Recreational Water Illnesses (RWI) - Saraniecki

Question 1

What is Trachoma also known as?
What causes it?
Transmission?

Answer 1

Chlamydial conjunctivitis
Chlamydia trachomatis is often a chronic or cyclic disease recycled from mom to children and in nurseries causing conjunctival scarring
transmission is person to person, or fomites or flies
spready by poor personal hygiene, esp 3rd world countries where it is a major cause of blindness

Question 2

Salmonella typhi
Reservoir?
Transmission?
Common?

Answer 2

Typhoid fever
reservoir: humans
transmission: food and water with fecal contamination, flies via mechanical, shellfish from sewage infested water, raw fruits and veggies fertilized with night soil
17 mil cases worldwide, 600k deaths, only 500 US annual cases

Question 3

Leptospira ssp
Description?
Transmission?
Reservoir?
Who is most at risk?

Answer 3

spirochete bacteria
zoonosis of domestic and wild animals
transmission: skin and/or mucosal contact with lake, stream, canal, irrigation water contaminated with urine of wild and domestic animals
reservoir: rats, swine, cattle, dogs, raccoons
occupational hazard for rice and sugarcane field workers

Question 4

Legionella pneumophilia
Symptoms?
Transmission?
Reservoir?

Answer 4

aka Legionnaires disease
pneumonia-like symptoms, 40% fatality
transmission via inhaled droplets only
reservoir: hot tubs, cooling towers, warm ponds, fountains

Question 5

Shigella sonnei and flexneri
reservoir?
Transmission?
Common?

Answer 5

Bacillary dysentery
450k US cases, 72% sonnei
small inoculum (10 - 200 cfu)
reservoir: only humans
transmission: fecal-oral, contaminated food and water, anal sexual contact, flies via mechanical trans to food and water

Question 6

Mycobacterium marinum
General description?
Transmission?

Answer 6

slow growing bacteria of fish and humans
skin infection via open cut or sore - acquired via aquariums, fish handling, and cool swimming pools

Question 7

Campylobacter jejuni
Reservoir?
Transmission?

Answer 7

causes gastroenteritis, aka travelers’ diarrhea, mostly foodborne
most common cause of US bacterial diarrhea
reservoir: wild and domestic animals especially poultry, cattle, puppies, kittens
transmission: undercooked chicken and pork, fecal contaminated food and water, can be P2P but uncommon

Question 8

E. Coli O157:H7
aka?
Symptoms?
Reservoir?
Transmission?

Answer 8

aka Shiga toxin producing E. coli
often grossly bloody diarrhea, can lead to HUS and kidney failure
reservoir: gut of ruminant animals - cattle, goats, sheep, deer, and elk + infected humans
transmission: raw or undercooked ground beef, alfalfa sprouts, unpasteurized juice and milk, dry cured salami, game meat, lettuce, petting zoos

Question 9

Norwalk virus
Infectious?
Reservoir?
Transmission?

Answer 9

aka Norwalk like virus aka Small round structured virus
very low infective dose, 10 to 100 PFU
NLVs detected in 20% Finnish children
reservoir: humans
transmission: fecal oral, 3% traces back to water

Question 10

Hepatitis A
reservoir?
transmission?
treatment?

Answer 10

aka Infectious hepatitis
reservoir: humans and other primates
transmission: fecal/oral, person to person, contaminated food and water (esp mollusks)
outbreaks relatively uncommon
vaccine available for lifetime immunity

Question 11

Hepatitis B
Circumstantial?

Answer 11

not considered RWI, however, it is possible if infected blood be on shared razors or toothbrushes in the grooming areas

Question 12

Giardia lamblia
aka?
Reservoir?
Transmission?

Answer 12

Bever Fever - protazoa
reservoir: humans, beavers, muskrats
transmission: p2p fecal/oral, common in institutions and day care, ingestion of cysts in contaminated water, contaminated food
Forms chlorine resistant cysts
one micron filter recommended

Question 13

Cryptosporidium parvum
aka?
Reservoir?
Transmission?
Infectious?

