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ORIGINAL ARTICLE
Keywords Abstract
bacterial indicators, bathing water quality,
hepatitis A virus, norovirus, RT-PCR. Aims: To assess the presence of viral pathogens in bathing water samples and to
evaluate the interdependency of bacterial indicator counts and viral detection.
Correspondence Methods and Results: Bathing water samples of 16 beaches collected along a
Filipa F. Vale, Faculty of Engineering, Catholic Portuguese Coastal area were screened for the hepatitis A virus (HAV) and
University of Portugal, Estrada Octávio Pato,
norovirus genogroup I (NVGI) using RT-PCR technique. Bacteriological water
2635-631 Rio de Mouro, Portugal.
E-mail: filipavale@fe.ucp.pt
quality was also assessed, according to European regulations. HAV and NVGI
were detected in 95% and 27% of the water samples, respectively, whereas
2009 ⁄ 1004: received 5 June 2009, revised 7 bacteriological quality was good in all but one sample, according to current
July 2009 and accepted 22 July 2009 water quality regulations.
Conclusions: All water samples would be considered of excellent quality
doi:10.1111/j.1365-2672.2009.04503.x according to the most recent European regulations. No relationship between
viral detection and regulatory-based bacterial indicators was found.
Significance and Impact of the Study: The current results reinforce the
importance of increased surveillance for pathogenic viruses in bathing waters.
relationship between virus and indicator bacteria present is a densely populated region, with more than one million
(Gerba et al. 1979; Noble and Fuhrman 2001; Rose et al. inhabitants. Several recreational and bathing areas are
2006). This lack of relationship could be because of their present along the coastline in the Tagus estuary and
morphological and physicochemical differences, which Atlantic coast; some of them are in close proximity to
may allow viruses to remain viable for longer periods of important urban centres (Lisbon, Oeiras and Cascais,
time in water, under a wider range of physicochemical among others). Three main effluents of wastewater treat-
conditions, including wastewater treatments that eliminate ment plants (WWTP) drain either to the Tagus River or to
bacteria (Metcalf et al. 1995; Fong and Lipp 2005). the Atlantic Ocean. The WWTP have an average daily out-
Common pathogenic viruses found in recreational put of approximately 50 000 m3 day)1, corresponding to
waters include hepatitis A virus (HAV), rotaviruses, noro- the treatment of 280 000 m3 day)1 of wastewater. Two of
viruses, adenoviruses and enteroviruses. These can cause them discharge directly into the estuary (22 000 m3 day)1),
illness when ingested or contacted with, including gastro- upstream of the recreational areas. The third, which serves
enteritis, diarrhoea and eye infections, to more severe the populations of the municipalities directly associated
conditions such as hepatitis, paralysis, meningitis, respira- with the recreational areas, has a single submarine point of
tory tract infections and myocarditis (Fong and Lipp discharge, 45 m deep and 2Æ7 km offshore.
2005). In addition to causing acute diseases, they are of The detection of enteroviruses is only to be determined
public health concern because of their low infectious in case of suspected outbreaks (Diário da República
dose. Moreover, there have been several virus-related out- Decree no. 236 ⁄ 1998), and no published information was
breaks (confirmed or suspected) linked to the ingestion found regarding the assessment of viral contamination in
of and contact with waters that meet faecal coliform stan- Portuguese waters intended for human use, either by
dards (Fong and Lipp 2005). molecular or by cell culture methods.
Despite their relevance as possible aetiological agents, The present study assessed the presence of viral patho-
the detection of viruses in water samples has been limited gens in bathing water samples of the Lisbon coastal area,
by two main constraints: (i) the generally low concentra- namely HAV and norovirus genogroup I (NVGI), using
tion of target viruses in aquatic samples, which requires reverse transcription PCR (RT-PCR). Standard bacterio-
sample concentration and purification to obtain sufficient logical indicators of water quality were also determined to
target sequences and limit carryover of assay inhibitors evaluate whether currently used microbiological indicators
(metal ions, humic and fulvic acids and phenolic com- reflect viral contamination.
pounds); (ii) the need for culturing in human ⁄ mamma-
lian cell lines, leading to long processing times, lower
Material and methods
sensitivity and lack of cell lines for many viruses of
concern (Fong and Lipp 2005; Jiang 2006).
