Our Latest Perspectives Posts

Controlling the Spread of Invasive Aquatic Species with the Ballast Water Management Convention
Written by By Chris Wiant, M.P.H, Ph.D.

Ballast Water Release

Ballast Water Release

Ballast water is the marine or fresh water taken into the ballast tank of a ship to improve the vessel’s stability, buoyancy and maneuverability. Unfortunately, the process of adding and subtracting ballast water, so vital to a ship’s operation, can have unintended consequences for aquatic ecosystems.

Ballast water may include aquatic life forms native to the ecosystem of the water “take in” point, but foreign to the ecosystem of the water “release” point. This watery exchange can promote the spread of invasive aquatic species, a global environmental issue that is the subject of the Ballast Water Management Convention. The Convention requires participating nations to have a ballast water management plan to help avoid disrupting native ecosystems with invasive aquatic species.

Many Years in Development

Zebra mussels are freshwater mussels originally indigenous to lakes and rivers of Russia and Ukraine; they are now thriving in numerous bodies of fresh water worldwide. Their dense growth blocks pipelines and clogs water intakes, among other detrimental effects.

Zebra mussels are freshwater
mussels originally indigenous to
lakes and rivers of Russia and
Ukraine; they are now thriving in numerous bodies of fresh
water worldwide. Their dense
growth blocks pipelines and clogs water intakes, among other
detrimental effects.

The new Convention is an initiative of the International Maritime Organization (IMO), a specialized agency of the United Nations. The Convention was adopted in 2004, but did not “come into force” until September 8, 2017, “twelve months after the date on which not less than 30 ‘states’ [a state is a nation in ‘UN speak’] with combined merchant fleets of not less than 35% of the gross tonnage of the world’s merchant shipping have signed it,” according to the official convention language. Although a ballast water management plan is a requirement for those nations that have ratified the Convention, many ships from both ratifying and non-ratifying nations already implement ballast water management plans.

Rooting out Aquatic Stowaways

There are two ballast water management tools through which the maritime industry can be regulated. The first is through the Ballast Water Exchange Standard, which requires ships to exchange a minimum of 95% ballast water volume at least 50 nautical miles from the nearest shore and in waters of 200 meters depth or more. This helps prevent invasive species spread in coastal and shallow waters that may be most vulnerable to the problem.

The second tool, the Ballast Water Performance Standard, involves meeting limits for aquatic organisms, including Vibrio cholera and E. coli in the ballast water. These water quality limits may be achieved through physical and/or chemical treatment methods. Among physical treatment methods are filtration, heat and UV radiation. The most common chemical methods used are chlorine-based disinfectants, such as chlorine bleach (a solution of sodium hypochlorite and water). Other chemical methods include ozone, peracetic acid and chlorine dioxide.1

Weighing the Risk of Disinfection Byproducts

Some concern has been expressed over the unintentional production of disinfection by-products (DBPs) from ballast water treatment and the potential health and environmental effects on aquatic life of DBPs in released ballast water. DBPs are unwanted products of the chemical reaction between disinfectants and organic matter in water. To avoid the potential human health effects from exposure to DBPs in municipal chlorinated drinking water, for example, the US Environmental Protection Agency regulates the most common DBPs to levels based on the best available science, incorporating a margin of safety. In weighing the risks of exposure to DBPs in drinking water, versus not disinfecting water appropriately, the World Health Organization notes:

“In attempting to control DBP concentrations, it is of paramount importance that the efficiency of disinfection is not compromised and that a suitable residual level of disinfectant is maintained throughout the distribution system.”2

Similarly, if we wish to control the spread of aquatic invasive species, we must evaluate a risk versus risk scenario in which we ask: Is it better to disinfect ballast water (to help prevent the spread of invasive species) or not disinfect ballast water (for fear of DBPs entering the aquatic environment)? This is the type of evaluation we perform when we decide, for example, whether it is better to get the annual flu shot (to help avoid the flu) versus not getting the flu shot (for fear of potentially rare side effects). Whereas most DBP research to date has been focused on drinking water, further work is needed to identify and evaluate the toxicity to marine life of DBPs produced and released in ballast water, especially marine ballast water.

According to the IMO, over 90% of the world’s trade is carried by sea because it is “the most cost-effective way to move en masse goods and raw materials around the world.” We think the entry into force of the Ballast Water Management Convention is a giant step in the right direction toward curtailing the unintended but potentially harmful spread of aquatic invasive species.

 

Chris Wiant, M.P.H, Ph.D., is president and CEO of the Caring for Colorado Foundation. He is also chair of the Water Quality & Health Council and a member of the National Drinking Water Advisory Council.

Click here to download this article.


