According to a recent study featured in the November issue of the U.S. Centers for Disease Control & Prevention (CDC) publication "Emerging Infectious Diseases," a link exists between drinking water and noroviruses. The study, "Norovirus Outbreaks from Drinking Water," grew out of an intensified monitoring program for foodborne disease outbreaks conducted in Finland. Finnish public health officials investigated 41 waterborne outbreaks for viruses, and determined that 18 were caused by noroviruses.

Inadequate disinfection is the most common reason for waterborne epidemics, while breaks in sewer lines in the vicinity of a well caused several large waterborne outbreaks, the study revealed. The investigation also found that Finland's 1,300 water treatment plants might be playing a role in the numerous recorded outbreaks, as many of the plants still use surface water (lakes or rivers) as source water. Additionally, poor sewage disposal was identified as the source of many small waterborne outbreaks in private homes or rental cottages.

The study's findings have resulted in increased awareness of viral risks, improved laboratory techniques and an increased capacity for analyzing environmental samples, particularly water. The study's conclusions include a recommendation that legislative measures for viral monitoring as part of the microbial risk assessment in drinking water production should be considered.

To read the complete report, please go to: http://www.cdc.gov/ncidod/EID/vol11no11/05-0487.htm

An initial report summarizing infectious disease surveillance findings in the three weeks after Hurricane Katrina found only one outbreak of norovirus in Texas, according to the U.S. Centers for Disease Control (CDC), state and local health departments. Additional infectious diseases were reported but not with the frequency that was originally anticipated.

Hurricane Katrina affected an area of approximately 90,000 square miles, resulting in the displacement of approximately one million U.S. Gulf Coast residents. Roughly 750 evacuation centers were established in at least 18 states to accommodate more than 200,000 evacuees.

Published in the last week's issue of the Journal of the American Medical Association (JAMA), dermatological conditions, diarrheal disease and respiratory ailments constituted the bulk of reported infectious diseases. The CDC findings included the report of 20 clusters of diarrheal illness in evacuation centers in Louisiana, Mississippi, Tennessee, and Texas.

The CDC report stated that the size of the population displacement complicated efforts by local and state public health officials to assess the current public health condition. However, initial emphasis was shifted toward non-standardized mechanisms for disease reporting, resulting in the timely recognition of suspected instances of infectious disease while effective local surveillance was being established. Health officials said that effective surveillance is under way in all affected states.

To read the complete report, please go to: http://jama.ama-assn.org/cgi/content/full/294/17/2158

Test results last week confirmed cases of Clostridium difficile (C. diff) at hospitals in Greater Cleveland, prompting testing for the illness into additional Cleveland-area hospitals. Molecular tests of bacteria from the Stokes Cleveland VA Medical Center found they are the same antibiotic-resistant superstrain that has caused outbreaks in Canada, Europe and other parts of the United States.

The virulent bacteria were blamed for as many as 2,000 deaths in Quebec, Canada in 2003 and 2004.

Until recently, C. diff typically caused nothing more than cramping and diarrhea. Yet health officials say that the newly identified strain, a "superbug", is difficult to treat, highly toxic and a potential life-threatening condition. British researchers reported in September that it produces up to 23 times more toxin than older strains.

Currently, Ohio hospitals are not required to report infections that patients acquire at their facilities. However, due to the growing threat a commitment to report cases of C. diff is now in place in area hospitals, according to infectious disease specialists.

According to local media reports, C. diff cases at the Cleveland VA Medical Center have reportedly dropped since the hospital adopted new disinfection measures, including the use of a bleach solution to clean patient rooms. In addition back-to-basics precautions by medical personnel and healthcare workers such as thorough hand washing before treating patients can reduce the spread of the disease.

China is facing the world's most severe and urgent water crisis, according to remarks made by Chinese Vice Minister for Construction, Qiu Baoxing at the first International Conference for China Urban Water Development Strategies. As a result of increased industrialization and population shifts, a combination of polluted water and the shortage of adequate water resources have raised concerns about the quality of tap water in China.

Chinese officials recently announced that they would have to invest billions of dollars to update water treatment technology to comply with newly created national water standards. It is estimated that China's daily urban water supply may reach 432.7 million cubic meters by 2010. Yet urban water treatment capacity in public water treatment plants will only be able to handle 282 million cubic meters, according to the China Water Association.

Chinese officials are urging large urban centers, such as, Chongqing, Guangzhou, Shanghai and Hangzhou to bring the quality of their tap water in accord with European drinking water standards in the next few years. However, a recent sample test conducted by China's Ministry of Science and Technology showed that tap water sampled in a downtown residential area of a large Chinese city contained 80 strains of the101 pollutants forbidden by the new drinking water quality standard.

Of the 1,300 Chinese rivers surveyed for water quality in last year, only 59.4 percent received a quality rating above grade III, the country's minimum standard for drinking water.

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