Sampling sites
The detection of viruses using molecular biology tools
has been extensively used since 1990, either directly from In a first round of collection, two 1-l bathing water sam-
concentrated samples or following cell culture. Polymer- ples were collected in 16 beaches from the Lisbon coastal
ase chain reaction (PCR) and several of its variations such area from May to July 2008 (Fig. 1 and Table 1). One of
as multiplexed PCR, nested PCR or real-time PCR are the 1-l samples was used for viral detection, and the sec-
faster, more sensitive and more specific than traditional ond for bacteriological water quality assessment. From
cell culture methods. However, increased false positive these 16 beaches, three of them were randomly chosen
rates may occur because of cross-contamination. Likewise, within the study area, for a second and a third round of
false negative results, because of the inhibition of the collection in September 2008 (Table 1) to confirm the
assay by compounds in the concentrated sample and the results obtained in the first round.
inability to determine viability are also limits of this
approach (Fong and Lipp 2005; Jiang 2006). These facts,
RNA extraction of positive viral controls
together with the traditional high cost of equipment and
consumables have delayed the implementation of molecu- Positive controls of HAV and NVGI were considered. The
lar tools as standard methods for viral detection and HAV strain HM175 was obtained from the National Insti-
monitoring. tute for Biological Standards and Control (South Mimms,
Many coastal recreational and bathing water areas UK); NVGI-positive stool samples were generously
across the developed world are located near urban areas, donated by the Centre for Environment, Fisheries and
and thus, are subject to contamination, which can lead to Aquaculture Science (Weymouth, UK). Viral RNA was
public health problems. The study area selection followed extracted using the QIAamp viral RNA mini kit (Qiagen,
this assumption. The Lisbon bay area (Portugal, Europe) Hilsen, Germany), according to the manufacturer’s
(a)
(b)
USBOA
CASCAIS OEIRAS
(c)
(a)
instructions, eluted in 60 ll of RNase-free water and stored this second step allows to wash the sample, by removing
at )80C until further use. inhibitors of DNA polymerase. Samples obtained in the
first concentration step were added to these filter units
and centrifuged at 4000 g for 15 min. After a wash step,
Virus concentration from bathing water samples
concentrated samples were recovered in 140 ll of RNase-
For viral detection, water samples were passed through free water and stored at )80C. Viral RNA was extracted
sterile membranes of 0Æ45 lm pore for bacteria removal, from concentrated samples as described in the previous
and pH was adjusted to 7Æ0. Water samples were concen- subsection.
trated using a positively charged membrane Sartobind
Q75 (Sartorius, Goettingen, Germany). Membranes were
RT-PCR
initially rinsed with TE buffer (10 mmol l)1 Tris adjusted
to pH 7Æ0 with HCl, spiked with 1 mmol l)1 EDTA). Viral RNA was used in the cDNA synthesis with the First
Samples were pumped through the membranes using a Strand cDNA synthesis kit (Fermentas, Canada), accord-
peristaltic pump (Braun, Melsungen, Germany) at a flow ing to the manufacturer’s instructions, using oligo(dT)18
rate of 10 ml min)1. Membranes were then washed with primers.
10 ml of TE buffer. The bound viral particles were eluted In a total volume of 50 ll, the cDNA was mixed with 1 ·
using 10 ml 0Æ5 mmol l)1 NaCl solution (Specht et al. (NH4)2SO4 buffer [75 mmol l)1 Tris–HCl, 20 mmol l)1
2004). Afterwards, a second concentration step was per- (NH4)2SO4 and 0Æ01% (v ⁄ v) Tween 20], 3 mmol l)1
formed using Amicon Ultra-15 Centrifugal Filter Devices MgCl2, 0Æ2 mmol l)1 dNTPs, 1 lmol l)1 of primers spe-
(Millipore, Carrigtwohill, Ireland). Besides concentration, cific for each viral group (Invitrogen, USA) and 1U Taq
Table 1 Water quality assessment of the 16 bathing water samples from the Lisbon geographic area. Coordinates of the sampling sites,
collection dates, bacteriologic water quality parameters and results of the PCR for the detection of hepatitis A virus (HAV) and norovirus geno-
group I (NVGI) are shown
*European Terrestrial Reference System 89; (Ihde, J., Luthardt, J., Boucer, C., Dunkley, P., Farrell, B., Gubler, E. and Torres, J., personal communi-
cation) European Spatial Reference Systems – Frames for Geoinformation Systems; http://www.crsgeo.eu/crseu/EN/References/Elemente/pub01
EuropeanSpatialRefernceSystems,templateId=raw,property=publicationFile.pdf/pub01EuropeanSpatialRefernceSystems.pdf
TC, total coliforms in 100 ml: good: £500; acceptable: 500 < TC £ 10 000; poor: >10 000.
