Ozone and peroxone disinfection of Toxocara canis eggs in water.

Water pollution in developing countries continues to be a major health problem due to various anthropological activities that contribute to the spread of many parasitic diseases, including those caused by helminths. The aim of this study is to explore the ability of ozone and peroxone to disinfect drinking water contaminated samples with Toxocara canis eggs. The oxidants used were ozone and ozone-hydrogen peroxide combination. The treatment of Toxocara canis eggs was carried out in a 50 ml reactor with an operating volume of 10 ml. The pH conditions (5, 7 and 10) were varied for each treatment. The treatment effect was calculated by counting eggs and examining the condition of the larvae larval condition (whole, broken and hatched larvae) using an optical microscope. The experiment was carried out by exposing the eggs for 60 and 120 minutes to ozone and peroxone. The best results were obtained for helminths treated with the ozone/hydrogen peroxide combination at pH 10, with an inactivation of 79.2%. The synergistic effect of ozone combined with hydrogen peroxide allows higher helminth egg inactivation rates, demonstrating that advanced oxidation processes are a real alternative to apply in the inactivation of Toxocara canis eggs. The results obtained in this study show that the ozone and peroxone treatment could be a useful disinfection process to destroy or inactivate Toxocara canis eggs in processes commonly applied in water treatment.

Human health risk assessment for (re)emerging protozoan parasites in surface water used for public supply and recreational activities.

Gastrointestinal diseases caused by protozoan parasites remain a major challenge in developing countries and ingestion of contaminated surface water represents one of the main sources by which these diseases are contracted. This study assessed the risk of infection and diseases caused by Cryptosporidium spp. and Giardia sp. due to ingestion of surface water used for public supply and recreational activities, focusing on the southeastern Brazilian Pardo River and applying the USEPA 1623 method to quantify (oo)cyst concentrations. Infection and disease probabilities due to ingestion of drinking water or during recreational activities were estimated using the Quantitative Microbial Risk Assessment (QMRA) approach. Mean concentrations of Cryptosporidium spp. and Giardia sp. in surface water ranged from 0.2 to 0.4 oocysts L-1 and 0.2 to 4.4 cysts L-1, respectively. Considering public water supply, annual infection probabilities were higher for adults than children and exceeded the USEPA limit; also, disease probabilities were higher for adults than children. For recreational activities, annual infection and disease probabilities were higher for children, followed by men and women. The occurrence of both parasites likely reflects raw sewage discharge, effluent from sewage treatment plants, and diffuse sources of pollution, such as runoff from pasture lands and deforested riparian forest corridors. Our results highlight substantial infection risks by both parasite types after conventional treatment of water used for public supply and also call for careful monitoring of water bodies used for recreational purposes.

Cryptosporidiosis outbreak in Amazonia, French Guiana, 2018.

BACKGROUND: Cryptosporidiosis outbreaks in South America are poorly documented. In March 2018, 51 cases of cryptosporidiosis were reported in Maripasoula, a village located in a remote forest area along the border between Surinam and French Guiana. METHOD: To identify the origin of the epidemic, we performed epidemiological, microbiological, and environmental investigations. Only the cases involving diarrhoea and Cryptosporidium-positive stool were considered as bona fide, while cases involving diarrhoea and close contact with a confirmed case were classified as "possible". RESULTS: We identified 16 confirmed cases and 35 possible ones. Confirmed cases comprised nine children (median age of 18 months, range: 6-21), one immunocompromised adult and six soldiers. One child required a hospitalisation for rehydration. All 16 Cryptosporidium stools were PCR positive, and sequencing of the gp60 gene confirmed only one Cryptosporidium hominis subtype IbA10G2. Tap water consumption was the only common risk factor identified. Contamination of the water network with Cryptosporidium parvum subtype IIdA19G2 was found. CONCLUSION: Water quality is a major public health issue in Amazonian French Guiana, especially for population at risk (children, people with comorbidity, travelers). For them, alternative water supply or treatment should be implemented.

Giardia spp., the most ubiquitous protozoan parasite in Argentina: human, animal and environmental surveys reported in the last 40 years.

