skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Health-based ingestion exposure guidelines for Vibrio cholerae: Technical basis for water reuse applications

Journal Article · · Science of the Total Environment

U.S. military and allied contingency operations are increasingly occurring in locations with limited, unstable or compromised fresh water supplies. Non-potable graywater reuse is currently under assessment as a viable means to increase mission sustainability while significantly reducing the resources, logistics and attack vulnerabilities posed by transport of fresh water. Development of health-based (non-potable) exposure guidelines for the potential microbial components of graywater would provide a logical and consistent human-health basis for water reuse strategies. Such health-based strategies will support not only improved water security for contingency operations, but also sustainable military operations. Dose-response assessment of Vibrio cholerae based on adult human oral exposure data were coupled with operational water exposure scenario parameters common to numerous military activities, and then used to derive health risk-based water concentrations. The microbial risk assessment approach utilized oral human exposure V. cholerae dose studies in open literature. Selected studies focused on gastrointestinal illness associated with experimental infection by specific V. cholerae serogroups most often associated with epidemics and pandemics (O1 and O139). Nonlinear dose-response model analyses estimated V. cholerae effective doses (EDs) aligned with gastrointestinal illness severity categories characterized by diarrheal purge volume. The EDs and water exposure assumptions were used to derive Risk-Based Water Concentrations (CFU/100 mL) for mission-critical illness severity levels over a range of water use activities common to military operations. Human dose-response studies, data and analyses indicate that ingestion exposures at the estimated ED1 (50 CFU) are unlikely to be associated with diarrheal illness while ingestion exposures at the lower limit (200 CFU) of the estimated ED10 are not expected to result in a level of diarrheal illness associated with degraded individual capability. The current analysis indicates that the estimated ED20 (approximately 1000 CFU) represents initiation of a more advanced stage of diarrheal illness associated with clinical care.

Research Organization:
Oak Ridge National Laboratory (ORNL), Oak Ridge, TN (United States); U.S. Army Public Health Center, Aberdeen Proving Ground, MD (United States)
Sponsoring Organization:
USDOE
Grant/Contract Number:
AC05-00OR22725; 2207-M135-A1
OSTI ID:
1708933
Alternate ID(s):
OSTI ID: 1474702
Journal Information:
Science of the Total Environment, Journal Name: Science of the Total Environment Vol. 613-614 Journal Issue: C; ISSN 0048-9697
Publisher:
ElsevierCopyright Statement
Country of Publication:
Netherlands
Language:
English
Citation Metrics:
Cited by: 2 works
Citation information provided by
Web of Science

References (30)

Evolution of new variants of Vibrio cholerae O1 journal January 2010
Volunteer studies of deletion mutants of Vibrio cholerae O1 prepared by recombinant techniques. journal January 1988
Toxin producing Vibrio cholerae O75 outbreak, United States, March to April 2011 journal May 2011
Global Climate and Infectious Disease: The Cholera Paradigm journal December 1996
Dishwashing water recycling system and related water quality standards for military use journal October 2015
Vibrio cholerae 01 Can Assume a Chlorine-Resistant Rugose Survival Form that Is Virulent for Humans journal December 1996
Norwalk-Like Viral Gastroenteritis Outbreak in U.S. Army Trainees journal April 2000
A voyage of discovery: cholera, climate and complexity journal February 2002
Cholera. journal January 1995
Measuring water ingestion from spray exposures journal August 2016
Cholera—Modern Pandemic Disease of Ancient Lineage journal November 2011
Clinical and Environmental Isolates of Vibrio cholerae Serogroup O141 Carry the CTX Phage and the Genes Encoding the Toxin-Coregulated Pili journal November 2001
Genomic diversity of 2010 Haitian cholera outbreak strains journal June 2012
Validation of a Volunteer Model of Cholera with Frozen Bacteria as the Challenge journal May 1998
The Pathogenicity of Nonenterotoxigenic Vibrio cholerae Serogroup 01 Biotype EI Tor Isolated from Sewage Water in Brazil journal March 1982
Incidence of Norovirus-Associated Medical Encounters among Active Duty United States Military Personnel and Their Dependents journal April 2016
Endotoxin health risk associated with high pressure cleaning using reclaimed water journal April 2017
Diarrheal Disease during Operation Desert Shield journal November 1991
Response of Man to Infection with Vibrio cholerae. I. Clinical, Serologic, and Bacteriologic Responses to a Known Inoculum journal January 1974
New evidence for an inflammatory component in diarrhea caused by selected new, live attenuated cholera vaccines and by El Tor and Q139 Vibrio cholerae. journal January 1996
Evidence for the Emergence of Non-O1 and Non-O139 Vibrio cholerae Strains with Pathogenic Potential by Exchange of O-Antigen Biosynthesis Regions journal May 2002
Review of pathogen treatment reductions for onsite non-potable reuse of alternative source waters journal April 2017
Risk-based enteric pathogen reduction targets for non-potable and direct potable use of roof runoff, stormwater, and greywater journal April 2017
Clinical and Immunologic Characteristics of Vibrio cholerae O139 Bengal Infection in North American Volunteers journal April 1995
Evidence for several waves of global transmission in the seventh cholera pandemic journal August 2011
Host-induced epidemic spread of the cholera bacterium journal June 2002
Simulation of enteric pathogen concentrations in locally-collected greywater and wastewater for microbial risk assessments journal April 2017
Evaluation in humans of attenuated Vibrio cholerae El Tor Ogawa strain Texas Star-SR as a live oral vaccine. journal January 1984
Development Of A Live, Oral, Attenuated Vaccine Against El Tor Cholera journal December 1994
Validation and Characterization of a Human Volunteer Challenge Model for Cholera by Using Frozen Bacteria of the New Vibrio cholerae Epidemic Serotype, O139 journal December 1999