FC, faecal coliforms in 100 ml: good: £100; acceptable: 100 < FC £ 2000; poor: >2000.
§According to Diário da República Decree no. 236 ⁄ 1998.
–EC, Escherichia coli in 100 ml: excellent: £250; good ⁄ sufficient: 250 < EC £ 500; poor: >500.
**FE, faecal enterococci in 100 ml: good: £100; good ⁄ sufficient: 100 < FE £ 185; poor: >185.
According to European Council Directive 2006 ⁄ 7 ⁄ EC.
Polymerase (Fermentas). After the initial denaturation at gel stained with ethidium bromide (Sigma-Aldrich, USA),
94C, PCR amplification was performed for 35 cycles, with visualized under UV light (UVIvue SXT-20M; Uvitec,
each cycle consisting of 94C for 1 min, 60C (NVGI) or Cambridge, UK) and documented using a Kodak Gel
66Æ5C (HAV) for 1 min and 72C for 1 min. The final Logic 100 Imaging System (Kodak, USA).
extension was performed at 72C for 5 min. The PCR To amplify by PCR highly conserved genomic regions,
products were analysed by electrophoresis in a 2% agarose revealed by ClustalW (Chenna et al. 2003), viral-specific
primers were used. For HAV, primer sequences targeted sequences were introduced in Blast (Altschul et al. 1997)
the genomic region corresponding to the interface of the for specificity confirmation.
VP1 and VP3 capsid proteins and were identical to those
described previously (De Leon et al. 1990), except for the
Bacteriological water quality assessment
addition of BamHI and KpnI restriction sites for cloning
(Table 2). Primer sequences for NVGI primer sequences Bacteriological water quality was assessed for all samples
were designed specifically for this study to amplify the by standard methods, according to both the Portuguese
genomic region corresponding to the interface of ORF1 (Diário da República Decree no. 236 ⁄ 1998) and the
and ORF2 and also have BamHI and KpnI restriction European (European Council Directive 2006 ⁄ 7 ⁄ EC) regu-
sites for cloning (Table 2). lations. For the bacteriological water quality assessment,
For PCR optimization, cloning and sequencing of the the membrane filtration technique combined with selec-
amplicons, a first group of PCR was performed using tive culture media for each parameter was used. Water
only the viral control samples. Bands with the desired samples were filtrated through sterile membranes of
molecular weight were removed from the gel and purified 0Æ45 lm pore (Macherey-Nagel, Düren, Germany), using
with QIAquickGel Extraction kit (Qiagen). The PCR a vacuum pump (Vacuubrand, Wertheim, Germany).
products were stored at )20C until further use. The Each membrane was incubated in a selective medium at
NVGI-positive stool sample was completely used in this an appropriate temperature: (i) for detection of total coli-
first group of reactions, so it was not possible to use it as form bacteria, the membrane was incubated in m-lauryl
positive control of the bathing water samples. sulfate agar (MLSA; Sigma-Aldricht) medium at 36 ± 2C
For bathing water samples, when bands with the for 24 h, and the yellow colonies tested for the absence of
desired molecular weight were not detected, a second oxidase activity, (ii) for detection of faecal coliform bacte-
round of PCR was performed for each viral group. ria, the membrane was incubated in MLSA medium at
44 ± 0Æ5C for 24 h, and the yellow colonies tested for
absence of oxidase activity, (iii) for detection of E. coli, an
Cloning and sequencing of HAV and NVGI probes
oxidase negative yellow colony, grown in MLSA medium,
For viral control samples, HAV and NVGI PCR products was transferred to Fluorocult medium (Merck, Germany)
were digested with BamHI and KpnI (Fermentas) over- and tested for the presence of glucuronidase enzyme and
night at 37C. The pBluescript II KS (+) vector (pBS KS; for the production of indole from tryptophan after addi-
Fermentas) was digested with the same restriction tion of Kovacs reagent (Merck) and (iv) for detection of
enzymes for 2 h at 37C, followed by digestion with calf faecal enterococci, membrane was incubated in Slanetz
intestine alkaline phosphatase (Fermentas) for 30 min at and Bartley agar medium (Oxoid, Cambridge, UK) at
37C. Ligation of inserts and vector was performed by T4 36 ± 2C for 48 h, and the red colonies were transferred
ligase (Invitrogen) in 1 : 1, 1 : 3 and 1 : 5 proportions to the Bile Aesculin agar medium (Merck) and tested for
(vector : insert) for 1Æ5 h at 24C in a final volume of the hydrolysis of aesculin (Clesceri et al. 1999).
