Estimation of norovirus infection risks to consumers of wastewater-irrigated food crops eaten raw

A quantitative microbial risk analysis—Monte Carlo method was used to estimate norovirus infection risks to consumers of wastewater-irrigated lettuce. Using the same assumptions as used in the 2006 WHO guidelines for the safe use of wastewater in agriculture, a norovirus reduction of 6 log units was required to achieve a norovirus infection risk of ,1023 per person per year (pppy), but for a lower consumption of lettuce (40–48 g per week vs. 350 g per week) the required reduction was 5 log units. If the tolerable additional disease burden is increased from a DALY (disability-adjusted life year) loss of 1026 pppy (the value used in the WHO guidelines) to 1025 pppy, the required pathogen reduction is one order of magnitude lower. Reductions of 4–6 log units can be achieved by very simple partial treatment (principally settling to achieve a 1-log unit reduction) supplemented by very reliable post-treatment health-protection control measures such as pathogen die-off (1 2 2 log units), produce washing in cold water (1 log unit) and produce disinfection (3 log units).