Giardia is a parasite distributed worldwide and one of the most prevalent intestinal protozoa in Argentina. We analysed all the national information regarding the prevalence of Giardia infections in humans, animals and environmental surveys over the last 40 years. In this work, we used Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the period between 1980 and 2019 was defined as time lapse for inclusion of the studies. The analysis was conducted using the LILACS, PubMed, Scopus and Argentina SciELO databases employing as keywords 'Giardia' AND 'Argentina'. We also carried out a manual review of papers. Of 304 articles, 92 fitted the eligibility criteria. Giardia was reported in 15 of the 23 Argentine provinces; human prevalence was between 3.4 and 64.8%. Indigenous children and residents in peri-urban areas had the higher infection rates. In animals, Giardia was identified mainly in dogs with a prevalence of 8.9 ± 7.0%, and studies of wild animals and cattle were notably scarce. Environmental studies showed that Giardia was detected in the soil and water which may act as reservoirs for this parasite revealing the need to modify the national water treatment legislation. The identification of Giardia genetic assemblages in the studies analysed was limited and showed that genotypes AII and B were found in humans while assemblage B was mainly detected in animals. This report provides useful information on epidemiological aspects of giardiasis in Argentina that may help to define future research priorities and provides useful tools for professionals regarding actual information on the prevalence of this infection.

Intestinal parasitic infections and associated factors in children of three rural schools in Colombia. A cross-sectional study.

Rural children are one of the populations that are most vulnerable to gastrointestinal parasite infections. Such diseases decrease the quality of life and result in growth and cognitive delays in the long term. This cross-sectional study was conducted to determine the frequency of intestinal parasite infections among rural schoolchildren in the municipality of Apulo, Colombia. A total of 97 stool samples from children aged between 5 and 15 years were collected and examined via direct light microscopy. Microscopic examination was repeated with sediments obtained using a fecal parasite concentrator, and the Kato-Katz test was performed. Frequency of intestinal parasite infection was 100%. Endolimax nana (77.35%), Blastocystis sp. (71.1%), Giardia intestinalis (39.1%), Entamoeba coli (25.7%), and the Entamoeba histolytica/dispar/moshkovskii complex (9.2%) were the most prevalent protozoa. Trichuris trichiura was the most prevalent helminth (12.3%), followed by Enterobius vermicularis (6.15%) and Ascaris lumbricoides (5.1%). Among the analyzed associated factors, consumption of untreated water increased the risk of acquiring pathogenic intestinal parasites. Finally, because G. intestinalis was the most prevalent pathogenic protozoan, molecular analysis was conducted to establish genetic assemblages and subassemblages of Giardia through sequence-based genotyping of the glutamate dehydrogenase, triose phosphate isomerase, and beta-giardin genes. A total of 14 G. intestinalis-positive samples were genotyped, which revealed the presence of subassemblages AI (n = 1), AII (n = 7), BIII (n = 2), BIV (n = 2), and BIII/BIV (n = 1) as well as a mixed subassemblage AII + BIII (n = 1). Our results indicate that gastrointestinal parasite infections in the tested population were mainly caused by suboptimal water quality. Moreover, molecular typing of G. intestinalis suggested contamination of water by animal- and human-derived cysts.

Real-time PCR detection of Toxoplasma gondii in surface water samples in São Paulo, Brazil.

Water is considered an important vehicle for the spread of human toxoplasmosis in several countries. Toxoplasma gondii oocysts can persist in the environment for long periods, being highly resistant to the various chemical inactivation processes commonly used by water supply systems, distinctly from simple filtration and flocculation that are efficient in removing oocysts from drinking water. The existing methodologies for identification and quantification of this parasite in water samples are not standardized and have limitations. This study aimed to evaluate the presence of T. gondii oocysts in surface water samples used as a source for the production of drinking water in the State of São Paulo, through the implementation of a specific methodology using real-time PCR technique (qPCR). Volumes of 20 L of the sample were concentrated by filtration in Envirocheck® HV capsules. For DNA extraction, the PowerSoil DNA isolation® kit (currently DNeasy PowerSoil®) was used. The target sequence selected for qPCR was a 62-base-pair fragment of the B1 gene. In the initial recovery evaluation of the method in four replicates of reverse osmosis water, the mean recovery was 48.5% (SD ± 11.5), while the mean recovery for method performance in matrices was 3.2% (SD ± 3.2) (rainy season) and 62.0% (SD ± 6.2) (dry period), suggesting that the characteristics of the samples and the climatic conditions interfere in the recovery efficiency. Of the 39 samples analyzed (May to December 2015), 7.7% (3/39) were positive for T. gondii, and among the ten sources studied; the occurrence of the oocysts was detected in 30% (3/10).

