TO: Town Council FOR: Council Meeting, April 16th, 2018
SPEAKER: Sandra Finley, resident
SUBJECT: Cholera cases, originating French Creek and Qualicum Bay. And April 9th report of norovirus. Human sewage a plausible factor in both.
(I edited the text submitted in advance to Council. The following is the verbal presentation, shorter.)
Thank-you for the opportunity to share information in support of my request for the establishment of a local working group on the issue of cholera, norovirus and human sewage in our offshore water.
These are serious matters.
I will present critical pieces of information, and not the detail in my written submission to you.
- VIHA (the Vancouver Island Health Authority) and the First Nations Health Authorities jointly issued an update 10 days ago. On April 6th. (#1 appended)
the cholera bacteria was found
- in the water samples, and
- in the herring eggs
- Department of Fisheries and Oceans (DFO) online information related to the cholera cases (URL), tells that the herring eggs are
- not safe for eating (you and get cholera) if harvested from the environment at French Creek and Qualicum Bay.
- it IS safe to eat roe taken directly from the herring
In other words,
- the herring eggs picked up the cholera from the water or rocks or beach.
- From the DFO report, March 23, 2018, quote (#2 appended):
marine water sampling results from March 6, 2018 (show) elevated fecal coliform levels in this area.
- A week ago, Monday April 9th, we received news that two oyster farms have been closed after a norovirus outbreak associated with Deep Bay and Denman Island. From the CBC Report:
. . . human sewage in the marine environment is currently believed to be the most plausible cause of shellfish contamination, according to BCCDC epidemiologist Marsha Taylor.
(BCCDC is the BC Centre for Disease Control.)
- There is another factor, I suspect. I have not found it anywhere in the recent discussions; Cruise Ships are another source of human sewage in Georgia Strait. Quote (#6 appended)
. . . the ship’s owners admitted fouling Canadian waters three times. The infractions cost Celebrity Cruises $100,000 in fines in Washington. In Canada, it paid nothing.
That information is dated (2007).
I have not found information on-line, to know the current state-of-affairs re cruise ship dumping of sewage in Georgia Strait.
UPDATE: Following the meeting I was approached by a gentleman; I hope to receive links from him to on-line current info.
NOTE: There is of course, the question of how the many people who ply the waters dispose of their waste, the funding and strength of enforcement of regulations.
- My experience is consistent with what DFO and the BC Centre for Disease Control are saying:
A couple of years ago, swimming with a friend parallel to the QB shoreline, going in the direction of French Creek, we encountered serious sewage contamination. The vegetation growth and condition of the water indicated to both of us that we were in long term effects, not a one-time accidental release. We beat a hasty and frightened retreat to our respective homes, for a hot bath with disinfectant.
Those are the pieces of information that will be on concern to all of us.
8. UPDATE The morning after I made the presentation to Council, a news update: 126 cases of norovirus in 3 provinces (BC, Alberta, Ontario) linked to BC oysters – – see below, under NOROVIRUS.
Moving on: historical information on cholera in Canada, quote: (#5 appended)
The annual number of reported cases of cholera in Canada during 1995 to 2004 ranged from 1 to 8. Most cases in Canada result from international travel to an affected region.
Analysis of the outbreak of CHOLERA in Haiti after the hurricane in 2010 (#4 appended) is helpful for understanding the disease.
- It is thought that this was the first-ever cholera in Haiti.
- By 2018 it is pretty well accepted that the cholera was introduced by UN Peace-keeping Troops who went to help.
- As with many disease organisms, people can carry the bug and be unaware. They are “asymptomatic”. If their feces enters a water supply, or a food supply by way of the water, it can be equally devastating.
- Originally, the cholera was attributed to peacekeepers who had been in Nepal. But DNA analysis of the bacteria established that there were strains of cholera from other countries where cholera is also endemic, where UN workers had also been.
- The UN military base was on a tributary that fed into a main River. Proper sanitation was not practiced. Outhouses were placed close to the tributary. The sewage was not properly controlled.
- By 2017-18, ten thousand Haitians have died from the introduced cholera. That does not include the numbers of people who became very sick but survived. The cholera spread to the adjacent Dominican Republic. 20 Venezuelans who visited the Dominican Republic then carried the vibrio cholerae bacteria to Venezuela.
