
Water Professional's Guide to Infectious Disease Outbreaks
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Content
- Intro
- Title Page
- Copyright
- Contents
- List of Figures
- List of Tables
- Preface
- Chapter 1 What Are Infectious Disease Outbreaks?: Rasha Maal-Bared, PhD
- Kari Brisolara
- Keerthi Palanisamy
- Leilani Perriatt
- & Albert Rubin
- 1.0 Infectious Diseases and Zoonoses
- 1.1 History of Infectious Agents and Disease Outbreaks
- 1.2 What Are Zoonoses?
- 2.0 Definitions You Should Know
- 2.1 Public Health Definitions
- 2.2 Microbiology Definitions
- 2.3 Water and Wastewater Treatment Definitions
- 2.4 Molecular Biology Definitions
- 3.0 Impacts on Economies, Communities, and Water Resource Recovery Facilities
- 3.1 Impacts on the Economy, Health Care, and Other Areas
- 3.2 Impacts on Water Resource Recovery Facilities-The COVID-19 Case Study
- 3.2.1 Lockdowns and Changes in Consumption Patterns
- 3.2.2 Increased Use of Wipes
- 3.2.3 Increased Consumption of Antibiotics, Disinfectants, and Cleaning Products
- 4.0 Resources
- 4.1 Publicly Available
- 4.2 Require Access
- Chapter 2 Pathogens in Wastewater: Chuck Gerba
- Tiong Gim Aw, PhD
- Bo Li
- Prakit Saingam
- Samendra Sherchan
- & Mark Sobsey
- 1.0 Classifications and Characteristics Relevant to Removal, Inactivation, or Control Microorganisms
- 1.1 Classes and Their Properties
- 1.2 The Chain of Infection
- 2.0 Epidemiology of Infectious Diseases in Water Resource Recovery Facility Workers
- 2.1 Major Routes of Exposure in Wastewater Systems
- 2.1.1 Untreated Wastewater
- 2.1.2 Bioaerosols
- 2.1.3 Sludge and Biosolids
- 2.2 Epidemiology of Infectious Diseases Among Wastewater Workers
- 3.0 Relevant Pathogens
- 3.1 Water, Sanitation, and Hygiene-Related Pathogens
- 3.1.1 Bacterial
- 3.1.1.1 Campylobacter
- 3.1.1.2 Escherichia coli and Its Pathogenic Strains
- 3.1.1.3 Salmonella
- 3.1.1.4 Vibrio cholerae
- 3.1.1.5 Shigella
- 3.1.1.6 Yersiniae enterocolitica
- 3.1.2 Viral
- 3.1.2.1 Aichi Viruses
- 3.1.2.2 Adenoviruses
- 3.1.2.3 Astroviruses
- 3.1.2.4 Enteroviruses
- 3.1.2.5 Hepatitis A
- 3.1.2.6 Norovirus
- 3.1.2.7 Rotavirus
- 3.1.2.8 Sapovirus
- 3.1.2.9 Reoviruses
- 3.1.2.10 Parechovirus
- 3.1.3 Protozoa
- 3.1.3.1 Cryptosporidium
- 3.1.3.2 Cyclospora
- 3.1.3.3 Entamoebah histolytica
- 3.1.3.4 Giardia
- 3.1.3.5 Toxoplasma gondii
- 3.1.3.6 Balantidium coli-Less Relevant
- 3.1.3.7 Blastocystis hominis
- 3.1.3.8 Cystoisospora belli (Formerly Isospora)
- 3.1.4 Fungi-Microsporidia
- 3.1.5 Helminths
- 3.2 Other Pathogens of Interest
- 3.2.1 Enteric
- 3.2.1.1 Leptospira-Common in Mice, Rodent Vector Control Issues
- 3.2.1.2 Aeromonas hydrophila and Other Pathogenic Species
- 3.2.1.3 Klebsiella Spp., Especially Klebsiella pneumoniae
- 3.2.1.4 Clostridium difficile
- 3.2.1.5 Clostridium perfringens (Primarily Foodborne and Detected as a Fecal Indicator)
- 3.2.1.6 Clostridium tetani (Cause of Tetanus From Wound and Related Exposures)
