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The volume of cold tap water consumed is an essential element in quantitative microbial risk assessment. This paper presents a review of tap water consumption studies. Study designs were evaluated and statistical distributions were fitted to water consumption data from The Netherlands, Great Britain, Germany and Australia. we conclude that the diary is to be preferred for collecting water consumption data. If a diary is not feasible, a 24 h recall would be the best alternative, preferably repeated at least once. From the studies evaluated, the mean daily consumption varies from 0.10L to 1.55L. No conclusions could be drawn regarding the effects of season, age and gender on tap water consumption. Physical activity, yearly income and perceived health status were reported to influence water consumption. Comparison of the different statistical probability distribution functions of the datasets demonstrated that the Poisson distribution performed better than the lognormal distribution as suggested by Roseberry and Burmaster. For quantitative microbiological risk assessment (QMRA) it is recommended to use country-specific consumption data and statistical distributions, if available. If no country specific data are available we recommend to use the Australian distribution data from the Melbourne diary study (Poisson, λ = 3.49 glasses/d) as a conservative estimate. [ABSTRACT FROM AUTHOR]

Defining water quality is difficult. To most people it means water that tastes and looks good and is safe to' drink. While the first two of these are relatively easy to define, defining what is safe drinking water is extremely complex. This is because the current water quality parameters are unable to predict reliably if drinking water is or is not be associated with disease. In this paper we will discuss Australia's unique opportunity to provide a different focus on water, andto describe the steps that are being taken by the Australian Water Industry through the Cooperative Research Centre for Water Quality andTreatment (CRC WQT) to understand this complex issue. In this paper only microbiological water quality will be discussed, as other investigators in the CRC WQT are dealing with other issues such as disinfection by-products. There are a number of reasons why Australia can approach the issue of water quality differently from other countries. Australia's most important advantage is having drinking water guidelines and not legally enforceable standards. As a result the Australian Water Industry and Government have considerably more flexibility than elsewhere. There are also several other important advantages including a sense of openness and trust between government, industry and academia; a focus on public health; the absence of a tradition of litigation; and the commitment of key players within CRC and Water Services Association of Australia. Research underway in Australia and elsewhere will provide a better understanding of microbiological water quality. Examples include the Water Quality Study currently underway in Melbourne and the planned case control studies of Cryptosporidium and Giardia. The importance of molecular biology and good disease surveillance is also being investigated. These issues will be discussed in this paper. [ABSTRACT FROM AUTHOR]

Noroviruses are a major cause of both sporadic and epidemic gastroenteritis in humans, but the mechanisms by which norovirus circulates within the community are poorly understood. In this study, we examined the hypothesis that asymptomatic people act as a reservoir for norovirus. Faecal specimens from 399 asymptomatic individuals were tested for norovirus by reverse transcription polymerase chain reaction (RT-PCR) methodology, and no norovirus was detected. The failure to detect norovirus was not apparently due to the test sample being resistant to norovirus infection, nor to the presence of PCR inhibitors in the test sample. The findings suggest that, if norovirus is carried by asymptomatic people, the carriage rate is very low; the upper bound (95% confidence interval, binomial distribution) of the carriage rate was only 0.8%. Thus, it is unlikely that asymptomatic people are an important reservoir for norovirus. [ABSTRACT FROM AUTHOR]

From any perspective, whether it be Australia or other countries, the issue of risk and food is one that includes all sectors of the community. The expansion of information technology and globalisation is making society as a whole more knowledgeable and expectant of safer foods with minimal risk. There is risk in everything and the basis of risk science is one that involves a number of established steps such as risk assessment, management and communication. The evolution of food technology, production and dietary habits, together with changes in trade, will no doubt raise new safety issues and governments need to be abreast of risk science to assess such changes. [ABSTRACT FROM AUTHOR]

Discusses the best way to protect people from cryptosporidiosis in drinking water. Presence of oocysts needed to cause infection; Requirements by the United States Environmental Protection Agency (EPA) for treatment of water; Water testing requirements in the United Kingdom; Cost of testing; Why the monitoring of treated water may not be an effective approach to protecting the public.

