Economic Assessment of the Waterborne Outbreak of Cryptosporidium hominis in Galway, 2007

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Resource or Project Abstract

Compromised water quality can have adverse effects on industry, particularly the tourism and agricultural sectors, as well as having significant impacts on public health. Infection associated with Cryptosporidium app. may result in chronic gastrointestinal sequelae in some people and may be fatal for those with impaired immune function. In Ireland, cases of cryptosporidiosis are usually associated with Cryptosporidium parvum and are predominantly rural in occurrence. Endemic disease generally occurs in spring (peaking in April). Cryptosporidium parvum is primarily a parasite of ruminant animals with incidental human infection associated with farming activities or interactions with animals. Cryptosporidium hominis is primarily a parasite of primates, including humans, and is less common in Ireland. Epidemiological data reveal that exposure to drinking water from private supplies represents a high risk for cryptosporidiosis. In March 2007, the largest outbreak of cryptosporidiosis since surveillance began in Ireland was identified, and was associated with contamination of the water supply serving Galway City and surrounding areas. The outbreak lasted for 5 months, by which time there were 242 confirmed cases of cryptosporidiosis, although it is likely that the actual number affected was far higher. A boil water notice was put in place for the duration of the outbreak and affected approximately 120,000 people living in the area, all of whom required an alternative water supply. A key challenge in managing the risk of waterborne infection associated with Cryptosporidium spp. is that the parasite is not inactivated by chlorination. Cryptosporidium spp. have become recognised as an important cause of waterborne infection, so existing water treatment systems will require additional investment to enhance treatment systems to manage this risk. The outbreak ended in August 2007 following major investments by local authorities in water treatment infrastructure and major disruption to residents and local businesses. The goal of this research was to place a monetary value on the costs and inconvenience imposed by the 2007 Galway outbreak on the public, local businesses, the healthcare system, local authorities, national agencies, tourism and other water-dependent sectors. The research also examined the relationship between the investment needed to mitigate risk of contamination with Cryptosporidium and the benefits that would arise from such an investment. Water quality incidents such as the 2007 outbreak may have negative impacts on the public?s confidence in the water supply, and may also negatively affect confidence in other public bodies. Although challenging, this research also explored these effects on confidence by the distribution of a survey among residents
of Galway City and County.
This study represents the first of its kind in Ireland and posed some challenges. The estimation of costs posed a particular challenge, particularly for the private sector where the study was limited by data availability.
Key findings from this project include:
1. The overall cost of the waterborne outbreak of cryptosporidiosis that occurred in Galway in 2007 was estimated to amount to ?19 million or ?120,000 per day of the outbreak.
2. The estimated total cost to households in the affected area was approximately ?3.9 million. This translates into an average cost of almost ?88 per household (or ?0.55 per household per day of the outbreak) in the boil notice zone over the 23 weeks (158 days) while the boil water notice was in effect.
3. The estimated cost to lodging and care businesses amounted to almost ?8 million or ?50,000 per day of the outbreak.
4. Almost ?6 million of the total cost of the outbreak was the cost of mitigation actions by the local authorities. This included ?388,000 for the installation of a UV treatment facility that effectively inactivates Cryptosporidium oocytes in water, thus preventing waterborne transmission.
5. When the capital investment necessary to accommodate the installation of a UV treatment
system was taken into account, the total cost was ?1,674,000. If we consider that this investment made prior to the outbreak would have prevented the outbreak, the potential saving per euro invested amounts to ?11.

