title: Policy, practice and decision making for zoonotic disease management: water and Cryptosporidium.
abstract: Decision making for zoonotic disease management should be based on many forms of appropriate data and sources of evidence. However, the criteria and timing for policy response and the resulting management decisions are often altered when a disease outbreak occurs and captures full media attention. In the case of waterborne disease, such as the robust protozoa, Cryptosporidium spp, exposure can cause significant human health risks and preventing exposure by maintaining high standards of biological and chemical water quality remains a priority for water companies in the UK. Little has been documented on how knowledge and information is translated between the many stakeholders involved in the management of Cryptosporidium, which is surprising given the different drivers that have shaped management decisions. Such information, coupled with the uncertainties that surround these data is essential for improving future management strategies that minimise disease outbreaks. Here, we examine the interplay between scientific information, the media, and emergent government and company policies to examine these issues using qualitative and quantitative data relating to Cryptosporidium management decisions by a water company in the North West of England. Our results show that political and media influences are powerful drivers of management decisions if fuelled by high profile outbreaks. Furthermore, the strength of the scientific evidence is often constrained by uncertainties in the data, and in the way knowledge is translated between policy levels during established risk management procedures. In particular, under or over-estimating risk during risk assessment procedures together with uncertainty regarding risk factors within the wider environment, was found to restrict the knowledge-base for decision-making in Cryptosporidium management. Our findings highlight some key current and future challenges facing the management of such diseases that are widely applicable to other risk management situations.
authors.affiliation: Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ, UK. Electronic address: z.austin@lancaster.ac.uk.
authors.forename: Zoë
authors.initials: Z
authors.lastname: Austin
authors.affiliation: Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ, UK.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Alcock
authors.affiliation: National Centre for Zoonosis Research, University of Liverpool Veterinary School, Leahurst, Chester High Road, Neston, Wirral CH64 7TE, UK; Institute of Infection and Global Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7ZJ, UK.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Christley
authors.affiliation: Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ, UK.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Haygarth
authors.affiliation: Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ, UK. Electronic address: louise.heathwaite@lancs.ac.uk.
authors.forename: A Louise
authors.initials: AL
authors.lastname: Heathwaite
authors.affiliation: National Centre for Zoonosis Research, University of Liverpool Veterinary School, Leahurst, Chester High Road, Neston, Wirral CH64 7TE, UK; Institute of Infection and Global Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7ZJ, UK.
authors.forename: Sophia M
authors.initials: SM
authors.lastname: Latham
authors.affiliation: Department of Sociology and School of Medicine, Lancaster University, Lancaster, LA1 4YT, UK.
authors.forename: Maggie
authors.initials: M
authors.lastname: Mort
authors.affiliation: Biological & Environmental Sciences, School of Natural Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
authors.forename: David M
authors.initials: DM
authors.lastname: Oliver
authors.affiliation: Biomedical and Life Sciences Division, Faculty of Health and Medicine, Lancaster University, LA1 4YQ, UK.
authors.forename: Roger
authors.initials: R
authors.lastname: Pickup
authors.affiliation: Institute of Infection and Global Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7ZJ, UK.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Wastling
authors.affiliation: ESRC Centre for Economic and Social Aspects of Genomics, Cesagen, Lancaster University, LA1 4YD, UK.
authors.forename: Brian
authors.initials: B
authors.lastname: Wynne
mesh_terms: D003457:Cryptosporidiosis / Q000517:prevention & control*; D003458:Cryptosporidium / Q000254:growth & development*; D003657:Decision Making; D004196:Disease Outbreaks / Q000517:prevention & control*; D060766:Drinking Water / Q000469:parasitology*; D004739:England; D004777:Environment; D058735:Environmental Policy; D006801:Humans; D057766:Policy; D011057:Politics; D018570:Risk Assessment; D012308:Risk Management; D014876:Water Pollution / Q000517:prevention & control*; D060753:Water Quality / Q000592:standards*; D014881:Water Supply
chemical_list: D060766:Drinking Water