It will be interesting to know the DNA of the cholera from the water and herring eggs, French Creek and Qualicum Bay. From where did this local cholera originate?
In general, transmission of cholera is rarely from person-to-person. It is typically introduced from the feces of an infected person. AS mentioned, some people are host to the bacteria without knowing (asymptomatic) – – the bacteria can still spread from their feces, too, if it becomes water-borne.
NOROVIRUS Regarding the 40 cases of norovirus from contaminated oysters during the past month: the symptoms of cholera and of norovirus are very similar, diarrhea and vomiting, rapid dehydration.
As noted earlier, the BCCDC attributed human sewage as plausible cause of the recent norovirus outbreak. The CBC Report on the outbreak (URL),
In late 2016 and early 2017, more than 400 norovirus cases associated with raw or undercooked B.C. oysters led to the closure of 13 farms.
That outbreak was declared over in April 2017. Human sewage was also suspected as the cause.
“Is there a solution? Yes, we need to pay more attention to what we are putting into the ocean,” said Pocock.
– – – – – – – – – – – – – –
A local resident with 20 years of sailing in local coastal waters records her observations, including
No doubt the French Creek outflow has a lot to do with it but the government will blame private septic tanks. This is simply not true with few exceptions. There are sufficient regulations that government could use, if this was really the problem.
In September 2017 I sent a copy to Town Council, of the submission I made to Provincial Government officials re The proposed Bowser Sewage Treatment Plant, submission to the BC Government (2017-09-12).
I explained the steps in Sequencing Batch Reactor Sewage Treatment with UV radiation, tertiary filtering, and marine disposal of liquid effluent. And why none of the steps do, or can, remove many of the poisons that are in liquid effluent. Nor does the process remove plastic microfibers that enter our water sources from the millions of washing machines (laundered clothing) that discharge “waste water” into sewage lines.
INSERT: The presentation (April 16th) was time limited. I did not make the point, hoping that Staff, Mayor and Councillors would: building a sewage treatment plant at Bowser is not going to address all the various sources of human sewage going into the marine environment.
Continuing – – – the end of my presentation to Council . . .
The question I ask is: what strategy is most likely to open people’s minds, so that they can hear, contemplate, and do actual problem-solving? Denial, reassurances, don’t cut it. . . . I am sure that, citizens and officials alike, take the situation seriously. So then I think we must diverge on how to address the problem. I see “more of the same” as the reason that the hole we’re in, is so deep.
Thomas describes the current strategy as: Close the water and food source down, hope nobody else gets sick. I think most of us will agree that we are capable of better than that.
I am requesting that the Town establish a Working Group to bring our community together in creative problem-solving on the serious feedback, cholera and norovirus, both related to human sewage in the water; French Creek, Qualicum Bay, Deep Bay, Denman Island; repeated annual occurrences of the norovirus.
Thank-you for your consideration,
- April 6, 2018 Update from Health Authorities. (FNHA and VIHA)
The First Nations Health Authority and Island Health would like to confirm that Vibrio cholerae bacteria has been found in both herring eggs and water samples collected in the French Creek area and Qualicum Bay closure areas.
- Department of Fisheries and Oceans (DFO) report, March 23:
This closure is in effect based on advice received from Vancouver Island Health Authority regarding concern for human health with multiple reports of diarrheal illness associated with herring egg consumption from product harvested on substrate in this area.
There are three lab confirmed cases of diarrheal illness after herring egg consumption for Vibrio cholera, an unusual organism not normally found in water in this region or country.
There are a number of existing sanitary closures for shellfish harvest in these areas and
marine water sampling results from March 6, 2018 showing elevated fecal coliform levels in this area.
Primary harvest is First Nations Food, Social and Ceremonial harvest, however recreational harvest could occur as well.
. . . Illness may include mild to severe nausea, vomiting, and very severe watery diarrhea. Some people don’t become ill and don’t know they have been infected.
- Vibrio cholerae bacteria: symptoms, how acquired, how it spreads (Wikipedia, excerpts)
cholerae was first isolated as the cause of cholera in 1854.
