Death on tap

Cryptosporidium kills AIDS victims in Dallas. Who will the pathogen claim next?

If Stewart's assertion is accurate, it is truly remarkable, since Dallas has exactly the kind of water-treatment system in which scientists say crypto has been found all over the country and world. His claim also flies in the face of a little-known Dallas water department policy:

According to a Dallas Water Utilities pamphlet published in 1995 called "Should I Be Concerned About Cryptosporidium?" and available on request at City Hall, the answer is definitely "yes."

In a very low-key description of a disease that is actually ferocious and horrific in its assault, the pamphlet says, "Symptoms include diarrhea, abdominal cramps, headaches, nausea, vomiting, low-grade fever. These symptoms may lead to weight loss and dehydration.

"For people in good health," the pamphlet warns, "the average recovery period is 10 to 14 days. For people with severely weakened immune systems, however, the disease can last for months and can be fatal.

"People with AIDS, people receiving treatment for certain cancers, organ transplant recipients, people suffering from certain illnesses, and malnourished children should take special precautions, such as boiling their drinking water."

That's Dallas drinking water.
John Thomas, former head of human resources at the Dallas Times Herald, a cofounder of the Dallas Gay and Lesbian Community Center, and a former executive director of the Dallas AIDS Resource Center, knew all of that. He told friends by e-mail in the last week of May that he had decided to refuse continued injections of saline and potassium needed to keep him alive because he had been informed crypto had invaded his body.

At the same time, three other crypto cases became known to the staff of AIDS Services of Dallas. ASD director Don Maison says two of the cases were people with HIV and one was a person who has tested negative for HIV.

"The only common factor in the cases was Dallas drinking water," Maison says.

Dr. Daniel J. Skiest, who treats HIV patients at Parkland's AIDSclinic, said that it is "fairly common" for people with advanced AIDS in Dallas to become infected by crypto and that it is "occasionally" the ultimate cause of death. At least one child has died of crypto at Bryan's House, a hospice for juvenile AIDS victims, according to director Cynthia Nunn.

But Stewart, the Dallas water boss, suggests cryptosporidium is only an issue because it is being stirred up by companies selling the new membrane-filter technology required to get crypto out of the water.

"The people selling these membranes want to sell them," Stewart says. "If they can unnerve the public and scare them into thinking that this is their only protection, then they can sell their product."

The cost of adding the necessary "membrane" filtration equipment to the treatment plants that supply Dallas with drinking water would be substantial. Russell Davis of California-based U.S. Filter, one of several companies that sell the new membrane technology to cities, says the one-time capital cost for installing the filters is about 50 cents per gallon of peak capacity, which would come to about $300 million in Dallas.

After it's built, Davis says, it may cost less to operate his company's system than the kind of system Dallas now uses, because the filters do not produce chemical sludge or the highly contaminated backwash effluent that comes out of the existing system and must be disposed of.

Of course, the prospect of spending $300 million for new treatment facilities and tacking the cost of the bonds onto the water rate is not at all attractive to officials in Dallas, where water-rate money is already spoken for. Most of the very expensive maintenance of the huge new levee system recently approved by voters for the Trinity River project, for example, will have to be borne by future water rates.

Stewart, head of Dallas Water Utilities, is emphatic that it would be a waste of the taxpayers' money to install the new generation of membrane filters here.

"We put out an excellent water," Stewart says. "I just got an award at the American Waterworks Association convention yesterday. Why would I want to put that on the backs of the citizens of Dallas?"

The AWWA Convention where Stewart was given his award was held in Dallas last week. His award, given for having completed a set of federal requirements on water testing, was largely ceremonial and typical of the sort of thing visiting firemen do for their local host.

Away from the hoopla on the main floor of the convention, however, in Spartan meeting rooms in the basement of the Dallas Convention Center, ranks of pocket-protector water-nerds from all over the nation and world sat on folding chairs and listened gravely while a number of experts made technical presentations arguing that crypto is a major issue and an issue everyone should be concerned about--definitely not just people with AIDS.

Jeffrey Griffiths, an assistant professor at Tufts University in Boston, told a roomful of water-types that crypto and other waterborne pathogens pose a serious, even mortal threat to many classes of people who suffer immune problems at various points in their lives.

Showing slide after slide of pregnant women, elderly people, infants, transplant recipients, cancer victims, and others whose immune systems may be permanently or temporarily impaired, Griffiths hammered home his point: Rather than being alone in their susceptibility to crypto, AIDS victims may actually be the coal-mine canaries whose demise is a warning of death for us all.

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