosis swims in it.
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People who have shigellosis should not prepare food or pour water for others until they
have been shown to no longer be carrying the Shigella bacterium.
If a child in diapers has shigellosis, everyone who changes the child's diapers should be
sure the diapers are disposed of properly in a closed-lid garbage can, and should wash
his or her hands carefully with soap and warm water immediately after changing the
diapers. After use, the diaper changing area should be wiped down with a disinfectant
such as household bleach, Lysol* or bactericidal wipes.
Basic food safety precautions and regular drinking water treatment prevents shigellosis.
At swimming beaches, having enough bathrooms near the swimming area helps keep the
water from becoming contaminated.
Simple precautions taken while traveling to the developing world can prevent getting
shigellosis. Drink only treated or boiled water, and eat only cooked hot foods or fruits you
peel yourself. The same precautions prevent traveler's diarrhea in general.
Children, especially toddlers aged 2 to 4, are the most likely to get shigellosis. Many cases
are related to the spread of illness in child-care settings, and many more are the result of
the spread of the illness in families with small children.
In the developing world, shigellosis is far more common and is present in most
communities most of the time. Chinese scientists have sequenced the genome of a
bacterium that is a leading cause of infant mortality in developing countries.
About one million people die of Shigella infections every year, most of them children. The
bacterium Shigella flexneri causes sudden and severe diarrhea in humans, known as
shigellosis.
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Some prevention steps occur every day, without thinking about it. Making municipal water
supplies safe and treating sewage are highly effective prevention measures that have
been in place for many years.
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Typhoid fever can be prevented and can usually be treated with antibiotics. If you are
planning to travel outside the United States, you should know about typhoid fever and
what steps you can take to protect yourself.
Salmonella typhi
Salmonella Typhi lives only in humans. Persons with typhoid fever carry the bacteria in
their bloodstream and intestinal tract. In addition, a small number of persons, called
carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and
carriers shed S. Typhi in their feces (stool).
You can get typhoid fever if you eat food or drink beverages that have been handled by a
person who is shedding S. Typhi or if sewage contaminated with S. Typhi bacteria gets
into the water you use for drinking or washing food. Therefore, typhoid fever is more
common in areas of the world where handwashing is less frequent and water is likely to
be contaminated with sewage. Once S. Typhi bacteria are eaten or drunk, they multiply
and spread into the blood-stream. The body reacts with fever and other signs and
symptoms.
In 1885, pioneering American veterinary scientist, Daniel E. Salmon, discovered the first
strain of Salmonella from the intestine of a pig. This strain was called Salmonella
choleraesuis, the designation that is still used to describe the genus and species of this
common human pathogen. Salmonella is a type of bacteria that causes typhoid fever and
many other infections of intestinal origin. Typhoid fever, rare in the U.S., is caused by a
particular strain designated Salmonella typhi. But illness due to other Salmonella strains,
just called "salmonellosis," is common in the U.S. Today, the number of known strains
(technically termed "serotypes" or "serovars") of this bacteria total over 2300.
129
Getting vaccinated
If you are traveling to a country where typhoid is common, you should consider being
vaccinated against typhoid. Visit a doctor or travel clinic to discuss your vaccination
options.
Remember that you will need to complete your vaccination at least 1 week before you
travel so that the vaccine has time to take effect. Typhoid vaccines lose effectiveness after
several years; if you were vaccinated in the past, check with your doctor to see if it is time
for a booster vaccination. Taking antibiotics will not prevent typhoid fever; they only help
treat it.
The chart below provides basic information on typhoid vaccines that are available in the
United States.
Total time
Number Time needed to Minimum Booster
Vaccine How
of doses between set aside age for needed
Name given
necessary doses for vaccination every...
vaccination
Ty21a
(Vivotif
Berna,
1 capsule
Swiss 4 2 days 2 weeks 6 years 5 years
by mouth
Serum and
Vaccine
Institute)
ViCPS
(Typhim
Injection 1 N/A 1 week 2 years 2 years
Vi, Pasteur
Merieux)
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Other symptoms of tularemia depend on how a person was exposed to the tularemia
bacteria. These symptoms can include ulcers on the skin or mouth, swollen and painful
lymph glands, swollen and painful eyes, and a sore throat.
F. tularensis
Gram stain
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Note any change in the behavior of your pets (especially rodents, rabbits, and hares) or
livestock, and consult a veterinarian if they develop unusual symptoms.
F. tularensis is a small Gram-negative aerobic bacillus with two main serotypes: Jellison
Type A and Type B. Type A is the more virulent form. The causative agent of the disease
was named after Dr. Edward Francis and the location where the organism was discovered,
Tulare County, California. Tularemia is frequently spread by direct contact with rabbits,
leading to the term "rabbit fever." However, the disease can also be spread by other
animals, typically rodents, and by arthropods. It is a primarily rural disease that is found in
all 50 states, except Hawaii.
Pathogenesis
Historical commentaries reference the virulence of the disease, indicating that people
have been aware of pathogenicity of Francisella for thousands of years. However, there
is still much to be learned about this extremely virulent organism. The disease can be
contracted by ingestion, inhalation, or by direct skin contact. Tularemia occurs in six
different forms: typhoidal, pneumonic, oculoglandular, oropharyngeal, ulceroglandular,
and glandular. Clinical diagnosis can be difficult since the disease mimics a slough of other
illnesses. Pathogenesis varies greatly depending on mode of infection.
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Treatment
If infection is suspected, diagnosis can be made based on serological assays since F.
tularensis is difficult to culture on standard media. Agglutination titers can be performed
following the first week of infection and reach a peak during the 4-8 weeks. Infected
individuals are normally placed on a regimen of streptomycin or gentamycin for 10-14
days. Beta-lactams are generally ineffective due to beta-lactamase activity.
133
Be prepared
Seasonal occurrences of musty/moldy or earthy tastes and odors may be detected in the
system water. Research by laboratories dedicated to this subject, has determined the
culprits are naturally occurring algal and fungal (microbiological) by-products. As algae in
the canals die, compounds known as Methyl-Isoborneol (MIB) and Geosmin are released
into the water.
These stable complex compounds, present in parts per trillion, are difficult to remove with
current technology. The detection of these compounds is dependent upon an individual's
olfactory sensitivity. Many people may never detect them, while others who are sensitive
may detect the musty/moldy taste and smell at levels below instrument detection levels.
Most water providers use activated carbon to adsorb the MIB and Geosmin, thus
alleviating the taste and odor.
Earthy-musty tastes and odors are produced by certain cyanobacteria (blue-green algae),
actinomycetes, and a few fungi. The substances are produced by actinomycetes and
cyanobacteria that cause tastes and odors in drinking-water include geosmin, methyl-
isoborneol (MIB), and cardin-4-ene-1-ol. Growing algae produce numerous volatile and
nonvolatile organic substances, including aliphatic alcohols, aldehydes, ketones, esters,
thioesters, and sulfides.
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Oscillatoria chalybea
Blooms
Blooms will produce the noxious substances 2-methyl isoborneol (MIB) and geosmin,
compounds that are responsible for causing an off-flavor in catfish. MIB and geosmin are
often described as smelling like "sweaty socks."
Microcystis aeruginosa
Commonly found in lakes and ponds. In the spring, large numbers floating on the water
surface produce a blue-tinge. Blooms of this cyanobacterium are also notorious for
producing a liver toxin that in large amount can kill fish and livestock.
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Arsenic
Arsenic is a naturally occurring element used since ancient times and has long been
known to be toxic to humans. Arsenic in ground water is largely the result of minerals
dissolving from weathered rocks and soils. Several types of cancer have been linked to
arsenic in water. In 2001 the US Environmental Protection Agency lowered the maximum
level of arsenic permitted in drinking water from 50 micrograms per liter (ug/L) to 10 ug/L.
Gastrointestinal and nervous system effects are common and the ingestion of relatively
small amounts can result in death. A recent study indicates that arsenic disrupts the
activity of glucocorticoids, compounds that have a variety of functions, including the
regulation of blood sugar.
Interestingly, this same study suggested that arsenic at high levels inhibits those
mechanisms that normally suppress tumor production. This finding led to the suggestion
that instead of causing cancer, arsenic promotes the
growth of tumors triggered by other carcinogens. And by
the way, arsenic-induced effects appeared at
concentrations as low as 2 micrograms per liter.
Some studies also found that arsenic harms the central and peripheral nervous systems
as well as heart and blood vessels. Arsenic has been associated with birth defects and
reproductive problems.
Conservative estimates based on all these data suggest that more than 34 million
Americans drink tap water supplied by systems containing average levels of arsenic that
pose unacceptable cancer risks. In October 2001, the Environmental Protection Agency
implemented new standards for arsenic in drinking water, lowering the maximum
acceptable level in parts per billion from 50ppb to 10ppb.
137
Arsenic has been found at 1,014 of the 1,598 National Priority List sites identified by the
Environmental Protection Agency (EPA).
138
Nitrates and nitrites are nitrogen-oxygen chemical units which combine with various
organic and inorganic compounds. The greatest use of nitrates is as a fertilizer.
139
Short-term
Excessive levels of nitrate in drinking water have caused serious illness and sometimes
death. The serious illness in infants is due to the conversion of nitrate to nitrite by the body,
which can interfere with the oxygen-carrying capacity of the child's blood. This can be an
acute condition in which health deteriorates rapidly over a period of days. Symptoms
include shortness of breath and blueness of the skin. Long-term: Nitrates and nitrites have
the potential to cause the following effects from a lifetime exposure at levels above the
MCL: diuresis, increased starchy deposits and hemorrhaging of the spleen.
Follow-up
Retest regularly. Nitrate levels greater than 5 mg/L indicate the possibility that agricultural
chemicals may be reaching the water source, and pesticide testing is recommended.
Whereas distillers and RO systems are only suitable for point of use (i.e., one or two
faucets in the home), anion exchange systems remove nitrates from the whole house.
Nitrate specific resin should be used with anion exchange systems to prevent the
possibility of a maladjusted or malfunctioning anion exchange system from increasing the
nitrate level due to sulfate exchange. We recommend that persons shopping for nitrate
removal systems shop carefully and purchase only from a dealer experienced in nitrate
removal.
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* Total coliforms are considered indicator organisms that typically do not cause disease
but might be associated with the presence of other disease-causing organisms.
Additional information regarding total coliforms is available at
http://www.epa.gov/safewater/dwa/electronic/tcr.pdf.
† Additional information is available at http://www.cleanwater.gov.
§ Additional terms are defined in the glossary.
¶ Additional information is available at http://www.nsf.org.
proposed GWR, EPA lists recommendations for protecting private water supplies at
http://www.epa.gov/safewater/pwells1.html and provides links to other sources of
information.
§§ Guidelines for pool operators and other information related to recreational water
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Alphabetical characters
ACUK: Acid chrome violet K
AECL: Alternate enhanced coagulant level
AOC: Assimilable organic carbon
ASDWA: Association of State Drinking Water Administrators
AWWA: American Water Works Association
AWWARF: AWWA Research Foundation
BAC: Biologically active carbon
BAF: Biologically active filtration
BAT: Best Available Technology
BCAA: Bromochloroacetic acid
BDOC: Biodegradable organic carbon
BMP: Best management practice
BOM: Biodegradable Organic Matter (=BDOC + AOC)
Br-: Bromide ion
BrO2-: Bromite ion
BrO3-: Bromate ion
CI: Confidence interval
Cl2: Chlorine
ClO2: Chlorine Dioxide
cm: centimeter
CT: Concentration-Time
CWS: Community Water System
D/DBP: Disinfectants/disinfection byproducts
DBP: Disinfection byproduct
DBPFP: Disinfection byproduct formation potential
DBPP: Disinfection byproduct precursors
DBPR: Disinfectants/disinfection byproducts rule
DBPRAM: DBP Regulatory Assessment Model
DBPs: Disinfection byproducts
DOC: Dissolved organic carbon
DPD: N,N-diethyl-p-phenylenediamine
DWEL: Drinking Water Equivalent Level
EBCT: Empty bed contact time
EMSL: EPA Environmental Monitoring and Support Laboratory (Cincinnati)
EPA: United States Environmental Protection Agency
ESWTR: Enhanced Surface Water Treatment Rule
FBR: Filter Backwash Rule
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B
BACKFLOW PREVENTION: To stop or prevent the occurrence of, the unnatural act of reversing
the normal direction of the flow of liquid, gases, or solid substances back in to the public potable
(drinking) water supply. See Cross-connection control.