- 3.2.1.7 Helicobacter Pylori
- 3.2.1.8 MRSA and Other Antibiotic Resistant Bacteria
- 3.2.1.9 Hepatitis E
- 3.2.2 Non-enteric
- 3.2.2.1 Staphylococcus aureus
- 3.2.2.2 Hepatitis B
- 3.2.2.3 Free-Living Amoeba-Acanthamoeba culbertsoni and A. keratitis
- 3.2.2.4 Free-Living Amoeba-Naegleria fowleri
- 3.2.2.5 Legionella pneumophila
- 3.2.2.6 Pseudomonas aeruginosa
- 3.2.2.7 Mycobacterium Avium Complex
- 3.2.3 Viruses That Receive Public Attention but That Have Limited Relevance in Wastewater
- 4.0 Resources for Additional Information on Specific Pathogens
- 4.1 Publicly Available
- 4.2 Additional Resources
- Chapter 3 Current State of the Knowledge on Treatment Efficacy: Kari Brisolara
- Philip Block, PhD
- Chuck Gerba
- Bob Reimers
- Jenny Reina
- Stan Shmia
- Jay Swift
- & Yue Xu, PhD
- 1.0 Introduction-overall Pathogens Removals
- 2.0 Wastewater Treatment to Protect Public Health
- 2.1 Effluent-UV
- 2.1.1 Chemistry
- 2.1.2 Mode of Action
- 2.1.3 Inactivation/Log Removals
- 2.1.4 Pros and Cons
- 2.1.4.1 Pros
- 2.1.4.2 Cons
- 2.2 Effluent-Chlorine, Chloramine, and Chlorine Dioxide
- 2.2.1 Chemistry
- 2.2.1.1 Chlorine Demand
- 2.2.1.2 Breakpoint Chlorination
- 2.2.2 Mode of Action
- 2.2.2.1 Chlorine Gas
- 2.2.2.2 Sodium Hypochlorite
- 2.2.2.3 Chloramine
- 2.2.3 Inactivation/Log Removals
- 2.2.4 Pros and Cons
- 2.2.4.1 Pros
- 2.2.4.2 Cons
- 2.3 Effluent-Peracetic Acid and Performic Acid
- 2.3.1 Inactivation/Removal
- 2.3.2 Pros and Cons
- 2.3.2.1 Pros
- 2.3.2.2 Cons
- 2.4 Effluent-Ozone
- 2.4.1 Mode of Action
- 2.4.2 Inactivation/Log Removal
- 2.4.3 Pros and Cons
- 2.5 Biosolids
- 2.5.1 Class A and Class B
- 2.5.2 Overview of Treatment Types With Pros/Cons
- 2.5.2.1 Anaerobic Digestion
- 2.5.2.2 Aerobic Digestion
- 2.5.2.3 Alkaline Stabilization
- 2.5.2.4 Composting
- 2.5.2.5 Thermal Drying
- 2.5.2.6 Pasteurization
- 2.6 Hospital Effluent
- 2.6.1 Hazards Associated With Medical Waste
- 2.6.2 Approved Methods to Disinfect Infectious Wastes
- 2.6.2.1 Incineration (Thermal Destruction)
- 2.6.2.2 Steam Sterilization (Autoclave)
- 2.6.2.3 Dry Heat Sterilization/Thermal Inactivation
- 2.6.2.4 Chemical Disinfection
- 2.6.2.5 Irradiation Technologies (Gamma, Microwave, and E-beam)
- 2.6.2.6 Emerging Technologies: Shredding Medical Waste Followed by Disinfectant
- 2.6.3 Summary of Pros and Cons of Treatment and Disposal Options
- 3.0 Monitoring Water for Pathogens
- 3.1 Molecular Versus Culture-Based Methods
- 3.1.1 Culture-Based Methods
- 3.1.2 Molecular-Based Methods
- 3.1.3 Limitations of Each Approach (Pros and Cons) in Relation With Public Health Decision-Making
- 3.1.3.1 Culture-Based Approaches
- 3.1.3.2 Molecular Approaches
- 3.2 Types of Indicators
- 3.2.1 Bacterial Indicators and Their Standard Methods
- 3.2.2 Protozoan Indicators and Their Standard Methods
- 3.2.3 Viral Indicators and Their Standard Methods
- 3.2.3.1 Bacteriophages
- 3.2.3.2 Other (PMMoV, Adenovirus)