Performance comparison of three methods for detection of Giardia spp. cysts and Cryptosporidium spp. oocysts in drinking-water treatment sludge.

Detecting pathogenic protozoa in drinking-water treatment sludge is a challenge as existing methods are complex, and unfortunately, there are no specific technical standards to follow. Selecting an efficient analytical method is imperative in developing countries, such as Brazil, in order to evaluate the risk of parasite infection. In this context, three methods to detect Giardia spp. cysts and Cryptosporidium spp. oocysts were tested in sludge generated when water with protozoa and high turbidity was treated. Jar testing was carried out using polyaluminium chloride as a coagulant to generate the residue to be analyzed. The results showed that calcium carbonate flocculation with reduced centrifugation and immunomagnetic separation obtained the highest recoveries in the tested matrix showing 60.2% ± 26.2 for oocysts and 46.1% ± 5 for cysts. The other two methods, the first using the ICN 7× cleaning solution and the second considering the acidification of the sample, both followed by the immunomagnetic separation step, also presented high recoveries showing 41.2% ± 43.3 and 37.9% ± 52.9 for oocysts and 11.5% ± 85.5 and 26% ± 16.3 for cysts, respectively. Evidently, these methods and others should be studied in order to make it possible to detect protozoa in settled residue.

Molecular detection and genotyping of pathogenic protozoan parasites in raw and treated water samples from southwest Colombia.

BACKGROUND: Protozoan parasites such as Giardia duodenalis, Cryptosporidium spp., Cyclospora cayetanensis, Toxoplasma gondii and Entamoeba histolytica represent a great challenge to the systems producing water for human consumption because their cystic forms are persistent in the environment and resist to the disinfection methods conventionally used for their control. In this study, we investigated the presence of these protozoan pathogens in both raw and treated water samples used for the production of drinking water in Nariño Department, southwest Colombia. We collected 110 water samples (10 lof each sample) and analyzed them with real-time PCR (qPCR). qPCR-positive samples were genotyped with PCR and DNA sequencing. RESULTS: Giardia duodenalis was detected in 35/110 (31.8%) of the samples and Cryptosporidium spp. in 9/110 (8.2%) of the samples; no sample was positive for T. gondii, E. histolytica or C. cayetanensis. Giardia duodenalis was detected in samples of both raw water (Drinking Water Treatment Plants (DWTP): 47.83%;Drinking Water Rural Plants (DWRP): 18.42%) and water collected either after conventional physicochemical treatment (26.09%) or after disinfection by chlorine (50%), whereas Cryptosporidium spp. were only detected in raw waters (DWTP: 17.39%; DWRP: 13.16%). The two pathogens were detected in both types of treatment plants supplying water to urban areas and to rural zones. Analysis of gdh and tpi markers identified assemblages AI, AII and H of G. duodenalis, while analysis of the small subunit rRNA and gp60 markers of Cryptosporidium-positive samples identified C. parvum (Subtype IIcA5G3c), C. galli, C. molnari, Cryptosporidium sp. genotype II of bats and Cryptosporidium sp. genotype VIII of birds. CONCLUSIONS: The results obtained demonstrate the presence of protozoan parasites in the water of the study region, and the need to improve the surveillance systems for these pathogens and identify the corresponding sources of contamination.

The therapeutic strategies against Naegleria fowleri.

Naegleria fowleri is a pathogenic amoeboflagellate most prominently known for its role as the etiological agent of the Primary Amoebic Meningoencephalitis (PAM), a disease that afflicts the central nervous system and is fatal in more than 95% of the reported cases. Although being fatal and with potential risks for an increase in the occurrence of the pathogen in populated areas, the organism receives little public health attention. A great underestimation in the number of PAM cases reported is assumed, taking into account the difficulty in obtaining an accurate diagnosis. In this review, we summarize different techniques and methods used in the identification of the protozoan in clinical and environmental samples. Since it remains unclear whether the protozoan infection can be successfully treated with the currently available drugs, we proceed to discuss the current PAM therapeutic strategies and its effectiveness. Finally, novel compounds for potential treatments are discussed as well as research on vaccine development against PAM.