During infection, V. cholerae secretes cholera toxin, a protein that causes profuse, watery diarrhea (known as “rice-water stool”). . . . V. cholerae can cause syndromes ranging from asymptomatic to cholera gravis. In endemic areas, 75% of cases are asymptomatic, 20% are mild to moderate, and 2-5% are severe forms such as cholera gravis. Symptoms include abrupt onset of watery diarrhea (a grey and cloudy liquid), occasional vomiting, and abdominal cramps. Dehydration ensues, with symptoms and signs such as thirst, dry mucous membranes, decreased skin turgor, sunken eyes, hypotension, weak or absent radial pulse, tachycardia, tachypnea, hoarse voice, oliguria, cramps, renal failure, seizures, somnolence, coma, and death. Death due to dehydration can occur in a few hours to days in untreated children. The disease is also particularly dangerous for pregnant women and their fetuses during late pregnancy, as it may cause premature labor and fetal death. In cases of cholera gravis involving severe dehydration, up to 60% of patients can die; however, less than 1% of cases treated with rehydration therapy are fatal. The disease typically lasts 4–6 days. Worldwide, diarrhoeal disease, caused by cholera and many other pathogens, is the second-leading cause of death for children under the age of 5 and at least 120,000 deaths are estimated to be caused by cholera each year. In 2002, the WHO deemed that the case fatality ratio for cholera was about 3.95%.
When visiting areas with epidemic cholera, the following precautions should be observed: drink and use bottled water; frequently wash hands with soap and safe water; use chemical toilets or bury feces if no restroom is available; do not defecate in any body of water and cook food thoroughly. . . .
The main reservoirs of V. cholerae are people and aquatic sources such as brackish water and estuaries, often in association with copepods or other zooplankton, shellfish, and aquatic plants.
Cholera infections are most commonly acquired from drinking water in which V. cholerae is found naturally or into which it has been introduced from the feces of an infected person. Other common vehicles include contaminated fish and shellfish, produce, or leftover cooked grains that have not been properly reheated. Transmission from person to person, even to health care workers during epidemics, is rarely documented. V. cholerae thrives in an aquatic environment, particularly in surface water. The primary connection between humans and pathogenic strains is through water, particularly in economically reduced areas that do not have good water purification systems.
- The 2010-2017 Haitian cholera outbreak. excerpts
(https://en.wikipedia.org/wiki/2010s_Haiti_cholera_outbreak) was the first modern large scale outbreak of cholera, once considered a beaten back disease with a preventative vaccine, yet now resurgent, having spread across Haiti from October 2010 to May 2017, waxing and waning with eradication effort and climate variability. The outbreak has connections to the political and sanitary conditions post-quake as well as UN peacekeeping. In terms of total infections, the outbreak since been surpassed by the war-fueled 2016–17 Yemen cholera outbreak, although the Haiti outbreak is still the most deadly modern outbreak.
By March 2017, it had killed 9,985 Haitians and others and sickened several hundred thousand persons while spreading to the neighboring countries of the Dominican Republic and Cuba.
. . . Before the outbreak, Haiti suffered from relatively poor public health and sanitation infrastructure. As of 2008, 37% of Haiti’s population lacked access to adequate drinking water, and 83% lacked improved sanitation facilities. This made Haiti particularly vulnerable to an outbreak of waterborne disease. In January, 2010, a massive earthquake hit Haiti, killing over 100,000 people and further disrupting healthcare and sanitation infrastructure in the country. In the aftermath of the earthquake, international workers from many countries arrived in Haiti to assist in the rebuilding effort, including a number of workers from countries where cholera was endemic. This presented an opportunity for cholera to spread to Haiti. Furthermore, Haiti had likely never suffered an outbreak of cholera previously; as such the population of Haiti had little to no immunity to cholera.
- The Canadian Encyclopedia offers a history of cholera in Canada. Excerpt (http://www.thecanadianencyclopedia.ca/en/article/cholera/ )
Cholera first reached Canada in 1832, brought by immigrants from Britain. . . . Cholera was fairly common around the world prior to the advent of modern sanitation methods developed in the 20th century. Familiarity with the disease reduced the fear in later epidemics and a better understanding of how it spreads has made more effective prevention possible.
