Modelling the Potential Risk of Infection Associated with Listeria monocytogenes in Irrigation Water and Agricultural Soil in Two District Municipalities in South Africa

Listeria monocytogenes (L. monocytogenes) is the etiologic agent of listeriosis which significantly affects immunocompromised individuals. The potential risk of infection attributed to L. monocytogenes in irrigation water and agricultural soil, which are key transmission pathways of microbial hazards to the human population, was evaluated using the quantitative microbial risk assessment modelling. A Monte Carlo simulation with 10,000 iterations was used to characterize the risks. High counts of L. monocytogenes in irrigation water (mean: 11.96 × 102 CFU/100 mL; range: 0.00 to 56.67 × 102 CFU/100 mL) and agricultural soil samples (mean: 19.64 × 102 CFU/g; range: 1.33 × 102 to 62.33 × 102 CFU/g) were documented. Consequently, a high annual infection risk of 5.50 × 10−2 (0.00 to 48.30 × 10−2), 54.50 × 10−2 (9.10 × 10−3 to 1.00) and 70.50 × 10−2 (3.60 × 10−2 to 1.00) was observed for adults exposed to contaminated irrigation water, adults exposed to contaminated agricultural soil and children exposed to agricultural soil, respectively. This study, therefore, documents a huge public health threat attributed to the high probability of infection in humans exposed to L. monocytogenes in irrigation water and agricultural soil in Amathole and Chris Hani District Municipalities in the Eastern Cape province of South Africa.

Microbial-Maximum Likelihood Estimation Tool for Microbial Quantification in Food From Left-Censored Data Using Maximum Likelihood Estimation for Microbial Risk Assessment

In food microbial measurements, when most or very often bacterial counts are below to the limit of quantification (LOQ) or the limit of detection (LOD) in collected food samples, they are either ignored or a specified value is substituted. The consequence of this approach is that it may lead to the over or underestimation of quantitative results. A maximum likelihood estimation (MLE) or Bayesian models can be applied to deal with this kind of censored data. Recently, in food microbiology, an MLE that deals with censored results by fitting a parametric distribution has been introduced. However, the MLE approach has limited practical application in food microbiology as practical tools for implementing MLE statistical methods are limited. We therefore developed a user-friendly MLE tool (called “Microbial-MLE Tool”), which can be easily used without requiring complex mathematical knowledge of MLE but the tool is designated to adjust log-normal distributions to observed counts, and illustrated how this method may be implemented for food microbial censored data using an Excel spreadsheet. In addition, we used two case studies based on food microbial laboratory measurements to illustrate the use of the tool. We believe that the Microbial-MLE tool provides an accessible and comprehensible means for performing MLE in food microbiology and it will also be of help to improve the outcome of quantitative microbial risk assessment (MRA).

Absence of virological and epidemiological evidence that SARS-CoV-2 poses COVID-19 risks from environmental fecal waste, wastewater and water exposures

This review considers evidence for infectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presence and COVID-19 infection and illness resulting from exposure to environmental fecal wastes and waters. There is no documented evidence that (1) infectious, replication-capable SARS-CoV-2 is present in environmental fecal wastes, wastewater or water, and (2) well-documented epidemiological evidence of COVID-19 infection, illness or death has never been reported for these exposure media. COVID-19 is transmitted mainly by direct personal contact and respiratory secretions as airborne droplets and aerosols, and less so by respiratory-secreted fomites via contact (touch) exposures. While SARS-CoV-2 often infects the gastrointestinal tract of infected people, its presence as infectious, replication-capable virus in environmental fecal wastes and waters has never been documented. There is only rare and unquantified evidence of infectious, replication-capable SARS-CoV-2 in recently shed feces of COVID-19 hospital patients. The human infectivity dose–response relationship of SARS-CoV-2 is unknown, thereby making it impossible to estimate evidence-based quantitative health effects assessments by quantitative microbial risk assessment methods requiring both known exposure assessment and health effects assessment data. The World Health Organization, Water Environment Federation, US Centers for Disease Control and Prevention and others do not consider environmental fecal wastes and waters as sources of exposure to infectious SARS-CoV-2 causing COVID-19 infection and illness.

Risk assessment of banknotes as a fomite of SARS-CoV-2 in cash payment transactions

BackgroundThe COVID 19 pandemic has triggered concerns and assumptions globally about transmission of the SARS-CoV-2 virus via cash transactions.ObjectivesAssess the risk of contracting COVID-19 through exposure to SARS-CoV-2 via cash acting as a fomite in payment transactions.MethodsA quantitative microbial risk assessment was conducted for a worst-case scenario assuming an infectious person at the onset of symptoms, when virion concentrations in coughed droplets are at their highest. This person then contaminates a banknote by coughing on it and immediately hands it over to another person, who might then be infected by transferring the virions with a finger from the contaminated banknote to a facial mucous membrane. The scenario considered transfer efficiency of virions on the banknote to fingertips when droplets were still wet and after having dried up and subsequently being touched by finger printing or rubbing the object.ResultsAccounting for the likelihood of the worst-case scenario to occur by considering 1) a local prevalence of 100 COVID-19 cases/100,000 persons, 2) a maximum of about 1/5th of infected persons transmit high virus loads and 3) the numbers of cash transactions/person/day, the risk of contracting COVID-19 via person-to-person cash transactions was estimated to be much lower than once per 39,000 days (107 years) for a single person. In the general populace, there will be a maximum of 2.6 expected cases/100,000 persons/day. The risk for a cashier at an average point of sale was estimated to be much less than once per 430 working days (21 months).DiscussionThe worst-case scenario is a rare event, therefore, for a single person, the risk of contracting COVID-19 via person-to-person cash transactions is very low. At a point of sale, the risk to the cashier proportionally increases but it is still low.