BACKFLOW: To reverse the natural and normal directional flow of a liquid, gases, or solid
substances back in to the public potable (drinking) water supply. This is normally an undesirable
effect.
BACKSIPHONAGE: A liquid substance that is carried over a higher point. It is the method by which
the liquid substance may be forced by excess pressure over or into a higher point.
BACTERIA: Small, one-celled animals too small to be seen by the naked eye. Bacteria are found
everywhere, including on and in the human body. Humans would be unable to live without the
bacteria that inhabit the intestines and assist in digesting food. Only a small percentage of
bacteria cause disease in normal, healthy humans. Other bacteria can cause infections if they get
into a cut or wound. Bacteria are the principal concern in evaluating the microbiological quality of
drinking water, because some of the bacteria-caused diseases that can be transmitted by
drinking water are potentially life-threatening.
BACTERIOPHAGE: Any of a group of viruses that infect specific bacteria, usually causing their
disintegration or dissolution. A bacteriophage (from 'bacteria' and Greek phagein, 'to eat') is any
one of a number of viruses that infect bacteria. The term is commonly used in its shortened form,
phage. Typically, bacteriophages consist of an outer protein hull enclosing genetic material. The
genetic material can be ssRNA (single stranded RNA), dsRNA, ssDNA, or dsDNA between 5 and
500 kilo base pairs long with either circular or linear arrangement. Bacteriophages are much
smaller than the bacteria they destroy - usually between 20 and 200 nm in size.
BACTERIUM: A unicellular microorganism of the Kingdom Monera. Bacteria are prokaryotes; their
cells have no true nucleus. Bacteria are classified into two groups based on a difference in cell
walls, as determined by Gram staining.
BALANCED POLYMORPHISM: A type of polymorphism in which the frequencies of the coexisting
forms do not change noticeably over many generations.
BARITE: Processed barium sulfate often used to increase drilling fluid densities in mud rotary.
BAROMETER: A device used to measure the pressure in the atmosphere.
BARR BODY: The dense object that lies along the inside of the nuclear envelope in cells of female
mammals, representing the one inactivated X chromosome.
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C
Ca: The chemical symbol for calcium.
CADMIUM: A contaminant that is usually not found naturally in water or in very small amounts.
CAKE: Dewatered sludge material with a satisfactory solids concentration to allow handling as a
solid material.
CALCIUM HARDNESS: A measure of the calcium salts dissolved in water.
CALCIUM ION: Is divalent because it has a valence of +2.
CALCIUM, MAGNESIUM AND IRON: The three elements that cause hardness in water.
CaOCl2.4H2O: The molecular formula of Calcium hypochlorite.
CARBON DIOXIDE GAS: The pH will decrease and alkalinity will change as measured by the
Langelier index after pumping carbon dioxide gas into water.
CARBON DIOXIDE GAS: The pH will decrease and alkalinity will change as measured by the
Langelier index after pumping carbon dioxide gas into water.
CARBONATE HARDNESS: Carbonate hardness is the measure of Calcium and Magnesium and
other hard ions associated with carbonate (CO32-) and bicarbonate (HCO3-) ions contained in a
solution, usually water. It is usually expressed either as parts per million (ppm or mg/L), or in
degrees (KH - from the German "Karbonathärte"). One German degree of carbonate hardness is
equivalent to about 17.8575 mg/L. Both measurements (mg/L or KH) are usually expressed "as
CaCO3" – meaning the amount of hardness expressed as if calcium carbonate was the sole
source of hardness. Every bicarbonate ion only counts for half as much carbonate hardness as a
carbonate ion does. If a solution contained 1 liter of water and 50 mg NaHCO3 (baking soda), it
would have a carbonate hardness of about 18 mg/L as CaCO3. If you had a liter of water
containing 50 mg of Na2CO3, it would have a carbonate hardness of about 29 mg/L as CaCO3.
CARBONATE, BICARBONATE AND HYDROXIDE: Chemicals that are responsible for the
alkalinity of water.
CAROLUS LINNAEUS: Swedish botanist and originator of the binomial nomenclature system of
taxonomic classification
CATALYST: A chemical compound used to change the rate (either to speed up or slow down) of
a reaction, but is regenerated at the end of the reaction.
CATHODIC PROTECTION: An operator should protect against corrosion of the anode and/or the
cathode by painting the copper cathode. Cathodic protection interrupts corrosion by supplying an
electrical current to overcome the corrosion-producing mechanism. Guards against stray current
corrosion.
CATION: Positively charged ion.
CAUSTIC SODA: Also known as sodium hydroxide and is used to raise pH.
CAUSTIC: NaOH (also called Sodium Hydroxide) is a strong chemical used in the treatment
process to neutralize acidity, increase alkalinity or raise the pH value.
CEILING AREA: The specific gravity of ammonia gas is 0.60. If released, this gas will accumulate
first at the ceiling area. Cl2 gas will settle on the floor.
CELL POTENIAL: The force in a galvanic cell that pulls electron through reducing agent to
oxidizing agent.
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D
DAILY MAXIMUM LIMITATIONS: The maximum allowable discharge of pollutants during a 24
hour period. Where daily maximum limitations are expressed in units of mass, the daily discharge
is the total mass discharged over the course of the day. Where daily maximum limitations are
expressed in terms of a concentration, the daily discharge is the arithmetic average measurement
of the pollutant concentration derived from all measurements taken that day.
DANGEROUS CHEMICALS: The most suitable protection when working with a chemical that
produces dangerous fumes is to work under an air hood.
DARCY’S LAW: (Q=KIA) A fundamental equation used in the groundwater sciences to
determine aquifer characteristics, where Q=Flux, K=Hydraulic Conductivity (Permeability), I =
Hydraulic Gradient (change in head), and A = Cross Sectional Area of flow.
DECANT: Separation of a liquid from settled solids by removing the upper layer of liquid after the
solids have settled.
DECIBELS: The unit of measurement for sound.
DECOMPOSE: To decay or rot.
DECOMPOSTION OF ORGANIC MATERIAL: The decomposition of organic material in water
produces taste and odors.
DEIONIZATION: The removal of ions, and in water's case mineral ions such as sodium, iron and
calcium.
DELIQUESCENE: Substances that absorb water from the atmosphere to form liquid solutions.
DEMINERALIZATION PROCESS: Mineral concentration of the feed water is the most important
consideration in the selection of a demineralization process. Acid feed is the most common
method of scale control in a membrane demineralization treatment system.
DENITRIFICATION: A biological process by which nitrate is converted to nitrogen gas.
DENTAL CARIES PREVENTION IN CHILDREN: The main reason that fluoride is added to a
water supply.
DEPOLARIZATION: The removal of hydrogen from a cathode.
DEPOSITION: Settling of particles within a solution or mixture.
DESICCANT: When shutting down equipment which may be damaged by moisture, the unit may
be protected by sealing it in a tight container. This container should contain a desiccant.
DESORPTION: Desorption is a phenomenon whereby a substance is released from or through a
surface. The process is the opposite of sorption (that is, adsorption and absorption). This occurs in
a system being in the state of sorption equilibrium between bulk phase (fluid, i.e. gas or liquid
solution) and an adsorbing surface (solid or boundary separating two fluids). When the
concentration (or pressure) of substance in the bulk phase is lowered, some of the sorbed
substance changes to the bulk state. In chemistry, especially chromatography, desorption is the
ability for a chemical to move with the mobile phase. The more a chemical desorbs, the less likely
it will adsorb, thus instead of sticking to the stationary phase, the chemical moves up with the
solvent front. In chemical separation processes, stripping is also referred to as desorption as one
component of a liquid stream moves by mass transfer into a vapor phase through the liquid-vapor
interface.
DETENTION LAG: Is the period of time between the moment of change in a chlorinator control
system and the moment when the change is sensed by the chlorine residual indicator.
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E
E. COLI, Escherichia coli: A bacterium commonly found in the human intestine. For water quality
analyses purposes, it is considered an indicator organism. These are considered evidence of
water contamination. Indicator organisms may be accompanied by pathogens, but do not
necessarily cause disease themselves.
EARTH METAL: See alkaline earth metal.
E. COLI, Escherichia coli: A bacterium commonly found in the human intestine. For water quality
analyses purposes, it is considered an indicator organism. These are considered evidence of
water contamination. Indicator organisms may be accompanied by pathogens, but do not
necessarily cause disease themselves.
ECDYSONE: A steroid hormone that triggers molting in arthropods.
ECOLOGICAL EFFICIENCY: The ratio of net productivity at one trophic level to net productivity
at the next lower level.
ECOLOGICAL NICHE: The sum total of an organism's utilization of the biotic and abiotic
resources of its environment. The fundamental niche represents the theoretical capabilities and
the realized niche represents the actual role.
ECOLOGY: The study of how organisms interact with their environments.
ECOSYSTEM: The sum of physical features and organisms occurring in a given area.
ECTODERM: The outermost tissue layer of an animal embryo. Also, tissue derived from an
embryonic ectoderm.
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G
G: (protein) A membrane protein that serves as an intermediary between hormone receptors and
the enzyme adenylate cyclase, which converts ATP to cAMP in the second messenger system in
non-steroid hormone action. Depending on the system, G proteins either increase or decrease
cAMP production.
G1 PHASE: The first growth phase of the cell cycle, consisting of the portion of interphase before
DNA synthesis is initiated.
G2 PHASE: The second growth phase of the cell cycle, consisting of the portion of interphase after
DNA synthesis but before mitosis.
GAIA HYPOTHESIS: An idea, first formulated by James E. Lovelock in 1979, which suggests that
the biosphere of the earth exists as a "superorganism" which exhibits homeostatic self- regulation
of the environment-biota global system.
GALVANIC CELL: Battery made up of electrochemical with two different metals connected by salt
bridge.
GAMETANGIUM: The reproductive organ of bryophytes, consisting of the male antheridium and
female archegonium; a multi-chambered jacket of sterile cells in which gametes are formed.
GAMETE: A sexual reproductive cell that must usually fuse with another such cell before
development begins; an egg or sperm.
GAMETOPHYTE: A haploid plant that can produce gametes.
GANGLION: A structure containing a group of cell bodies of neurons.
GAP JUNCTION: A narrow gap between plasma membranes of two animal cells, spanned by
protein channels. They allow chemical substances or electrical signals to pass from cell to cell.
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H
H2SO4: The molecular formula of Sulfuric acid.
HABIT: In biology, the characteristic form or mode of growth of an organism.
HABITAT: The kind of place where a given organism normally lives.
HABITUATION: The process that results in a long-lasting decline in the receptiveness of
interneurons to the input from sensory neurons or other interneurons (sensitization, adaptation).
HALF: The average amount of time it takes for one-half of a specified quantity of a substance to
decay or disappear.
HALIDES: A halide is a binary compound, of which one part is a halogen atom and the other part
is an element or radical that is less electronegative than the halogen, to make a fluoride, chloride,
bromide, iodide, or astatide compound. Many salts are halides. All Group 1 metals form halides
with the halogens and they are white solids. A halide ion is a halogen atom bearing a negative
charge. The halide anions are fluoride (F), chloride (Cl), bromide (Br), iodide (I) and astatide (At).
Such ions are present in all ionic halide salts.
HALL EFFECT: Refers to the potential difference (Hall voltage) on the opposite sides of an
electrical conductor through which an electric current is flowing, created by a magnetic field
applied perpendicular to the current. Edwin Hall discovered this effect in 1879.
HALOACETIC ACIDS: Haloacetic acids are carboxylic acids in which a halogen atom takes the
place of a hydrogen atom in acetic acid. Thus, in a monohaloacetic acid, a single halogen would
replace a hydrogen atom. For example, chloroacetic acid would have the structural formula
CH2ClCO2H. In the same manner, in dichloroacetic acid two chlorine atoms would take the place
of two hydrogen atoms (CHCl2CO2H).
