CASA Update: Ebola Dialogue Tool Developed in Collaboration with the CA Department of Public Health and Expert Microbiologists

Support for coverage of safety issues in provided by ehs

Greg Kester, CASA

Greg Kester, CASA

By Greg Kester
Director of Renewable Resource Programs

Following the Ebola epidemic in West Africa in 2014 and the subsequent presence of a few cases in the United States, the wastewater sector was concerned about the management of wastewater which would be generated by hospital patients infected with Ebola. There were conflicting messages from the Center for Disease Control, The World Health Organization, and others and questions surfaced over the science upon which those recommendations were based.

Immediately following the issuance of guidance from the Centers for Disease Control (CDC) in late 2014, the California Association of Sanitation Agencies (CASA) issued recommendations for dialogue between wastewater treatment agencies and local hospitals and public health officials regarding the management of wastewater produced by patients infected with the Ebola virus (released November 24, 2014 and last revised January 13, 2015). The recommendations are updated in the attached guidance dated June 2, 2016, and based upon new research as described below.

All versions of the guidance were developed in close coordination with several preeminent microbiologists, and are intended to offer an additional layer of protection for workers who may come into contact with wastewater prior to its treatment. Shortly after the release of the first dialogue tool in November 2014, I engaged with the California Department of Public Health, which was concerned that hospitals were receiving differing instructions on disposal of Ebola patient wastes which led to the January 2015 revision.

All participants agreed that there was a need for further Ebola research. CASA successfully raised funds to support an Ebola surrogate survivability study conducted by the Water and Environmental Technology Center at the University of Arizona. Based upon that research, we have revised the recommended means of disinfection of wastewater from hospital patients infected with Ebola.

It is recommended that 1 cup of 0.25% Peracetic Acid (PAA) be added to the toilet waste and held for 15 minutes prior to flushing.

A PAA product which has been approved by the Food and Drug Administration (FDA) for spores, viruses and M. tuberculosis, may be used. Alternatively, 1 cup of low alcohol quaternary ammonium disinfectant may be used as long as it has documented effectiveness against norovirus and enterovirus.

The guidance below is released with concurrence from expert microbiologists: Dr. Charles Gerba – University of Arizona; Dr. Mark Sobsey – University of North Carolina; Dr. Charles Haas – Drexel University; and Dr. Kyle Bibby – University of Pittsburgh and from the National Association of Clean Water Agencies, and in collaboration with the California Department of Public Health.

Action Items: Please contact me at, for more information about the guidance or research project.

On June 22 WEF will present a webinar on Antibiotic Resistance. The webinar is free for members. Details:

About the Author

Alec Mackie

Support great stories about water professionals & projects. Join CWEA

Leave a Reply

Your email address will not be published. Required fields are marked *