SPH Researchers Teach Russians ‘Germ Warfare’

In the summer of 1993, an outbreak of a waterborne disease in Milwaukee killed more than 100 people and sickened 400,000 others. The crisis could have been ripped from the pages of a germ-warfare thriller in which post-Cold War agents sabotage innocent-looking drinking water, but in real life a bacterium named Cryptosporidium proved to be the culprit.

The crisis marked a notable battle in a different kind of germ warfare, provoked not by saboteurs, but instead by microscopic pathogens. Keeping this kind of germ warfare in mind, more than 20 water supply officials from 10 Russian cities reported to the Harvard School of Public Health this week for basic training.

Timothy Ford, associate professor of environmental microbiology; Andrey Egorov, doctoral candidate in the Department of Environmental Science and Engineering Program; and Jennifer Adibi, U.S.-Russia project coordinator in the same program, organized the Russians’ visit with the help of their Russian partner, Vladislav Fourman. The week-long seminar included lectures and field trips to nearby water treatment facilities and represented one component of a four-year project between SPH and the Russian Ministry of Health and State Committee on Environmental Protection in Environmental Health Management.

“Ideally, we want them to take information back to their respective water utilities and set up workable treatment schemes,” Ford said.

The SPH seminar addressed the health effects of water pollution, advanced water monitoring, treatment techniques, information systems, and risk management. Not all of the technologies discussed are applicable immediately to Russia, mainly due to costs. But that did not deter the Russian visitors from learning lessons to be implemented later.

“The questions are relevant and important for everybody,” said Nina Drijd, director of a Russian environmental surveillance system. “We hope to take the ideas to Russia and implement them there.”

And, even after spending 26 hours on planes to reach the SPH seminar, Drijd added telling testimony to the seminar’s effectiveness. “It was worth it,” she said.

Health officials have battled waterborne diseases for more than a century. In the early 1900s, U.S. officials introduced filtration and then chlorine to water treatment methods. Disease rates dropped dramatically. Over time, researchers developed finer methods of filtration and other means to protect water sources.

But officials in both developed and developing countries should remain vigilant over drinking water safety, Ford warned. The incidence of waterborne disease is increasing, he said, and pathogens can cause a plethora of unpleasant and sometimes deadly illnesses such as diarrhea and typhoid. The agents target the most vulnerable; the elderly, the very young, and immuno-compromised fare much worse than healthy adults when it comes to drinking tainted water.

The pathogens thrive in aging and overtaxed water systems. Over time, layers of organic materials ranging from feces to dirt build up on the interiors of pipes. These layers, called biofilms, can serve as hospitable homes to opportunistic pathogens, which grow under the protective films. The biofilms buffer the pathogenic agents against flushing and chlorination. Older pipes also tend to crack open more easily than new ones, which allows contaminants into the water stream long after the water leaves the treatment plant.

Russian officials protect their water sources using methods similar to Western strategies, but a crumbling economy hinders their work. “They have a fairly good water treatment system,” said Ford, “but it is deteriorating with no basis in place for improvements.” The results are growing rates of incidences of hepatitis A and cholera.

And the rates may be dramatically underreported. Ford cites a global problem of underreporting because the symptoms of waterborne-provoked illness can be vague or easily misdiagnosed. Gastrointestinal discomfort can be attributed to many sources, and water may not be the most obvious.

People suffering from vague symptoms may be prescribed antibiotics that are useless against viruses; such a problem is particularly worrisome in Russia, where some antibiotics are available over the counter, said Ford.

Christina Roache is editor of the SPH Around the School newsletter.