Search Results (82)

Background: Non-cholera Vibrio species are rare waterborne pathogens that can cause severe infections. Among these, few cases of Vibrio metschnikovii infections have been reported, especially in the gastrointestinal tract, with no cardiac tissue involvement as a result. Following the PRISMA checklist, we conducted a literature review, and thirteen articles for twenty-two cases overall were included: seven cases of sepsis (in three cases, the echocardiographic results were negative), seven cases of pneumonia, two skin infections, eleven cases of diarrhoea, and a gastroenteritis outbreak. This report documents the expanding clinical spectrum and the role played by V. metschnikovii in infective endocarditis. Case report: A 28-year-old male patient was referred to the cardiac surgery unit for urgent mitral valve replacement due to suspicion of infective endocarditis. Microbiological tests yielded negative results. Following recovery and discharge with antimicrobial therapy for 6 weeks, the patient experienced prosthesis detachment, necessitating re-hospitalisation for an emergency valve replacement. Vibrio metschnikovii was identified on the prosthesis valve through PCR and successfully treated with ciprofloxacin. However, a spontaneous rupture of the ascending thoracic aorta led to a neurological injury. Discussion: This case represents the first case of valve infection caused by Vibrio metschnikovii, characterised by diagnostic and therapeutic challenges and the involvement of the great vessels. Also considered in this case, for a disease with a median age of 58 years (11–83) and a male-to-female ratio of 2.2, were one male neonate and six cases for whom neither sex nor age was indicated. Excluding gastrointestinal cases, the septic forms are associated with high morbidity, although the single case described involved a young and healthy subject. Risk factors for the pathogen or predisposing/pathological conditions for endocarditis did not emerge. The routes and the time of infection could not be determined, deepening the possibility of occupational exposure via the patient’s position as a boat worker. Poor sensitivity to third-generation cephalosporins has been reported in the literature: the absence of an antibiogram does not allow for a comparison, although resolution was achieved with ciprofloxacin. Conclusion: The rising global incidence of non-cholera Vibrio infections, driven by environmental changes, calls for urgent research into the factors behind their pathogenicity and infection routes. Diagnostic complexities have emerged together with clinical severity. Full article

The unprecedented development of coastal cities in West Africa is marked by anarchic urbanization accompanied by ineffective environmental management, leading to water pollution. This study is conducted in the southern districts of Lomé, Togo, an area built on sandbars where inappropriate attitudes, behaviors, and inadequate hygiene and sanitation practices prevail. The objective of this study is to characterize the quality of groundwater in the study area. Bacteriological and physicochemical analyses were carried out on 11 wells in 10 districts in the southern districts during the four seasons of the year. The analysis shows that the groundwater is polluted in all seasons. Nitrate concentrations exceed 50 mg/L in 65% of the samples, while chloride levels surpassed 250 mg/L in 18% of the cases. Regardless of the season, the dominant facies is sodium chloride and potassium chloride. In all districts, the analysis of microbiological parameters including total germs (30 °C, 100/mL), total coliforms (30 °C, 0/mL), Escherichia coli (44 °C, 2/250 mL), fecal streptococci (0/100 mL), and anaerobic sulfite reducers (44 °C, 2/20 mL) reveals values exceeding the European Union standards (2007). Groundwater contamination is facilitated by the sandy nature of the soil, which increases its vulnerability to various pollutants. Togo continues to experience cholera outbreaks, aggravated by poor sanitation infrastructure and limited vaccination coverage. Public health efforts are directed toward improving sanitation and raising awareness about waterborne and non-communicable diseases. Full article

