How influenza pandemic control can lead to unpreparedness: modelling the ecotoxicity of pharmaceutical usage

Singer, Andrew. 2010 How influenza pandemic control can lead to unpreparedness: modelling the ecotoxicity of pharmaceutical usage. [Other] In: Influenza 2010: Zoonotic Influenza and Human Health, Oxford, UK, 21-23 September 2010. (Unpublished)

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Background and aims: The global public health community has closely monitored the unfolding of the 2009-10 influenza pandemic to best mitigate its impact on society. However, little attention has been given to the impact that our response to a pandemic might have on the environment. Antiviral and antimicrobial drugs prescribed to treat influenza and influenza-associated complications are poorly metabolized in vivo; once ingested, they are subsequently excreted into wastewater in a biologically-active form. Methods: Here we use a global spatially structured epidemic model to simulate the quantities of drugs used during an influenza pandemic under different conditions. We couple this model to a wastewater and river flow model, to project drug concentrations in wastewater treatment plants (WWTPs) and receiving rivers in the Thames basin in Southern England. Results: Ecotoxicologic modeling shows that projected concentrations of antibiotics in WWTPs and receiving rivers would not exceed toxicity thresholds in the case of a mild pandemic, as observed with the current H1N1 pandemic. However, at the peak of a moderate or severe pandemic, the mean antibiotic usage could increase by 13% and 252% as compared to inter-pandemic periods, respectively. Nearly one-third of the microbial community in 70% of the WWTPs in the Thames basin are projected to be growth-inhibited during a severe pandemic, and preliminary empirical evidence signals the potential disruption of bacterial biofilms upon exposure to WWTP-relevant concentrations of Tamiflu. Between 5 to 40% of the length of the Thames River receiving WWTP effluent is projected to exceed thresholds for microbial growth-inhibition by antibiotics. Conclusions: Projections indicate no ecotoxicologic risk for a situation consistent with the 2009-10 H1N1 influenza pandemic. However, a more severe pandemic might result in reduced WWTP efficacy, resulting in the release of partly untreated sewage into receiving rivers, leading to eutrophication, fish kill, and contamination of drinking water abstraction points.

Item Type: Publication - Conference Item (Other)
Programmes: CEH Topics & Objectives 2009 - 2012 > Biogeochemistry > BGC Topic 3 - Managing Threats to Environment and Health
UKCEH and CEH Sections/Science Areas: Hails
Boorman (to September 2014)
NORA Subject Terms: Biology and Microbiology
Ecology and Environment
Date made live: 07 Mar 2012 16:26 +0 (UTC)

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