In the modern world cholera becomes endemic due to a lack of infrastructure and weak health care systems that lower the effectiveness of sanitation and contribute to conditions that allow the bacteria to thrive. The disease is common in refugee camps because of crowded and unsanitary conditions. South America had outbreaks of cholera in the 1990s and outbreaks continue to occur sporadically in southern Africa. Cholera is endemic in Malawi, Zambia and Mozambique. In Zimbabwe, deteriorating political conditions have also affected the social system and cholera is becoming endemic even in the nation’s capital, Harare, where modern sanitation formerly helped prevent cholera. Medical professionals are attempting to improve public education about cholera prevention in regions prone to it, but without government investment in sanitation infrastructure, only limited success can be achieved.
The annual number of reported cases of cholera in Canada during 1995 to 2004 ranged from 1 to 8. Most cases in Canada result from international travel to an affected region. Cholera is considered a “reportable disease,” which means that local, national and international health authorities must be notified upon discovery. Reporting diseases is an important practice for epidemiology, which allows for disease monitoring and establishes patterns of occurrence around the globe.
- Sewage from Cruise Ships (and other marine craft)
RAW SEWAGE, WEST COAST WATERS (a couple of examples):
- Puget Sound would no longer be a toilet for vessels dumping raw or partially treated sewage overboard under a regulation proposed by the (Washington) state Department of Ecology. (http://www.seattletimes.com/seattle-news/environment/no-more-sewage-dumping-in-puget-sound-new-epa-rule-proposes/ (Nov 7 2016)
- CONCERNS: how little we know – –http://globalnews.ca/news/2898256/photos-massive-algae-bloom-causing-strait-of-georgia-waters-to-turn-bright-green/
- Cruise on down to our dumping ground (Be Aware of the date of this article: April 18, 2007, Straight)
. . . the ship’s owners admitted fouling Canadian waters three times. The infractions cost Celebrity Cruises $100,000 in fines in Washington. In Canada, it paid nothing.
“The excuse was, ‘We’ll pay the fine in Washington but we won’t pay the fine in Canada because Canada doesn’t care,’” said Ross Klein, a social-work professor at Memorial University in St. John’s, Newfoundland, and a leading critic of the cruise industry. “Even if you’re brain-dead, it’s obvious if you’ve got to follow regulations in California, Washington, and Alaska, and you don’t in Canada, what are you going to do in Canada? That in itself speaks volumes.”
The Mercury’s inconsistent treatment is indicative of how the cruise industry has evolved on the Pacific coast, with each jurisdiction applying its own standards to the ships. At one end of the run is Alaska, which, thanks to an August 2006 referendum, has by far the toughest laws. At the other end is Washington state, which has a memorandum of understanding with the industry that is at least strong enough to allow the state to fine ships like the Mercury when they dump in Washington waters.
In the middle is B.C., which depends on its federal government to protect the coast. Canada has never fined a cruise ship for a violation and is unlikely to do so under current guidelines. “It’s a green light to empty your holding tank between Washington state and Alaska,” Klein said. Canada’s weak guidelines and lack of enforcement send a clear message to cruise-ship owners about how they are to regard B.C., he said. “It means it’s the toilet bowl.”
THE MERCURY IS JUST one of 33 Vancouver-based cruise ships that will be churning through B.C. on the Alaska run this summer, which actually kicked off on April 8 with the arrival of the Zaandam. Altogether, they will make about 300 trips and carry an estimated 930,000 passengers, each paying an average of $1,500, up the coast and back. Many of the ships carry more than 2,000 people, making them the equivalent of floating cities, with all the consumer needs and wastes you would expect from a luxury resort of that size. (The next generation of ships, the first of which will be ready in 2009, will carry more than 8,000 passengers. Besides the liquid waste, each person on a cruise produces 3.5 kilograms of garbage per day, Klein said, much more than they would in their land-based lives.) Much of the ships’ time in the province will be in the confined waters of Hecate Strait, the Inside Passage, and between Vancouver Island and the mainland.
“There is a great concern that Canada could become a dumping ground,” said Fred Felleman, a Seattle-based researcher who consults on cruise-ship issues for the Bluewater Network, a national organization fighting marine pollution. With the relatively contained waters and vulnerable whale populations, he said, that’s a worry. “I don’t believe there’s any place we should be dumping sewage sludges, but if you have to dump sludges, you don’t want to do it in the Inside Passage.”
But the current rules are likely making it more and more attractive for the cruise companies to do just that. “It’s going to be Haro Strait, Georgia Strait, or Queen Charlotte Sound, would be my guess.”