Exploring global Cryptosporidium emissions to surface water.

The protozoan parasite Cryptosporidium is a major cause of diarrhoea worldwide. This paper presents the first model-based inventory with 0.5 by 0.5 degree resolution of global Cryptosporidium emissions for the year 2000 from humans and animals to surface water. The model is based on nutrient distribution modelling, because the sources and transport of oocysts and nutrients to the surface water are comparable. Total emissions consist of point source emissions from wastewater and nonpoint source emissions by runoff of oocysts in manure from agricultural lands. Results indicate a global emission of 3 × 10(17) oocysts per year, with comparable contributions from point and nonpoint sources. Hot-spot areas for point sources are big cities in China, India and Latin America, while the area with the largest nonpoint source emissions is in China. Uncertainties in the model are large. Main areas for further study are (i) excretion rates of oocysts by humans and animals, (ii) emissions of humans not connected to sewage systems, and (iii) retention of oocysts to determine surface water pathogen concentrations rather than emissions. Our results are useful to health organisations to identify priority areas for further study and intervention.