10 ll. The total volume was used to transform competent
E. coli XL1B (donated by Bioalvo, S.A.). The cells were
Statistical analysis
incubated at 37C for 15 h in LB medium supplemented
with ampicillin (100 lg ml)1), IPTG (0Æ1mmol l)1) and The association between bacteriological water quality
X-Gal (20mg ml)1) (Fermentas). Presumptive colonies categories and presence or absence of viral contamination
were screened for the presence of inserts. Plasmid DNA was tested via one-sided Fisher exact tests (statistica,
was extracted with QIAprep Spin Miniprep kit (Qiagen), ver. 8; Statsoft, Tulsa, OK, USA). The relationship between
according to the manufacturer’s instructions, and digested bacterial counts and viral presence was evaluated using a
with BamHI and KpnI. After insert sequencing, the binary logistic regression model (statistica, ver. 8).
Table 2 List of primer sequences used for hepatitis A virus (HAV) and norovirus genogroup I (NVGI) detection
*Restriction sites for BamHI (GGATCCC) and KpnI (GGATCC) used for cloning in pBluescript KS(+) are underlined.
(a) M 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 M
(b) M 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 M
Figure 2 Gel electrophoresis of the RT-PCR products of hepatitis A virus (HAV; a), norovirus genogroup I (NVGI; b) amplification from 16 bathing
water samples. All gel electrophoresis correspond to second round PCRs except (a) which is a first round. The conserved genomic regions have
222 bp (HAV+) and 118 bp (NVGI+); NS, non specific amplifications. Lanes: M, 100-bp DNA ladder (Invitrogen) with 16 fragments raging from
the top: 2072, 1500, 1400, 1300, 1200, 1100, 1000, 900, 800, 700, 600, 500, 400, 300, 200 and 100 bp. (a) 1, Belém; 2, Torre; 3, Carcavelos;
4, Parede; 5, Avencas; 6, Bafureira; 7, S. Pedro Estoril; 8, Azarujinha; 9, Poça; 10, Tamariz; 11, Moitas; 12, Conceição ⁄ Duquesa; 13, Rainha; 14,
Cresmina; 15, Guincho; 16, Abano; 17, HAV cDNA; 18, PCR negative control. (b) 1, Belém; 2, Torre; 3, Carcavelos; 4, Parede; 5, Avencas; 6,
Bafureira; 7, S. Pedro Estoril; 8, Azarujinha; 9, Poça; 10, Tamariz; 11, Moitas; 12, Conceição ⁄ Duquesa; 13, Rainha; 14, Cresmina; 15, Guincho;
16, Abano; 17, PCR negative control.
1 2 3 4 5 6 7 8 M 9 10 11 12 13 14 15
Figure 3 Gel electrophoresis of the RT-PCR products of hepatitis A virus (HAV; lanes 1–8), norovirus genogroup I (NVGI; lanes 9–15) amplification
from three bathing water samples of the second and third round of collection. All gel electrophoresis correspond to second round PCRs. The
conserved genomic regions have 222 bp (HAV+) and 118 bp (NVGI+). Lanes: M, 100-bp DNA ladder with 16 fragments raging from the top:
2072, 1500, 1400, 1300, 1200, 1100, 1000, 900, 800, 700, 600, 500, 400, 300, 200 and 100 bp. 1, Carcavelos (second collection); 2, Carca-
velos (third collection); 3, Bafureira (second collection); 4, Bafureira (third collection); 5, Guincho (second collection); 6, Guincho (third collection);
7, HAV cDNA; 8, PCR negative control; 9, Carcavelos (second collection); 10, Carcavelos (third collection); 11, Bafureira (second collection); 12,
Bafureira (third collection); 13, Guincho (second collection); 14, Guincho (third collection); 15, PCR negative control.
and Lipp 2005) and is mandatory in some countries or ing water possibly do not reflect viral contamination
autonomic regions (Ibarluzea et al. 2007). (Schvoerer et al. 2000; Noble and Fuhrman 2001; Jiang
Because of the small size of viral particles, mechanical and Chu 2004; Rose et al. 2006).
filtration is often not possible; therefore, ultrafiltration or The detection of viral genomes does not imply that the
adsorption–elution methods, using electropositive or elec- populations using these waters are at immediate risk.