Cryptosporidium spp. and Giardia spp. in feces and water and the associated exposure factors on dairy farms.

The aims of this study were to verify the prevalence of Cryptosporidium spp. and Giardia spp. in animal feces and drinking water on dairy farms and to identify a possible relation between the exposure factors and the presence of these parasites. Fecal samples from cattle and humans and water samples were collected on dairy farms in Paraná, Brazil. Analysis of (oo)cysts in the feces was performed by the modified Ziehl-Neelsen staining and centrifugal flotation in zinc sulfate. Test-positive samples were subjected to nested PCR amplification of the 18SSU ribosomal RNA gene for identification of Cryptosporidium and Giardia and of the gp60 gene for subtyping of Cryptosporidium. Microbiological analysis of water was carried out by the multiple-tube method and by means of a chromogenic substrate, and parasitological analysis was performed on 31 samples by direct immunofluorescence and nested PCR of the genes mentioned above. Identification of the species of Cryptosporidium was performed by sequencing and PCR with analysis of restriction fragment length polymorphisms. The prevalence of Giardia and Cryptosporidium was higher in calves than in adults. Among the samples of cattle feces, Cryptosporidium parvum was identified in 41 (64%), C. ryanae in eight (12.5%), C. bovis in four (6.3%), C. andersoni in five (7.8%), and a mixed infection in 20 samples (31.3%). These parasites were not identified in the samples of human feces. Thermotolerant coliform bacteria were identified in 25 samples of water (45.5%). Giardia duodenalis and C. parvum were identified in three water samples. The gp60 gene analysis of C. parvum isolates revealed the presence of two strains (IIaA20G1R1 and IIaA17G2R2) in the fecal samples and one (IIaA17G2R1) in the water samples. The presence of coliforms was associated with the water source, structure and degradation of springs, rain, and turbidity. The prevalence of protozoa was higher in calves up to six months of age. C. parvum and G. duodenalis were identified in the water of dairy farms, as were thermotolerant coliforms; these findings point to the need for guidance on handling of animals, preservation of water sources, and water treatment.

Presence of Toxoplasma gondii in Drinking Water from an Endemic Region in Southern Mexico.

Toxoplasmosis can be acquired through the ingestion of contaminated drinking water with oocysts of Toxoplasma gondii, highly resistant to the routinely disinfection processes; based on chlorination commonly used in the water supply industry. The aim of this study was to determine the presence of T. gondii DNA in samples of public drinking water from an endemic region of southern Mexico. In total 74 samples of water (5 L each) were collected from the three well fields (I, II, and III) and 71 independent wells, distributing public drinking water to the city of Merida Yucatan, after passing through the chlorination process. Water samples were filtered and concentrated by a sucrose solution, then DNA was extracted and evaluated through a nested-PCR (nPCR) specific for T. gondii. Positive samples were detected in 5.4% (4/74) of the water samples. This is the first report of the presence of T. gondii DNA in public drinking water from a large city in southern Mexico, where their consumption without any postpurification treatment could pose a risk for acquiring the infection in the urban population.

The population density of Lymnaea columella (Say, 1817) (Mollusca, Lymnaeidae) an intermediate host of Fasciola hepatica (Linnaeus, 1758), in the Caparaó microregion, ES, Brazil / Densidade populacional de Lymnaea columella (Say, 1817) (Mollusca, Lymnaeidae) hospedeiro intermediário de Fasciola hepatica (Linnaeus, 1758) na Microrregião do Caparaó, ES, Brasil

Abstract The aim of this study was to monitor the population density of Lymnaea columella, an intermediate host of Fasciola hepatica, in various aquatic habitats and in drinking water in the area of the Instituto Federal de Educação, Ciência e Tecnologia do Espírito Santo, on Caparaó Microregion, municipality of Alegre, state of Espírito Santo, Brazil. Monthly samplings were performed at certain points between drainage areas and drinking water in cattle and goat production systems during the years 2010 to 2013. The mean temperature, precipitation and the frequency of samples of L. columella were analysed graphically according the monthly average during the study period. A total of 2,038 molluscs were collected, 1558 of which were L. columella, that predominated in all sampled points. The highest average of specimens observed for L. columella was in the years 2010 and 2013 (51.0), and occurred decreased in 2011 (19.8). The temperature and precipitation averaged is 23.7 °C and 141 mm/year, respectively. Rainfall peak occurred in March (2011, 2013) and November (2012), during these periods the population of L. columella growth. There was no significant difference in the relationship between the specimens observed with seasons (dry-wet), thus the population of L. columella remained stable and can be found throughout the year.