- 4.0 Low- and High-resource Settings
- 4.1 Defining the Issue
- 4.2 Technologies and Solutions
- 5.0 Resources
- 5.1 Publicly Available
- 5.2 Require Access
- Chapter 4 Understanding Risk and Knowledge Gaps: Mark Sobsey, Lee Gary, Bo Li, Prakit Saingam, & Samendra Sherchan
- 1.0 Assessing Risk
- 1.1 Qualitative Comparisons
- 1.2 Quantitative Assessments Using Quantitative Microbial Risk Assessment and Disability Adjusted Life Year
- 1.2.1 How the World Health Organization Uses DALYs to Quantify Risks
- 1.2.2 What Is QMRA, and How Is It Conducted?
- 1.2.3 Approaches and Metrics Used to Evaluate and Quantify Risk
- 2.0 Examples of Risk Analyses and Associated Metrics
- 2.1 Health Risk-Based Guidance for the Safe Use of Human Fecal Wastes for Agriculture
- 2.2 Health Risk-Based Microbial Standards for Treatment of Human Wastes Using Commercial Nonsewered Sanitation Systems On-Site
- 2.3 Health Risk Analysis for the Microbial Quality of Drinking Water
- 2.4 Epidemiological Health Risk-Based Approach to Address Pathogen Risks in Recreational Waters
- 2.5 Categorical Health Risk Analysis in Relation to Bacteriological Quality of Bathing Waters Based on Field Epidemiological Studies
- 2.6 Assessing and Managing Health Risks from Legionella in Water
- 3.0 Managing Risk and Promoting Preparedness
- 3.1 Identifying, Isolating, and Treating Infections to Prevent and Control Them
- 3.2 Vaccinations and Vaccines Against Known Pathogens
- 3.3 Disinfecting Hospital Waste and Similar Wastes Present in Communities
- 3.4 Disinfecting Surfaces and Tools
- 3.5 Hygiene Practices, Such as Handwashing at Critical Times
- 3.5.1 Handwashing at Critical Times
- 3.5.2 Other Hygiene Measures
- 3.6 Preventing or Reducing Exposure to Pathogens
- 3.6.1 Personal Protective Equipment
- 3.6.2 Engineering Controls of Pathogens
- 3.7 Awareness, Education, and Communication
- 4.0 Case Study: Using Qmra to Assess the Risk of Ebola Transmission to Wastewater Workers
- 5.0 Resources
- 5.1 Publicly Available
- 5.2 Require Access and/or Cited in Text
- Chapter 5 Utility Management and Operation: Learning From Others: Aditya Ramamurthy, Nija Ali, Adam Baron, Stephanie Corso, Shea Dunifon, Maureen Holman, Alexandra Lampson, Dusti Lowndes, Scott Perry, & Nelson Sims
- 1.0 Understanding the Macroeconomy
- 2.0 The Circular Economy
- 3.0 Operational Excellence and Performance
- 4.0 Business Continuity: The Dc Water Case
- 4.1 Financial Measures
- 4.1.1 Affordability, Access, and Customer Assistance
- 4.1.2 Revenue Streams (e.g., Reduced Usage, Extended Periods of Nonpayment)
- 4.1.3 Customer-Focused Assistance Programs
- 4.1.3.1 DC Water Cares
- 4.1.3.2 Emergency Residential Relief
- 4.1.3.3 Multifamily Assistance Program for Tenants and Renters
- 4.1.4 Utility Financing Strategies
- 4.1.5 Funding and Grants
- 4.2 Cybersecurity
- 4.3 Utility Workforce
- 4.3.1 Recruitment, Retention, and Staff Engagement
- 4.3.2 Motivation and Morale (Internal and Customer Facing)
