Assessment of relative potential for Legionella species or surrogates inhalation exposure from common water uses.

The Legionella species have been identified as important waterborne pathogens in terms of disease morbidity and mortality. Microbial exposure assessment is a tool that can be utilized to assess the potential of Legionella species inhalation exposure from common water uses. The screening-level exposure assessment presented in this paper developed emission factors to model aerosolization, quantitatively assessed inhalation exposures of aerosolized Legionella species or Legionella species surrogates while evaluating two generalized levels of assumed water concentrations, and developed a relative ranking of six common in-home uses of water for potential Legionella species inhalation exposure. Considerable variability in the calculated exposure dose was identified between the six identified exposure pathways, with the doses differing by over five orders of magnitude in each of the evaluated exposure scenarios. The assessment of exposure pathways that have been epidemiologically associated with legionellosis transmission (ultrasonic and cool mist humidifiers) produced higher estimated inhalation exposure doses than pathways where epidemiological evidence of transmission has been less strong (faucet and shower) or absent (toilets and therapy pool). With consideration of the large uncertainties inherent in the exposure assessment process used, a relative ranking of exposure pathways from highest to lowest exposure doses was produced using culture-based measurement data and the assumption of constant water concentration across exposure pathways. In this ranking, the ultrasonic and cool mist humidifier exposure pathways were estimated to produce the highest exposure doses, followed by the shower and faucet exposure pathways, and then the toilet and therapy pool exposure pathways.

Environmental persistence of a highly pathogenic avian influenza (H5N1) virus.

Human cases of disease caused by highly pathogenic avian influenza (HPAI) viruses of the H5N1 subtype are rare, yet characterized with a mortality rate of approximately 60%. Tests were conducted to determine the environmental persistence of an HPAI (H5N1) virus on four materials (glass, wood, galvanized metal, and topsoil) that could act as fomites or harbor the virus. Test coupons were inoculated with the virus and exposed to one of five environmental conditions that included changes in temperature, relative humidity, and simulated sunlight. At time periods up to 13 days, the virus was extracted from each coupon, and quantified via cytopathic effects on Madin-Darby canine kidney cells. The virus was most persistent under the low temperature condition, with less than 1 log reduction on glass and steel after 13 days at low relative humidity. Thus, at these conditions, the virus would be expected to persist appreciably beyond 13 days.