HALOGENS: Group 7 on the Periodic Table and are all non-metals.
HAPLOID: The condition of having only one kind of a given type of chromosome.
HARD WATER: Hard water causes a buildup of scale in household hot water heaters. Hard water
is a type of water that has high mineral content (in contrast with soft water). Hard water primarily
consists of calcium (Ca2+), and magnesium (Mg2+) metal cations, and sometimes other
dissolved compounds such as bicarbonates and sulfates. Calcium usually enters the water as
either calcium carbonate (CaCO3), in the form of limestone and chalk, or calcium sulfate
(CaSO4), in the form of other mineral deposits. The predominant source of magnesium is
dolomite (CaMg(CO3)2). Hard water is generally not harmful. The simplest way to determine the
hardness of water is the lather/froth test: soap or toothpaste, when agitated, lathers easily in soft
water but not in hard water. More exact measurements of hardness can be obtained through a
wet titration. The total water 'hardness' (including both Ca2+ and Mg2+ ions) is read as parts per
million or weight/volume (mg/L) of calcium carbonate (CaCO3) in the water. Although water
hardness usually only measures the total concentrations of calcium and magnesium (the two
most prevalent, divalent metal ions), iron, aluminum, and manganese may also be present at
elevated levels in some geographical locations.
HARDNESS: A measure of the amount of calcium and magnesium salts in water. More calcium
and magnesium lead to greater hardness. The term "hardness" comes from the fact that it is hard
to get soap suds from soap or detergents in hard water. This happens because calcium and
magnesium react strongly with negatively-charged chemicals like soap to form insoluble
compounds.
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IMAGINAL DISK: An island of undifferentiated cells in an insect larva, which are committed
(determined) to form a particular organ during metamorphosis to the adult.
IMBIBITION: The soaking of water into a porous material that is hydrophilic.
IMMUNE RESPONSE: 1) A primary immune response is the initial response to an antigen, which
appears after a lag of a few days. 2) A secondary immune response is the response elicited when
the animal encounters the same antigen at a later time. The secondary response is normally more
rapid, of greater magnitude and of longer duration than the primary response.
IMMUNOGLOBULINE: The class of proteins comprising the antibodies.
IMMUNOLOGICAL: 1) Immunological distance is the amount of difference between two proteins
as measured by the strength of the antigen: antibody reaction between them. 2) Immunological
tolerance is a mechanism by which an animal does not mount an immune response to the antigenic
determinants of its own macromolecules.
IMMUNOMAGNETIC SEPARATION (IMS): A purification procedure that uses microscopic,
magnetically responsive particles coated with an antibodies targeted to react with a specific
pathogen in a fluid stream. Pathogens are selectively removed from other debris using a magnetic
field.
IMPERVIOUS: Not allowing, or allowing only with great difficulty, the movement of water.
IMPRINTING: A type of learned behavior with a significant innate component, acquired during a
limited critical period.
In practice, water with an LSI between -0.5 and +0.5 will not display enhanced mineral dissolving
or scale forming properties. Water with an LSI below -0.5 tends to exhibit noticeably increased
dissolving abilities while water with an LSI above +0.5 tends to exhibit noticeably increased scale
forming properties.
In Series: Several components being connected one to the other without a bypass, requiring
each component to work dependent on the one before it.
IN SERIES: Several components being connected one to the other without a bypass, requiring
each component to work dependent on the one before it.
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JODIUM: Latin name of the halogen element iodine.
JOULE: The SI unit of energy, defined as a newton-meter.
JUXTAGLOMERULAR APPARATUS (JGA): Specialized tissue located near the afferent arteriole
that supplies blood to the kidney glomerulus; JGA raises blood pressure by producing renin, which
activates angiotensin.
K
K- SELECTION: The concept that life history of the population is centered upon producing relatively
few offspring that have a good chance of survival.
KARYOGAMY: The fusion of nuclei of two cells, as part of syngamy.
KARYOTYPE: A method of classifying the chromosomes of a cell in relation to number, size and
type.
KEYSTONE PREDATOR: A species that maintains species richness in a community through
predation of the best competitors in the community, thereby maintaining populations of less
competitive species.
KILL = C X T: Where other factors are constant, the disinfecting action may be represented by:
Kill=C x T. Kill=C x T. C= Chlorine T= Contact time.
KILOCALORIE: A thousand calories; the amount of heat energy required to raise the temperature
of 1 kilogram of water by primary C.
KIN SELECTION: A phenomenon of inclusive fitness, used to explain altruistic behavior between
related individuals.
KINESIS: A change in activity rate in response to a stimulus.
KINETIC ENERGY: The ability of an object to do work by virtue of its motion. The energy terms
that are used to describe the operation of a pump are pressure and head. The energy of motion.
Moving matter does work by transferring some of its kinetic energy to other matter.
KINETICS: A sub-field of chemistry specializing in reaction rates.
KINETOCHORE: A specialized region on the centromere that links each sister chromatid to the
mitotic spindle.
KINGDOM: A taxonomic category, the second broadest after domain.
KREBS CYCLE: A chemical cycle involving eight steps that completes the metabolic breakdown
of glucose molecules to carbon dioxide; occurs within the mitochondrion; the second major stage
in cellular respiration. Also called citric acid cycle or tricarboxylic acid (TCA) cycle.
L
L.O.T.O.: If a piece of equipment is locked out, the key to the lock-out device the key should be
held by the person who is working on the equipment. The tag is an identification device and the
lock is a physical restraint.
LABORATORY BLANK: See Method blank
LABORATORY CONTROL SAMPLE (LCS): See Ongoing precision and recovery (OPR) standard
LACRIMATION: The secretion of tears, esp. in abnormal abundance Also, lachrymation,
lachrimation.
LACTEAL: A tiny lymph vessel extending into the core of the intestinal villus and serving as the
destination for absorbed chylomicrons.
LACTIC ACID: Gram-positive, anaerobic; produce lactic acid through fermentation; include
Lactobacillus, essential in dairy product formation, and Streptococcus, common in humans.
LAGGING STRAND: A discontinuously synthesized DNA strand that elongates in a direction away
from the replication fork.
LAMARCK: Proposed, in the early 1800s, that evolutionary change may occur via the inheritance
of acquired characteristics. This idea, which has since been discredited, holds that the changes in
characteristics which occur during an individual's life can be passed on to its offspring.
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M PHASE: The mitotic phase of the cell cycle, which includes mitosis and cytokinesis.
M.S.D.S.: Material Safety Data Sheet, now S.D.S. (Safety Data Sheet). A safety document must
an employer provide to an operator upon request.
MACROEVOLUTION: Evolutionary change on a grand scale, encompassing the origin of novel
designs, evolutionary trends, adaptive radiation, and mass extinction.
MACROMOLECULE: A giant molecule of living matter formed by the joining of smaller molecules,
usually by condensation synthesis. Polysaccharides, proteins, and nucleic acids are
macromolecules.
MACROPHAGE: An amoeboid cell that moves through tissue fibers, engulfing bacteria and dead
cells by phagocytosis.
MAGNESIUM HARDNESS: Measure of the magnesium salts dissolved in water – it is not a
factor in water balance.
MAJOR HISTOCOMPATIBILITY COMPLEX: A large set of cell surface antigens encoded by a
family of genes. Foreign MHC markers trigger T-cell responses that may lead to rejection of
transplanted tissues and organs.
MAKEUP WATER: Fluid introduced in a recirculating stream to maintain an equilibrium of
temperature, solids concentration or other parameters. Also refers to the quantity of water required
to make a solution.
MALIGNANT TUMOR: A cancerous growth; an abnormal growth whose cells multiply excessively,
have altered surfaces, and may have unusual numbers of chromosomes and/or aberrant metabolic
processes.
MALPHIGHIAN TUBULE: A unique excretory organ of insects that empties into the digestive tract,
removes nitrogenous wastes from the blood, and functions in osmoregulation.
MANTLE: A heavy fold of tissue in mollusks that drapes over the visceral mass and may secrete
a shell.
MARBLE AND LANGELIER TESTS: Are used to measure or determine the corrosiveness of a
water source.
MASS NUMBER: The sum of the number of protons plus the number of neutrons in the nucleus
of an atom; unique for each element and designated by a superscript to the left of the elemental
symbol.
MATRIX SPIKE (MS): A sample prepared by adding a known quantity of organisms to a specified
amount of sample matrix for which an independent estimate of target analyte concentration is
available. A matrix spike is used to determine the effect of the matrix on a method’s recovery
efficiency.
MATRIX: The nonliving component of connective tissue, consisting of a web of fibers embedded in
homogeneous ground substance that may be liquid, jellylike, or solid.
MATTER: Anything that takes up space and has mass.
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N
NAD+: Nicatinamide adenine dinucleotide (oxidized); a coenzyme present in all cells that assists
enzymes in transferring electrons during the redox reactions of metabolism.
NANO-FILTRATION: A specialty membrane filtration process that rejects solutes larger than
approximately one nanometer (10 angstroms) in size.
NANOMETER: A unit of measure (length). 1 nm is equal to 1 x 10: 9 m, or 1/1,000,000 mm.
NaOCl: Is the molecular formula of Sodium hypochlorite.
NaOH: Is the molecular formula of Sodium hydroxide.
NASCENT: Coming into existence; emerging.
NATURAL ORGANIC MATTER: Organic matter present in natural waters.
NEAT: Conditions with a liquid reagent or gas performed with no added solvent or co-solvent.
NEGATIVE CONTROL: See Method blank.
NEGATIVE FEEDBACK: A primary mechanism of homeostasis, whereby a change in a
physiological variable that is being monitored triggers a response that counteracts the initial
fluctuation.
NEURAMINIDASE: A surface enzyme possessed by some influenza viruses which help the virus
penetrate the mucus layer protecting the respiratory epithelium and also plays a role in budding of
new virus particles from infected cells.
NEURON: A nerve cell; the fundamental unit of the nervous system, having structure and
properties that allow it to conduct signals by taking advantage of the electrical charge across its
cell membrane.
NEUROSECRETORY CELLS: Cells that receive signals from other nerve cells, but instead of
signaling to an adjacent nerve cell or muscle, release hormones into the blood stream.
NEUROTRANSMITTER: The chemical messenger released from the synaptic terminals of a
neuron at a chemical synapse that diffuses across the synaptic cleft and binds to and stimulates
the postsynaptic cell.
NEUTRAL VARIATION: Genetic diversity that confers no apparent selective advantage.
NEUTRALIZATION REACTIONS: Chemical reactions between acids and bases where water is
an end product.
NEUTRALIZATION: The chemical process that produces a solution that is neither acidic nor
alkaline. Usually with a pH between 6 and 8.
NEUTRINO: A particle that can travel at speeds close to the speed of light and are created as a
result of radioactive decay.
NEUTRON: An uncharged subatomic particle of about the same size and mass as a proton.
NH4+: The molecular formula of the Ammonium ion.
NITRATES: A dissolved form of nitrogen found in fertilizers and sewage by-products that may
leach into groundwater and other water sources. Nitrates may also occur naturally in some
waters. Over time, nitrates can accumulate in aquifers and contaminate groundwater.
NITROGEN AND PHOSPHORUS: Pairs of elements and major plant nutrients that cause algae
to grow.
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O
O3: The molecular formula of ozone.
OLIGOTROPHIC: A reservoir that is nutrient-poor and contains little plant or animal life. An
oligotrophic ecosystem or environment is one that offers little to sustain life. The term is commonly
utilized to describe bodies of water or soils with very low nutrient levels. It derives etymologically
from the Greek oligo (small, little, few) and trophe (nutrients, food). Oligotrophic environments are
of special interest for the alternative energy sources and survival strategies upon which life could
rely.
ONGOING PRECISION AND RECOVERY (OPR) STANDARD: A method blank spiked with
known quantities of analytes. The OPR is analyzed exactly like a sample. Its purpose is to assure
that the results produced by the laboratory remain within the limits specified in this method for
precision and recovery.
OOCYST AND CYST STOCK SUSPENSION: See Stock suspension.
