Risk assessment of waterborne coxsackievirus

Abstract

Coxsackieviruses are the most common nonpolio enteroviruses found in domestic wastewater and in contaminated surface water, groundwater, and drinking water. These viruses can cause vomiting, fever, headache, rash, and diarrhea and result in such serious outcomes as aseptic meningitis, myocarditis, respiratory illness, encephalitis, and insulin-dependent diabetes mellitus. Previous research investigating enteroviruses in water samples treated the enteroviruses as a group and did not focus on specific viruses. This article describes a risk assessment approach to evaluate the potential public health effects associated with drinking water and recreational waters contaminated by coxsackievirus. An exponential model developed from human dose-response studies was used to describe the infectivity of coxsackievirus type B and estimate daily and yearly risks of infection, morbidity, and mortality. The stability of coxsackievirus in the environment, its resistance to water treatment and its association with a range of serious illnesses underscore the importance of maintaining reliable and effective treatment of wastewater and drinking water. Additional research is needed on the occurrence of coxsackievirus in water supplies, with viral testing focusing on identification of specific viruses rather than viral groups. The resulting data will lead to a more complete database that can assist in the decision-making process for water treatment and watershed protection programs. - MPM.