1Werschkun, B. et al. (2014). Emerging risks from ballast water treatment: The run-up to the International Ballast Water Management Convention. Chemosphere, v. 112, Oct. 2014, pp. 258-266. On line, available: http://www.sciencedirect.com/science/article/pii/S0045653514005268.

2 WHO (2011). Guidelines for Drinking-water Quality, 4th Edition, WHO Press: Geneva, Switzerland. On line, available: http://apps.who.int/iris/bitstream/10665/44584/1/9789241548151_eng.pdf

 

TESTING

Getting Hepatitis A Off the Streets of San Diego
Written by By Ralph Morris, M.D., M.P.H.

Hepatitis AA Hepatitis A outbreak centered on homeless and illicit drug-using populations in the County of San Diego, California, has prompted a public health emergency. Headline-grabbing responses by local officials describe washing the streets and sidewalks with chlorine bleach solution, aggressively vaccinating the vulnerable populations, and distributing personal hygiene kits. What caused this local outbreak and can these measures help mitigate it?

The Facts about Hepatitis A

Hepatitis A is a highly contagious viral disease that affects the human liver, according to the US Centers for Disease Control and Prevention (CDC). It is usually spread through the fecal-to-oral route, either by person-to-person contact or by consuming contaminated food or water.

Before the era of drinking water chlorination, over a century ago, Hepatitis A, along with typhoid fever and cholera, was one of the great waterborne scourges of American life. Today chlorine-based disinfectants are routinely used during water treatment to destroy the Hepatitis A virus along with a host of other potentially deadly microbes.

Hepatitis A infections can range in severity from a mild illness of a few weeks to a severe illness lasting several months, according to CDC; although rare, it can cause acute liver failure. Overall, US Hepatitis A infection rates are low, probably as a result of the vaccine’s wide availability. Yet, over 400 people in San Diego have been infected since the start of the local outbreak; 292 people have been hospitalized and 16 have died of the disease, according to the County of San Diego Health & Human Services Agency. How did this happen?

Missing: A Sanitary Environment

High on the list of factors contributing to the outbreak is an apparent shortage of public restrooms in areas where homeless people and illicit drug users congregate. This apparently has led to some open defecation. An August 31 directive from the County instructed the city to wash streets and sidewalks with diluted household bleach solution (providing explicit directions) and expand public restroom and hand-washing access. San Diego Councilwoman Lorie Zapf, in a KPBS interview, said she had visited the San Diego River region in July and saw “an insane amount of trash” that included human feces, meth cookers, syringes and stolen property.

The county directive will help reduce human contact with fecal matter and infected surfaces. These measures will impose a needed barrier along the fecal-to-oral route of the virus’ transmission, helping to prevent not only Hepatitis A but potentially several other diseases known to spread via the same path.

The best way to prevent Hepatitis A is by getting vaccinated and maintaining good personal hygiene and sanitation. The vaccine, introduced in 1995, and now routinely administered to US children, travelers to certain countries, and persons at risk for the disease, lasts a lifetime, protecting against reinfection. Since the beginning of the outbreak in March, there have been over 250 mass vaccination events, and nurses deployed to areas frequented by the homeless, according to an NPR report.

Homelessness and illicit drug use remain significant societal issues, which must be addressed. Meanwhile, we have the tools at our disposal to combat this public health emergency and get Hepatitis A off the streets of San Diego. Key to our long term public health success will be using the lessons learned in San Diego to help prevent future emergencies of the same kind.

 

Ralph Morris, M.D., M.P.H., is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

Click here to download this article.

 

TESTING

Cleaning up After Hurricane Harvey: Chlorine Bleach Is Your Friend
Written by By the Water Quality & Health Council

Houston residents walk across a flooded street on August 27, 2017. Hurricane Harvey dumped trillions of gallons of water in several Gulf states, leading to devastating flooding.

Houston residents walk across a flooded street on August 27, 2017. Hurricane Harvey dumped trillions of gallons of water in several Gulf states, leading to devastating flooding.

After the shock and heartbreak of experiencing a flood comes the clean up to prevent further damage and spread of disease. Flood cleanup starts with removing flood water (usually contaminated with sewage) and drying the affected areas. Evaluate all items touched by flood waters, deciding which to keep and which to toss. Whenever possible, use a disinfecting solution of chlorine bleach to disinfect items touched by flood waters.