Quantitative Health Risk Assessment of Wastewater Treatment Plant Worker Exposed to Staphylococcus Aureus Bioaerosol During Warm and Cold Periods: Disease Burden and Sensitivity Analysis

Biological treatment in wastewater treatment plants (WWTPs) releases high amounts of bioaerosols carrying a variety of pathogens. Quantitative microbial risk assessment (QMRA) is a framework prevalently intended for the quantitative estimation of health risks for occupational exposure scenarios (e.g. in WWTPs). However, the quantitative contributions of health-risk-estimate inputted variable parameters remain ambiguous. Therefore, this research aimed to study the disease burden of workers exposed to Staphylococcus aureus bioaerosol during warm and cold periods and to strictly quantify the contributions of the inputted parameters of disease burden by sensitivity analysis based on Monte Carlo simulation. The results showed that the disease health risk burden in the warm period was higher than in the cold period, disease health risk burden in the rotating-disc aeration mode was regularly higher than in the microporous aeration mode. The disease health risk burden of the workers with personal protective equipment (PPE) almost all satisfied the WHO benchmark (≤10E-6 DALYs pppy), and was consistently lower by one or two orders of magnitude than the workers without PPE in both warm and cold periods. Referring to the sensitivity analysis, exposure concentration and aerosol ingestion rate were the most and second predominant factor for the estimated risk in all exposure scenarios, respectively. The sensitivity of the removal fraction by employing PPE ranked third in the contribution to disease health risk burden. In addition, no remarkable differences were revealed in the sensitivity percentage ratio between warm and cold periods. This research can deepen the understanding of the QMRA framework and promote the development of sensitivity analysis, especially under various meteorological conditions (warm and cold periods).

Cost Analysis and Health Risk Assessment of Wastewater Reuse from Secondary and Tertiary Wastewater Treatment Plants

Irrigation with reclaimed water is a widespread solution to coping with water scarcity, especially in the Middle East and North Africa (MENA) region. This paper presents a systematic evaluation approach of six treatment alternatives proposed for Alexandria WWTP in Egypt as an applied example. This approach evaluates the effluent quality and cubic meter price from the proposed treatment alternatives while managing the health risks associated with reclaimed water irrigation. Rotavirus, Salmonella, Giardia duodenalis, and Ascaris were studied as waterborne pathogens. A quantitative microbial risk assessment model was used for the estimation of annual infection risks. The exposure scenarios include farmers and vegetable consumers. Activated sludge provided the lowest costs; however, it gave the lowest efficiencies and highest health risks. On the other hand, the highest efficiency and lowest health risks were obtained by the membrane bioreactor. The resulting price of a cubic meter of treated wastewater, used in irrigation, ranged from 0.082 to 0.133 USD. Irrigation using tertiary-treated wastewater achieved the target infection risk for unrestricted irrigation without using advanced treatment facilities. The results of this study could give a comprehensive view of reusing wastewater to decision-makers to address both water and food poverty not only in Egypt but also in other countries in MENA with similar economic and agro-ecological conditions.

Analysis of scenarios to reduce the probability of acquiring hemolytic uremic syndrome associated with beef consumption

The objective of this study was to develop a quantitative microbial risk assessment (QMRA) model to evaluate potential risk mitigation strategies to reduce the probability of acquiring hemolytic uremic syndrome (HUS) associated with beef consumption in Argentina. Five scenarios were simulated to evaluate the effect of interventions on the probability of acquiring HUS from Shiga toxin-producing Escherichia coli (STEC)-contaminated ground beef and commercial hamburger consumption. These control strategies were chosen based on previous results of the sensitivity analysis of a baseline QMRA model ( Brusa et al., 2020 ). The application of improvement actions in abattoirs not applying Hazard Analysis and Critical Control Points (HACCP) for STEC would result 7.6 times lower in the probability that consumers acquired HUS from ground beef consumption, while the implementation of improvements in butcher shops would lead to a smaller reduction. In abattoirs applying HACCP for STEC, the risk of acquiring HUS from commercial hamburger consumption was significantly reduced. Treatment with 2% lactic acid, hot water and irradiation reduced 4.5, 3.5 and 93.1 times the risk of HUS, respectively. The most efficient interventions, in terms of case reduction, being those that are applied in the initial stages of the meat chain.