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PAC: A disadvantage of using PAC is it is very abrasive and requires careful maintenance of
equipment. One precaution that should be taken in storing PAC is that bags of carbon should not
be stored near bags of HTH. Removes tastes and odors by adsorption only. Powered activated
carbon frequently used for taste and odor control because PAC is non-specific and removes a
broad range of compounds. Jar tests and threshold odor number testing determines the
application rate for powdered activated carbon. Powdered activated carbon, or PAC, commonly
used for in a water treatment plant for taste and odor control. Powdered activated carbon may be
used with some success in removing the precursors of THMs.
PARAMECIUM: Paramecia are a group of unicellular ciliate protozoa formerly known as slipper
animalcules from their slipper shape. They are commonly studied as a representative of the
ciliate group. Simple cilia cover the body which allows the cell to move with a synchronous
motion (like a caterpilla). There is also a deep oral groove containing inconspicuous compound
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Q
QUANTA: It is the minimum amount of bundle of energy.
QUANTITATIVE TRANSFER: The process of transferring a solution from one container to
another using a pipette in which as much solution as possible is transferred, followed by rinsing of
the walls of the source container with a small volume of rinsing solution (e.g., reagent water,
buffer, etc.), followed by transfer of the rinsing solution, followed by a second rinse and transfer.
QUANTUM MECHANICS: The study of how atoms, molecules, subatomic particles, etc. behave
and are structured.
QUARKS: Elementary particle and a fundamental constituent of matter.
QUICKLIME: A calcium oxide material produced by calcining limestone to liberate carbon
dioxide, also called “calcined lime” or “pebble lime”, commonly used for pH adjustment. Chemical
formula is CaO.
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S- BLOCK ELEMENTS: Group 1 and 2 elements (alkali and alkaline metals), which includes
Hydrogen and Helium.
S.T.P.: Standard temperature and pressure standard temperature and pressure the
temperature of 0°C and pressure of 1 atmosphere, usually taken as the conditions when stating
properties of gases.
SAFE YIELD: A possible consequence when the “safe yield” of a well is exceeded and water
continues to be pumped from a well, is land subsidence around the well will occur. Safe yield
refers to a long-term balance between the water that is naturally and artificially recharged to an
aquifer and the groundwater that is pumped out. When more water is removed than is recharged,
the aquifer is described as being out of safe yield. When the water level in the aquifer then drops,
we are said to be mining groundwater.
SALINE SOLUTION: General term for NaCl in water.
SALT BRIDGE: Devices used to connection reduction with oxidation half-cells in an
electrochemical cell.
SALTS ARE ABSENT: Is a strange characteristic that is unique to water vapor in the atmosphere.
SALTS: Ionic compounds composed of anions and cations.
SAMPLE: The water that is analyzed for the presence of EPA-regulated drinking water
contaminants. Depending on the regulation, EPA requires water systems and states to take
samples from source water, from water leaving the treatment facility, or from the taps of selected
consumers. Sampling Location: A location where soil or cuttings samples may be readily and
accurately collected.
SANITARY SURVEY: Persons trained in public health engineering and the epidemiology of
waterborne diseases should conduct the sanitary survey. The importance of a detailed sanitary
survey of a new water source cannot be overemphasized. An on-site review of the water sources,
facilities, equipment, operation, and maintenance of a public water systems for the purpose of
evaluating the adequacy of the facilities for producing and distributing safe drinking water. The
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T
TALC: A mineral representing the one on the Mohs Scale and composed of hydrated magnesium
silicate with the chemical formula H2Mg3(SiO3)4 or Mg3Si4O10(OH)2.
TASTE AND ODORS: The primary purpose to use potassium permanganate in water treatment is
to control taste and odors. Anaerobic water undesirable for drinking water purposes because of
color and odor problems are more likely to occur under these conditions. Taste and odor
problems in the water may happen if sludge and other debris are allowed to accumulate in a
water treatment plant.
TCE, trichloroethylene: A solvent and degreaser used for many purposes; for example dry
cleaning, it is a common groundwater contaminant. Trichloroethylene is a colorless liquid which is
used as a solvent for cleaning metal parts. Drinking or breathing high levels of trichloroethylene
may cause nervous system effects, liver and lung damage, abnormal heartbeat, coma, and
possibly death. Trichloroethylene has been found in at least 852 of the 1,430 National Priorities
List sites identified by the Environmental Protection Agency (EPA).
TDS: Ion exchange is an effective treatment process used to remove iron and manganese in a
water supply. This process is ideal as long as the water does not contain a large amount of TDS.
When determining the total dissolved solids, a sample should be filtered before being poured into
an evaporating dish and dried. Demineralization may be necessary in a treatment process if the
water has a very high value Total Dissolved Solids.
TDS-TOTAL DISSOLVED SOLIDS: An expression for the combined content of all inorganic and
organic substances contained in a liquid which are present in a molecular, ionized or micro-
granular (colloidal sol) suspended form. Generally, the operational definition is that the solids
(often abbreviated TDS) must be small enough to survive filtration through a sieve size of two
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U
U.S. ENVIRONMENTAL PROTECTION AGENCY: In the United States, this agency responsible
for setting drinking water standards and for ensuring their enforcement. This agency sets federal
regulations which all state and local agencies must enforce.
ULTRAFILTRATION: A low pressure membrane filtration process which separates solutes up to
0.1 micron size range.
UN NUMBER: A four digit code used to note hazardous and flammable substances.
UNCERTAINTY PRINCIPLE: Knowing the location of a particle makes the momentum uncertain,
while knowing the momentum of a particle makes the location uncertain.
UNCERTAINTY: A characteristic that any measurement that involves estimation of any amount
cannot be exactly reproducible.
UNDER PRESSURE IN STEEL CONTAINERS: After chlorine gas is manufactured, it is primarily
transported in steel containers.
UNIT CELL: The smallest repeating unit of a lattice.
UNIT FACTOR: Statements used in converting between units.
UNIT FILTER RUN VOLUME (UFRV): One of the most popular ways to compare filter runs. This
technique is the best way to compare water treatment filter runs.
UNIVERSAL OR IDEAL GAS CONSTANT: Proportionality constant in the ideal gas law (0.08206
Lꞏatm/(Kꞏmol)).
UP FLOW CLARIFIER: Clarifier where flocculated water flows upward through a sludge blanket to
obtain floc removal by contact with flocculated solids in the blanket.
V
VALENCE BOND THEORY: A theory explaining the chemical bonding within molecules by
discussing valencies, the number of chemical bonds formed by an atom.
VALENCE ELECTRON: The outermost electrons of an atom, which are located in electron shells.
VAN DER WAALS FORCE: One of the forces (attraction/repulsion) between molecules.
VAN’T HOFF FACTOR: Ratio of moles of particles in solution to moles of solute dissolved.
VAPOR PRESSURE: Pressure of vapor over a liquid at equilibrium.
VAPOR: The gaseous phase of a material that is in the solid or liquid state at standard temperature
and pressure.
VAPOR: When a substance is below the critical temperature while in the gas phase.
VAPORIZATION: Phase change from liquid to gas.
VELOCITY HEAD: The vertical distance a liquid must fall to acquire the velocity with which it
flows through the piping system. For a given quantity of flow, the velocity head will vary indirectly
as the pipe diameter varies.
VELOCITY HEAD: The vertical distance a liquid must fall to acquire the velocity with which it
flows through the piping system. For a given quantity of flow, the velocity head will vary indirectly
as the pipe diameter varies.
VENTURI: If water flows through a pipeline at a high velocity, the pressure in the pipeline is
reduced. Velocities can be increased to a point that a partial vacuum is created.
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WAIVERS: Monitoring waivers for nitrate and nitrite are prohibited.
WASTE ACTIVATED SLUDGE: Excess activated sludge that is discharged from an activated
sludge treatment process.
WASTEWATER: Liquid or waterborne wastes polluted or fouled from households, commercial or
industrial operations, along with any surface water, storm water or groundwater infiltration.
WATER H2O: A chemical substance, a major part of cells and Earth, and covalently bonded.
WATER HAMMER: A surge in a pipeline resulting from the rapid increase or decrease in water
flow. Water hammer exerts tremendous force on a system and can be highly destructive.
WATER PURVEYOR: The individuals or organization responsible to help provide, supply, and
furnish quality water to a community.
WATER QUALITY CRITERIA: Comprised of both numeric and narrative criteria. Numeric criteria
are scientifically derived ambient concentrations developed by EPA or States for various
pollutants of concern to protect human health and aquatic life. Narrative criteria are statements
that describe the desired water quality goal.
WATER QUALITY CRITERIA: Comprised of both numeric and narrative criteria. Numeric criteria
are scientifically derived ambient concentrations developed by EPA or States for various pollutants
of concern to protect human health and aquatic life. Narrative criteria are statements that describe
the desired water quality goal.
WATER QUALITY STANDARD: A statute or regulation that consists of the beneficial designated
use or uses of a waterbody, the numeric and narrative water quality criteria that are necessary to
protect the use or uses of that particular waterbody, and an antidegradation statement.
WATER QUALITY: The 4 broad categories of water quality are: Physical, chemical, biological,
radiological. Pathogens are disease causing organisms such as bacteria and viruses. A positive
bacteriological sample indicates the presence of bacteriological contamination. Source water
monitoring for lead and copper be performed when a public water system exceeds an action level
for lead of copper.
WATER RECLAMATION: The restoration of wastewater to a state that will allow its beneficial
reuse.
WATER VAPOR: A characteristic that is unique to water vapor in the atmosphere is that water
does not contain any salts.
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X
X-RAY DIFFRACTION: A method for establishing structures of crystalline solids using singe
wavelength X-rays and looking at diffraction pattern.
X-RAY PHOTOELECTRON SPECTROSCOPY: A spectroscopic technique to measure
composition of a material.
X-RAY: Form of ionizing, electromagnetic radiation, between gamma and UV rays.
Y
YIELD: The amount of product produced during a chemical reaction.
Z
ZERO DISCHARGE: A facility that discharges no liquid effluent to the environment.
ZONE MELTING: A way to remove impurities from an element by melting it and slowly travel
down an ingot (cast).
ZWITTERION: Is a chemical compound whose net charge is zero and hence is electrically
neutral. But there are some positive and negative charges in it, due to the formal charge, owing to
the partial charges of its constituent atoms.
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The following are terms that will be found in this course, especially in the
waterborne disease area and laboratory/sampling chapters.
Best available technology or BAT means the best technology, treatment techniques, or
other means which the Administrator finds, after examination for efficacy under field
conditions and not solely under laboratory conditions, are available (taking cost into
consideration). For the purposes of setting MCLs for synthetic organic chemicals, any BAT
must be at least as effective as granular activated carbon.
Community water system is a public water system which serves at least 15 service
connections used by year-round residents, or regularly serves at least 25 year-round
residents.
Compliance cycle is the nine-year calendar year cycle during which public water systems
must monitor. Each compliance cycle consists of three three-year compliance periods.
Compliance period is a three-year calendar year period within a compliance cycle. Each
compliance cycle has three three-year compliance periods.
Point-of-use treatment device (POU) is a treatment device applied to a single tap used
for the purpose of reducing contaminants in drinking water at that one tap.
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State means the agency of the State or Tribal government which has jurisdiction over
public water systems. During any period when a State or Tribal government does not have
primary enforcement responsibility pursuant to section 1413 of the Act, the term "State"
means the Regional Administrator of the U.S. Environmental Protection Agency.
Surface water means all water which is open to the atmosphere and subject to surface
runoff.
Fecal Coliform and E coli are bacteria whose presence indicates that the water may be
contaminated with human or animal wastes. Microbes in these wastes can cause short-
term effects, such as diarrhea, cramps, nausea, headaches, or other symptoms.
Turbidity has no health effects. However, turbidity can interfere with disinfection and
provide a medium for microbial growth. Turbidity may indicate the presence of disease
causing organisms. These organisms include bacteria, viruses, and parasites that can
cause symptoms such as nausea, cramps, diarrhea, and associated headaches.
Cryptosporidium is a parasite that enters lakes and rivers through sewage and animal
waste. It causes cryptosporidiosis, a mild gastrointestinal disease. However, the disease
can be severe or fatal for people with severely weakened immune systems. The EPA and
CDC have prepared advice for those with severely compromised immune systems who
are concerned about Cryptosporidium.
