Exposure to Norovirus at the beach

Swimming in fecally-contaminated natural waterbodies can result in gastrointestinal (GI) infections and associated symptoms. However, the pathogenic microorganisms responsible are often unidentified because studies nearly always rely on self-reported symptoms. Noroviruses have been considered a likely cause because they are relatively resistant to conventional wastewater treatment and can survive in the environment.

norovirus-2Symptoms among swimmers usually occur within a few days of exposure, consistent with a short incubation period characteristic of noroviruses.

In the summer of 2009, we conducted an epidemiology study at a beach in Puerto Rico. We previously reported no association between swimming and self-reported GI symptoms at this beach. As part of this study, we also collected saliva samples from a subset of participants (N=1300) using an Oracol oral swab: on the day of the beach visit (S1); after 10-12 days (S2); and after approximately three weeks (S3), and tested them for IgG antibody responses to two common noroviruses (Norwalk and VA387) using a Luminex platform and a previously published method. An immunoconversion, indicating a potential new infection, was defined as at least a fourfold increase in norovirus-specific median fluorescence intensity (MFI) from the S1 to the S2 sample with the S3 sample remaining at least two times above the baseline (S1) MFI.

Approximately 4.7% (N=61) immunoconverted to at least one of the noroviruses. Swimmers who immersed their head in water had a higher rate of immunoconversion (5.5%) compared to non-swimmers (2.0%) (OR=3.32, 95% CI 1.2-9.5). Immunoconversion to norovirus was not associated with increased self-reported GI symptoms, indicating these infections were largely asymptomatic.

To our knowledge, this is the first epidemiology study to show an association between norovirus infection and swimming exposure. This abstract does not reflect EPA policy.

Evidence for asymptomatic norovirus infection transmission associated with swimming at a tropical beach

Soceity for Epidemiology Research, Miami, FL, June 07 – 16, 2016

Wade, Tim, S. Augustine, S. Griffin, K. Simmons, T. Eason, K. Oshima, E. Sams, A. Egorov, AND A. Dufour


I miss my hot tub, I miss my sauna, I don’t miss the viruses

From August to September 2014 a water quality study was conducted on five popular public Danube beaches in Vojvodina, Serbia.

serbia.beach.waterTo assess the safety of Danube water for bathing, physical, chemical, bacteriological tests were performed. While many parameters for monitoring the quality of water are regulated by law, there are neither national nor international legislations addressing the presence of viruses in recreational waters. In this study, we performed analyses that surpassed national requirements, and investigated if adenovirus, enterovirus or rotavirus genetic material was present in samples of recreational water collected for quality monitoring.

Of 90 water samples obtained during the study, enterovirus material was not found in any sample, but adenovirus and rotavirus genetic materials were respectively detected in 60 and 31 samples. Statistical analyses showed a significant correlation between adenovirus DNA and total coliforms in the water. Even when water samples were adequate for recreational use, adenoviruses were detected in 75% (57/76) of such samples. Our results indicate that implementation of viral indicators in recreational water might be helpful to better assess public health safety. This might be particularly relevant in areas where urban wastewater treatment is insufficient and surface waters affected by wastewater are used for recreation.

Testing For Viral Material In Water Of Public Bathing Areas Of The Danube During Summer, Vojvodina, Serbia, 2014

Eurosurveillance, Volume 21, Issue 15, 14 April 2016

A Jovanović Galović, S Bijelović, V Milošević, I Hrnjaković Cvjetkovic, M Popović, G Kovačević , J Radovanov, N Dragić, V Petrović


E. coli in beach sand: It happens, but is it a risk?

After surveying popular beaches in Hawaii, researchers from the University of Hawaii found that bacteria love the beach just as much as humans do. Turns out, the sand contained high levels of nasty bugs like E. coli.

dingo.beachThe researchers discovered that warm, moist sand provides the ideal breeding ground for bacteria brought in by waste water run-off, sewage, or garbage dumped on the beach. “Beach sand needs to be considered carefully in assessing its impact on public health,” cautioned lead author Tao Yan, Ph.D. The side effect from your perfect afternoon in contaminated sand? Things like diarrhea, vomiting, rashes, and infections, the study authors warn.

But don’t freak out and cancel that trip to Cabo just yet, says Russ Kino, M.D., the medical director of the Emergency Department at Providence Saint John’s Health Center in Santa Monica, CA. “There’s nothing to worry about from walking or playing on the beach,” he says. “If you have an open wound on your legs or feet then there is a risk of infection, but just walking around the beach? Forget it. You’re safe.”

