Guidelines for Canadian Drinking Water Quality: Guideline Technical Document - Enteric Protozoa: Giardia and Cryptosporidium

Table of Contents

• Part I. Overview and Application
  • 1. Guideline
  • 2. Executive summary
    • 2.1. Health effects
    • 2.2. Exposure
    • 2.3. Analysis and treatment
    • 2.4. Quantitative microbial risk assessment
  • 3. Application of the guideline
• Part II. Science and Technical Considerations
  • 4. Description
    • 4.1. Giardia
      • 4.1.1. Life cycle
      • 4.1.2. Species
    • 4.2. Cryptosporidium
      • 4.2.1. Life cycle
      • 4.2.2. Species
  • 5. Sources and exposure
    • 5.1. Giardia
      • 5.1.1. Sources
      • 5.1.2. Survival
      • 5.1.3. Exposure
      • 5.1.4. Waterborne illness
    • 5.2. Cryptosporidium
      • 5.2.1. Sources
      • 5.2.2. Survival
      • 5.2.3. Exposure
      • 5.2.4. Waterborne illness
    • 5.3. Relationship to indicator organisms
      • 5.3.1. Treated drinking water
      • 5.3.2. Surface water sources
      • 5.3.3. Groundwater sources
  • 6. Analytical methods
    • 6.1. Sample collection
    • 6.2. Sample filtration and elution
    • 6.3. Sample concentration and separation
    • 6.4. (Oo)cyst detection
      • 6.4.1. Immunofluorescence assay
      • 6.4.2. Flow cytometry
      • 6.4.3. Molecular methods
    • 6.5. Recovery efficiencies
    • 6.6. Assessing viability and infectivity
      • 6.6.1. Excystation
      • 6.6.2. Fluorogenic dyes
      • 6.6.3. Reverse transcriptase-polymerase chain reaction
      • 6.6.4. Fluorescence in situ hybridization (FISH)
      • 6.6.5. Animal infectivity assays
      • 6.6.6. Cell culture infectivity assays
  • 7. Treatment technology
    • 7.1. Municipal scale
      • 7.1.1. Level of treatment necessary
      • 7.1.2. Physical removal
        • 7.1.2.1. Conventional filtration
        • 7.1.2.2. Membrane filtration
        • 7.1.2.3. Physical log removal credits for treatment barriers
      • 7.1.3. Chemical disinfection
        • 7.1.3.1. Water quality characteristics
        • 7.1.3.2. CT concept for disinfection
        • 7.1.3.3. Chemical resistance
        • 7.1.3.4. Disinfection by-products
      • 7.1.4. Ultraviolet light disinfection
      • 7.1.5. Multi-disinfectant strategy
      • 7.1.6. Treatment efficiency
    • 7.2. Residential scale
  • 8. Health effects
    • 8.1. Giardia
      • 8.1.1. Infection
      • 8.1.2. Pathogenesis and immune response
      • 8.1.3. Symptoms and treatment
    • 8.2. Cryptosporidium
      • 8.2.1. Infection
      • 8.2.2. Pathogenesis and immune response
      • 8.2.3. Symptoms and treatment
  • 9. Risk assessment
    • 9.1. Health-based targets
    • 9.2. Acceptable levels of risk
    • 9.3. Quantitative microbial risk assessment approach
      • 9.3.1. Hazard identification
      • 9.3.2. Exposure assessment
      • 9.3.3. Dose-response assessment
      • 9.3.4. Risk characterization
    • 9.4. International considerations
  • 10. Rationale
  • 11. References
• Appendix A: CT tables for the inactivation of Giardia lamblia cysts by chlorine, chlorine dioxide, chloramine and ozone at various temperatures
• Appendix B: CT tables for the inactivation of Cryptosporidium oocysts by chlorine dioxide and ozone at various temperatures
• Appendix C: Other enteric waterborne protozoans of interest: Toxoplasma gondii, Cyclospora cayetanensis and Entamoeba histolytica
• Appendix D: QMRA model
• Appendix E: Selected Giardia and Cryptosporidium outbreaks related to public, semi-public and private drinking water systems in Canada
• Appendix F: QMRA case study
• Appendix G: Acronyms and abbreviations