Disinfection

School of Civil and

Monroe L. Weber-Shirk Environmental Engineering
 Overview
Why does getting this right matter? Chlorine
Disinfection Options
Chlorine Chlorine sources
Ozone Gas
Irradiation with Ultraviolet light Bleach
Iodine Onsite production
Silver Chemistry
Disinfection mechanisms Metals
Chicks law Water
CT Ammonia
Problems with Disinfection Organics
Disinfection-by-products The case for Chlorine
Tastes and odors It kills stuff
Real pathogens Residual
Getting the right dose Recontamination
Poisson Distribution of Pathogens Regrowth
Probability of ingesting k pathogens Hypochlorinators
Implications for dose dependency Chlorine free
WaterBorne Disease Outbreaks Some European cities
 Chlorine saves lives

If you accept the Chlorine eliminated Typhoid

Line
Then you will likely recommend chlorination as
the first line of defense in the Global South-
But in small systems (in the Global South)
Chlorine dose is generally not controlled based on a
target residual dose
Surface water may currently be untreated and hence
have high turbidity
that correlates with high chlorine demand
that contains pathogens embedded in organic particles
 WHO on alternative disinfectants:
Iodine, silver, copper, quaternary ammonium compounds

none of them are considered suitable for long-term use to

disinfect drinking water
Iodine is difficult to deliver to water and can cause adverse
health effects
However, iodine, either dissolved in water or in the form
of an iodinated exchange resin, has been used for short-
term water treatment
Silver and copper are difficult to deliver to water and are
only bacteriostatic.
Quaternary ammonium compounds are limited in
availability, costly and not effective against viruses and
parasites.
 Silver as a Disinfectant

Silver is used as a bacteriostatic agent for point-of-use or

household water treatment by storing water in vessels
composed of silver or passing water through porous or
granular filter media impregnated with silver
Many microbes including viruses, protozoan cysts,
oocysts, and bacterial spores, are not inactivated at silver
concentrations employed for point-of-use drinking water
treatment
Bacteria may develop silver resistance
Therefore, silver is not recommended for routine
disinfection of household water
 Chlorine Disinfection Mechanisms*

Oxidation of membrane-bound enzymes for

transport and oxidative phosphorylation
Oxidation of cytoplasmic enzymes
Oxidation of cytoplasmic amino acids to nitrites
and aldehydes
Oxidation of nucleotide bases
Chlorine substitution onto amino acids (more likely)
DNA mutations
DNA lesions
*It is possible that none of these mechanisms have been documented
 Chicks Law

The death of microorganisms is first order with respect to

time
Thus, the remaining number of viable microorganisms, N,
decreases with time, t, according to:
dN
kN
dt
where k is an empirical constant descriptive of the
microorganism, pH and disinfectant used.
Integrating with respect to time, and replacing limits (N =
No at t = 0) yields: 1
N pC* kt
N N 0e kt
ln kt
N0 ln 10
 EPA Pathogen Inactivation
Requirements
Safe Drinking Water Act
SDWA requires 99.9% inactivation for
Giardia and 99.99% inactivation of viruses
Giardia is more difficult to kill with
chlorine than viruses and thus Giardia
inactivation determines the CT
Concentration x Time
 EPA Credits for Giardia
Inactivation
Treatment type Credit
Conventional Filtration 99.7%
Direct Filtration* 99%
Disinfection f(time, conc., pH, Temp.)

* No sedimentation tanks
 EPA Disinfection CT Credits

To get credit for 99.9% inactivation of Giardia:

Contact time (min)
chlorine pH 6.5 pH 7.5
(mg/L) 2C 10C 2C 10C
0.5 300 178 430 254
1 159 94 228 134
Inactivation is a function of _______,
time ____________
concentration
pH
______, temperature
and ___________.
Where did these numbers (to 3 significant digits) come from?
 CT equation for Giardia

CCl tcontact 0.2828 pH 2.69 CCl0.15 0.933
T -5
pC *

tcontact 0.2828 pH 2.69 CCl0.85 0.933
T -5
pC *
CCl = Free Cl2 Residual [mg/L]
tcontact CCl0.85 tcontact = Time required [min]
pC*

0.2828 pH 2.69 0.933
T -5


pH = pH of water
T = Temperature, degrees C
Chicks Law! pC* = -[Log(fraction
remaining)]
Note: These equations are NOT dimensionally correct!
 Disinfectant Limitations

Disinfection by products
Tastes and Odors
Real pathogens
Getting the right dose
 Disinfection Byproducts

