Quantitative Microbial Risk Assessment of Cryptosporidium and Giardia in Public Drinking Water in China

We aimed to assess the risks of Cryptosporidium and Giardia infections associated with drinking water for local residents, based on a quantitative microbial risk assessment, in three densely populated regions of China. In total, 45 source water samples and 45 treated water samples were collected from June to December 2014. Five Cryptosporidium-positive samples and 5 Giardia-positive samples were found. The annual probability of infection for individuals in Jintan (6.27 × 10 ^-4-2.05 × 10 ^-3 for Cryptosporidium and 7.18 × 10 ^-4-2.32 × 10 ^-3 for Giardia), Ezhou (6.27 × 10 ^-4-1.10 × 10 ^-2 for Cryptosporidium and 3.65 × 10 ^-4-1.20 × 10 ^-3 for Giardia), and Binyang (3.79 × 10 ^-4-1.25 × 10 ^-3 for Cryptosporidium) exceeded the tolerable risk of infection of 10 ^-4 set by the United States Environmental Protection Agency. Moreover, the corresponding disease burdens of cryptosporidiosis and giardiasis, due to direct drinking and residual water in these regions, exceeded the threshold of 10 ^-6 disability-adjusted life years per person per year set by the World Health Organization. These results provide insights into strategies to improve the safety of drinking water.