  • When using a disinfecting solution to clean up after a flood, remember to:
    • Wear gloves and protective clothing. Do not touch your face or eyes.
    • Change the disinfecting solution often and whenever it is cloudy.
    • Be thorough. Wash and dry everything well.
    • When finished, wash your hands thoroughly with soap and water for at least 20 seconds, even if you have worn gloves.
    • Wash contaminated clothing in the hottest possible water with detergent and chlorine bleach if fabric instructions permit.
  • If an item got wet, assume it is contaminated.
  • Disinfecting works best when all loose dirt and debris are removed first. That’s why the CDC recommends first washing surfaces with soap and warm, clean water. Next, use a household bleach solution to disinfect.
  • Prepare a bleach solution (3/4 cup regular strength chlorine bleach or 1/2 cup concentrated bleach to one gallon of water) to disinfect walls, floors and other surfaces touched by floodwaters. Keep the area wet for at least two minutes.
  • When addressing exterior surfaces, such as outdoor furniture, patios, decks and play equipment, keep surfaces wet with disinfecting solution for 10 minutes after removing loose dirt and debris with soap and warm, clear water. This may mean wetting the surface with disinfecting solution more than once.
  • Carpets and rugs that have been soaked for more than 24 hours should be discarded. If carpets and rugs were soaked for less than 24 hours, evaluate as follows: Carpets that contacted sewage-contaminated floodwater should be discarded. Carpets that contacted only clean basement seepage or lawn runoff may be dried and cleaned. Washable throw rugs usually can be cleaned adequately in a washing machine. For more information on cleaning flood-damaged carpets and rugs, see this North Dakota State University website.
  • Chlorine bleach solutions degrade quickly, so be sure to make a fresh solution daily as needed. Unused solution may be discharged into the toilet or sink.

Finally, if you have a private well on your property that is below flood level, it is recommended that under non-flood conditions you extend the top of the well above the expected flood level and install proper seals on all openings into the well to prevent entry of flood waters. If a well is flooded, refer to the US Environmental Protection Agency’s What to Do After the Flood for directions on decontaminating your well.

This article is excerpted from a more comprehensive article posted on August 11, titled “Preparing for the Next Flood and its Aftermath.”

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TESTING

Kitchen Sponges: Cleaning Tool or Germ Dispenser?
Written by By the Water Quality & Health Council

The notorious kitchen sponge—that germ-ridden object found in many households—is at the center of a new controversy about controlling the spread of infections in the home. Several years ago we reported a University of Florida research team found microwaving spongevery wet sponges for two minutes at high power killed or inactivated over 99 percent of all the living pathogens in sponges and cleaning pads that had been soaked in a “witch’s brew of germs.” Easy and convenient, right? Think again: A team of German researchers using genetic techniques to characterize sponge microbes says that neither boiling nor microwaving sponges may be particularly effective in the long run. Careful testing of alternative sponge treatments is needed, but in the meantime, the researchers recommend the best course may be ditching your kitchen sponge once per week for a new one.

Sponge Microbe Dynamics

First, the German team found the density of bacteria in some portions of 14 German kitchen sponge samples to be equivalent to that found in feces! Significantly, their data show “…regularly sanitized sponges (as indicated by their users) did not contain less bacteria than uncleaned ones.” But in an interesting, Darwinian twist, the researchers suggest the most resistant bacteria in sponges preferentially survive boiling or microwaving, only to repopulate the sponge rapidly after these treatments. Some of these are more pathogenic too, for example, “RG2-related bacteria” identified in the test sponges may have the potential to cause diseases in humans. The scientists state, “…a prolonged application of sanitation measures of kitchen sponges is not advisable.” In other words, the more you “challenge” sponge microbes with disinfection, the more you may encourage the survival of the fittest and most likely to make you sick.

Because kitchen sponges are moist, have high surface area, and are frequently wiped over food preparation and dining surfaces, they are a major agent of cross-contamination. Ironically, the more kitchen surfaces are wiped by the conscientious house cleaner with a contaminated sponge, the more contaminated the surfaces may become. For example, one of the resistant bacteria shown to survive treatment, Moraxella osloensis, is common in sponges and is found consistently on sink, faucet, refrigerator door and stove surfaces. You may have smelled Moraxella; it imparts a disagreeable odor to sponges and laundry.

Scientific Inquiry is Open-ended

The new study demonstrates the ongoing nature of scientific investigation: What we once thought true may not stand the test of the next investigation. The scientific method requires continual testing and reformulation of hypotheses based on meticulously collected data. The scientific method does not guarantee that any given conclusions are correct. The German researchers correctly note that additional studies in this area are needed. We agree and wonder if soaking kitchen sponges regularly in appropriate chlorine bleach and water solutions would be effective. For now, the advice to replace sponges weekly is prudent, but stay tuned!

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TESTING

Preparing for the Next Flood and its Aftermath
Written by By Fred Reiff, P.E.