Infections with zoonotic pathogens have received increasing attention in recent years, as reflected in the literature of both veterinary and human medicine. Cryptosporidium and Giardia are recognised as the principal causes of waterborne outbreaks worldwide, but there is still limited data on the role of wild carnivores, such as red foxes and wolves, as reservoir hosts and in disseminating these pathogens in the environment. The aim of the current project was to analyse the prevalence and abundance of Cryptosporidium and Giardia infections in foxes from seven voivodeships and in wolves from the Warmia-Masuria Voivodeship in Poland and to conduct a phylogenetic analysis of the detected parasites. For the detection of both parasites, we used the commercial immunofluorescent assay MeriFluor Cryptosporidium/Giardia. For Cryptosporidium detection we also applied modified Ziehl–Neelsen (ZN) staining of faecal smears and, following PCR amplification, sequenced the 18S rDNA locus. For Giardia detection, we sequenced the glutamate dehydrogenase (gdh) gene. In total, 117 and 69 faecal samples obtained from red foxes and wolves, respectively, were screened for the presence of Cryptoporidium/Giardia. In red foxes, prevalence was 38.5% and 15.4% for Cryptosporidium spp. and G. intestinalis, respectively. In wolves, the prevalence of Cryptosporidium spp. was 14.5%, and only one sample was Giardia-positive. Cryptosporidium canis, Cryptosporidium sp. vole genotype, C. baileyi and Cryptosporidium sp. were identified in red foxes, while C. canis and Cryptosporidium sp. were detected in wolves. Our results indicate that red foxes and grey wolves act as reservoir hosts of Cryptosporidium spp. and G. intestinalis in natural areas in Poland. Full article

In September 2024, the Egyptian Health Ministry declared an Escherichia coli (E. coli) outbreak in the southern province of Aswan. The spread of an ambiguous illness erupted in the village of Abu Al-Rish Bahri, 20 kilometers north of Aswan, with hundreds of citizens arriving at the governorate’s local hospitals suffering from severe gastrointestinal infections. The authorities, however, did not trace the outbreak’s most common source nor determine whether it was food- or water-borne. The official explanations for the frequent cases and the reported fatalities were inconclusive. There was an evident lack of comprehensive documentation on the extent of the infection, the exposed population, the prevalence pattern of the pathogen, or the retrieved E. coli isolates. In addition, the Egyptian government denied any possible association between the contamination of drinking water and the recent Aswan crisis. Challenging the official narrative, this article proposes a scientific report based on featuring the status of E. coli infection in Egypt, highlighting the gaps in the announced outbreak claims and adapting water pollution as an alarming hypothesis for the peculiar Aswan disease. Full article

Salmonellosis is the second most common foodborne bacterial gastroenteritis in humans in Finland and worldwide. In Finland, a national salmonella control program covering cattle, pigs, and poultry, as well as the meat and eggs obtained from them, has been in place since the country joined the EU in 1995. To identify trends in the incidence of salmonellosis and to reflect on their causes, we analyzed Salmonella case data from the Finnish Infectious Disease Register (FIDR) from 1995 to 2022 and outbreak data from the national food and waterborne outbreak register (the FWO register) in the period 2010–2022. From 1995–1999 to 2015–2019, the incidence of salmonellosis decreased by 66% and 63% for domestic and travel-related cases, respectively. Most salmonellosis cases (72%) were travel-related, and, of them, 27% were infected in Southeast Asia. The most common serovars were S. Typhimurium and S. Enteritidis (38% and 19% of domestic cases, and 7% and 39% of travel-related cases). During 2010–2022, Salmonella sp. was reported as a cause in 31 foodborne outbreaks. In 14 of them, the source was identified at foodstuff level, and 12 sources were of foreign origin. The results of this study indicate that the national salmonella control program may have prevented domestic human infections in Finland. Full article

