title: Assessment of the efficacy of the first water system for emergency hospital use.
abstract: OBJECTIVE
  The First Water Responder B package water treatment device was evaluated for its ability to reduce the levels of spiked indicators and pathogens (Escherichia coli, MS2 coliphage, murine adenovirus, and Cryptosporidium oocysts) in a surface water to partially evaluate its appropriateness to be used to provide safe drinking water to hospitals during emergency situations.
  
  
  METHODS
  Lake water was collected in 50-L carboys and spiked with selected indicators and pathogens (E coli, MS2 coliphage, murine adenovirus, and Cryptosporidium oocysts) at 2 different spike levels (low and high). This water was treated using the First Water Responder B, and the microorganisms were enumerated before and after treatment using US Environmental Protection Agency and Standard Methods. Microbial removal efficiencies were compared with Environmental Protection Agency guidelines.
  
  
  RESULTS
  E coli spikes ranged from 2.9 to 1059 colony-forming units (CFU)/100 mL with removals to below detection limits (1 CFU/100 mL) to 2.8 CFU/100 mL or 0.98 to 3.5 log(10) reductions. MS2 coliphage spikes ranged from 3 plaque-forming units (PFU) to 837 PFU/100 mL with removals to below detection limits (1 PFU/100 mL) to 11.7 PFU/100 mL or 0.65 to 1.9 log(10) reductions. Murine adenovirus spikes ranged from 203 to 8410 most probable number (MPN) of infectious units/100 mL with removals to below detection limits (23 MPN infectious units/100 mL) to 1370 MPN infectious units/100 mL or 0.79 to >1.2 log(10) reductions. Cryptosporidium parvum oocyst spikes ranged from 52 to 853 oocysts per liter with removals to below detection limits (<1 oocyst per liter) to 0.3 oocysts per liter or >2.2 to 3.4 log(10) reductions.
  
  
  CONCLUSIONS
  Although the First Water system could remove a significant portion of the spiked organisms, it is recommended that this point-of-use system be coupled with chemical disinfection in a multiple-barrier approach to provide water of the highest reasonably achievable quality for hospital use in emergency situations.
authors.affiliation: Wisconsin State Laboratory of Hygiene, 2601 Agriculture Dr, Madison, WI 53718, USA. longsc@slh.wisc.edu
authors.forename: Sharon C
authors.initials: SC
authors.lastname: Long
authors.forename: Jeremy
authors.initials: J
authors.lastname: Olstadt
mesh_terms: D000256:Adenoviridae; D003458:Cryptosporidium; D004327:Drinking Behavior; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D004926:Escherichia coli; D006801:Humans; D017909:Levivirus; D011787:Quality of Health Care; D012449:Safety; D014481:United States; D014871:Water Microbiology; D018508:Water Purification / Q000379:methods* / Q000592:standards