Sources of
MCLG1 MCL Potential Health Effects
Contaminant Contaminant in
(mg/L)2 (mg/L)2 from Ingestion of Water
Drinking Water
Bromate zero 0.010 Increased risk of cancer Byproduct of drinking water
disinfection (plants that use
ozone)
Chlorite 0.8 1.0 Anemia; infants & young Byproduct of drinking water
children: nervous system disinfection (plants that use
effects chlorine dioxide)
Haloacetic acids n/a6 0.060 Increased risk of cancer Byproduct of drinking water
(HAA5) disinfection

Total none7 0.10 Liver, kidney or central nervous Byproduct of drinking water
Trihalomethanes ---------- ---------- system problems; increased disinfection
risk of cancer
(TTHMs) n/a6 0.080
 Disinfectants

MRDLG Sources of
MRDL1 Potential Health Effects
Contaminant 1
Contaminant in
(mg/L)2 from Ingestion of Water
(mg/L)2 Drinking Water

Chloramines MRDLG MRDL Eye/nose irritation; stomach Water additive used to control
(as Cl2) =41 =4.01 discomfort, anemia microbes

Chlorine (as MRDLG MRDL Eye/nose irritation; stomach Water additive used to control
Cl2) =41 =4.01 discomfort microbes

Chlorine MRDLG MRDL Anemia; infants & young Water additive used to control
dioxide (as =0.81 =0.81 children: nervous system effects microbes
ClO2)

Maximum Residual Disinfectant Level (MRDL) - The highest level of a disinfectant allowed in drinking water.
There is convincing evidence that addition of a disinfectant is necessary for control of microbial contaminants.
Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which
there is no known or expected risk to health. MRDLGs do not reflect the benefits of the use of disinfectants to control
microbial contaminants.
 Tastes and Odors: Taste Thresholds

Complaints of the chlorine taste should not be discounted

Chlorine taste may prevent some consumers from using
treated water
Need to convince consumers that
the chemical taste is healthy
 Chlorine Taste Acceptance

The introduction of chlorine into a community that

has always drunk water without the addition of
chemicals can be difficult.
Reducing the amount of chlorine added might
increase the social acceptance of chlorination.
With less chlorine, there is less breakthrough of
chlorinated compounds into the finished water, and
therefore less of a chemical taste.
If the water doesnt taste strongly like chemicals,
more people are likely to subscribe to the use of
chlorine for disinfection.
 Inactivation of Shielded Pathogens

Many of the studies measuring inactivation

of pathogens by disinfectants were
conducted using dispersed pathogens
What happens if the pathogens are
embedded in an organic particle?
Faecal contamination potentially contains
pathogens embedded in protective organic
matter.
 Cell Associate virus was inside fetal
rhesus kidney derived cells
0.36 mg/L
average
free Cl2 at
pH 6

What do you
conclude?
86

CCl t to get pC* of 4 is (86 min)*(0.36 mg/L)=31 (min mg/L)

 Conclusions from Virus in Kidney
Cells
The rate of virus deactivation dropped
significantly when the virus particles were
inside kidney cells
The deactivation of embedded virus
particles can not be described by a single
Chicks Law is violated
first order reaction (________________)
What is controlling the rate of virus
deactivation?
Scales of the Embedded Virus

Deactivation
Location rate
Dispersed Very fast
Inside cell with
1000 nm
disrupted cell Slow
wall
1 m
Inside intact
Very slow
cell
Virus particles are about 20 nm
HOCl are about 0.2 nm
Mass Transport and Chlorine
Protection
Chlorine must diffuse
through cell contents to
reach virus
Organic material inside
the cell reacts with
chlorine before it gets to
the virus
 Scale this up to a Faecal Aggregate

Turbid water could easily

have organic particles that
are 10 or even 100 m in
diameter
The amount of organic
matter in a small particle
and the slow diffusion
would provide long term 10 m
protection for embedded
pathogens
 Getting the Right Dose:
WHO on Chlorination
exposed
Chlorine compounds usually destroy pathogens after 30
minutes of contact time, and free residual chlorine (0.20.5
mg per liter of treated water) can be maintained in the
water supply to provide ongoing disinfection.
Several chlorine compounds, such as sodium hypochlorite
and calcium hypochlorite, can be used domestically, but
the active chlorine concentrations of such sources can be
different and this should be taken into account when
calculating the amount of chlorine to add to the water.
The amount of chlorine that will be needed to kill the
pathogens will be affected by the quality of the untreated
water and by the strength of the chlorine compound used.
If the water is excessively turbid, it should be filtered or
allowed to settle before chlorinating it
Remove particles first!
(___________________________)
 Pathogen Poisson Process
Probability
Suppose we have an average pathogen
concentration of C in our drinking water
Suppose we drink volume V
What is the probability that we will ingest k
pathogens?
Suppose V=1L, C=2/L, what is probability
of ingesting exactly 2 pathogens?
CV CV
k
2
2
P e 2
k P e 0.27
k! k
2!
 Probability of k Pathogens

CV=15

45% chance of not

getting sick!