Giardia lamblia is a parasite that enters lakes and rivers through sewage and animal
waste. It causes gastrointestinal illness (i.e., diarrhea, vomiting, and cramps).
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3. What do the following abbreviations stand for and what do they mean: gpm,
MGD, TTHM, psi, HAA, NTU, and mg/L.
Gallons per minute- Million Gallons a Day - Total Trihalomethanes – Pounds Per Square
Inch –Haloacetic acids - Nephelometric turbidity unit -Milligrams Per Liter
4. What are the relationship between mg/L and ppm; ug/L and ppb?
Milligram per liter: Milligram per liter of substance and part per million are equals
amounts in water. While you can easily convert between micrograms/liter and
milligrams/liter, and between PPM and PPB, it’s not so easy to convert between the
different types of units such as milligrams/liter to PPM.
To convert to PPM, you would first need to know the density of the substance, and the
density of what the substance is in.
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Parts per million (ppm) or Milligrams per liter (mg/l) - one part per million corresponds to
one minute in two years or a single penny in $10,000.
Parts per billion (ppb) or Micrograms per liter - one part per billion corresponds to one
minute in 2,000 years, or a single penny in $10,000,000.
Parts per trillion (ppt) or Nanograms per liter (nanograms/l) - one part per trillion
corresponds to one minute in 2,000,000 years, or a single penny in $10,000,000,000.
7. Fecal Coliform: Fecal coliform positive indicates the presence of E. coli, which
means there is a greater chance of pathogens being present. The laboratory tests for
coliform include the MPN method, the Membrane Filter test, the Colilert test, and the
presence-absence test.
10. Point-of-entry sample (POE): A type of water sample taken after treatment and
before reaching the first consumer.
11. Acute Health Effect: An immediate (i.e. within hours or days) effect that may result
from exposure to certain drinking water contaminants (e.g., pathogens).
12. Non-acute violation: If the MCL is exceeded and none of the positive results
indicated a presence of Fecal Coliform, a Tier 2 violation has occurred. This level of
violation used to be called a non-acute violation.
13. Routine Sample: Samples collected on a routine basis to monitor for contamination.
Collection should be in accordance with an approved sampling plan.
This course contains EPA’s federal rule requirements. Please be aware that each state
implements drinking water regulations that may be more stringent than EPA’s
regulations. Check with your state environmental agency for more information.
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There is an important exception to the three repeat samples rule. The regulations also
state that when repeats are taken the minimum number of samples is raised to five for the
month. A system that collects just one sample a month must collect four repeat samples,
when the sample is positive, in order to have five samples as required.
Whenever a system has to take repeat samples, a minimum of five routine samples must
also be submitted the following month. This is only an issue for systems that normally turn
in four or fewer samples each month. If the five samples are negative the system can
return to its normal sampling schedule the next month.
Small systems that have fewer than four sampling sites have a problem complying with
the “upstream and downstream” aspects of the repeat sampling requirements. In this case,
samples should be taken at as many separate sites as possible and then wait a minimum
of 2 hours before resampling enough sites to get the required number of samples. Repeat
sample with red seal tape.
16. Action level: The level of lead or copper which, if exceeded, triggers treatment or
other requirements that a water system must follow.
17. What does the membrane filter test analyze with regards to bacteriological
sampling?
Membrane Filter Technique: A standard test used for measuring coliform numbers
(quantity) in water is the membrane filter technique. This technique involves filtering a
known volume of water through a special sterile filter. These filters are made of
nitrocellulose acetate and polycarbonate, are 150 μm thick, and have 0.45 μm diameter
pores. A grid pattern is printed on these filter disks in order to facilitate colony counting.
When the water sample is filtered, bacteria (larger than 0.45 μm) in the sample are trapped
on the surface of the filter. The filter is then carefully removed, placed in a sterile petri
plate on a pad saturated with a liquid medium, and incubated for 20-24 hours at 37°C.
One assumes that each bacterium trapped on the filter will then grow into a separate
colony. By counting the colonies one can directly determine the number of bacteria in the
water sample that was filtered. The broth medium usually employed in detecting total
coliforms is M-Endo Broth MF. Total coliform colonies will be pink to dark red in color and
will appear to have a golden green color.
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19. Pathogenic: Organisms or bugs that cause disease. These include bacteria, viruses,
cysts and anything capable of causing disease in humans, like cryptosporidiosis, typhoid,
cholera and so on. There are other organisms that do not create disease, these are called
non-pathogenic organisms.
20. Toxic: Stuff that will kill you. A substance which is poisonous to living organisms.
21. pH: A measure of the acidity of water. The pH scale runs from 0 to 14 with 7 being
the mid point or neutral. A pH of less than 7 is on the acid side of the scale with 0 as the
point of greatest acid activity. A pH of more than 7 is on the basic (alkaline) side of the
scale with 14 as the point of greatest basic activity. For example, the acidity of a sample
with a pH of 5 is ten times greater than that of a sample with a pH of 6. A difference of 2
units, from 6 to 4, would mean that the acidity is one hundred times greater, and so on.
Normal rain has a pH of 5.6 – slightly acidic because of the carbon dioxide picked up in
the earth's atmosphere by the rain.
22. Aesthetic: Attractive or appealing water or things in water that will not make you sick
but may appear to change the water’s color or taste.
23. Culinary: Having to do with cooking food. Potable water is often called culinary water.
26. What is Escherichia Coliform and what does it indicate in relation to drinking
water?
E. coli is a sub-group of the fecal coliform group. Most E. coli bacteria are harmless and
are found in great quantities in the intestines of people and warm-blooded animals. Some
strains, however, can cause illness. The presence of E. coli in a drinking water sample
almost always indicates recent fecal contamination meaning there is a greater risk that
pathogens are present.
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27. What problems are associated with Hydrogen Sulfide in the water?
Hydrogen sulfide is a gas which, when dissolved in water, gives it a “rotten egg” odor.
Chlorination will remove this gas from the water but the effectiveness of the chlorine for
disinfection is lessened.
28. When Hydrogen sulfide reacts with chlorine, it produces Sulfuric acid and
elemental Sulfur: It is therefore recommended that aeration be applied prior to the
addition of chlorine for the most effective disinfection.
29. Why is it important to know what the turbidity of the water is when using
chlorine? To be careful not to overdose with chlorine or properly dose with chlorine.
The rule also strengthens filter performance requirements to ensure 2-log Cryptosporidium
removal, establishes individual filter monitoring to minimize poor performance in individual
units, includes Cryptosporidium in the definition of GWUDI, and explicitly considers
unfiltered system watershed control provisions. The rule also reflects a commitment to the
importance of maintaining existing levels of microbial protection in public water systems
as plants take steps to comply with newly applicable DBP standards.
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32. What are the turbidity requirements for Direct and Conventional filtration
plants?
For conventional and direct filtration systems (including those systems utilizing in-line
filtration), the turbidity level of representative samples of a system's filtered water
(measured every four hours) must be less than or equal to 0.3 NTU in at least 95 percent
of the measurements taken each month. The turbidity level of representative samples of
a system's filtered water must not exceed 1 NTU at any time. Conventional filtration is
defined as a series of processes including coagulation, flocculation, sedimentation, and
filtration resulting in substantial particulate removal. Direct filtration is defined as a series
of processes including coagulation and filtration but excluding sedimentation resulting in
substantial particle removal.
33. What are chloramines, how are they formed, and do they have any beneficial
use?
Chloramines: Ammonia and Chlorine are combined. Cl2NH3 Yes, limited use and this
chemical will create less THMS than chlorine alone. Chloramine is a disinfectant used to
treat drinking water. It is formed by mixing chlorine with ammonia. Although it is a weaker
disinfectant than chlorine, it is more stable and extends disinfectant benefits throughout a
water utility's distribution system (a system of pipes water is delivered to homes through).
Some water systems use chloramine as a secondary disinfectant to maintain a disinfectant
residual throughout the distribution system so that drinking water remains safe as it travels
from the treatment facility to the customer.
Chloramine has been used by water systems for almost 90 years, and its use is closely
regulated. Since chloramine is not as reactive as chlorine, it forms fewer disinfection
byproducts.
Some disinfection byproducts, such as the trihalomethanes (THMs) and haloacetic acids
(HAAs), may have adverse health effects and are closely regulated. Because a chloramine
residual is more stable and longer lasting than free chlorine, it provides better protection
against bacterial regrowth in systems with large storage tanks and dead-end water mains.
Chloramine, like chlorine, is effective in controlling biofilm, which is a coating in the pipe
caused by bacteria. Controlling biofilm also tends to reduce coliform bacteria
concentrations and biofilm-induced corrosion of pipes.
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The diverse assemblage of organisms that carry out all of their life functions within the
confines of a single, complex eukaryotic cell are called protozoa.
Paramecium, Euglena, and Amoeba are well-known examples of these major groups of
organisms. Some protozoa are more closely related to animals, others to plants, and still
others are relatively unique. Although it is not appropriate to group them together into a
single taxonomic category, the research tools used to study any unicellular organism are
usually the same, and the field of protozoology has been created to carry out this research.
The unicellular photosynthetic protozoa are sometimes also called algae and are
addressed elsewhere. This report considers the status of our knowledge of heterotrophic
protozoa (protozoa that cannot produce their own food).
Free-living Protozoa
Protozoans are found in all moist habitats within the United States, but we know little about
their specific geographic distribution. Because of their small size, production of resistant
cysts, and ease of distribution from one place to another, many species appear to be
cosmopolitan and may be collected in similar microhabitats worldwide (Cairns and
Ruthven 1972). Other species may have relatively narrow limits to their distribution.
Marine ciliates inhabit interstices of sediment and beach sands, surfaces, deep sea and
cold Antarctic environments, planktonic habitats, and the algal mats and detritus of
estuaries and wetlands.
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Protozoa are around 10–50 micrometer, but can grow up to 1 mm and can easily be seen
under a microscope. Protozoa exist throughout aqueous environments and soil. Protozoa
occupy a range of trophic levels. As predators, they prey upon unicellular or filamentous
algae, bacteria, and microfungi.
Protozoa play a role both as herbivores and as consumers in the decomposer link of the
food chain. Protozoa also play a vital role in controlling bacteria populations and biomass.
As components of the micro- and meiofauna, protozoa are an important food source for
microinvertebrates. Thus, the ecological role of protozoa in the transfer of bacterial and
algal production to successive trophic levels is important. Protozoa such as the malaria
parasites (Plasmodium spp.), trypanosomes and leishmania are also important as
parasites and symbionts of multicellular animals.
Most protozoa exist in 5 stages of life which are in the form of trophozoites and cysts. As
cysts, protozoa can survive harsh conditions, such as exposure to extreme temperatures
and harmful chemicals, or long periods without access to nutrients, water, or oxygen for a
period of time.
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The process by which the protozoa takes its cyst form is called encystation, while the
process of transforming back into trophozoite is called excystation.
Protozoa can reproduce by binary fission or multiple fission. Some protozoa reproduce
sexually, some asexually, and some both (e.g. Coccidia). An individual protozoan is
hermaphroditic.
Classification
Protozoa were commonly grouped in the kingdom of Protista together with the plant-like
algae and fungus-like water molds and slime molds. In the 21st-century systematics,
protozoans, along with ciliates, mastigophorans, and apicomplexans, are arranged as
animal-like protists. However, protozoans are neither Animalia nor Metazoa (with the
possible exception of the enigmatic, moldy Myxozoa).
Sub-groups
Protozoa have traditionally been divided on the basis of their means of locomotion,
although this is no longer believed to represent genuine relationships:
* Flagellates (e.g. Giardia lambia)
* Amoeboids (e.g. Entamoeba histolytica)
* Sporozoans (e.g. Plasmodium knowlesi)
* Apicomplexa
* Myxozoa
* Microsporidia
* Ciliates (e.g. Balantidium coli)
There are many ways that infectious diseases can spread. Pathogens usually have
specific routes by which they are transmitted, and these routes may depend on the type
of cells and tissue that a particular agent targets. For example, because cold viruses infect
the respiratory tract, they are dispersed into the air via coughing and sneezing.
Once in the air, the viruses can infect another person who is unlucky enough to inhale air
containing the virus particles.