tronegative filters, are employed (Fong and Lipp 2005). However, when the viral signal is concurrent with high
In this work, we chose to perform adsorption–elution of levels of faecal indicator bacteria, it may suggest a recent
viruses with an electropositive filter, because it is one of human sewage contamination and a potential health risk
the most commonly used techniques. This requires no (Rose et al. 2006). When the detection of viral genetic
manipulation of pH, given that enteric viruses are nega- material is not accompanied by high bacterial indicator
tively charged at environmental pH (Lipp et al. 2001). counts, it may suggest an old source of faecal contamina-
However, some co-eluates could have interfered with the tion (Jiang and Chu 2004). Given that viral genetic mate-
subsequent reactions and originated the observed nonspe- rial is degraded within days when the capsid is removed,
cific amplifications. this would mean that the detected particle is probably still
The occurrence of nonspecific amplifications in the infectious (Fong and Lipp 2005). With the used method-
bathing water samples, probably because of suboptimal ology (RT-PCR), the viral load was not quantified, so a
PCR conditions, highlights one of the potential drawbacks quantitative assessment of the risk, as attempted by Rose
of the detection of viruses using molecular methods. et al. (2006), was not possible.
Primer pair specificity was checked with Primer Blast The mode of transmission of HAV and noroviruses is
(Rozen and Skaletsky 2000) against the ‘nr’ database, and generally person to person or by oral intake after faecal con-
no nonspecific products were predicted. Likewise, PCR tamination. Waterborne transmission is less important in
results from purified HAV RNA (Fig. 2a, lane 17) did not the spread of hepatitis A than person-to-person contact and
yield any unexpected band, and the Blast results of the accounts for 2% of the source of infection (Cuthbert 2001).
sequenced products confirmed the identity of the ampli- HAV has already been associated with a swimming pool out-
cons. It should be noted, however, that the primers may break because of contamination with sewage (Mahoney
be prone to self-amplification (Fig. 2a, lane 18, Fig. 3, et al. 1992). In contrast, noroviruses are considered to be
lane 8). Under suboptimal conditions, this could lead to one of the main causes of waterborne gastroenteritis out-
increased nonspecific amplification, which may be an breaks (Bosch et al. 2008) and were associated with several
explanation for the extra bands found in most of the outbreaks in recreational waters (e.g. Sartorius et al. 2007
bathing water samples, with both HAV and NVGI primer and references within). Even though NVGI genomes were
pairs (Fig. 2a,b and 3). found in less water samples than HAV (27% vs 95%, respec-
In the current study, no association was found between tively), their high infectivity make them a possible health
viral contamination and bacteriological water quality, and risk factor in the studied area.
viral contamination was detected even in samples with Wastewater effluent discharges upstream of the recrea-
zero or near zero total coliforms (Moitas, Cresmina, tional areas might have influenced the viral quality of
Guincho and Bafureira in the second and third round of seawater and both human and ecosystem health. The
collections; Table 1). This is in accordance with several WWTP whose output is closer and upstream of the recre-
other reports and suggests that the indicators legally ational areas only had primary treatment at the time of
demanded to assess the microbiological quality of drink- this study. The wastewater of 100 000 inhabitants of
Lisbon (upstream the recreational areas) still drains detection, and potential water quality assessment tools.
untreated into the estuary, which could help to explain Microbiol Mol Biol Rev 69, 357–371.
the high detection rates of viral genomes, even with low Gerba, C.P., Goyal, S.M., LaBelle, R.L., Cech, I. and Bodgan,
bacterial counts. Works are underway to add secondary G.F. (1979) Failure of indicator bacteria to reflect the
treatment to the above-mentioned WWTP and to link all occurrence of enteroviruses in marine waters. Am J Public
the sewage system of the city. It would be valuable to Health 69, 1116–1119.
repeat the assessment of viral contamination in the stud- Griffin, D.W., Donaldson, K.A., Paul, J.H. and Rose, J.B.
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Ibarluzea, J.M., Santa Marina, L., Moreno, B., Serrano, E.,
water quality in this respect.
Larburu, K., Maiztegi, M.J. and Yarzabal, A. (2007)
Viral fragments cloned in the current study are to be
Somatic coliphages and bacterial indicators of bathing
implemented as probes in a DNA chip, for the simulta-
water quality in the beaches of Gipuzkoa, Spain. J Water
neous detection of different types of microbiological
Health 5, 417–426.
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of viral detection methodologies, especially near viruses in southern California urban rivers. J Appl Micro-
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