If you live in a flood-prone area, are you prepared for the next deluge? According to the National Oceanic and Atmospheric Administration (NOAA), fast moving water that reaches just over your ankles can knock you off your feet. And don’t try to drive through it. Driving on flooded roads is the floodmost common thunderstorm-related hazard that can kill you, according to NOAA. It is especially difficult to recognize flood danger in darkness or other conditions of poor visibility. As the National Weather Service urges, if you come to a flooded portion of roadway, “Turn Around Don’t Drown®”.

Head for the Hills

If it is necessary to evacuate your home, head for higher ground at a pre-designated meeting place known to your family. Pet owners should have an emergency plan for their pets that includes shelter, food and water. If possible, turn off electrical power, gas and water supplies before leaving. If flooding is a common risk where you live, you may be able to avoid the backflow of unsanitary flood water into your house by installing backflow valves or plugs on drains or other sewer connections.

Each member of the household should have a pre-packed emergency bag or kit that can be grabbed on the way out the door during a rapid evacuation. The bags should contain at least a change of clothes, a supply of needed medicines to last several days, personal hygiene items, flashlight, drinking water and some packaged emergency food that doesn’t require cooking. At least one bag should contain a first aid kit. Your cell phone can help you stay informed about flooding conditions and in contact with loved ones, so keep it charged especially during “flood season.” A hand-crank radio can be useful for prolonged power outages. Keep your car gassed up and some emergency cash on hand.

When Sheltering in Place

The American Red Cross recommends each household have at least two weeks of supplies at home, including:

  • One gallon of water per person per day or the ability to purify this volume with chlorine bleach
  • Nonperishable food
  • A manual can opener
  • Flashlights
  • Battery-powered or hand-crank radio
  • Extra batteries for flashlights and radios
  • First aid kit
  • Seven-day supply of medications
  • A multi-purpose tool
  • Sanitation and personal hygiene items (e.g., soap, toothpaste and wipes)
  • Copies of important personal documents

Floods may cause public water systems to issue precautionary boil water notices due to turbidity or water main infiltration. If you have electric or gas service for your range, bring tap water to a rolling boil for one minute (or for three minutes if your elevation is greater than 2,000 meters or about 6,500 feet). To augment your water supply, the Centers for Disease Control and Prevention (CDC) recommends sanitizing bathtubs and sink basins with bleach [use about 1 tablespoon of regular bleach (5.25%) or 2 teaspoons of high strength bleach (8.25%) per gallon of water], rinsing, and then filling them with clean water and doing the same with empty soda bottles. (See Water Storage Tips to Assist in Emergency Preparedness.) Stay current with tetanus shots in the event that you sustain a puncture wound or a wound becomes contaminated during or after a flood. Children receive tetanus shots as part of their normal vaccination plans; adults require tetanus boosters every ten years.

Flood Cleanup: Chlorine Bleach Is Your Friend

Flood cleanup starts with removing flood water (usually contaminated with sewage) and drying the affected areas. Evaluate all items touched by flood waters, deciding which to keep and which to toss. Whenever possible, use a disinfecting solution of chlorine bleach to disinfect items touched by flood waters.

  • When using a disinfecting solution to clean up after a flood, remember to:
    • Wear gloves and protective clothing. Do not touch your face or eyes.
    • Change the disinfecting solution often and whenever it is cloudy.
    • Be thorough. Wash and dry everything well.
    • When finished, wash your hands thoroughly with soap and water for at least 20 seconds, even if you have worn gloves.
    • Wash contaminated clothing in the hottest possible water with detergent and chlorine bleach if fabric instructions permit.
  • If an item got wet, assume it is contaminated.
  • Disinfecting works best when all loose dirt and debris are removed first. That’s why the CDC recommends first washing surfaces with soap and warm, clean water. Next, use a household bleach solution to disinfect.
  • Prepare a bleach solution (3/4 cup regular strength chlorine bleach or 1/2 cup concentrated bleach to one gallon of water) to disinfect walls, floors and other surfaces touched by floodwaters. Keep the area wet for at least two minutes.
  • When addressing exterior surfaces, such as outdoor furniture, patios, decks and play equipment, keep surfaces wet with disinfecting solution for 10 minutes after removing loose dirt and debris with soap and warm, clear water. This may mean wetting the surface with disinfecting solution more than once.
  • Carpets and rugs that have been soaked for more than 24 hours should be discarded.  If carpets and rugs were soaked for less than 24 hours, evaluate as follows: Carpets that contacted sewage-contaminated floodwater should be discarded. Carpets that contacted only clean basement seepage or lawn runoff may be dried and cleaned. Washable throw rugs usually can be cleaned adequately in a washing machine. For more information on cleaning flood-damaged carpets and rugs, see this North Dakota State University website.
  • Chlorine bleach solutions degrade quickly, so be sure to make a fresh solution daily as needed. Unused solution may be discharged into the toilet or sink.