There is conflicting evidence about the contribution of drinking water to endemic community gastroenteritis in water supplies which meet conventional microbiological standards with some studies reporting associations between drinking water and endemic disease and others finding no evidence that water is implicated in disease. This study reports the results of an ecological study investigating the effect on community gastroenteritis of chlorinating a city of over 3 million people in the mid 1970s. Prior to chlorination faecal coliforms were regularly identified in the water. Admissions for gastroenteritis and attendances to the Emergency Department of the Royal Children's Hospital, Melbourne's major children's hospital, were measured between 1974 and 1980 inclusive and the influence of chlorination on rates of gastroenteritis was examined. No statistically significant difference was found in the number of admissions or emergency department visits before and after chlorination of the water supply. The study highlights the need for caution when interpreting the relationships between drinking water and gastroenteritis. The result suggests that water was not a dominant contributor to the burden of gastrointestinal disease in the community despite faecal coliforms being present in the water supply. It indicates the need for caution when attributing significant illness to drinking water when there have been only small changes in water quality without first stringently reviewing the studies methodology and understanding their limitations.

There are few data available on the incidence of endemic waterborne disease in the developed world. This study aims to determine if there was a measurable decline in gastroenteritis related faecal specimens following the introduction of water treatment. The rate of faecal specimens for gastroenteritis was obtained for 17 communities one year before and after the introduction of water treatment in two states of Australia between 1992 and 1996. Of these 17 systems, 10 had filtration added to existing disinfection, while seven had both disinfection and filtration or disinfection alone added to no existing treatment. The rate of faecal sampling varied from a reduction of 55% to an increase of 198%. Large changes in water quality parameters occurred following treatment but there was no significant correlation between these changes and changes in the rate of faecal specimens. In this study there was no consistent change in gastrointestinal related faecal specimens despite marked changes in water quality. This suggests that the reduction in endemic gastrointestinal disease as a result of the introduction of water treatment was small as a percentage of all gastroenteritis. However, water treatment remains essential to protecting public health.

A double-blinded, randomized, controlled trial was carried out in in Melbourne, Australia, to determine the contribution of drinking water to gastroenteritis. Melbourne is one of the few major cities in the world that draws drinking water from a protected forest catchment with minimal water treatment (chlorination only). Six hundred families were randomly allocated to receive either real or sham water treatment units (WTUs) installed in their kitchen. Real units were designed to remove viruses, bacteria, and protozoa. Study participants completed a weekly health diary reporting gastrointestinal symptoms during the 68-week observation period. There were 2,669 cases of highly credible gastroenteritis (HCG) during the study (0.80 cases/person/year). The ratio of HCG episode rates for the real WTU group compared to the sham WTU group was 0.99 (95% confidence interval, 0.85-1.15, p = 0.85). We collected 795 fecal specimens from participants with gastroenteritis, and pathogens were not more significantly common in the sham WTU group. We found no evidence of waterborne disease in Melbourne. The application of this methodology to other water supplies will provide a better understanding of the relationship between human health and water quality.

To assess the rate of fecal vancomycin-resistant enterococci (VRE) colon ization in Austalia, we examined specimens from 1,085 healthy volunteers. VRE was cultured from 2(0.2%) of 1,085 specimens; both were vanB Enter ococcus faecium, identical by pulsed-field gel electrophoresis, but with a pattern rare in Melbourne hospitals.

Objective: To describe an outbreak of Cryptosporidium gastroenteritis in a swimming pool in Melbourne in early 1998 that was not detected through routine surveillance, and discuss difficulties in identifying such outbreaks., Methods: The Water Quality Study (WQS) was a large community-based study of gastroenteritis. Following suspicion of an outbreak of cryptosporidiosis within the study group, due to pool "X", a nested case control study was performed. Each case of Cryptosporidium gastroenteritis was matched with six controls and data from weekly Health Diaries from the WQS were reviewed. The Department of Human Services also instigated active surveillance among patrons at pool "X" using a systematic sample of 50 people from the pool's swim-school enrollment list., Results: There were seven cases of Cryptosporidium gastroenteritis in the case control study. Five cases and eight controls swam at pool "X" during the outbreak period. The adjusted odds of developing cryptosporidial diarrhoea if an individual swam at pool "X" was 34.5 (CI 2.3-2548). DHS identified another 11 laboratory confirmed cases associated with pool "X" as well as cases not linked to pool "X". 125 cases were identified throughout Melbourne with the suspected involvement of seven swimming pools., Conclusions: Despite a high odds ratio of developing cryptosporidiosis this outbreak was not detected by routine surveillance methods. Current outbreak detection methods lack sensitivity, specificity or timeliness., Implications: Improved surveillance systems are required if outbreaks of gastroenteritis are to be detected early so an intervention can be instigated to reduce the amount of subsequent illness.

