A good mystery always entails intriguing circumstances and a circuitous pathway to its solution. Whether it’s a deceptive villain intent on causing mayhem for the masses or a calculating killer, focusing single mindedly on his next victim, the goal is always the same – stay undetected and strike again. This same objective may be true for a new genre of mysteries involving water borne illnesses. The solution, however, may not be as “elementary” as Sherlock implied.
Getting sick from ingesting or being in contact with contaminated water is nothing new. Nasty illnesses such as dysentery, cholera, botulism, and many others, have probably been impacting people since they first began gathering around the communal watering hole.
Historical records reveal water contamination problems have been around for centuries and offer basic solutions for dealing with them. Sometimes it was boiling water and other times it was replacing water with other beverages. For example, European sailor’s in the 1700’s were known to brew a beer with a higher alcohol and hops content, which acted like a preservative, for their long journeys to India. It was referred to as India Pale Ale and has recently made quite a come-back in the burgeoning micro-brewery market.
It wasn’t until the late nineteenth and early twentieth centuries that water treatment practices starting to take hold in the United States. Water experts figured out a combination of filtration and disinfection, typically by chlorination, would keep water sources safe for consumption. While this simple, yet effective, treatment technology has prevented countless outbreaks of water-borne illnesses over the last century, it may have met its match.
Strains of bacteria and protozoa are being found that are resistant to chlorination, making them extremely difficult to kill. Worse yet, only a small number of these germs are required to cause an illness. One parasite of concern is cryptosporidium; a protozoan originating from human and animal feces as well as seasonal run-off. “Crypto” is known to stick on water filter membranes and even high doses of chlorine have difficulty terminating this culprit.
The Center for Disease Control (CDC) recently announced there were twice as many crypto outbreaks in 2016 as there were in 2014. States hardest hit on 2016 were Alabama, Arizona and Ohio. Specifically, the CDC website reported “Arizona identified 352 people sick with Crypto for July–October 2016, compared with no more than 62 cases for any one year in 2011–2015. Ohio identified 1,940 people sick with Crypto in 2016, compared with no more than 571 cases for any one year in 2012–2015.” The mystery here is whether the increase in outbreaks is due to increased reporting, better detection or simply more cases occurring.
Another perpetrator guilty of recidivism is the bacteria Legionella. Different species of this bug are responsible for Pontiac Fever and the more well-known Legionaries’ Disease. According to a June 6, 2016 Washington Post web article, Legionnaire’s outbreaks have quadrupled over the last 15 years. Recent large outbreaks occurred in Flint, Michigan and New York City.
Unfortunately, the health impacts of Legionella are more serious than Cryptosporidium. Crypto can cause nausea, stomach cramps and diarrhea for up to three weeks but Legionella can kill. Medical treatment costs are high. CDC Director Tom Frieden has stated “The annual cost of treating Legionnaires’ disease, based on hospital claims, is about $434 million…”
The mystery to be solved with Legionella is how to detect it before an outbreak occurs. Legionella can be eliminated with proper water treatment but often it goes undetected until it’s too late. It can build up in older plumbing infrastructures and strike when people breathe in small droplets of water containing the bacteria.
Legionella is a more challenging culprit to arrest. It’s costly to replace antiquated water infrastructure and It’s not easy to check closed-systems for bacterial contamination. Still, the CDC recommends proper maintenance of building water systems as the key to prevention.
But for now, that key may have fallen into the wrong hands…