Agents vary greatly in their stability in the environment. Some viruses may survive for only
a few minutes outside of a host, while some spore-forming bacteria are extremely durable
and may survive in a dormant state for a decade or more.
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Most have mitochondria although some have later lost theirs. Mitochondria were
derived from aerobic alpha-proteobacteria (prokaryotes) that once lived within their
cells.
Eukaryotic Cells
Eukaryotic cells are generally much larger than prokaryotes, typically with a thousand
times their volumes. They have a variety of internal membranes and structures, called
organelles, and a cytoskeleton composed of microtubules and microfilaments, which plays
an important role in defining the cell's organization.
Eukaryotic DNA is divided into several bundles called chromosomes, which are separated
by a microtubular spindle during nuclear division. In addition to asexual cell division, most
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The nucleus is surrounded by a double membrane, with pores that allow material to move
in and out. Various tube- and sheet-like extensions of the nuclear membrane form what is
called the endoplasmic reticulum or ER, which is involved in protein transport. It includes
rough sections where ribosomes are attached, and the proteins they synthesize enter the
interior space or lumen. Subsequently, they generally enter vesicles, which bud off from
the smooth section. In most eukaryotes, the proteins may be further modified in stacks of
flattened vesicles, called Golgi bodies or dictyosomes.
Vesicles may be specialized for various purposes. For instance, lysosomes contain
enzymes that break down the contents of food vacuoles, and peroxisomes are used to
break down peroxide which is toxic otherwise.
Contractile Vacuoles
Many protozoa have contractile vacuoles, which collect and expel excess water, and
extrusomes, which expel material used to deflect predators or capture prey. In multicellular
organisms, hormones are often produced in vesicles. In higher plants, most of a cell's
volume is taken up by a central vacuole or tonoplast, which maintains its osmotic pressure.
Many eukaryotes have slender motile projections, usually called flagella when long and
cilia when short. These are variously involved in movement, feeding, and sensation. These
are entirely distinct from prokaryotic flagella. They are supported by a bundle of
microtubules arising from a basal body, also called a kinetosome or centriole,
characteristically arranged as nine doublets surrounding two singlets. Flagella also may
have hairs or mastigonemes, scales, connecting membranes, and internal rods. Their
interior is continuous with the cell's cytoplasm.
Centrioles
Centrioles are often present even in cells and groups that do not have flagella. They
generally occur in groups of one or two, called kinetids that give rise to various
microtubular roots. These form a primary component of the cytoskeletal structure, and are
often assembled over the course of several cell divisions, with one flagellum retained from
the parent and the other derived from it.
Centrioles may also be associated in the formation of a spindle during nuclear division.
Some protists have various other microtubule-supported organelles. These include the
radiolaria and heliozoa, which produce axopodia used in flotation or to capture prey, and
the haptophytes, which have a peculiar flagellum-like organelle called the haptonema.
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These pseudopods are also used to capture prey; they simply engulf the food. They can
detect the kind of prey and use different 'engulfing tactics'.
The image from the last page shows several cell organelles. Left from the center we can
see aspherical water expelling vesicle and just right of it, the single nucleus of this species
can be seen. Other species may have many nuclei. The cell is full of brown food vacuoles
and also contains small crystals.
Protozoa Information
Our actual knowledge of salinity, temperature, and oxygen requirements of marine
protozoa is poor (although some groups, such as the foraminifera, are better studied than
others), and even the broadest outlines of their biogeographic ranges are usually a
mystery.
Soil-dwelling protozoa have been documented from almost every type of soil and in every
kind of environment, from the peat-rich soil of bogs to the dry sands of deserts. In general,
protozoa are found in greatest abundance near the soil surface, especially in the upper 15
cm (6 in), but occasional isolates can be obtained at depths of a meter (yard) or more.
Protozoa do not constitute a major part of soil biomass, but in some highly productive
regions such as forest litter, the protozoa are a significant food source for the
microinvertebrates, with a biomass that may reach 20 g/m2 of soil surface area there.
Bick (1972), for example, provided a guide to ciliates that are useful as indicators of
environmental quality of European freshwater systems, along with their ecological
distribution with respect to parameters such as amount of organic material and oxygen
levels. Foissner (1988) clarified the taxonomy of European ciliates as part of a system for
classifying the state of aquatic habitats according to their faunas.
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The word amoeba or ameba is variously used to refer to it and its close relatives, now
grouped as the Amoebozoa, or to all protozoa that move using pseudopods, otherwise
termed amoeboids.
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There is also a deep oral groove containing inconspicuous compound oral cilia (as found
in other peniculids) that is used to draw food inside. They generally feed upon bacteria
and other small cells. Osmoregulation is carried out by a pair of contractile vacuoles, which
actively expel water absorbed by osmosis from their surroundings.
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Parasites
Protozoa are infamous for their role in causing disease, and parasitic species are among
the best-known protozoa. Nevertheless, our knowledge has large gaps, especially of
normally free-living protozoa that may become pathogenic in immunocompromised
individuals.
They are found worldwide and have the ability to thrive in many ecological conditions. Until
the past few years, their ubiquity did not cause a threat to human health, and few
systematists worked to describe and classify the species.
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Recently, however, certain human pathogens were shown to not only survive but also to
multiply in the cytoplasm of free-living, nonpathogenic protozoa. Indeed, it is now believed
that protozoa are the natural habitat for certain pathogenic bacteria. To date, the main
focus of attention has been on the bacterium Legionella pneumophila, the causative
organism of Legionnaires' disease; these bacteria live and reproduce in the cytoplasm of
some free-living amoebae (Curds 1992). More on this subject in the following pages.
Symbionts
Some protozoa are harmless or even beneficial symbionts. A bewildering array of ciliates,
for example, inhabit the rumen and reticulum of ruminates and the cecum and colon of
equids. Little is known about the relationship of the ciliates to their host, but a few may aid
the animal in digesting cellulose.
Data on Protozoa
While our knowledge of recent and fossil foraminifera in the U.S. coastal waterways is
systematically growing, other free-living protozoa are poorly known. There are some
regional guides and, while some are excellent, many are limited in scope, vague on
specifics, or difficult to use. Largely because of these problems, most ecologists who
include protozoa in their studies of aquatic habitats do not identify them, even if they do
count and measure them for biomass estimates (Taylor and Sanders 1991).
Parasitic protozoa of humans, domestic animals, and wildlife are better known although
no attempt has been made to compile this information into a single source. Large gaps in
our knowledge exist, especially for haemogregarines, microsporidians, and
myxosporidians (see Kreier and Baker 1987).
Museum Specimens
For many plant and animal taxa, museums represent a massive information resource. This
is not true for protozoa. In the United States, only the National Natural History Museum
(Smithsonian Institution) has a reference collection preserved on microscope slides, but it
does not have a protozoologist curator and cannot provide species' identification or
verification services. The American Type Culture Collection has some protozoa in culture,
but its collection includes relatively few kinds of protozoa.
As components of the micro- and meiofauna, protozoa are an important food source for
microinvertebrates. Thus, the ecological role of protozoa in the transfer of bacterial and
algal production to successive trophic levels is important.
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Because of the small size of protozoa, their short generation time, and (for some species)
ease of maintaining them in the laboratory, ecologists have used protozoan populations
and communities to investigate competition and predation.
The result has been an extensive literature on a few species studied primarily under
laboratory conditions. Few studies have been extended to natural habitats with the result
that we know relatively little about most protozoa and their roles in natural communities.
Intraspecific competition for common resources often results in cannibalism, sometimes
with dramatic changes in morphology of the cannibals (Giese 1973). Field studies of
interspecific competition are few and most evidence for such species interactions is
indirect (Cairns and Yongue 1977).
Contractile Vacuoles
Many protozoa have contractile vacuoles, which collect and expel excess water, and
extrusomes, which expel material used to deflect predators or capture prey. In multicellular
organisms, hormones are often produced in vesicles. In higher plants, most of a cell's
volume is taken up by a central vacuole or tonoplast, which maintains its osmotic pressure.
Many eukaryotes have slender motile projections, usually called flagella when long and
cilia when short.
These are variously involved in movement, feeding, and sensation. These are entirely
distinct from prokaryotic flagella. They are supported by a bundle of microtubules arising
from a basal body, also called a kinetosome or centriole, characteristically arranged as
nine doublets surrounding two singlets. Flagella also may have hairs or mastigonemes,
scales, connecting membranes, and internal rods. Their interior is continuous with the
cell's cytoplasm.
233
Centrioles may also be associated in the formation of a spindle during nuclear division.
Some protists have various other microtubule-supported organelles. These include the
radiolaria and heliozoa, which produce axopodia used in flotation or to capture prey, and
the haptophytes, which have a peculiar flagellum-like organelle called the haptonema.
Paramecium
Members of the genus Paramecium are single-celled, freshwater organisms in the
kingdom Protista. They exist in an environment in which the osmotic concentration in their
external environment is much lower than that in their cytoplasm. More specifically, the
habitat in which they live is hypotonic to their cytoplasm. As a result of this, Paramecium
is subjected to a continuous influx of water, as water diffuses inward to a region of higher
osmotic concentration.
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Giardiasis
Giardiasis is a commonly reported protozoan-caused disease. It has also been
referred to as “backpacker’s disease” and “beaver fever” because of the many cases
reported among hikers and others who consume untreated surface water. Symptoms
include chronic diarrhea, abdominal cramps, bloating, frequent loose and pale greasy
stools, fatigue and weight loss.
The incubation period is 5-25 days or longer, with an average of 7-10 days. Many
infections are asymptomatic (no symptoms).
Giardiasis occurs worldwide. Waterborne outbreaks in the United States occur most
often in communities receiving their drinking water from streams or rivers without
adequate disinfection or a filtration system. The organism, Giardia lamblia, has been
responsible for more community-wide outbreaks of disease in the U.S. than any other
pathogen. Drugs are available for treatment but are not 100% effective.
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All of these diseases, with the exception of hepatitis A, have one symptom in common:
diarrhea. They also have the same mode of transmission, fecal-oral, whether through
person-to-person or animal-to-person contact, and the same routes of transmission,
being either foodborne or waterborne.
Although most pathogens cause mild, self-limiting disease, on occasion, they can
cause serious, even life threatening illness. Particularly vulnerable are persons with
weak immune systems such as those with HIV infections or cancer. By understanding
the nature of waterborne diseases, the importance of properly constructed, operated
and maintained public water systems becomes obvious.
While water treatment cannot achieve sterile water (no microorganisms), the goal of
treatment must clearly be to produce drinking water that is as pathogen-free as
possible at all times. For those who operate water systems with inadequate source
protection or treatment facilities, the potential risk of a waterborne disease outbreak is
real. For those operating systems that currently provide adequate source protection
and treatment, operating and maintaining the system at a high level on a continuing
basis is critical to prevent disease.
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Cryptosporidiosis is typically an acute short-term infection but can become severe and
non-resolving in children and immunocompromised individuals. The parasite is
transmitted by environmentally hardy cysts (oocysts) that, once ingested, excyst in the
small intestine and result in an infection of intestinal epithelial tissue. The genome of
Cryptosporidium parvum was sequenced in 2004 and was found to be unusual amongst
Eukaryotes in that the mitochondria seem not to contain DNA. A closely-related species,
C. hominis, also has its genome sequence available. CryptoDB.org is a NIH-funded
database that provides access to the Cryptosporidium genomics data sets.
When C. parvum was first identified as a human pathogen, diagnosis was made by a
biopsy of intestinal tissue (Keusch, et al., 1995).
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There have been six major outbreaks of cryptosporidiosis in the United States as a result
of contamination of drinking water (Juranek, 1995). One major outbreak in Milwaukee in
1993 affected over 400,000 persons.
Outbreaks such as these usually result from drinking water taken from surface water
sources such as lakes and rivers (Juranek, 1995). Swimming pools and water park wave
pools have also been associated with outbreaks of cryptosporidiosis. Also, untreated
groundwater or well water public drinking water supplies can be sources of contamination.