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Contact Information for This Resource

Dr. Dearbháile Morris
National University of Ireland Galway
Lecturer, Discipline of Bacteriology,
School of Medicine, National University of Ireland Galway, n/a, Galway, Galway, Galway
Telephone: 091 544652
e-mail: dearbhaile.morris@nuigalway.ie

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Access Information For This Resource

SAFER-Data Display URL http://erc.epa.ie/safer/iso19115/display?isoID=3140
Resource KeywordsWaterborne pathogen, Cryptosporidium, economic assessment, Galway
EPA/ERTDI/STRIVE Project Code2013-W-DS-11
EPA/ERTDI/STRIVE Project ThemeNot Applicable
Resource Availability: Any User Can Download Files From This Resource
Public-Open
Limitations on the use of this ResourceNONE
Number of Attached Files (Publicly and Openly Available for Download): 0
Project Start Date Tuesday 1st April 2014 (01-04-2014)
Earliest Recorded Date within any attached datasets or digital objects Tuesday 1st April 2014 (01-04-2014)
Most Recent Recorded Date within any attached datasets or digital objects Tuesday 1st March 2016 (01-03-2016)
Published on SAFERWednesday 3rd August 2016 (03-08-2016)
Date of Last EditWednesday 3rd August 2016 at 15:51:40 (03-08-2016)
Datasets or Files Updated On Wednesday 3rd August 2016 at 15:31:47 (03-08-2016)

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Description of Geographical Characteristics of This Project or Dataset
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Supplementary Information About This Resource

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Water is a limited and precious resource and is being consumed worldwide at unsustainable levels. According to the UN World Water Development Report, 47% of the world?s population will be living in areas of high water stress by 2030. Compromises in water quality can have adverse affects on industry, particularly the tourism and agricultural sectors as well as significant impacts on public health. With the establishment of Irish Water and the introduction of direct charges to domestic users, it is now more crucial than ever to assure the quality of water being delivered to consumers. Within the EU, water quality is generally good, although pathogenic micro-organisms remain a hazard in drinking and recreational waters. In Ireland of particular concern is the level of non-compliance for microbiological parameters found in some drinking water supplies and bathing waters. Despite the documented improvements in water quality in Ireland in recent years, a number of incidents have occurred where the quality of water available to the community has been compromised due to contamination. In March 2007, the largest outbreak of cryptosporidiosis since surveillance began was identified, and was associated with contamination of the water supply serving Galway City and surrounding areas. The outbreak lasted for five months by which time there were 242 confirmed cases of cryptosporidiosis, although it is likely that the actual number affected was far higher. A boil water notice was put in place for the duration of the outbreak affecting approximately 120,000 people, all of whom required an alternative water supply. The outbreak ended in August 2007 following major investments by local authorities in water treatment infrastructure and major disruption to residents and local businesses. Water quality incidents such as the outbreak of cryptosporidiosis in Galway in 2007 can have a major economic impact on the entire community ? residential and commercial. The goal of this research was to place a monetary value on the costs and inconveniences imposed by the 2007 Galway outbreak on the public, local businesses, the healthcare system, local authorities, national agencies, tourism and other water-dependent sectors. The research also examined the relationship between the investment needed to mitigate risk of contamination with Cryptosporidium and the benefits that would arise from such an investment. Water quality incidents such as the 2007 outbreak may have negative impacts on the public?s confidence in the water supply, and may also negatively affect confidence in other public bodies. Although challenging, this research also explored these effects on confidence by the distribution of a survey among residents of Galway City and County.
Supplementary Information
We thank all relevant representatives of Galway County Council, Galway City Council, the Health
Service Executive (HSE), the EPA and others for provision of data. We thank Dr Ronán Hennessey
for generation of relevant maps. We would also like to thank residents of Galway City and Galway
County for responding to the survey and the Health Research Board (HRB) for funding the summer
student scholarship under which it was conducted.
We also wish to thank the project advisory committee, comprising Dr John Curtis (ESRI), Mr Ray
Brennan (Galway City Council), Dr Darragh Page (EPA), Dr Gerry Galvin (Irish Water) and Dr
Dorothy Stewart (EPA) for their input.

Ordanance survey Ireland generalised ED and settlement data was used to generate maps of the area affected by the biol water notice. Additional references for this include EEA Corine CLC 2012; OpenStreetMap contibutors. This was performed under NUIG licence
Links To Other Related Resources
  http://www.nuigalway.ie/medicine-nursing-and-health-sciences/medicine/disciplines/bacteriology/research/economicassessmentofwaterbornecryptosporidiosisoutbreak/ (Opens in a new window)



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