Diapositivo 1

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Sand pathogens and their indicators on coastal
and inland designated beaches João Brandão
(Project manager)?
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What is INSA

• A centennial public health institute (1899-2009)?
• A State Laboratory (RD, reference, health
  observatory)?
• Committed to Public Health gains
• National bioterrorism and outbreak surveillance
  institution

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Blue Flag Portugal

• 22 years of activity
• Increase from 37 to 220 awarded beaches since
  1987 till today
• Currently 40 of designated beaches of all of
  Portugal (550) are currently awarded
• Program runs on a voluntary basis financed mainly
  by municipalities but also by private sponsors

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Past

• 1989 - Mycology group of INSA look into fungi in
  sand (joint study with Portuguese National
  Directorate of Health).
• For 10 years, several beach sands were screened
  for fungi, following different approaches.

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Pityriasis versicolor by Malassezia furfur
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Examples of fungal infections easily passed on
to non-immunocompromised individuals by sand
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World Health Organization, 2003, in Guidelines
for safe recreational water environments, p118.

• From a recreational viewpoint, sand beaches
  are sought after. Especially in higher latitudes,
  a significant percentage of time is spent on the
  beach itself rather than in the water.
• A number of genera and species that may be
  encountered through contact with sand are
  potential pathogens. Accordingly concerns has
  been expressed that beach sand may act as
  reservoir of vectors of infection.

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Population with increased risk without specific
disorders
Pregnant women
Children
Elderly
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Actual beach on the south coast of Lisbon during
a misty day in the Summer
Where do you find most people (Please dont try
and find Wally!)?
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New European Bathing Water Directive (2006/7/EC)?

• Risk Assessment
• Surrounding environment identification of
  possible pollution sources
• Tighter limits and overview of a sequence of
  results
• Adjusted limits and parameters for fresh and sea
  bathing waters

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5 Regions Bimonthly sampling during 13 months
3 beaches per region 1 Beach awarded with the
Blue Flag 1 Beach with no direct human
interference 1 Beach with documented poor water
quality
210 sand samples 105 water samples
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Dry Sand
Wet Sand
Water front
Sterile sampling bag and gloves
Transport in cold and analysis within 24 hours of
sampling
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Bacterial parameters for sand quality assessment

• Coliform bacteria
• Escherichia coli
• Intestinal enterococci

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Values of the parameters for sand quality
assessment
Mycologic Parameters MRV 1.
Yeasts 60 cfu/g 2. Potential pathogenic
moulds (filamentous fungi) 85 cfu/g 3.
Dermatophytes 15 cfu/g
Bacteriologic Parameters (chosen from the
original) MRV 1. Total
coliforms 100 cfu/g 2. E. coli 20
cfu/g 3. Enterococci 20 cfu/g
Acredited by ISO 17025 (certificate
L4025)? Maximum Recommended Value
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Continental Portugal sand monitorization during
2006-2008
2006 66 beaches 2007 72 beaches 2008 90
beaches
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Factors that positively influence the quality of
beach sand

• Garbage - Frequent removal of litter and garbage
  from sand and neighbouring areas
• Garbage recipients - Number of garbage recipients
  appropriate for the length of the beach
• Sand treatment - based on experience of one
  region with weekly iodine spraying
• Surroundings - Identification and treatment of
  neighbouring contaminated areas

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Factors that negatively influence the quality of
beach sand

• Over-use of beach
• Admission of pets
• Accumulation of garbage
• Abandonment of remains from fishing
• Rodents and prowling animals

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Currently

• We currently provide this service to the
  community and the demand has been growing every
  year (currently over 100/bathing season,
  including blue flag program)?
• The Blue Flag is contemplating insertion of the
  sand quality within the awarding criteria
• Were extending internationally in order to
  gather information and compare experiences on
  other climates and regions, namely within Europe,
  America and Mediterranean coasts.
• Were going molecular detection in Portugal to
  try and set up high put-through and low cost of
  sand analysis

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2008-2010 - Molecular approach and Pathogens

• Other countries are participating on a consortium
  basis, with local funding, namely UK, Hong Kong
  and Spain
• Specific pathogens and molecular means of
  identification of those and of the current
  indicators are under study
• Details on pathogens will be handed out at the
  end of the workshop

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List of technical people currently involved in
sand analysis
Mycology Laboratory (INSA) Laura Rosado (head
of the lab)? Cristina Veríssimo Raquel
Sabino João Brandão Celia Alves Helena Parada
Water Microbiology Laboratory (INSA) Leonor
Falcão (head of the lab)? Manuela Barroso Cecília
Silva Raquel Rodrigues
Microbiology Laboratory (Portuguese Environmental
Agency) Isabel Moura (head of the lab)? Maria
Ana Cunha Bela Wergiskowski Carmen Rosado Graça
Noronha
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Questions?
Image of a beach in Algarve