What is probability of k < (dose)?

Let dose = 15
Find cumulative probability for k=14
 Find probability that k>0

CV
k CV=1
Pk e CV
k!

CV
0

Pk 0 e CV e CV
0!
Pk 0 1 e CV

For CV = 1, Pk>0 = 0.63

For CV = 0.001, Pk>0 = 0.001 (converge for small CV)
 Effect of Pathogen Dose

For CV = 0.001, Pk>0 = 0.001

What happens if the pathogen dose is 10 rather
than 1?
Lets assume that the concentration of this new
pathogen is 10 times as great (CV=0.01)
What is the probability that you ingest 10 or
more? For CV = 0.01, Pk10 = 3x10-27
Pathogens with an infectious dose of 1 are
potentially quite harmful even at very low
concentrations!
Pathogens with an infectious dose>1 are not
dangerous at low concentration!
Waterborne Disease Outbreaks in the
US (1985)
G. lamblia was the most frequently identified pathogen for
the seventh consecutive year, causing three (20%) of 15
waterborne outbreaks.
In each of the outbreaks, as in well-characterized
waterborne outbreaks of giardiasis in the past, water
chlorination had been maintained at adequate levels to
make outbreaks of bacterial diseases unlikely, but the lack
of an intact filtering system capable of filtering Giardia
cysts, distribution system problems, and mechanical
deficiencies allowed drinking water to become a vehicle of
giardiasis.
 Waterborne Disease Outbreaks
(1993)
The majority of outbreaks (68%) during 1991-1992 were
classified as AGI of unknown etiology
Water sampling showed the presence of coliforms and/or
deficiencies in chlorination for 91% of these outbreaks
24 outbreaks (71%) were associated with contaminated
untreated or inadequately treated groundwater
Two outbreaks were associated with treatment deficiencies
in water systems using UV light for disinfection
Three protozoal outbreaks during 1991-1992 occurred in
systems that were equipped with chlorine disinfection and
met EPA coliform standards but were not equipped with
filtration
 Waterborne Disease Outbreaks
(1993)
Four of the six surface water systems associated with
WBDOs were equipped with filtration.
In three of these outbreaks, raw water quality had deteriorated
because of sewage effluents that were not appropriately
diluted as a result of low stream flows during dry weather.
During the outbreaks associated with these systems, filtration
deficiencies were noted, with elevated turbidity in finished
water.
Decreased filtration efficiency combined with
deterioration in raw water quality also contributed to the
WBDO in Milwaukee (1993).
It appears that chlorination was unable to provide an
effective barrier when filtration failed
 A fatal waterborne disease
epidemic in Walkerton, Ontario
An estimated 2,300 people became seriously ill and seven died from
exposure to microbially contaminated drinking water in the town of
Walkerton, Ontario, Canada in May 2000
The Walkerton operators were asked to provide a chlorine residual
(majority to be free chlorine) of 0.5 mg/L after 15 min.
Evidence at the Inquiry revealed that chlorine dosage practice at Well
#5 was insufficient to achieve a 0.5 mg/L residual even in the absence
of any chlorine demand.
Although the evidence did not allow for an estimate of the chlorine
demand at the time Well #5 was contaminated, it was reasonable to
assume that the contamination causing this outbreak was accompanied
by a chlorine demand sufficient to consume entirely, or almost entirely,
the low chlorine dose thereby allowing inadequately disinfected water
into the distribution system
Chlorine must have been consumed because there was
an outbreak
 Chlorine Sources

On Site Production (electrolysis)

Chlorine gas (Cl2)
Liquid Bleach (NaOCl)
Calcium hypochlorite (Contains 65%
available chlorine) Ca(OCl)2
Bleach Concentration in terms of Bleach concentration in terms of Additional Information
sodium hypochlorite (NaOCL) Available Chlorine (As Cl2) (estimated)
Density of
Trade Grams per Specific gravity
Wt. % Trade % Grams per liter Wt. % the solution
% liter of the solution
(lb/U.S. gal)
5 5.4 53.9 4.8 5.1 51.4 9.0 1.08
10 11.6 115.8 9.5 11.0 110.4 9.7 1.16
15 18.6 185.7 14.3 17.7 177.0 10.3 1.24
 Chlorine