Finally, if you have a private well on your property that is below flood level, it is recommended that under non-flood conditions you extend the top of the well above the expected flood level and install proper seals on all openings into the well to prevent entry of flood waters. If a well is flooded, refer to the US Environmental Protection Agency’s What to Do After the Flood for directions on decontaminating your well.

Fred M. Reiff, P.E., is a retired official from both the U.S. Public Health Service and the Pan American Health Organization, and lives in the Reno, Nevada area.

Click here to download this article.

TESTING

Sepsis: A New Global Health Priority
Written by By Ralph Morris, M.D., M.P.H

“Sepsis,” according to the Centers for Disease Control and Prevention (CDC), is “a complication caused by the body’s overwhelming and life-threatening response to infection, which can lead to tissue damage, organ failure, and death.” More commonly known as “blood poisoning,” sepsis strikes “with equal ferocity in resource-poor areas and in the developed world,” according to Dr. Konrad Reinhart, Chairman of the Global Sepsis Alliance. Sepsis is now front and center for the world health community: At a May 2017 World Health Assembly1, sepsis was designated a new global health priority and a resolution was adopted to improve its prevention, diagnosis and management.

Although reliable data are unavailable, globally there are an estimated 31 million cases and some six million deaths from sepsis annually.2 Most of those deaths are preventable, however, with early detection and timely treatment with antibiotics. According to one study involving over 2,000 septic shock patients, following the onset of hypotension (abnormally low blood pressure), each hour of delay in administering an antimicrobial was associated with an average decrease in survival of 7.6%.3 A Perspective in the New England Journal of Medicine by Dr. Reinhart and others notes, “The progression from infection to sepsis can be insidious and is unpredictable.”4

sepsisqa-2015-big

Difficult to Diagnose

The signs and symptoms of sepsis are represented in the CDC poster above. In its early stages, sepsis is difficult to diagnose because many of the signs and symptoms match those for other conditions. A combination of two of these symptoms should be sufficient to suspect sepsis.

Anyone can develop sepsis from an infection, but it is most common in people aged 65 years old or older, children under the age of one and people with weakened immune systems or chronic medical conditions, such as diabetes.

Why are sepsis cases on the rise?

According to the Global Sepsis Alliance, sepsis cases may be on the rise due to a combination of potential factors, including:

✔   Poor socioeconomic conditions

✔   Increased awareness and tracking of the condition

✔   An aging population with more chronic diseases

✔   An upsurge in major surgical interventions and invasive procedures

✔   Broader use of immunosuppressive and chemotherapeutic agents

✔   The spread of antibiotic-resistant organisms

Prevention

Preventing sepsis starts with preventing infection through:

  • Appropriate hand hygiene
  • Access to vaccinations
  • Access to clean water, sanitation and hygiene
  • Proper disinfection of wounds with iodine, hydrogen peroxide or sodium hypochlorite (see, for example, Vibrio Infection: Rare, but Worth Knowing About)
  • Clean childbirth and surgical practices
  • Increased awareness of sepsis among the public and the medical community so that asking the question, “Could this be sepsis?” becomes more routine

Sepsis has been called “one of the oldest and most elusive syndromes in medicine,”5 and it remains largely unknown to the public. Meanwhile, there are indications that sepsis is on the rise in the US where hospital admissions for the condition have overtaken those for heart attack and stroke6. Sepsis also causes or contributes to half of all deaths in US hospitals and is a leading cause of annual hospital costs. Improvements are needed so that healthcare providers everywhere can better define and code the disease to enable reliable global statistical data.

As Dr. Reinhart and his colleagues note, the World Health Assembly resolution on sepsis has the potential to save millions of lives. We agree and look forward to measurable progress in the struggle to control this subtle killer.

 

Ralph Morris, M.D., M.P.H., is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

Click here to download this article.


1 The World Health Assembly is the decision-making body of the World Health Organization.

2 Fleischmann, C. et al., (2016). Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations, American Journal of Respiratory and Critical Care Medicine, v. 193, No. 3. On line, available: http://www.atsjournals.org/doi/10.1164/rccm.201504-0781OC

3 Kumar, A. et al. (2006). Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock, Critical Care Medicine. On line, available: https://www.ncbi.nlm.nih.gov/pubmed/16625125

4 Reinhart, K. et al., (June 28, 2017). Perspective: Recognizing Sepsis as a Global Health Priority — A WHO Resolution, New England Journal of Medicine. On line, available: http://www.nejm.org/doi/full/10.1056/NEJMp1707170

5 Angus, D.C, van der Poll, T. (2013). Severe sepsis and septic shock. New England Journal of Medicine. On line, available: http://www.nejm.org/doi/full/10.1056/NEJMra1208623#t=article.