Pandemics of infectious disease and growing anti-microbial resistance (AMR) pose major threats to global health, trade, and security. Conflict and climate change compound and accelerate these threats. The One Health approach recognizes the interconnectedness of human, animal, and environmental health, but is grounded in the biomedical model, which reduces health to the absence of disease. Biomedical responses are insufficient to meet the challenges. The COVID-19 pandemic is the most recent example of the failure of this biomedical model to address global threats, the limitations of laboratory-based surveillance, and the exclusive focus on vaccination for disease control. This paper examines the current paradigm through the lens of polio and the global campaign to eradicate it, as well as other infectious threats including mpox and drug-resistant tuberculosis, particularly in the context of armed conflict. Decades before vaccines became widely available, public health measures—ventilation, chlorination, nutrition and sanitation— led to longer, healthier, and even taller lives. Chlorine, our primary tool of public health, conquered cholera and transformed infection control in hospitals. The World Health Organization (WHO), part of the One Health alliance, focuses mainly on antibiotics and vaccines to reduce deaths due to superbugs and largely ignores the critical role of chlorine to control water-borne diseases (including polio) and other infections. Moreover, the One Health approach ignores armed conflict. Contemporary wars are characterized by indiscriminate bombing of civilians, attacks targeting healthcare, mass displacement and lack of humanitarian access, conditions which drive polio outbreaks and incubate superbugs. We discuss the growing trend of attacks on healthcare and differentiate between types: community-driven attacks targeting vaccinators in regions like Pakistan, and state-sponsored attacks by governments such as those of Syria and Russia that weaponize healthcare to deliberately harm whole populations. Both fuel outbreaks of disease. These distinct motivations necessitate tailored responses, yet the WHO aggregates these attacks in a manner that hampers effective intervention. While antimicrobial resistance is predictable, the escalating pandemic is the consequence of our reliance on antibiotics and commitment to a biomedical model that now borders on pathological. Our analysis reveals the international indenture to the biomedical model as the basis of disease control is the root driver of AMR and vaccine-derived polio. The unique power of vaccines is reduced by vaccination-only strategy, and in fact breeds vaccine-derived polio. The non-specific effects of vaccines must be leveraged, and universal vaccination must be supplemented by international investment in water chlorination. This will reduce health costs and strengthen global health security. While vaccines are an important weapon to combat pandemics and AMR, they must be accompanied by the entire arsenal of public health interventions. Full article

Waterborne illnesses lead to millions of fatalities worldwide each year, particularly in developing nations. In this paper, we introduce a comprehensive system designed for the autonomous early detection of viral outbreaks transmitted through water to ensure sustainable access to healthy water resources, especially in remote areas. The system utilizes an autonomous water quality monitoring setup consisting of an airborne water sample collector, an autonomous sample processor, and an artificial intelligence-aided microscopic detector for risk assessment. The proposed system replaces the time-consuming conventional monitoring protocol by automating sample collection, sample processing, and pathogen detection. Furthermore, it provides a safer processing method against the spillage of contaminated liquids and potential resultant aerosols during the heat fixation of specimens. A morphological image processing technique of light microscopic images is used to segment images, assisting in selecting a unified appropriate input segment size based on individual blob areas of different bacterial cultures. The dataset included harmful pathogenic bacteria (A. baumanii, E. coli, and P. aeruginosa) and harmless ones found in drinking water and wastewater (E. faecium, L. paracasei, and Micrococcus spp.). The segmented labeled dataset was used to train deep convolutional neural networks to automatically detect pathogens in microscopic images. To minimize prediction error, Bayesian optimization was applied to tune the hyperparameters of the networks’ architecture and training settings. Different convolutional networks were tested in accordance with different required output labels. The neural network used to classify bacterial cultures as harmful or harmless achieved an accuracy of 99.7%. The neural network used to identify the specific types of bacteria achieved a cumulative accuracy of 93.65%. Full article

Identified as a potential reference pathogen by the WHO Guidelines for Drinking-Water Quality, Rotavirus (RV) is among the main enteric viruses that cause waterborne diseases. The aim of this study was to identify and correlate the presence of RV in collective and individual water sources of rural communities in the state of Goiás, within the seasons in which the collections were made (rainy and dry seasons). For this, 86 water samples in the dry period and 160 samples in the rainy period were collected. Concentration of water samples, extraction of viral genetic material and molecular tests were performed. When analyzing the presence of RV in the samples, taking into consideration the period studied, RV was found to be more prevalent in the dry season (54.7%) than in the rainy season (20%), showing a strong statistical association with the dry season (p-value < 0.001). The presence of pathogenic microorganisms in water is a public risk issue, enabling the emergence of outbreaks, endemics and epidemics. In the present research, there was an association between the presence of Rotavirus and the dry period of the year when compared to the rainy period. Full article