First large-scale chlorination was in 1908 at the

Boonton Reservoir of the Jersey City Water Works
in the United States
Chlorine
Widely used in the US oxidizes organic
Typical dosage (1-5 mg/L) matter
variable, based on the chlorine demand
goal of 0.2 mg/L residual
Trihalomethanes (EPA primary standard is 80
g/L)
Chlorine concentration is measured as Cl2 even
when in the form of HOCl or OCl-
 Chlorine Reactions

Charges 0 +1 -2 +1 -1
Cl2 + H2O H+ + HOCl + Cl-
Hypochlorous acid HOCl H+ + OCl- Hypochlorite ion
The sum of HOCl and OCl- is called the
free chlorine
____ ______ residual
_______
 Chlorine and pH

HOCl is the more HOCl H+ + OCl-

effective disinfectant
Therefore chlorine
disinfection is more
low
effective at ________
pH
pk
Dissociation constant is
10-7.5
HOCl and OCl- are in
equilibrium at pH 7.5
 Ammonia Reactions
-3 +1 -3+1 +1
NH3(aq) + HOCl NH2Cl+ H2O
Combined chlorine
NH2Cl + HOCl NHCl2+ H2O
Substitution reactions
The combined chlorine maintains its oxidizing
potential
 Breakpoint Chlorination

Removal of ammonia by chlorination

-3 +1 0 -1
2NH3(aq) + 3HOCl N2+ 3Cl- + 3H2O

Oxidizing equivalents of chlorine are

consumed
 Does Chlorine Completely oxidize
organic matter? NO!
4HOCl + CH4 CO2 + 2H2O + 4Cl- + 4H+

Oxidation states
Carbon in organic matter (-4)
Carbon in carbon dioxide (+4)
Chlorine in HOCl (+1)
Chloride (-1)
Therefore should take 4 moles of chlorine
(Cl2) per mole of organic carbon
23.6 g chlorine/g organic carbon
Chlorine Demand vs. Total Organic
Carbon

0.5 mg chlorine
mg carbon
 Reaction with organic compounds
with unsaturated linkages
Cl OH
C C + HOCl C C
H H H H
Chlorine doesnt oxidize the organic carbon
Chlorine maintains its oxidation number

0.5 mg Cl2 mole Cl2 mole Cl 1 12 g C mole Cl 1

g g g
mg C 70.9 g Cl2 mole Cl2 mole C 12 mole C
 Chlorine Demand vs Turbidity

Disclaimer There is If using the standard

no solid connection dose of 2 mg/L, then
between chlorine no residual above 15
demand and turbidity NTU!
But organic matter is
often associated with
particulate matter Based on 6
watersheds in
western Oregon
 The Case for Chlorine

It kills stuff
Residual
Recontamination
Regrowth
 Effect of Chlorination on
Inactivating Selected Bacteria
Bacteria Cl2 Concentration Time Ct Factor (mg- Reduction(%) Reference
(mg/l) (min) min/l)

Campylobacter jejuni 0.1 5 0.5 99.99 Blaser et al, 1986

Escherichia coli 0.2 3 5 99.99 Ram and Malley,
1984
Legionella pneumophila 0.25 60-90 18.75 99 Kuchta et al, 1985
Mycobacterium chelonei 0.7 60 42 99.95 Carson et al, 1978
Mycobacterium fortuitum 1.0 30 30 99.4 Pelletier and
DuMoulin, 1987
Mycobacterium 0.15 60 9 70 Pelletier and
intracellulare DuMoulin, 1987
Pasteurella tularensis 0.5-1.0 5 3.75 99.6-100 Baumann and
Ludwig, 1962
Salmonella typhi 0.5 6 3 99 Korol et al, 1995
Shigella dysenteriae 0.05 10 0.5 99.6-100 Baumann and
Ludwig, 1962
Staphylococcus aureus 0.8 0.5 0.4 100 Bolton et al, 1988
Vibrio cholerae(smooth 1.0 <1 <1 100 Rice et al, 1993
strain)
Vibrio cholerae (rugose 2.0 30 60 99.999 Rice et al, 1993
strain)
Yersinia enterocolitica 1.0 30 30 92 Paz et al, 1993
 Effect of Chlorination on
Inactivating Selected Viruses
Viruses Cl2 Time Ct factor Reduction Reference
Concentration (min) (mg-min/l) (%)
(mg/l)
Adenovirus 0.2 40-50 sec 0.15 99.8 Clarke et al, 1956
Coxsackie 0.16-0.18 3.8 0.06 99.6 Clarke and
Kabler, 1954
Hepatitis A 0.42 1 0.42 99.99 Grabow et al,
1983
Norwalk 0.5-1.0 30 22.5 -- Keswick et al,
1985
Parvovirus 0.2 3.2 0.64 99 Churn et al, 1984
Poliovirus 0.5-1.0 30 22.5 100 Keswick et al,
1985
Rotavirus 0.5-1.0 30 22.5 100 Keswick et al,
1985
 Effect of Chlorination on
Inactivating Selected Protozoa