Answer 13

Diarrheal disease
reservoir: humans, cattle, cats, dogs
transmission: fecal/oral, waterborne (including RWI contact with diarrhea), foodborne
low infective dose - 10 to 100 oocysts

Question 14

How is cryptosporidium parvum prevented?

Answer 14

oocysts are highly resistant to chlorine, pool shock necessary
can be removed through coagulation, flocculation, sedimentation followed by 1 or 2 micron filtration (absolute filters)
fruits and veggies cannot be cleaned effectively of this

Question 15

Naegleria fowleri
aka?
reservoir?
transmission?
severity?

Answer 15

PAM - Primary Amoebic Meningoencephalitis
reservoir: ubiquitous in soil and water
transmission: contaminated water via nasal passages, warm corp of engineer lakes, warm calm shallow coves and geothermal pools, also improperly maintained swimming pools
200 confirmedd cases, 97% mortality

Question 16

Toxoplasma gondii
symptoms?
reservoir?

Answer 16

Toxoplasmosis
endemic to 22% of US population
most people are asymptomatic, mild cases flu-like with swollen lymph nodes, sever cases brain and organ damage
reservoir: oocysts in guts of cats and felines - cats eat infected rodents
intermediate hosts: sheep, goats, rodents, swine, cattle, chicken, birds

Question 17

How is Toxoplasma gondii transmitted?
(3)

Answer 17

food/waterborne - contaminated undercooked pork, lamb, venison, cross contamination, ingestion of contaminated water by feline feces
zoonotic - ingestion of oocysts via feces found in litter boxes and children’s sand boxes
congenital - transplacental transfer of tachyzoites in blood from newly infected mother to fetus, infants can develop serious eye and brain damage

Question 18

Dracunculus medinensis
aka?
Location?
Reservoir?
Transmission?
Control?

Answer 18

Guinea-worm infection
occurs only in dry regions of Africa and Asia
reservoir: only humans
transmission: ingestion of larvae from stagnant fresh water
infective dose: one cyst, egg, or larvae
control method: filtration

Question 19

Pseudomonas aeruginosa
description?
reservoir?

Answer 19

one of two “swimmers itch” helminths
thermophilic
common to hot tubs, geothermal pools
UTIs and URIs in immunocompromised
reservoir: water sources and systems, poorly disinfected pools and whirlpools, hospitals - antibiotic resistant nosocomial disease

Question 20

Schistosoma ssp
Transmission?
Symptoms?
Control?

Answer 20

aka Swimmer’s Itch
schistosome dermatitis
egg-infected migratory fowl feces dropped into lakes and saltwater beaches
eggs enter snails and develop into larvae
free swimming larvae cercaria burrow subdermally then die, causing rash/itch
control: break the lifecycle, eliminate the snail host with copper sulfate 10mg/l, also immediate post-swim showering

Question 21

Schistosoma mansoni
description?
reservoir?

Answer 21

Bilharziasis, Bilharzia, snail fever
after penetrating skin, S. mansoni larvae travel to blood stream, develop into trematode (blood fluke)
migrates to lungs, liver, and bladder
reservoir: humans, 250 million people infected

Question 22

Ascaris lumbricoides
description?
reservoir?
transmission?

Answer 22

large intestinal round worms
few or no symptoms
reservoir: humans, ascarid eggs in soil
transmission: ingestion of eggs from contaminated soil or uncooked produce

Question 23

What is a notable RWI fungal disease?

Answer 23

Ringworm or Tinea - NOT a worm, fungus
Trichophyton tinea ssp
Highly contagious, not truly waterborne
Transmission: P2P via skin-to-skin contact or by fomites, combs, unwashed clothes, shower or pool surfaces
pets/cats can also be carriers