Winter ulcer disease (WUD) is widely recognized as a serious threat to animal welfare and a major contributor to revenue loss within the aquaculture sector, particularly affecting the salmon-farming industry. This highlights the significant impact of WUD on both animal well-being and the economic sustainability of fish farming. WUD causes hemorrhagic signs and results in dermal lesions and ulcers. This disease can lead to higher mortality rates and a considerable decline in the fish’s market value. Moritella viscosa, a Gram-negative bacterium, is predominantly, but not exclusively, correlated with the emergence of WUD, mostly during the colder seasons. Waterborne transmission is the primary way for spreading the bacterium within a population. However, there is remarkable variation in the prevalence and characteristics of WUD in different regions. In Europe, this disease often occurs in the winter, and the intensity and occurrence of outbreaks are influenced by water temperature and salinity. In contrast, outbreaks are typically observed in the summer and mid-autumn in Eastern Canada. Despite the administration of various polyvalent vaccines, outbreaks of skin ulcers have been documented in Canada, and studies have highlighted the possible roles of other bacterial pathogens in Atlantic salmon. This review discusses the etiology, pathogenesis, and potential mitigation or prevention strategies for WUD, mainly in Atlantic salmon. Moreover, it underscores the necessity of conducting further investigations to discover the potential unknown causative agents of ulcerative disease and design appropriate vaccines or preventive strategies for these pathogens. Full article

This narrative review was aimed at collecting updated knowledge on the risk factors, illnesses caused, and measures for the prevention of protozoan infections transmitted by food and drinking water. Reports screened dated from 2019 to the present and regarded global prevalence in food handlers, occurrence in food and drinking water, impact on human health, and recently reported outbreaks and cases of severe infections attributable to the dietary route. Cryptosporidium spp., Cyclospora cayetanensis, Entamoeba histolytica, and Cystoisospora belli were the protozoans most frequently involved in recently reported waterborne and foodborne outbreaks and cases. Blastocystis hominis was reported to be the most widespread intestinal protozoan in humans, and two case reports indicated its pathogenic potential. Dientamoeba fragilis, Endolimax nana, and Pentatrichomonas hominis are also frequent but still require further investigation on their ability to cause illness. A progressive improvement in surveillance of protozoan infections and infection sources took place in developed countries where the implementation of reporting systems and the application of molecular diagnostic methods led to an enhanced capacity to identify epidemiological links and improve the prevention of foodborne and waterborne protozoan infections. Full article

Background: waterborne disease outbreaks (WGDOs) following the contamination of drinking water remain a public health concern. Methods: The current study aims to assess the occurrence and identify gaps in the notification and investigation of WGDOs in Greece. Data for 2004–2023 were retrieved and summarized. Results: Thirty-five outbreaks with 6128 recorded cases were identified. The median time from the date of onset in the first cases to reporting was 7 days (range: 1–26 days). Authorities were informed by health care services in thirty (85.7%) outbreaks and by the media in five (14.3%). The investigation methods used varied. An analytical study was conducted in nine (25.7%) outbreaks and the testing of clinical samples in twenty-seven (77.1%). In three (11.1%) outbreaks, clinical samples were simultaneously tested for multiple bacteria, viruses, and parasites. Water samples were collected in nineteen (54.3%) outbreaks (in three after chlorination) with a mean time lag of 5 days (range: 1–20 days) from the first cases. A pathogen in clinical samples was identified in 20 (57.1%) outbreaks and, in 1 (6.25%), the same microorganism was isolated in both clinical and water samples. Conclusions: delays in reporting and the heterogeneity of investigations depict that the surveillance of WGDOs and response practices should be strengthened, and operational procedures should be standardised. Full article