6 Fleischmann, C. et al. op. cit.

TESTING

Keeping Your Reusable Water Bottle Clean
Written by By Chris Wiant, M.P.H., Ph.D.

Louisville Water Company promotes filling reusable water bottles with tap water

Louisville Water Company promotes filling reusable water bottles with tap water

The reusable water bottle is one of those “grab and go” items that travel with many of us on a daily basis. The filled water bottle provides a handy means of hydrating on the spot. As we’ve noted, many water fountains now conveniently include water bottle-filling features. There’s just one caveat to deriving the maximum health benefit from reusable water bottles: They should be thoroughly cleaned and sanitized on a regular basis to avoid contamination.

Germs Love Moist Environments

Germs thrive in moist environments such as parts of the cap and interior of your water bottle. As Dr. Charles Gerba of the University of Arizona notes, if you use your fingers to open and close the water bottle cap, there is a good chance that bacteria will be introduced into the cap, where moisture will support its growth. This is yet another reason for appropriate hand hygiene, but we recognize washing your hands before using a water bottle is usually not possible. Perhaps these situations call for portable hand sanitizer use?

According to Gerba, although germs from your mouth transferred by backwash into your water bottle will not harm you, germs from someone sharing your water bottle can make you sick. And if your water bottle buddy is opening the bottle with his or her own hands, well, there’s another opportunity for contaminating the bottle.

Water Bottle Maintenance

It simply won’t do to refill your water bottle day after day without a regular maintenance plan. Here are some suggestions to help keep it sanitized:

  • Open and run top and container body through the dishwasher (if dishwasher-safe)
  • Wash components with soapy water and then sanitize with a dilute solution of bleach. To mix up a sanitizing solution, add 1/2 teaspoon of 8.25% bleach to one quart (4 cups) of water (or 1/4 tablespoon of 5.25% bleach to one quart of water); allow water bottle parts to remain in contact with the solution for two minutes, and then rinse
  • Use dedicated water bottle cleansing tablets purchased online or at sporting goods and camping supply stores

Reusable water bottles have become part of our everyday gear. Get the maximum health benefit from their use by keeping them clean and sanitized!

Chris Wiant, M.P.H, Ph.D., is president and CEO of the Caring for Colorado Foundation.  He is also chair of the Water Quality & Health Council and a member of the National Drinking Water Advisory Council.

Click here to download this article. 

TESTING

Avoiding Salmonella from Backyard Poultry
Written by the Water Quality & Health Council

BackyardPoultryBackyard poultry farming is an increasingly popular trend in urban and suburban areas that permit it, giving families a fun way to raise food while learning to care for animals. Assuming roosters are banned in the neighborhood for their earsplitting “cock-a-doodle-doo,” what could be the downside of raising poultry in the backyard? The answer is illness. Unfortunately, outbreaks of Salmonella infection linked to backyard poultry are on the rise. We have described this type of disease in a previous article as a “zoonotic disease,” which is one that can spread between animals and humans under natural conditions, e.g., in your own backyard.

According to the Centers for Disease Control and Prevention (CDC), Salmonella bacteria reside in poultry droppings and on the feathers, feet and beaks of poultry, even though the chicks and ducklings may appear clean and healthy. Any human contact, whether through handling poultry directly or contacting cages, coops, feed and water dishes, hay, plants and soil in the area in which the poultry live, can expose backyard poultry farmers to Salmonella bacteria.

Multistate Outbreaks

According to the CDC, there were a record number of illnesses associated with backyard poultry in 2016. Currently, CDC advises there are eight Salmonella outbreaks linked to backyard poultry nationwide. As of May 25, 2017, there were 372 cases of illness reported from Salmonella bacteria in 47 states; 71 people have been hospitalized. The outbreaks have been associated with chicks and ducklings from several hatcheries. Are these outbreaks grounds for abandoning your dream of a backyard flock? Hardly! As always, knowledge is power, and understanding how poultry can transmit bacteria to humans is half the battle when it comes to avoiding infection. The other half is implementing safe practices around live poultry.