Resumo O objetivo deste estudo foi acompanhar a variação da densidade populacional de Lymnaea columella, hospedeiro intermediário de Fasciola hepatica, em diferentes tipos de coleções hídricas e bebedouros na área do Instituto Federal de Educação, Ciência e Tecnologia do Espírito Santo, na microrregião do Caparaó, município de Alegre, estado do Espírito Santo, Brasil. Foram realizadas coletas mensais em pontos determinados entre áreas de drenagem e bebedouros de animais nos setores de bovinocultura e caprinocultura durante os anos de 2010 a 2013. As médias de temperatura, precipitação e a frequência de exemplares de L. columella foram analisadas graficamente de acordo com a média mensal ao longo do período avaliado. Foram coletados 2.038 moluscos, sendo 1558 de L. columella, espécie predominante em todos os pontos amostrados. A maior média de espécimes observadas para L. columella foi nos anos de 2010 e 2013 (51,0), ocorrendo um decréscimo em 2011 (19,8). A temperatura apresentou média de 23,7°C e precipitação de 141 mm/ano. Picos de precipitação ocorreram em Março (2011, 2013) e Novembro (2012), nestes períodos foi observado aumento populacional de L. columella. Não houve diferença significativa na relação entre as espécimes observadas com as estações do ano (seca-chuvosa), dessa forma, a população de L. columella se mostrou estável, podendo ser encontrada durante todo ano.

O uso de larvicidas em água potável é seguro? / Is the use of larvicides in drinking water safe? / ¿El uso de lavicida en la agua potable es seguro?

Provavelmente sim. Não existem evidências que comprovem a segurança do uso de larvicidas em água potável. Entretanto, os poucos estudos que existem avaliando o efeito em população de mamíferos, assim como as avaliações de biodisponibilidades e citotoxicidade, demonstram que em baixa concentração são seguros e não há efeitos carcinogênicos ou genotóxico. Os larvicidas avaliados e autorizados para uso em água potável pela Organização Mundial de Saúde, destinada para consumo humano são: DIFLUBENZUROM, METOPRENO, NOVALUROM, Pirimifós/, PIRIPROXIFEM, ESPINOSADE, TEMEFÓS, além do Bacillus thuringiensis israelensis (BTI). Recomenda-se sempre usar a dose correta dos larvicidas. O temephós é utilizado para tratamento de focos, mas não deve ser utilizado em aquários com peixes. Aprovado para uso em água de consumo humano. O pyriproxyfen é um éter e não há evidências que comprovem que cause dano em fetos de mamíferos. BTI é recomendado como larvicida para uso em saúde pública, é uma bactéria que em contato com a água libera substâncias tóxicas para as larvas de alguns insetos. A aplicação deverá ser realizada por profissional treinado. O BTI não apresenta ingesta diária aceitável, entretanto a orientação de uso deve ser de 1-5mg/litro. A avaliação de substâncias químicas de qualquer natureza sempre deve salientar a possibilidade de bioacumulação. As substâncias que não são biodegradadas, são biopersistentes e mantêm-se em altas quantidades nos tecidos dos seres vivos. Portanto, mesmo que as substâncias não sejam para consumo humano direto a avaliação do seu uso na agricultura, leito de rio e pastos deve ser avaliada criteriosamente.

Probably yes. There is no evidence to prove the safety of the use of larvicides in drinking water. However, there are few studies evaluating the effect on the population of mammals, as are the bioavailabilities and cytotoxicity reviews show that in low concentrations are safe and no genotoxic or carcinogenic effects. Larvicides evaluated and authorized for use in drinking water by the World Health Organization, intended for human consumption are: DIFLUBENZUROM, METOPRENO, NOVALUROM, Pirimifós/, PIRIPROXIFEM, ESPINOSADE, TEMEFÓS, beyond Bacillus thuringiensis israelensis (BTI). It is recommended to always use the correct dose of larvicides. Temephos is used to treat outbreaks, but should not be used in fish tanks. Approved for use in drinking water. The pyriproxyfen is an ether and there is no evidence to support that it causes damage in mammalian fetuses. BTI are recommended as larvicides for use in public health, it is a bacterium that contact with water releases toxic to the larvae of some insects. The application should be performed by trained professional. BTI has no acceptable daily intake, however the guidance of use should be 1-5mg/liter. The evaluation of chemicals of any kind should always stress the possibility of bioaccumulation. Substances that are not biodegraded are biopersistent and remain at high levels in the tissues of living things. So even if the substances are not for direct human consumption, an appraisal of its use in agriculture, river bed and pastures should be carefully evaluated.