- 4.3.3 Union Engagement and Policy Flexibility
- 5.0 Risk Management
- 5.1 Customer Risks
- 5.2 Risk Identification and Response Strategies
- 6.0 Utility Operations Leveraging the Incident Management Team
- 6.1 Incident Management for Common Operation Picture and Span of Control
- 6.1.1 Incident Management and Incident Command
- 6.1.2 Incident Management Team
- 6.1.3 Continuous Evaluation and Action Plans
- 6.1.4 Planning Meetings
- 6.1.5 Operations Briefs
- 6.1.6 Information Gathering and Documentation
- 6.1.7 Communications
- 6.1.8 Transition to Long-Term Recovery and Demobilizing of IMT
- 6.1.9 After-Action Activities and Review
- 6.2 Utility Operations and Supply Chain Management
- 6.2.1 Initial Awareness and Response
- 6.2.2 Chemical Supply Security
- 6.2.3 Centralize the Procurement of PPE and Cleaning Supplies
- 6.2.4 Creation of an Authority-Wide COVID-19 Work Order
- 6.2.5 Sourcing Team for COVID-19
- 6.2.6 Authority Manning and Policy Decisions
- 6.2.7 Leveraging the Incident Command System Reporting Structure
- 6.2.8 Teamwork and Thinking Out of the Box
- 6.3 Facility Readiness
- 6.4 DC Water's Return-to-Workplace Readiness
- 6.4.1 Ongoing Communication With Employees
- 6.4.2 Facilities Readiness, Space Planning, and Capacity Limitations
- 6.4.3 Collaborating With Government Agency's Reopen Teams
- 7.0 Changes in Laboratory Testing
- 7.1 Drinking Water Testing
- 7.2 Wastewater Testing
- 8.0 Health and Safety
- 9.0 Strategic Communications
- 9.1 Introduction
- 9.2 Identifying the Problem and the Audience
- 9.2.1 The Problem
- 9.2.2 Mapping Stakeholders
- 9.2.3 Audience Profiles
- 9.2.3.1 Regulators
- 9.2.3.2 Customers
- 9.2.3.3 Internal Communications
- 9.3 Develop Campaign Strategies and Content
- 9.3.1 Assessment
- 9.3.2 Branding
- 9.3.3 Content
- 9.3.4 Strategy
- 9.3.4.1 Be Omnichannel
- 9.3.4.2 Be Collaborative
- 9.3.4.3 Be Fluid
- 9.4 Digital Communications: Social Media Engagement and Participation
- 9.5 Communicating With the Media
- 9.5.1 Before the Crisis
- 9.5.2 During the Crisis
- 9.5.3 After the Crisis
- 9.6 Deploy and Debrief
- 10.0 References
- Chapter 6 Occupational Health Protection: Tom Burgess, MS, CSP, CIH
- David Gill
- Albert Rubin
- & Mark Wilson
- 1.0 Introduction
- 2.0 Exposure Assessment
- 2.1 Strategy
- 2.2 Basic Characterization
- 2.2.1 Criteria for Acceptable Exposure (Infection Risk)
- 2.2.2 Workplace Characterization (Exposure Risk)
- 2.3 Exposure Assessment
- 2.3.1 Exposure Groups
- 2.3.2 Qualitative Assessment
- 2.3.2.1 Aerosols
- 2.3.2.2 Qualitative Assessment Example
- 2.3.3 Quantitative Assessment
- 2.3.4 Exposure Risk
- 3.0 Controls
- 3.1 Hierarchy of Controls
- 3.2 Elimination/Engineering
- 3.3 Administrative
- 3.4 Personal Protective Equipment
- 3.5 Controlled Risk
- 4.0 Implementation and Management
- 4.1 Leadership and Employee Participation
- 4.2 Resources and Communication
- 4.3 Operational Planning and Control
