Waterborne rotavirus: A risk assessment

A risk assessment approach was used to estimate the public health impacts from exposure to human rotavirus in drinking and recreational waters. Rotavirus is the major cause of viral gastroenteritis worldwide and several waterborne outbreaks have been documented. This results in a significant economic impact on society in terms of direct medical costs, loss of work, quality of life and mortality. The virus is common in domestic wastewater and polluted surface waters. Dose-response data in human adult volunteers indicate that it is the most infective of all the enteric viruses, and this was used to develop a microbial risk assessment model to estimate daily and yearly risks of infection, morbidity and mortality for exposure via drinking and recreational waters using existing information on the occurrence of rotavirus. The disease is most severe for the very young, the elderly, and the immunocompromised. Case fatality rates in the United States are 0.01% in the general population, 1% in the elderly, and up to 50% in the immunocompromised. Analysis indicates that significant risks of disease (5 x 10^-1-2.45 x 10^-3)) could result for drinking and recreational waters in which rotavirus has been detected. The major limitation in assessing the risks of waterborne rotaviral infections at present is the lack of data on its occurrence in water and the potential for human exposure.