The highly environmentally resistant cyst of C. parvum allows the pathogen to survive
various drinking water filtrations and chemical treatments such as chlorination. Although
municipal drinking water utilities may meet federal standards for safety and quality of
drinking water, complete protection from cryptosporidial infection is not guaranteed. In
fact, all waterborne outbreaks of cryptosporidiosis have occurred in communities where
the local utilities met all state and federal drinking water standards (Juranek, 1995).
238
Giardia infection can occur through ingestion of dormant cysts in contaminated water, or
by the fecal-oral route (through poor hygiene practices). The Giardia cyst can survive for
weeks to months in cold water and therefore can be present in contaminated wells and
water systems, and even clean-looking mountain streams, as well as city reservoirs, as
the Giardia cysts are resistant to conventional water treatment methods, such as
chlorination and ozonolysis.
Zoonotic transmission is also possible, and therefore Giardia infection is a concern for
people camping in the wilderness or swimming in contaminated streams or lakes,
especially the artificial lakes formed by beaver dams (hence the popular name for
giardiasis, "Beaver Fever").
239
Those who work with children are also at risk of being infected, as are family members of
infected individuals. Not all Giardia infections are symptomatic, so some people can
unknowingly serve as carriers of the parasite.
The life cycle begins with a non-infective cyst being excreted with feces of an infected
individual. Once out in the environment, the cyst becomes infective. A distinguishing
characteristic of the cyst is 4 nuclei and a retracted cytoplasm. Once ingested by a host,
the trophozoite emerges to an active state of feeding and motility. After the feeding stage,
the trophozoite undergoes asexual replication through longitudinal binary fission. The
resulting trophozoites and cysts then pass through the digestive system in the feces. While
the trophozoites may be found in the feces, only the cysts are capable of surviving outside
of the host.
Distinguishing features of the trophozoites are large karyosomes and lack of peripheral
chromatin, giving the two nuclei a halo appearance. Cysts are distinguished by a retracted
cytoplasm. This protozoa lacks mitochondria, although the discovery of the presence of
mitochondrial remnant organelles in one recent study "indicate that Giardia is not
primitively amitochondrial and that it has retained a functional organelle derived from the
original mitochondrial endosymbiont"
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On average, about one in 10 people who are infected with E. histolytica becomes sick
from the infection. The symptoms often are quite mild and can include loose stools,
stomach pain, and stomach cramping.
Amebic dysentery is a severe form of amebiasis associated with stomach pain, bloody
stools, and fever. Rarely, E. histolytica invades the liver and forms an abscess. Even less
commonly, it spreads to other parts of the body, such as the lungs or brain.
Scientific Classification
Domain: Eukaryota
Phylum: Amoebozoa
Class: Archamoebae
Genus: Entamoeba
Species: E. histolytica
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Vorticella is a genus of protozoa, with over 100 known species. They are stalked inverted
bell-shaped ciliates, placed among the peritrichs. Each cell has a separate stalk anchored
onto the substrate, which contains a contracile fibril called a myoneme. When stimulated
this shortens, causing the stalk to coil like a spring. Reproduction is by budding, where the
cell undergoes longitudinal fission and only one daughter keeps the stalk.
Vorticella mainly lives in freshwater ponds and streams - generally anywhere protists are
plentiful. Other genera such as Carchesium resemble Vorticella but are branched or
colonial.
Domain: Eukaryota
Phylum: Ciliophora
Class: Oligohymenophorea
Subclass: Peritrichia
Order: Sessilida
Family: Vorticellidae
Genus: Vorticella
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Rotifers get their name (derived from Greek and meaning "wheel-bearer"; they have also
been called wheel animalcules) from the corona, which is composed of several ciliated
tufts around the mouth that in motion resemble a wheel. These create a current that
sweeps food into the mouth, where it is chewed up by a characteristic pharynx (called the
mastax) containing a tiny, calcified, jaw-like structure called the trophi. The cilia also pull
the animal, when unattached, through the water. Most free-living forms have pairs of
posterior toes to anchor themselves while feeding.
Rotifers have bilateral symmetry and a variety of different shapes. There is a well-
developed cuticle which may be thick and rigid, giving the animal a box-like shape, or
flexible, giving the animal a worm-like shape; such rotifers are respectively called loricate
and illoricate.
243
Males in the class Monogononta may be either present or absent depending on the
species and environmental conditions. In the absence of males, reproduction is by
parthenogenesis and results in clonal offspring that are genetically identical to the parent.
Individuals of some species form two distinct types of parthenogenetic eggs; one type
develops into a normal parthenogenetic female, while the other occurs in response to a
changed environment and develops into a degenerate male that lacks a digestive system,
but does have a complete male reproductive system that is used to inseminate females
thereby producing fertilized 'resting eggs'.
Resting eggs develop into zygotes that are able to survive extreme environmental
conditions such as may occur during winter or when the pond dries up. These eggs
resume development and produce a new female generation when conditions improve
again. The life span of monogonont females varies from a couple of days to about three
weeks.
Bdelloid rotifers are unable to produce resting eggs, but many can survive prolonged
periods of adverse conditions after desiccation. This facility is termed anhydrobiosis, and
organisms with these capabilities are termed anhydrobionts. Under drought conditions,
bdelloid rotifers contract into an inert form and lose almost all body water; when
rehydrated, however, they resume activity within a few hours.
Bdelloids can survive the dry state for prolonged periods, with the longest well-
documented dormancy being nine years. While in other anhydrobionts, such as the brine
shrimp, this desiccation tolerance is thought to be linked to the production of trehalose, a
non-reducing disaccharide (sugar), bdelloids apparently lack the ability to synthesize
trehalose.
Bdelloid rotifer genomes contain two or more divergent copies of each gene. Four copies
of hsp82 are, for example, found. Each is different and found on a different chromosome,
excluding the possibility of homozygous sexual reproduction.
244
245
247
Mitochondria
The bacterial cell is surrounded by a lipid membrane, or cell membrane, which encloses
the contents of the cell and acts as a barrier to hold nutrients, proteins and other essential
components of the cytoplasm within the cell.
As they are prokaryotes, bacteria do not tend to have membrane-bound organelles in their
cytoplasm and thus contain few large intracellular structures. They consequently lack a
nucleus, mitochondria, chloroplasts and the other organelles present in eukaryotic cells,
such as the Golgi apparatus and endoplasmic reticulum.
251
255
256
A bacteriophage (from 'bacteria' and Greek phagein, 'to eat') is any one of a number of
viruses that infect bacteria. The term is commonly used in its shortened form, phage.
Typically, bacteriophages consist of an outer protein hull enclosing genetic material. The
genetic material can be ssRNA (single stranded RNA), dsRNA, ssDNA, or dsDNA
between 5 and 500 kilo base pairs long with either circular or linear arrangement.
Bacteriophages are much smaller than the bacteria they destroy - usually between 20 and
200 nm in size.
Phages are estimated to be the most widely distributed and diverse entities in the
biosphere. Phages are ubiquitous and can be found in all reservoirs populated by bacterial
hosts, such as soil or the intestine of animals.
One of the densest natural sources for phages and other viruses is sea water, where up
to 9×108 virions per milliliter have been found in microbial mats at the surface, and up to
70% of marine bacteria may be infected by phages.
259
In contrast, "lysogenic" phages do not kill the host but rather become long-term parasites
and make the host cell continually secrete more new virus particles. The new virions bud
off the plasma membrane, taking a portion of it with them to become enveloped viruses
possessing a viral envelope. All released virions are capable of infecting a new bacterium.
260
Numbers of salmonella may be so low in clinical samples that stools are routinely also
subjected to "enrichment culture", where a small volume of stool is incubated in a selective
broth medium, such as selenite broth or Rappaport Vassiliadis soya peptone broth,
overnight.
These media are inhibitory to the growth of the microbes normally found in the healthy
human bowel, while allowing salmonellae to become enriched in numbers. Salmonellae
may then be recovered by inoculating the enrichment broth on one or more of the primary
selective media. On blood agar, they form moist colonies about 2 to 3 mm in diameter.
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The ability to produce biofilm (a.k.a. "rugose", "lacy", or "wrinkled") can be an indicator of
dimorphism, which is the ability of a single genome to produce multiple phenotypes in
response to environmental conditions. Salmonellae usually do not ferment lactose; most
of them produce hydrogen sulfide which, in media containing ferric ammonium citrate,
reacts to form a black spot in the center of the creamy colonies.
Classification
Salmonella taxonomy is complicated. As of December 7, 2005, there are two species
within the genus: S. bongori (previously subspecies V) and S. enterica (formerly called
S. choleraesuis), which is divided into six subspecies:
* I—enterica
* II—salamae
* IIIa—arizonae
* IIIb—diarizonae
* IV—houtenae
* V—obsolete (now designated
S. bongori)
* VI—indica
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Shigella dysenteriae is a species of the rod-shaped bacterial genus Shigella. Shigella can
cause shigellosis (bacillary dysentery). Shigellae are Gram-negative, non-spore-forming,
facultatively anaerobic, non-motile bacteria.
S. dysenteriae, spread by contaminated water and food, causes the most severe
dysentery because of its potent and deadly Shiga toxin, but other species may also be
dysentery agents. Shigella infection is typically via ingestion (fecal–oral contamination);
depending on age and condition of the host as few as ten bacterial cells can be enough
to cause an infection. Shigella causes dysentery that result in the destruction of the
epithelial cells of the intestinal mucosa in the cecum and rectum. Some strains produce
enterotoxin and Shiga toxin, similar to the verotoxin of E. coli O157:H7. Both Shiga toxin
and verotoxin are associated with causing hemolytic uremic syndrome.
Shigella invades the host through epithelial cells of the large intestine. Using a Type III
secretion system acting as a biological syringe, the bacterium injects IpaD protein into cell,
triggering bacterial invasion and the subsequent lysis of vacuolar membranes using IpaB
and IpaC proteins. It utilizes a mechanism for its motility by which its IcsA protein triggers
actin polymerization in the host cell (via N-WASP recruitment of Arp2/3 complexes) in a
"rocket" propulsion fashion for cell-to-cell spread.
The most common symptoms are diarrhea, fever, nausea, vomiting, stomach cramps, and
straining to have a bowel movement. The stool may contain blood, mucus, or pus (e.g.
dysentery). In rare cases, young children may have seizures. Symptoms can take as long
as a week to show up, but most often begin two to four days after ingestion. Symptoms
usually last for several days, but can last for weeks. Shigella is implicated as one of the
pathogenic causes of reactive arthritis worldwide.
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Bottom Photo: Another method is using a petri dish with a filter membrane. The broth and
membrane used vary depending on the sample type for water or wastewater.
264
In fact, stormwater runoff in urbanized areas has been found to be surprisingly high in
fecal coliform bacteria concentrations. General coliforms, E. Coli, and Enterococcus
bacteria are the "indicator" organisms generally measured to assess microbiological
quality of water.
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Keep in the back of your mind that the ratio of indicators to actual pathogens is not
fixed. It will always be different, sometimes very different. Whenever you are trying to form
a mental map of reality based on water tests, you should include in the application of your
water intuition an adjustment factor for your best guess of the ratio between indicators and
actual pathogens.
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The samples are taken in sterile 100 mL containers. These containers, when used for
chlorinated water samples, have a sodium thiosulfate pill or solution to dechlorinate the
sample.
The sample is placed in cold storage after proper sample taking procedures are
followed. (See sample
procedures below)
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Procedure:
1. Counters are alcohol wiped.
2. Bench sheets are filled out.
3. Samples are removed from refrigeration.
4. Sterile wrapped utensils are placed on counters.
5. Filtration units are placed onto sterile membrane filters by aseptic technique using
sterile forceps.
6. Sterile petri dishes are labeled.
7. The samples closures are clipped.
8. The sample is shaken 25 times 1 foot in length within 7 seconds.
9. 100 mL is filtered and rinsed with sterile distilled water 3 times.
10. The membrane filter is aseptically removed from filter holder.
11. A sterile padded petri dish is used and the membrane filter is rolled onto the pad
making sure no air bubbles form.
12. The sterile labeled lid is placed on the petri dish.
13. 2 blanks and a known is run with each series of samples.
14. The samples are placed in the 35oC + .5oC incubator stacked no higher than 3 for
22 – 24 hours (Humidity can be maintained by saturated paper towels placed under
containers holding petri dishes.)