Probablemente sí. No hay evidencia para demostrar la seguridad del uso de larvicidas en la agua potable. Sin embargo, hay pocos estudios que evalúan el efecto sobre la población de mamíferos, como son los biodisponibilidad y las revisiones de citotoxicidad muestran que en concentraciones bajas son seguros y sin efectos genotóxicos o cancerígenos. Larvicidas evaluadas y autorizadas para su uso en la agua potable por la Organización Mundial de Salud, destinados al consumo humano son: DIFLUBENZUROM, METOPRENO, NOVALUROM, Pirimifós/, PIRIPROXIFEM, ESPINOSADE, TEMEFÓS, más allá de Bacillus thuringiensis israelensis (BTI). Se recomienda utilizar siempre la dosis correcta de larvicidas. Temephos se utiliza para tratar los brotes, pero no se debe utilizar en los tanques de peces. Aprobado para uso en la agua potable. El piriproxifeno es un éter y no hay evidencia para apoyar que causa daños en los fetos de mamíferos. Se recomienda BTI como larvicida para uso en la salud pública, es una bacteria que en contacto con el agua tóxicas para las larvas de algunos insectos. La aplicación debe ser realizada por profesionales capacitados. BTI no tiene ninguna ingesta diaria admisible, sin embargo, la orientación de uso debe ser 1-5 mg/litro. La evaluación de los productos químicos de cualquier tipo siempre se debe hacer hincapié en la posibilidad de bioacumulación. Las sustancias que no se biodegradan, son biopersistente y se mantienen en niveles altos en los tejidos de los seres vivos. Así que incluso si las sustancias no son para el consumo humano directo, una apreciación de su uso en la agricultura, lecho del río y pastos debe ser cuidadosamente evaluada.

The population density of Lymnaea columella (Say, 1817) (Mollusca, Lymnaeidae) an intermediate host of Fasciola hepatica (Linnaeus, 1758), in the Caparaó microregion, ES, Brazil.

The aim of this study was to monitor the population density of Lymnaea columella, an intermediate host of Fasciola hepatica, in various aquatic habitats and in drinking water in the area of the Instituto Federal de Educação, Ciência e Tecnologia do Espírito Santo, on Caparaó Microregion, municipality of Alegre, state of Espírito Santo, Brazil. Monthly samplings were performed at certain points between drainage areas and drinking water in cattle and goat production systems during the years 2010 to 2013. The mean temperature, precipitation and the frequency of samples of L. columella were analysed graphically according the monthly average during the study period. A total of 2,038 molluscs were collected, 1558 of which were L. columella, that predominated in all sampled points. The highest average of specimens observed for L. columella was in the years 2010 and 2013 (51.0), and occurred decreased in 2011 (19.8). The temperature and precipitation averaged is 23.7 °C and 141 mm/year, respectively. Rainfall peak occurred in March (2011, 2013) and November (2012), during these periods the population of L. columella growth. There was no significant difference in the relationship between the specimens observed with seasons (dry-wet), thus the population of L. columella remained stable and can be found throughout the year.

Frequency and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba hartmanni in the context of water scarcity in northeastern Brazil.