Legionella pneumophila has been pinpointed by the World Health Organization as the highest health burden of all waterborne pathogens in the European Union and is responsible for many disease outbreaks around the globe. Today, standard analysis methods (based on bacteria culturing onto agar plates) need several days (~12) in specialized analytical laboratories to yield results, not allowing for timely actions to prevent outbreaks. Over the last decades, great efforts have been made to develop more efficient waterborne pathogen diagnostics and faster analysis methods, requiring further advancement of microfluidics and sensors for simple, rapid, accurate, inexpensive, real-time, and on-site methods. Herein, a lab-on-a-chip device integrating sample preparation by accommodating bacteria capture, lysis, and DNA isothermal amplification with fast (less than 3 h) and highly sensitive, colorimetric end-point detection of L. pneumophila in water samples is presented, for use at the point of need. The method is based on the selective capture of viable bacteria on on-chip-immobilized and -lyophilized antibodies, lysis, the loop-mediated amplification (LAMP) of DNA, and end-point detection by a color change, observable by the naked eye and semiquantified by computational image analysis. Competitive advantages are demonstrated, such as low reagent consumption, portability and disposability, color change, storage at RT, and compliance with current legislation. Full article

Background: In August 2022, the Hellenic National Public Health Organisation was notified about a gastroenteritis outbreak in town A in Southern Greece. Investigations aimed to identify the source and implement control measures. Methods: Case definition categories were used in a 1:3 case–control study. Cases and controls were interviewed about various exposures. Cases’ stool samples were cultured on agar plates and characterised by serotyping, antimicrobial susceptibility testing and Pulse Field Gel Electrophoresis (PFGE). Environmental investigations included tap water sampling for microbiological and chemical analysis in town A and inspection of the water supply system. Results: We identified 33 cases (median age: 17 years). Tap water consumption was the only significant risk factor for gastroenteritis (OR = 5.46, 95% CI = 1.02–53.95). Salmonella (S.) Bovismorbificans isolated from eight stool and one tap water samples had identical PFGE profiles. No resistant isolates were identified. Residual chlorine levels were lower than the acceptable limits before and during the outbreak. We advised consumption of bottled water and adherence to strict hand hygiene rules until tap water was declared suitable for drinking. Conclusions: Epidemiological and molecular data revealed a waterborne S. Bovismorbificans outbreak in town A. We recommend local water safety authorities to ensure that residual chlorine levels comply with the legislation towards water safety planning, to mitigate risks. Full article

Norovirus (NoV) is a major cause of acute gastroenteritis outbreaks worldwide. A comprehensive understanding of the transmission mode is of great significance for the prevention and control of the NoV infection. Currently, the transmission modes of NoV include contact, food-borne, water-borne and aerosol transmission. The first three modes are more common, while aerosol transmission is seldom reported. In this paper, the source, generation mechanism, infectivity, sampling and related outbreaks of NoV aerosol are summarized and discussed. Full article

Campylobacteriosis causes a significant disease burden in humans worldwide and is the most common type of zoonotic gastroenteritis in Finland. To identify infection sources for domestic Campylobacter infections, we analyzed Campylobacter case data from the Finnish Infectious Disease Register (FIDR) in 2004–2021 and outbreak data from the National Food- and Waterborne Outbreak Register (FWO Register) in 2010–2021, and conducted a pilot case-control study (256 cases and 756 controls) with source attribution and patient sample analysis using whole-genome sequencing (WGS) in July–August 2022. In the FIDR, 41% of the cases lacked information on travel history. Based on the case-control study, we estimated that of all cases, 39% were of domestic origin. Using WGS, 22 clusters of two or more cases were observed among 185 domestic cases, none of which were reported to the FWO register. Based on this case-control study and source attribution, poultry is an important source of campylobacteriosis in Finland. More extensive sampling and comparison of patient, food, animal, and environmental isolates is needed to estimate the significance of other sources. In Finland, campylobacteriosis is more often of domestic origin than FIDR notifications indicate. To identify the domestic cases, travel information should be included in the FIDR notification, and to improve outbreak detection, all domestic patient isolates should be sequenced. Full article