Tips for Backyard Poultry Farmers1

  • Wash Your Hands with soap and water after touching live poultry or objects in their environment. Wash your hands after touching shoes or clothing that have come in contact with live poultry or their environment. This is especially important for children, who frequently put their hands in their mouths.
  • Keep Poultry Out of Your Living Space. Do not let live poultry inside your house or even on your patio, deck or porch.
  • Do Not Eat Where Poultry Live and Roam. Your risk of infection rises if you eat where poultry live and roam.
  • Protect the Most Vulnerable. Children under the age of five, adults older than 65 and people with weakened immune systems are the most vulnerable to infection and should not handle live poultry or related equipment.
  • Clean and Disinfect all Poultry Equipment Outdoors, including cages, feed and water containers. According to the University of Minnesota Extension, undisinfected coops frequently carry Salmonella. Always clean before disinfecting for best results. Those who clean chicken manure should wear a proper face mask and ensure good ventilation while working.
    • The US Department of Agriculture provides a handy cleaning and disinfecting checklist for backyard poultry owners and recommends applying a US Environmental Protection Agency (EPA)-registered disinfectant, such as chlorine bleach2, that is effective against avian influenza virus or other diseases of concern, such as salmonellosis. Information on the effectiveness of the disinfectant and disinfecting directions will be on the product label.
  • Chlorinate Poultry Drinking Water. The University of Minnesota Extension website notes that routine chlorination of poultry drinking water to a minimum of 1-1.5 ppm free chlorine has been reported in research to reduce the spread of Salmonella.
  • Do Not Snuggle or Kiss Poultry or Let Children Do So, as cute as chicks and ducklings may be.
  • When Collecting Eggs
    • Wash hands after collecting eggs.
    • Collect eggs often to avoid eggs becoming dirty or breaking; throw away cracked eggs.
    • Dirt and debris clinging to egg shells can be removed with fine sandpaper, a brush, or cloth.
    • Do not wash eggs as cold water can pull bacteria into the egg.
    • Refrigerate eggs after collecting them.
    • Cook eggs thoroughly to destroy Salmonella, which could be present in eggs.

A breakfast of fresh eggs from the hens in the backyard coop is a delicious reward for the work that goes into raising poultry. Stay well and productive by being an informed backyard poultry farmer!

Click here to download this article.


1 Tips are based on CDC’s “Advice to Backyard Flock Owners.” Online, available:   https://www.cdc.gov/zoonotic/gi/outbreaks/livepoultry.html

2 According to Clorox, Salmonella on surfaces can be destroyed with a solution of ½ cup of 8.25% chlorine bleach added to one gallon of water; apply to surface free of dirt and droppings (clean surfaces first) and leave wet for 5-7 minutes. Finally, rinse with plain water.

 

TESTING

A New Resource to Help Curtail Norovirus: Pictogram Disinfection Posters
Written by By Linda F. Golodner

Norovirus, the dreaded illness popularly known as the “stomach bug,” is the leading cause of gastrointestinal upset in the US. According to the US Centers for Disease Control and Prevention (CDC), there are 19 to 21 million cases of norovirus in the US annually. The highly contagious virus is an unwelcome visitor in schools, day care and elder care settings, offices, sporting venues, cruise ships and more. Norovirus presents the greatest health risk to young children and the elderly. norovirus prevention poster norovirus cleanup posterGlobally, the economic burden of norovirus hovers around $60 billion in healthcare costs and lost productivity.

The Perfect Pathogen

As described by CDC’s Dr. Aron J. Hall in an “Editor’s Choice” article in The Journal of Infectious Diseases in May, 2012, norovirus may be the “Perfect Pathogen,” because, among other factors, it:

  • Is quickly and profusely shed through diarrhea and vomiting.
  • Only requires a minimum of about 18 viral particles to infect an individual (up to five billion infectious doses are present in each gram of feces from an infected person).
  • Is environmentally stable; it can survive both freezing and heating, although not thorough cooking; it is resistant to many chemical disinfectants; it can persist on surfaces for up to two weeks.
  • Rapidly evolves before the population develops immunity.
  • Is associated with a low mortality rate. Of nearly 700 million annual cases of norovirus worldwide, there are approximately 219,000 deaths, a mortality rate of only about 0.031%. Its low mortality rate helps keep the virus alive and spreading to others.

Given these characteristics, norovirus will continue to be a force to be reckoned with at least until a successful vaccine is developed and disseminated.

Norovirus Disinfection Posters

In 2013, a team of public health and consumer advocates was convened by the American Chemistry Council’s Chlorine Chemistry Division to develop a set of clear instructions for disinfecting surfaces against norovirus using appropriate solutions of chlorine bleach. The need for simple-to-follow directions was great, according to a request from the New Jersey Somerset County Department of Health. The ad hoc task force included representatives from the New Jersey Somerset County Department of Health, CDC, the National Environmental Health Association, the Water Quality and Health Council and the American Chemistry Council. The posters developed by the group are available on the “Resources” page of the Water Quality and Health Council website, and have been downloaded tens of thousands of times.