This study aimed to estimate the frequency, associated factors, and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, andEntamoeba hartmanni infections. We performed a survey (n = 213 subjects) to obtain parasitological, sanitation, and sociodemographic data. Faecal samples were processed through flotation and centrifugation methods.E. histolytica, E. dispar, E. moshkovskii, and E. hartmanni were identified by nested-polymerase chain reaction (PCR). The overall prevalence of infection was 22/213 (10.3%). The infection rate among subjects who drink rainwater collected from roofs in tanks was higher than the rate in subjects who drink desalinated water pumped from wells; similarly, the infection rate among subjects who practice open defecation was significantly higher than that of subjects with latrines. Out of the 22 samples positive for morphologically indistinguishableEntamoeba species, the differentiation by PCR was successful for 21. The species distribution was as follows: 57.1% to E. dispar, 23.8% to E. histolytica, 14.3% toE. histolytica and E. dispar, and 4.8% E. dispar and E. hartmanni. These data suggest a high prevalence of asymptomatic infection by the group of morphologically indistinguishable Entamoeba histolytica/dispar/moshkovskiicomplex and E. hartmanni species. In this context of water scarcity, the sanitary and socioenvironmental characteristics of the region appear to favour transmission.

Avaliação parasitológica e bacteriológica do gelo comercializado na cidade de Juazeiro do Norte – CE / Parasitological and bacteriological evaluation of the ice sold in the city of Juazeiro do Norte - CE

A água é a matéria-prima utilizada na produção de gelo e a adoção de práticas rigorosas de higiene em sua fabricação, manuseio, embalagem, conservação e distribuição torna-se indispensável. O método de congelamento não é capaz de destruir os patógenos contaminantes, pois os mesmos permanecem em estado de latência até que o produto entre em processo de fusão. O estudo teve como objetivo avaliar as condições parasitológicas e bacteriológicas do gelo comercializado para consumo no município de Juazeiro do Norte, CE. Trata-se de um estudo analítico e transversal, realizado a partir de análises microbiológicas, por meio da técnica dos tubos múltiplos, e parasitológicas, pelo método de Hoffmann Modificado, técnica de Faust e pesquisa de Cryptosporidium spp. pela técnica de Ziehl-Neelsen Modificado, conhecido como coloração de Kinyoun. Em quinze amostras adquiridas em diferentes bairros deste município, 66,7% apresentaram coliformes totais e 33,3% coliformes termotolerantes. Na avaliação parasitológica, 33,3% estavam contaminadas por Giardia lamblia e 6,6% por Cryptosporidium spp. As irregularidades higienicossanitárias, que abordam desde o processo de fabricação do produto até a sua distribuição nos estabelecimentos, são as possíveis causas de contaminações parasitárias e microbiológicas. Reforça-se, portanto, a necessidade de estabelecer estratégias a fim de detectar os possíveis pontos de contaminação do gelo, buscando solucionar o problema e, assim, prevenir os consumidores de possíveis infecções e parasitoses, além de garantir a segurança deste alimento.

Since this is the raw material used in the production of ice, it is essential to adopt strict hygiene practices in their manufacturing, handling, packaging, storage and distribution. Since the freezing method is not able to destroy contaminating pathogens because the microorganisms remain in the sleep state until the product goes into melting process. The objective of this study was to evaluate the parasitological and bacteriological ice conditions marketed for consumption in Juazeiro do Norte, Ceará. It's about an analytic and transversal study, conducted from microbiological, using the technique of multiple tubes, and parasitological through the modified method of Hoffmann, Faust technic and detection of Cryptosporidium spp. by Ziehl-Neelsen Modified, known as Kinyoun staining. In fifteen samples, acquired in different neighborhoods of the city, 66,7% had total coliforms and 33,3% thermotolerant coliforms. In parasitological evaluation, 33.3% were contaminated with Giardia lamblia and 6,6% with Cryptosporidium spp. The hygienic and sanitary irregularities, which range from the manufacturing process of the product to distribution establishments, are possible causes of parasitic and microbiological contamination. Therefore, it reinforces the need to provide strategies to detect the possible points of contamination of ice, seeking to solve the problem and then prevent consumers from possible infections, in addition to ensure the safety of food.

Frequency and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba hartmanni in the context of water scarcity in northeastern Brazil

This study aimed to estimate the frequency, associated factors, and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, andEntamoeba hartmanni infections. We performed a survey (n = 213 subjects) to obtain parasitological, sanitation, and sociodemographic data. Faecal samples were processed through flotation and centrifugation methods.E. histolytica, E. dispar, E. moshkovskii, and E. hartmanni were identified by nested-polymerase chain reaction (PCR). The overall prevalence of infection was 22/213 (10.3%). The infection rate among subjects who drink rainwater collected from roofs in tanks was higher than the rate in subjects who drink desalinated water pumped from wells; similarly, the infection rate among subjects who practice open defecation was significantly higher than that of subjects with latrines. Out of the 22 samples positive for morphologically indistinguishableEntamoeba species, the differentiation by PCR was successful for 21. The species distribution was as follows: 57.1% to E. dispar, 23.8% to E. histolytica, 14.3% toE. histolytica and E. dispar, and 4.8% E. dispar and E. hartmanni. These data suggest a high prevalence of asymptomatic infection by the group of morphologically indistinguishable Entamoeba histolytica/dispar/moshkovskiicomplex and E. hartmanni species. In this context of water scarcity, the sanitary and socioenvironmental characteristics of the region appear to favour transmission.