Background and Aims: The objective of this study was to describe the prevalence of pathogenic microorganisms in asymptomatic individuals in a community study in Melbourne, Australia., Methods: The study population was a subset of 2803 individuals participating in the Water Quality Study; a community based randomized trial. Faecal specimens (1091) were collected over a 3-month period from asymptomatic individuals. Specimens were tested for a range of bacteria including Salmonella, Shigella and Campylobacter species. Rotavirus and adenovirus were detected using a Rota-Adeno latex kit, and protozoa were detected using a permanent stain (modified iron-haemotoxylin)., Results: Twenty-eight known pathogens were identified from the 1091 faecal specimens, a total carriage rate of 2.6%. Giardia species were present in 18 specimens (1.6%), Salmonella in four (0.4%), Campylobacter in one (0.1%), Cryptosporidium in four (0.4%) and adenovirus in one (0.1%). Blastocystis hominis was found in 65 specimens. The median age of those without a pathogen was 12.5 years compared with 6.6 years for those with a pathogen (P=0.02)., Conclusions: Except for Giardia, pathogens were rarely found in asymptomatic individuals in the community. The prevalence of pathogens was higher in children than adults.

An investigation was undertaken at a printing company into an apparently high prevalence of trace dipstick hematuria discovered during routine medical examinations. In both the printing employees (n = 225) and a control group (n = 118) from other industries, the prevalence of hematuria exceeded that described in most previous reports (31% and 25%, respectively, using the criterion of > 12 glomerular red cells or > 2 nonglomerular red cells/microliter of urine). No focus of abnormality was identified within the printing plant and no association was identified between reported exposure to potentially toxic substances and the degree of hematuria. An occupational hygiene inspection and medical follow-up of selected workers did not reveal any significant abnormalities. The limitations of available information concerning "normal" urinalysis results suggests that hematuria may not be a useful test for the screening of occupational groups at risk of bladder cancer.

Insertions of the TOL plasmid transposons Tn4651 and Tn4653 into the Pseudomonas aeruginosa PAO chromosome were isolated by a temperature selection technique. The locations and orientations of 16 insertions were determined by pulsed field gel electrophoresis and Southern hybridization with genomic and TOL DNA probes. All insertions occurred within a 334 kb region of the chromosome (representing less than 6% of the genome) with nine of the inserts clustered within a 10 kb area. Each transposon was able to insert in either orientation. An internal duplication of the 39 kb excisable region of pWW0 was seen in two independent insertions.

A procedure has been developed which allows transformation of P. aeruginosa strain PAO with plasmid and bacteriophage DNA at a frequency of 10(-6) per recipient cell. The method is similar in outline to that developed for Escherichia coli. It involves growing the recipient cells to 3-5 x 10(8) per ml in nutrient broth, washing the cells with 0.1 M MgCl2, resuspending in 0.175 M CaCl2 for 20 min, exposing to DNA for 1 h and then heat pulsing at 42 degrees C for 1 min. Some plasmid markers are expressed immediately, whereas others require time for phenotypic expression.

The soil isolate Pseudomonas putida MW1000 can grow on toluene and other hydrocarbons; in this respect it is similar to strains of Pseudomonas which carry the TOL plasmid. By conjugation experiments, the genes conferring these growth abilities have been shown to be located on the bacterial chromosome, linked to vil and catB. A 56-kilobase segment of the bacterial chromosome of MW strains carrying the TOL genes can transpose to the IncP-1 plasmid R18-18. Physical analysis of these TOL R18-18 hybrids has shown that the TOL segment is almost identical to the same region found in the TOL plasmid pWW0.

A new transposon, Tn2521, coding for carbenicillin, streptomycin, spectinomycin, and sulfanilamide resistance, has been identified in Pseudomonas aeruginosa. The transposon occurs naturally in the chromosome of clinical strains of P. aeruginosa isolated in geographically separated hospitals. This has been demonstrated by its transductional linkage to the pur-136 marker and also by Southern hybridization. Tn2521 is 6.8 kilobases, can transpose from the chromosome to both IncP-1 and IncP-2 plasmid genomes, and has a pattern of restriction endonuclease sites unlike that of any previously described transposon. The carbenicillin resistance carried by Tn2521 is due to the PSE-4 type of beta-lactamase.

Strains of Pseudomonas aeruginosa resistant to gentamicin, tobramycin, streptomycin, and sulphonamide have been isolated from patients at two Sydney hospitals. The multiple resistance of all these strains was due to a transmissible plasmid. The significance of the identification of this plasmid, in this variety of strains and at two hospitals, for the treatment of Ps. aeruginosa infections is discussed.