1. 1 NS SHARE North South Shared Aquatic Resources NS SHARE North South Shared Aquatic Resources CRYPTOSPORIDIUM SE Advisory Council Carlow 4 th July, 2007 Tony McNally Project Co-ordinator

2. 2 What is it? Not new – not a bacterium or virus. Protozoan parasite. (Plasmodium – 300M worldwide : Toxoplasma – 60M US)

3. 3 Is there just one type? Many species – not all infect humans Parasite is found in mammals, birds, fish and reptiles C. hominis (man) C. parvum (cattle and man) (C. andersoni, C. rabbit, C. muris) Found throughout the world

4. 4 What does it do? 3 rd Most Common Cause of Infective Diarrhoea (England / Wales) Cryptosporidiosis symptoms - profuse watery diarrhoea / abdminal pain / fever / nausea Oocyst (4- 6 μM) Ingested Lifecycle in 1 host Cannot grow outside the host Excysts in GI tract Environment - Oocyst resistant 7 days 1 – 2 weeks Several weeks

5. 5 Why is it a problem? Waterborne – small size, survive for long periods & chlorine resistant AIDS and Immunocompromised – chronic and life threatening (Some drugs and treatments effective) Milwaukee – 1993: 400,000 ill and 100 deaths January 2004 - Cryptosporidiosis became a notifiable disease in Ireland

6. 6 Irish Outbreaks Greater Belfast – April (129 cases) /August (117 cases) 2000 & April 2001 (230 cases). Mullingar – April 2002; 26 cases. Lough Owel services 25,000 people including 4 hospitals, 4 nursing homes, 331 food premises and 39 pre-school facilities and schools. Carlow Town - March 2005 – 31 Cases (8 hospitalised) Surface Water Supplies – Crypto present (0.009 – 0.28/10l) (Private Well and animal contact also implicated) Portlaw, Waterford Oct 2006 – 8 cases (1 hospitalised) Groundwater Borehole/Spring – Crypto present (0.01 – 0.21/10l) UV installed Galway City - March 2007 – 236 cases (1.12oocysts/10L)

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8. 8 How do you know it’s present? DIFFICULTIES - Small size / relatively low concentration in environment / separation from other particles Water sampling - Analysis

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10. 10 How can we prevent it? Identify Risks (Scottish Model) Catchment Management Storage Treatment - Solid Liquid Separation*** Disinfection Distribution System Integrity Monitor (Crypto/Works)

11. 11 Report of Waterborne Cryptosporidiosis Subcommittee of the Scientific Advisory Committee NDSC November 2004

12. Crytosporidium Pathway Pathway Surface water River Lake Estuary Sea Groundwater Aquifer Well Borehole Surface water River Lake Estuary Sea Groundwater Aquifer Well Borehole Infected Humans Infected Animals Infected Humans Infected Animals UWWTP Septic Tank Proprietary Treatment System Sludge disposal Slurry spreading Animal droppings Contact with infected animals ReceptorSource Human origin Animal origin Direct Discharge Through the soil Over the ground On Site Wastewater Treatment System Measures Municipal Discharges Measures Nitrates Action Plan Measures