He doesn’t dispute that there are poop germs (and worse) on beaches, but he says that our built-in safety system—our skin—does a great job of keeping germs out. Even if you’re doing something a little more dirty, like letting your friends bury you in the sand, enjoying a picnic on the beach, or having a romantic (ahem) moment, you’re more likely to get sick from the activity than you are from the sand, according to Kino.

“Honestly, the biggest risk from the beach is a sunburn,” he says, adding that his number one tip for beach safety is to wear a hat and shirt with UPF protection and a good sunscreen, as melanoma is still the number one cancer killer of women under 35 years of age.

Going public: anger over ‘lack of warning’ on E. coli at Irish beach

E. coli was detected in the water off of Bettystown beach, Co Meath, where families and young children have been swimming during the warm weather.

dp.beach.jun.13But locals are furious that the presence of the bug was not widely publicized before Wednesday, the hottest day of the year.

Meath County Council was criticized yesterday for failing to put up large notices and not having staff at Bettystown beach notifying people that the water had elevated levels of E. coli and enterococci bacteria.

However, Meath County Council said that within an hour of getting the results of tests on the water that it erected a notice at the entrance to the beach and put it on its website.

But this was criticized by parents and politicians who said signage wasn’t obvious.

One mother, whose children had been in the sea on Wednesday afternoon, said she spent “all night worrying” about them.

Cows on a beach

Imagine the levels of E. coli O157 and other Shiga-toxin producing E. coli (STEC) in that sand for the kiddies to play in.

This picture from, axppp/ZUMA Press, shows a herd of cows resting on a beach in Corsica, France on Monday (May 24).

Faded Tribune reports that for years, authorities have been trying to put a stop to the packs of animals that regularly wander onto the streets of this sun-kissed island between France and Italy.

Nearly every day, the herds damage village property and frequently cause serious road accidents. Last year, authorities had to stop air traffic at Figari airport in southern Corsica after pigs invaded the main runway. A few months ago, a bull tripped off a cliff and landed on the terrace of a bar. In their attempts to end the stampede, mayors from towns across the island have called in veterinarians, military police and the central French government — all to no avail.

Local officials estimate that 10 000 cows and many more pigs roam the island, which is three times the size of Long Island. In recent months, mayors have passed bylaws giving wolf hunters the authority to shoot the rambling animals.

Eating beach sand can be messy – at both ends

When it gets hot in Kansas, we go to Florida.

We’re leaving in a week, with a little work along the way before we settle into our rental on sexy Venice Beach, Florida. It’s the antithesis of places like South Beach, Miami, where celebrities flock and appearances rule. Venice – founded as a retirement community by the Brotherhood of Locomotive Engineers in the 1920s – is about as quiet as it gets.

With good beaches.

This year we’ll have 7-month-old Sorenne, and she’s starting to crawl (see below). If she can do this on hardwood, sand will be a breeze.

So we have to aware of sand in the mouth.

Besides the yuck factor, researchers at the University of North Carolina have found that digging in sand on beaches near water with high levels of fecal bacteria could be a risk factor for developing the drips.

For the study, reported in The American Journal of Epidemiology, researchers got contact information for more than 25,000 people visiting seven beaches within seven miles of sewage treatment plants.

About 10 days later, the researchers called and asked how they had spent their day at the beach and whether they had experienced problems like vomiting or diarrhea since then.

Those who dug in the sand, the study found, were significantly more likely to report having been sick — with those who had allowed themselves to be buried in the sand most affected. Children seemed to be at extra risk.

The best advice: wash your damn hands, especially before eating.

This isn’t the first time sand has been implicated in human illness.

In May, 2008, children’s playgrounds on Sydney’s northern beaches were closed after a rare form of salmonella normally linked to tropical fish made dozens of toddlers seriously ill.

Sydney sandpits closed again after Salmonella found

It’s a good thing Hugh Jackman and his trainer work out at Sydney’s Bondi Beach (right, from a couple of days ago) rather than the city’s Northern Beaches, which have again been closed due to Salmonella.

In May, 2008, children’s playgrounds were closed on Sydney’s Northern Beaches after a rare form of salmonella, paratyphi B var java, normally linked to tropical fish, made dozens of toddlers seriously ill.

The sand was replaced at a cost of $140,000 but recent testing has confirmed the same Salmonella has returned.

Today, the Daily Telegraph reports that Hitchcock Park at Avalon and Winnererremy Bay at Mona Vale on the Northern Beaches have been fenced off for the second time this year, while a third South Avalon playground has not re-opened since May.