Cl2
Concentration Time Ct Factor Reduction
Protozoa (mg/l) (min) (mg-min/l) (%) Reference
Cryptosporidium 80 90 7200* 90 Korich et al,
parvum 1990
Entamoeba 1.0 50 50 100 Snow, 1956
histolytica
Giardia lamblia -- -- 68-389 99.9 AWWA, 1999
Naegleria fowleri 0.5-1.0 60 45 99.99 de Jonckheere
and van de
Voorde,
1976
 The Case for a Residual

Disinfect any recontamination

Prevent bacteria growth in the treated water
Do pathogens grow in water?
The real reason for maintaining residuals during
treatment and distribution is to control
microbiological growths when the water is
biologically unstable.
Control those non-pathogenic slime-forming
organisms
Current practice in North America tries to kill all
microorganisms whenever possible
Protection Against Recontamination

In order to be effective the following

requirements must be met
The amount of chlorine demand must not
exceed the residual
The pathogens must be dispersed (not
associated with other particles)
This is unlikely if the contamination is faecal
The pathogens must be susceptible to chlorine
 Growth of Bacteria in Water
Distribution Systems
Consumption of dissolved oxygen
Increased heterotrophic plate counts or coliform
counts
This does not imply a health risk
Decreased hydraulic capacity of the pipes
Formation of taste/odor compounds
Geosmin, mercaptans, amines, tryptophans, sulfates
Increased rates of pipe corrosion
I dont have any evidence that this biological
growth has a significant public health impact
 Pathogen Growth in Distribution
Systems (CDC)
Biofilms are coatings of organic and inorganic
materials in pipes that can harbor, protect, and
allow the proliferation of several bacterial
pathogens, including Legionella and
Mycobacterium avium complex (MAC).
Mycobacterium avium complex, MAC, is an
opportunistic bacterial pathogen, is resistant to
water disinfection (much more so than Giardia
cysts), and grows in pipe biofilms
I need more data here! Is this a real public health threat?
 WHO on Regrowth

There is no evidence to implicate the occurrence of most

microorganisms from biofilms (excepting, for example,
Legionella, which can colonize water systems in buildings)
with adverse health effects in the general population
through drinking water, with the possible exception of
severely immunocompromised people
Water temperatures and nutrient concentrations are not
generally elevated enough within the distribution system to
support the growth of E. coli (or enteric pathogenic
bacteria) in biofilms.
Thus, the presence of E. coli should be considered as
evidence of recent faecal contamination.

http://www.who.int/water_sanitation_health/dwq/en/gdwq3_4.pdf
 WHO on Regrowth (2)

Viruses and the resting stages of parasites (cysts,

oocysts, ova) are unable to multiply in water.
Relatively high amounts of biodegradable organic
carbon, together with warm temperatures and low
residual concentrations of chlorine, can permit
growth of Legionella, V. cholerae, Naegleria
fowleri, Acanthamoeba and nuisance organisms in
some surface waters and during water distribution
http://www.who.int/water_sanitation_health/dwq/en/gdwq3_7.pdf

Where is the original research for these conclusions?