15. After 22- 24 hours view the petri dishes under a 10 –15 power magnification with
cool white fluorescent light.
16. Count all colonies that appear pink to dark red with a metallic surface sheen – the
sheen may vary in size from a pin head to complete coverage.
17. Report as Total Coliform per 100 mL.
18. If no colonies are present report as <1 coliform/100mL.
Anything greater than 1 is over the limit for drinking water for 2 samples taken 24 hours
apart. Further investigation may be necessary – follow Standard Methods accordingly.
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E. coli O157:H7
E. coli O157:H7 (bacterium) found in human feces. Symptoms vary with type caused
gastroenteritis.
Consumers can prevent E. coli O157:H7 infection by thoroughly cooking ground beef,
avoiding unpasteurized milk, and washing hands carefully. Because the organism lives in
the intestines of healthy cattle, preventive measures on cattle farms and during meat
processing are being investigated.
E. coli O157:H7 was first recognized as a cause of illness in 1982 during an outbreak of
severe bloody diarrhea; the outbreak was traced to contaminated hamburgers. Since then,
most infections have come from eating undercooked ground beef.
The combination of letters and numbers in the name of the bacterium refers to the specific
markers found on its surface and distinguishes it from other types of E. coli.
Currently, there are four recognized classes of enterovirulent E. coli (collectively referred
to as the EEC group) that cause gastroenteritis in humans. Among these is the
enterohemorrhagic (EHEC) strain designated E. coli O157:H7. E. coli is a normal
inhabitant of the intestines of all animals, including humans. When aerobic culture
methods are used, E. coli is the dominant species found in feces.
Normally E. coli serves a useful function in the body by suppressing the growth of harmful
bacterial species and by synthesizing appreciable amounts of vitamins. A minority of
E. coli strains are capable of causing human illness by several different mechanisms.
E. coli serotype O157:H7 is a rare variety of E. coli that produces large quantities of one
or more related, potent toxins that cause severe damage to the lining of the intestine.
These toxins [verotoxin (VT), shiga-like toxin] are closely related or identical to the toxin
produced by Shigella dysenteriae.
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Under the Safe Drinking Water Act, the EPA requires public water systems to monitor for
coliform bacteria. Systems analyze first for total coliform, because this test is faster to
produce results. Any time that a sample is positive for total coliform, the same sample
must be analyzed for either fecal coliform or E. coli. Both are indicators of contamination
with animal waste or human sewage.
The largest public water systems (serving millions of people) must take at least 480
samples per month. Smaller systems must take at least five samples a month unless the
state has conducted a sanitary survey – a survey in which a state inspector examines
system components and ensures they will protect public health – at the system within the
last five years.
Systems serving 25 to 1,000 people typically take one sample per month. Some states
reduce this frequency to quarterly for ground water systems if a recent sanitary survey
shows that the system is free of sanitary defects.
Some types of systems can qualify for annual monitoring. Systems using surface water,
rather than ground water, are required to take extra steps to protect against bacterial
contamination because surface water sources are more vulnerable to such
contamination. At a minimum, all systems using surface waters must
disinfect. Disinfection will kill E. coli O157:H7.
270
Among other known sources of infection are consumption of sprouts, lettuce, salami,
unpasteurized milk and juice, and swimming in or drinking sewage-contaminated water.
Bacteria in diarrheal stools of infected persons can be passed from one person to another
if hygiene or hand washing habits are inadequate. This is particularly likely among toddlers
who are not toilet trained. Family members and playmates of these children are at high
risk of becoming infected. Young children typically shed the organism in their feces for a
week or two after their illness resolves. Older children rarely carry the organism without
symptoms.
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In some persons, particularly children under 5 years of age and the elderly, the infection
can also cause a complication called hemolytic uremic syndrome, in which the red blood
cells are destroyed and the kidneys fail. About 2%-7% of infections lead to this
complication. In the United States, hemolytic uremic syndrome is the principal cause of
acute kidney failure in children, and most cases of hemolytic uremic syndrome are caused
by E. coli O157:H7.
272
Aspiration means choking such that secretions in the mouth get past the choking reflexes
and instead of going into the esophagus and stomach, mistakenly, enter the lung. The
protective mechanisms to prevent aspiration is defective in patients who smoke or have
lung disease. Aspiration now appears to be the most common mode of transmission.
Legionella may multiply to high numbers in cooling towers, evaporative condensers, air
washers, humidifiers, hot water heaters, spas, fountains, and plumbing fixtures. Within
one month, Legionella can multiply, in warm water-containing systems, from less than 10
per milliliter to over 1,000 per milliliter of water. Once high numbers of Legionella have
been found, a relatively simple procedure for disinfecting water systems with chlorine and
detergent is available. This procedure is not part of a routine maintenance program
because equipment may become corroded.
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Most labs will provide a quantitative epifluorescence microscopic analysis of your cooling
tower and potable water samples for 14 serogroups of Legionella pneumophila and 15
other Legionella species (listed below).
Culture methods are good during outbreaks for bio-typing; but culture methods lack
sensitivity for routine, quantitative monitoring. Many factors will inhibit growth or
identification of legionella on BCYE with or without antimicrobial agents, heat or acid
treatment.
Culture methods will not identify non-culturable legionella that can still cause outbreaks
(non-culturable, viable legionella have been reported in several peer-reviewed
journals). Only DFA tests performed by trained laboratory personnel can identify these
legionellae. Direct fluorescent antibody (DFA) tests using a battery of monoclonal
antibodies provide more useful routine monitoring information than culture methods.
Legionella species of bacteria cause Legionnaire's disease. They are gram negative (but
stain poorly), strictly aerobic rods.
The U.S. Environmental Protection Agency and the U.S. Occupational Safety and Health
Administration recommend routine maintenance of water-containing equipment. Most
State health departments recommend monthly testing for Legionella as part of a routine
maintenance program.
274
Viruses vary in size from the largest poxviruses of about 450 nanometers (about 0.000014
in) in length to the smallest polioviruses of about 30 nanometers (about 0.000001 in).
Viruses are not considered free-living, since they cannot reproduce outside of a living cell;
they have evolved to transmit their genetic information from one cell to another for the
purpose of replication. Viruses often damage or kill the cells that they infect, causing
disease in infected organisms.
A few viruses stimulate cells to grow uncontrollably and produce cancers. Although many
infectious diseases, such as the common cold, are caused by viruses, there are no cures
for these illnesses.
The difficulty in developing antiviral therapies stems from the large number of variant
viruses that can cause the same disease, as well as the inability of drugs to disable a virus
without disabling healthy cells. However, the development of antiviral agents is a major
focus of current research, and the study of viruses has led to many discoveries important
to human health.
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Capsids
The viral protective shell, or capsid, can be either helical (spiral-shaped) or icosahedral
(having 20 triangular sides). Capsids are composed of repeating units of one or a few
different proteins. These units are called protomers or capsomers. The proteins that make
up the virus particle are called structural proteins. Viruses also carry genes for making
proteins that are never incorporated into the virus particle and are found only in infected
cells. These viral proteins are called nonstructural proteins; they include factors required
for the replication of the viral genome and the production of the virus particle.
Capsids and the genetic material (DNA or RNA) they contain are together referred to as
nucleocapsids. Some virus particles consist only of nucleocapsids, while others contain
additional structures.
Some icosahedral and helical animal viruses are enclosed in a lipid envelope acquired
when the virus buds through host-cell membranes. Inserted into this envelope are
glycoproteins that the viral genome directs the cell to make; these molecules bind virus
particles to susceptible host cells.
Bacteriophages
The most elaborate viruses are the bacteriophages, which use bacteria as their hosts.
Some bacteriophages resemble an insect with an icosahedral head attached to a tubular
sheath. From the base of the sheath extend several long tail fibers that help the virus
attach to the bacterium and inject its DNA to be replicated, direct capsid production, and
virus particle assembly inside the cell.
The single-stranded RNA circle collapses on itself to form a rod-like structure. The only
known mammalian pathogen that resembles plant viroids is the deltavirus (hepatitis D),
which requires hepatitis B virus proteins to package its RNA into virus particles. Co-
infection with hepatitis B and D can produce more severe disease than can infection with
hepatitis B alone. Prions are mutated forms of a normal protein found on the surface of
certain animal cells.
Virus Classification
Viruses are classified according to their type of genetic material, their strategy of
replication, and their structure. The ICNV report published in 1995 assigned more than
4000 viruses into 71 virus families. Hundreds of other viruses remain unclassified because
of the lack of sufficient information.
276
There are five types of hepatitis -- A through E -- all of which cause inflammation of the
liver. Type D affects only those who also have hepatitis B, and hepatitis E is extremely
rare in the United States.
277
278
Cyanobacteria
Cyanobacteria include unicellular and colonial species. Colonies may form filaments,
sheets or even hollow balls. Some filamentous colonies show the ability to differentiate
into several different cell types: vegetative cells, the normal, photosynthetic cells that are
formed under favorable growing conditions; akinetes, the climate-resistant spores that
may form when environmental conditions become harsh; and thick-walled heterocysts,
which contain the enzyme nitrogenase, vital for nitrogen fixation. Heterocysts may also
form under the appropriate environmental conditions (anoxic) wherever nitrogen is
necessary.
Heterocyst-forming species are specialized for nitrogen fixation and are able to fix nitrogen
gas, which cannot be used by plants, into ammonia (NH3), nitrites (NO2) or nitrates (NO3),
which can be absorbed by plants and converted to protein and nucleic acids.
279
Many cyanobacteria also form motile filaments, called hormogonia, that travel away from
the main biomass to bud and form new colonies elsewhere. The cells in a hormogonium
are often thinner than in the vegetative state, and the cells on either end of the motile chain
may be tapered. In order to break away from the parent colony, a hormogonium often
must tear apart a weaker cell in a filament, called a necridium.
Each individual cell of a cyanobacterium typically has a thick, gelatinous cell wall. They
differ from other gram-negative bacteria in that the quorum sensing molecules
autoinducer-2[4] and acyl-homoserine lactones are absent. They lack flagella, but
hormogonia and some unicellular species may move about by gliding along surfaces. In
water columns some cyanobacteria float by forming gas vesicles, like in archaea.
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Dimensions
CYLINDER: Volume (Cu. ft) = 3.14 X Radius (ft) X Radius (ft) X Depth (ft)
Flow Rate
Multiply —> to get
to get <— Divide
cc/min 1 mL/min
3
cfm (ft /min) 28.31 L/min
3
cfm (ft /min) 1.699 m3/hr
cfh (ft3/hr) 472 mL/min
cfh (ft3/hr) 0.125 GPM
GPH 63.1 mL/min
GPH 0.134 cfh
GPM 0.227 m3/hr
GPM 3.785 L/min
oz/min 29.57 mL/min
General Conversions
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FLOW RATE (gpm): Flow Rate (gpm) = 2.83 (Diameter, in)2 (Distance, in)
Height, in
% SLOPE = Rise (feet) X 100
Run (feet)
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BY-PASS WATER (gpd) = Total Flow (GPD) X Plant Effluent Hardness (gpg)
Filtered Hardness (gpg)
HARDNESS
HARDNESS (mg/L as CaCO3) = A (mls of titrant) X 1000
Mls of Sample
CHEMICAL ADDITION
FILTRATION
FILTRATION RATE = Flow Rate (gpm)
(gpm/sq. ft) Surface Area (sq. ft)
BACKWASH PUMPING RATE = Filter Area (sq. ft) X Backwash Rate (gpm/sq. ft)
(gpm)
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Glossary References
Benenson, Abram S., editor. 1990. Control of Communicable Diseases in Man. 15th ed.
Baltimore: Victor Graphics, Inc.
Foster, Laurence, M.D. 1985. “Waterborne Disease - It’s Our Job to Prevent It”. PIPELINE
newsletter, Oregon Health Division, Drinking Water Program, Portland, Oregon 1(4 ): 1-3.
Foster, Laurence, M.D. 1990. “Waterborne Disease,” Methods for the Investigation and
Prevention of Waterborne Disease Outbreaks. Ed. Gunther F. Craun. Cincinnati: U.S.
Environmental Protection Agency.
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