Discussions at the Albuquerque Norovirus Conference in the summer of 2016 identified the fact that some food industry and other workers do not read in any language (not even their own), prompting the need for a set of norovirus “pictogram” posters to illustrate with as few words as possible norovirus surface clean up and disinfection steps. The ad hoc group that developed the first set of “language” posters (now in English, Spanish and French) reconvened and welcomed the input of our colleagues from the City of Albuquerque Environmental Health Department in developing the new poster resource. The pictogram posters, illustrated at the top of this article, are the proud product of our careful collaboration, and join the “language” posters as freely downloadable resources from the Water Quality and Health Council website. It is our sincere hope that all of these posters will be used widely to help curtail the spread of the notorious norovirus.

 

Linda F. Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality and Health Council.

Click here to download this article.

 

TESTING

Fancy Meeting You Here! Targeting Household Germs in Unexpected Places
Written by By Linda F. Golodner

PerspectivesPic1When the weather warms up after a long winter, I get the urge to throw open windows and tackle spring cleaning chores. It’s a great feeling of accomplishment to complete these chores, but I recently learned from WebMD that some of the germiest places in homes are not even on most people’s radar. The table below, based on information from WebMD, lists the most unexpected hiding places for household germs, the reasons why they thrive in those places, and how you can reduce their unwanted presence.

 

Germ Hangout

Why They Love it There

What to Do About it

Kitchen sponge For germs, the kitchen sponge is a moist maze of top-notch dwelling places. Not only is there regular contact with water, but there is also often plenty of food debris swept up in sponges to sustain germs.

According to WebMD, your kitchen sponge is probably the dirtiest thing in your house.

Researchers from the University of Florida report microwaving very wet sponges for two minutes at high power kills or inactivates more than 99 percent of all sponge germs. (See For Disinfecting Sponges, Microwaving is a Simple Solution.)

Kitchen towels and dish cloths should be replaced daily and laundered using chlorine bleach, if fabric instructions permit.

Kitchen sink Lots of germs are washed into the sink when meals are being prepared; germs may originate from raw vegetables, fruit, meat, fish or poultry. The constant supply of water and food in the sink encourages germs to proliferate. Disinfect sink sides and bottom twice per week using a kitchen sanitizer. And pour a solution of one teaspoon of bleach in one quart of water down the drain once each month.
Toothbrush holder Toothbrushes harbor bacteria from your mouth, and when kept near the toilet in your bathroom, can even become contaminated with fecal bacteria. Toothbrush holders harbor these same germs. First, position your toothbrush holder as far away from the toilet as possible. Do not allow adjacent toothbrushes to touch, and run the toothbrush holder through the dishwasher once a week. The good news is that toothbrush holders keep brushes vertical, which permits better drying between uses, and germs want moisture. Want to cut down on the germs you transfer to your toothbrush? Use an antibacterial mouth rinse before you brush your teeth.
Dog bowl Fido might appear to lick his food and water bowls “clean,” but don’t be fooled: Pet bowls are havens for microscopic “pets,” such as bacteria. Wash pet bowls daily with hot, soapy water. Once per week, soak bowls for about 10 minutes in a solution made by adding a cap of chlorine bleach to one gallon of water.
Coffee maker The chamber that holds the water in your coffee maker is dark and moist, “home, sweet home” for bacteria. Give those bacteria a jolt by filling the water chamber with a few cups of white vinegar. Wait 30 minutes, then turn the machine on and let the vinegar run through. Follow up by running clean water through the machine.
Stove knobs Stove knobs are frequently touched, but often overlooked during cleaning. Stove knobs contact the hands of cooks, who shift back and forth between the stove and other food preparation spots, transferring germs and food debris to the knobs. Remove stove knobs and give them a hot, soapy bath once per week. If knobs cannot be removed, clean them in place.
Bathroom faucet Bathroom faucets are contacted by hands in need of washing by virtue of the reason people enter the bathroom in the first place. According to WebMD, faucet handles in the bathroom sink have more germs on them than the toilet handle or the bathroom doorknob. Motion-sensing faucets are an ideal solution, but short of that major investment, sanitize your bathroom and kitchen faucet handles daily using a kitchen or bathroom disinfectant.
Countertops Countertops are like bus stops for germs. These surfaces are where we may drop off and pick up the “germ du jour.” Daily, we deposit all manner of objects on countertops, and then proceed to wipe them down with our kitchen sponge (see public enemy #1 at the top of this list).   Is it any wonder that they become contaminated? Wash countertops with warm, soapy water, rinse and use a disinfectant recommended by the manufacturer of your countertop.

Linda F. Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality and Health Council.

Click here to download this article. 

TESTING

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