- 4.4 Emergency Preparedness and Response
- 4.5 Performance Evaluation
- 5.0 Resources
- Chapter 7 Wastewater-Based Surveillance: Anna Mehrotra
- Tiong Gim Aw, PhD
- & Krystin Kadonsky
- 1.0 Background
- 1.1 Definitions
- 1.2 Origins
- 1.3 Historical Uses by Public Health Agencies
- 1.3.1 Poliovirus and the Global Polio Eradication Initiative
- 1.3.2 Illicit Drugs and the European Monitoring Centre for Drugs and Drug Addiction
- 1.3.3 COVID-19 and the U.S. Centers for Disease Control and Prevention
- 2.0 Methodology
- 2.1 Sample Collection
- 2.1.1 Sampling Locations
- 2.1.2 Sample Matrices
- 2.1.3 Sampling Approaches
- 2.1.4 Sample Preservation
- 2.2 Sample Processing
- 2.2.1 For Chemicals
- 2.2.2 For Pathogens
- 2.2.2.1 Pretreatment
- 2.2.2.2 Concentration
- 2.2.2.3 Nucleic Acid Extraction
- 2.3 Analysis
- 2.3.1 Mass Spectrometry
- 2.3.2 Nucleic Acid Amplification-Based Methods
- 2.3.3 Next Generation Sequencing
- 2.3.4 Quality Assurance/Quality Control
- 2.4 Data Interpretation and Sharing
- 2.4.1 Normalization
- 2.4.2 Complementary Data Sources
- 2.4.3 Data Representation and Display Practices
- 2.5 Data Application and Use
- 3.0 Limitations
- 4.0 Ethical Considerations
- 5.0 Resources
- Chapter 8 Looking Forward: Opportunities for the Water Sector and Its Workforce: Shea Dunifon
- Kari Brisolara
- Jen Loudon
- Bina Nayak, PhD
- Leilani Perriatt
- & Aditya Ramamurthy
- 1.0 Introduction: A Workforce with Diverse Perspectives
- 2.0 Water Sector Challenges during Covid-19
- 2.1 Emergency Response Planning
- 2.2 Knowledge Management and Communications
- 2.3 Pathogen Awareness and Training
- 2.4 Remote Work
- 2.5 Reduced Workforce
- 2.6 Morale and Tension
- 3.0 The Influence of Water Sector Experience and Role in Perceptions of Challenges and Opportunities in the Water Sector
- 3.1 Recent College Graduates and Job Seekers (Less Than 1 Year of Experience)
- 3.2 Young Professionals (1-10 Years)
- 3.3 Mid-Level Employees (10-15 Years)
- 3.4 Senior Employees (15+ Years)
- 4.0 Skills and Competencies for Water Professionals
- 4.1 Skills-Specific Learned Abilities Needed to Perform a Job Well
- 4.2 Competencies-Behaviors That Lead to Job Success
- 4.3 Job Descriptions, Competencies, and Checklists for Each Group
- 4.3.1 Field Crews (Water, Wastewater, and Collection Systems)
- 4.3.2 Public Health Professionals
- 4.3.3 Laboratory Technicians
- 4.3.4 Health and Safety Professionals
- 4.3.5 Public Affairs Professionals
- 5.0 Opportunities for the Water Sector
- 5.1 Shape Public Perception in a Positive Manner
- 5.2 Promote Clear and Transparent Communications
- 5.3 Utility Participation in Research
- 5.4 Create a Diverse, Equitable, and Inclusive Workforce
- 5.5 Promote Trade Careers Within Schools-Universities Are Not the Only Path
- 5.6 Identify and Highlight Advocates for the Industry
- 6.0 Resources
- 6.1 Publicly Available
- 6.2 Require Access
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