SCIENCE, POLITICS, AND THE PUBLIC’S HEALTH科学政治和公众健康.pptVIP

Cryptosporidium exposure associated with crabbing within urban Baltimore watersheds Cynthia McOliver, MPH Johns Hopkins University Bloomberg School of Public Health 2007 Introduction: Recreational Water Activities Recreational water activities are important to people and communities all across the United States Fishing/angling, crabbing, boating, swimming and related activities In our area, the Chesapeake Bay and its tributaries support both recreational activities and subsistence activities Baltimore waters such as the Baltimore Harbor, Patapsco, Jones Falls and Gunpowder are popular sites Photo credits: Top: /cbpo/planyourvisit/outdooractivities.htm; Middle: Personal photo; Bottom: US Fish and Wildlife Service Eufaula National Wildlife Refuge in Alabama Baltimore, MD: Urban setting for fishing and crabbing Our waters are receiving pathogens (bacteria, viruses, parasites eg Cryptosporidium) from many sources: Point source: Human waste water treatment effluents Nonpoint sources: Combined and sanitary sewer overflows Storm/rain event runoff Animals/pets Some of these pathogens cause human sickness such as gastroenteritis from foodborne/waterborne exposure Photo credit: top, leaking sewage main, http://www.ci.baltimore.md.us/government//minority/images/MBEoutreachWWP.pdf; Bottom: Immunofluorescently stained Cryptosporidium oocysts, H.D.A Lindquist, U.S. EPA Studies: Part 1 Question: Are persons with HIV/AIDS at risk of exposure to Cryptosporidium from recreational water contact? Questions regarding type/frequency/location of water contact, residence, age, ethnicity, consumption of local catch, GI symptoms, handwashing etc Premise: Persons with HIV/AIDS and other immunosuppressions are likely to develop severe/chronic illness from infections from Cryptosporidium (Colford et al., 1996 Am J Epidemiol. 1996 Nov 1;144(9):807-16; Chen et al., N Engl J Med. 2002 May 30;346(22):1723-31 ) Recreational waters in Baltimore area, caught fish and handwashes