Risk Assessment of waterborne coxsackievirus

Virus contamination of the water environment through disposal of human wastewater remains a concern for the water industry. Coxsackieviruses are the most common nonpolio enteroviruses found in domestic wastewater and in contaminated surface water, groundwater, and drinking water. Although most infections result in mild febrile illness, coxsackieviruses are capable of causing a wide range of serious illnesses (including aseptic meningitis, myocarditis, and respiratory illness) and are associated with cases of insulin‐dependent diabetes mellitus. A risk assessment approach was used to evaluate the potential public health effects associated with contaminated drinking water and recreational waters. An exponential model developed from human dose–response studies was used to describe the infectivity of coxsackievirus type B and estimate daily and yearly risks of infection, morbidity, and mortality. Concentrations of coxsackievirus reported in the literature were used to examine potential exposure. Although risks of infection for coxsackievirus are lower than for rotavirus, levels detected during outbreaks resulted in risks of 10 –1 annually for drinking water. Risks assuming an ingestion of 100 mL per swim were 10 –2 for a 10‐day exposure to freshwater. The severity of the diseases associated with this type of virus and its widespread contamination emphasize the importance of maintaining reliable wastewater and drinking water treatment.