 Life without Chlorine

Amsterdam stopped chlorinating in 1983

 Recommendations for Chlorine as
Sole Treatment
Low turbidity (<30 NTU) and low chlorine
demand for effective use; pre-treat turbid water
(WHO)
Pre-treat means using a particle removal technology
first
Low turbidity probably means good quality
groundwater (from a spring or from a well)
Surface water would generally not meet the NTU
requirement
Chlorine requires process control (feedback based
on residual chlorine concentration)
 Hypochlorinator
Float
1.0 m
1.5 PVC
overflow tube

Transparent
1.05 m flexible tube
1.78 m (0.5)

PVC needle
valve 0.5 PVC tube

Water in the distribution tank

 Example Conservation of Mass
Changing Volume
Float

1.0 m

cs
r V
n dA =-
t cv
r dV 1.5 PVC
overflow tube

Transparent
1.05 m flexible tube
h0
1.78 m (0.5)
Vor Aor =-
t cv
dV

PVC needle
valve 0.5 PVC tube
dV Ares dh
Vor Aor Water in the distribution tank
dt dt

Vor Aor Qor Orifice in the needle valve

dh Integrate to get h as f(t)

Ares K or Aor 2 gh 0
dt
 Finding the chlorine depth as f(t)
h t
Ares dh
K or Aor 2g
h0 h
dt
0

Ares
2 h1/ 2 h01/ 2 t
K or Aor 2g

2
tK or Aor 2 g
h h 1/ 2

0
2 Ares

Aor g
2
Aor g
h h01/ 2 tK or h h0 tK or
Ares 2
Ares 2
 Finding Q as f(t)
Aor g
Q K or Aor 2 gh h h0 tK or
Ares 2

Aor g
Q K or Aor 2g h0 tK or
Ares 2

Find Aor as function of initial target flow rate

Q0
Aor Set the valve to get desired dose initially
K or 2 gh0
 Surprise Q decreases linearly!
Aor g Q0
Q K or Aor 2g h0 tK or Aor
Ares 2 K or 2 gh0

tQ0
K or Q0 2g Q0 g Q

1
h0
Q h0 tK or
K or 2 gh0 K or Ares 2 gh0

Q0 h0 A res 2 h0

Q tQ0
1
Relationship between Q0 and Ares? Q0 2 Ares h0

Flow at Q0 for 4 days (tdesign) would empty reservoir

Q0 hres
Q0tdesign Ares hres
Ares t design

Q 1 t hres CCl2 1 t hres

1 1
Q0 2 t design h0 CCl2 2 tdesign h0
0
 Hypochorinator Fix
http://web.mit.edu/d-lab/honduras.htm
Conclusions
 Reflections

What is one explanation for why Biosand

filters dont perform as well as expected?
 Calicivirus - An Emerging
Contaminant in Water
Annual estimates among adults in the U.S. reveal
approximately 267 million episodes of diarrhea leading to
612,000 hospitalizations and 3,000 deaths
In the last 3 decades it has become increasingly clear that
viral agents are responsible for much of this public health
burden
Human caliciviruses (HuCVs) have been estimated to
cause 9596% of nonbacterial gastroenteritis outbreaks
(Fankhauser et al., 1998; K.Y. Green et al., 2000).
These viruses are considered ubiquitous in nature and
stable in the environment, thereby increasing their
propensity to spread and cause disease
 Calicivirus

Four genera
Lagovirus
Vesivirus
Norwalk-like viruses (Noroviruses or NLVs) Cause
Sapporo-like viruses (Sapoviruses or SLVs) disease in
humans
Single structural protein that makes up the
viral capsid
27-40 nm in diameter
 Norovirus: Infectious Dose

Human volunteer feeding studies have determined

the number of viral particles needed to initiate
infection is 10 to 100 Huffman, D. E., K. L. Nelson, et al. (2003).

The infectious dose may well be the result of mass

transfer limitations in the gut
i.e. the virus needs to be transported to the villi in the
gastric mucosa and attach to initiate infection
Thus it is likely that 1 viral particle is sufficient to
initiate infection Weber-Shirk
 Norovirus: Clinical Illness and
Diagnosis
The most common symptoms of NLV infections include
mild to moderate diarrhea, abdominal cramps, and nausea
(Adler and Zickl, 1969; Hedberg and Osterholm, 1993).
Other symptoms may include headache, malaise, chills,
cramping, and abdominal pain. Stools typically do not
contain blood or mucus.
The onset of illness is generally within 24 to 28 h of
exposure with a relatively short duration of illness (12 to 60
h).
Adult infection with NLV can be distinguished from
bacterial pathogens such as Salmonella and Shigella due to
its characteristic projectile vomiting (Adler and Zickl, 1969;
Caul, 1996)
 Norovirus: Inactivation

A 1-log reduction in the RTPCR signal of

Norwalk virus was observed after treatment
with 2 mg/L monochloramine at pH 8 for 3
h
Norwalk virus appears to be fairly resistant
to free chlorine and monochloramine