Detection by PCR of pathogenic protozoa in raw and drinkable water samples in Colombia.

We evaluated the presence of DNA of Giardia, Toxoplasma, and Cryptosporidium by PCR, and of Giardia and Cryptosporidium genera by immunofluorescence antibody test (IFAT), in water samples, before, during, and after plant treatment for drinkable water. We applied this method in 38 samples of 10 l of water taken from each of the water treatment steps and in 8 samples taken at home (only for Toxoplasma PCR) in Quindio region in Colombia. There were 8 positive samples for Cryptosporidium parvum (21 %), 4 for Cryptosporidium hominis (10.5 %), 27 for Toxoplasma gondii (58.6 %), 2 for Giardia duodenalis assemblage A (5.2 %), and 5 for G. duodenalis assemblage B (13.1 %). By IFAT, 23 % were positive for Giardia and 21 % for Cryptosporidium. An almost perfect agreement was found between IFAT and combined results of PCR, by Kappa composite proportion analysis. PCR positive samples were significantly more frequent in untreated raw water for C. parvum (p = 0.02). High mean of fecal coliforms, high pH values, and low mean of chlorine residuals were strongly correlated with PCR positivity for G. duodenalis assemblage B. High pH value was correlated with PCR positivity for C. parvum. Phylogenetic analysis of DNA sequences was possible, showing water and human clinical sequences for Toxoplasma within the same phylogenetic group for B1 repeated sequence. PCR assay is complementary to IFAT assay for monitoring of protozoa in raw and drinkable water, enabling species identification and to look for phylogenetic analysis in protozoa from human and environmental sources.

ACUTE TOXOPLASMOSIS IN A BREASTFED INFANT WITH POSSIBLE TRANSMISSION BY WATER / Toxoplasmose aguda em um lactente durante a amamentação, com possível transmissão pela água

Toxoplasma gondii transmission via breastfeeding has been discussed; however, no cases have been confirmed to date. This article describes a case of acute toxoplasmosis diagnosed in a mother and her six-month-old breastfed infant. The study accounts for the possibility of breast milk transmission and directs both clinicians and pediatricians to the hypothesis that both patients acquired toxoplasmosis via water ingestion.

A transmissão do Toxoplasma gondii através do aleitamento materno tem sido discutida; no entanto, até o momento nenhum caso foi confirmado. Este artigo relata um caso de toxoplasmose aguda diagnosticada na mãe e no seu bebê com seis meses de vida, que estava em amamentação exclusiva. Embora apresente a possibilidade de transmissão pelo leite materno, o estudo chama a atenção de clínicos e pediatras para a mais provável hipótese de que ambos adquiriram toxoplasmose pela ingestão de água.

Integrating surveillance data on water-related diseases and drinking-water quality; action-research in a Brazilian municipality.

The Brazilian Ministry of Health proposed a research study involving municipal professional staff conducting both epidemiological and water quality surveillance to facilitate the integration of the data which they collected. It aimed to improve the intersectoral collaboration and health promotion activities in the municipalities, especially regarding drinking-water quality. We then conducted a study using the action-research approach. At its evaluation phase, a technique which we called 'the tree analogy' was applied in order to identify both possibilities and challenges related to the proposed interlinkage. Results showed that integrating the two data collection systems cannot be attained without prior institutional adjustments. It suggests therefore the necessity to unravel issues that go beyond the selection and the interrelation of indicators and compatibility of software, to include political, administrative and personal matters. The evaluation process led those involved to re-think their practice by sharing experiences encountered in everyday practice, and formulating constructive criticisms. All this inevitably unleashes a process of empowerment. From this perspective, we have certainly gathered some fruit from the Tree, but not necessarily the most visible.