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in the spring of
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1993 an unexplained illness struck the
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residents of Milwaukee Wisconsin 400,000
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people developed serious
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gastrointestinal illness 4,000 were
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hospitalized and by the time it was
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under control more than a 100 people
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died Health officials suspected it was
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influenza
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but it was something more serious and
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much more difficult for Medical
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detectives to uncover
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[Music]
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[Music]
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[Music]
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Milwaukee Wisconsin the 17th largest
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city in the United States with a
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population of almost 1 million
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people it's a city known for its German
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culture summer
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festivals and Long Cold Winters with
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plenty of
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snow Milwaukee is the home of several
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large breweries producing 11 million
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barrels of beer annually but in the
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spring of
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1993 Milwaukee became famous for
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something
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else an unexplained outbreak of
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gastrointestinal illness which spread
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rapidly throughout the community 4,000
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people rushed to area hospitals all with
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the same symptoms severe cramps diarrhea
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nausea and fever I had the diarrhea off
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and on all week I missed two days of
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work and I thought it was and it came
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back again hardest hit were individuals
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with weakened immune systems infants the
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elderly cancer and AIDS patients and
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those who had organ or bone marrow
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transplants four-year-old Becky Ferman
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suffered from a particularly bad case
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she was just a vibrant child she was
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highly intelligent very vivacious very
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talkative very friendly um just a normal
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kid Becky Ferman was born HIV positive
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which made her particularly susceptible
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to the mysterious outbreak this got to
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be absolute water turning from brown to
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Yellow to
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Green terrible odor and she would
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have 8 n 10 11 12 B movements a day
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40-year-old Antonio claudo was also
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affected like Becky he too is HIV
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positive but the severity of the cramps
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and diarrhea he developed during the out
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break was alarming yeah I freaked
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out I was like
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is is
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this this what's happening to me a
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nature course of the virus itself of the
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HIV AIDS or is this something else the
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primary suspects were shagel Giardia
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campor or
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salmonella but stool samples from the
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infected individuals were all negative
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we knew this was big I mean we knew a
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lot of people were sick we knew a lot of
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kids were sick we were beginning to get
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reports from hospitals that patients
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particularly with immune compromising
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conditions particularly HIV AIDS were
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having very difficult times shaking
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loose of this outbreak and so we were uh
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beginning to understand that this was in
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fact an
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epidemic and health officials had no
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idea what was causing it
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[Music]
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within 24 hours of the outbreak the
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mayor of Milwaukee knew he faced a
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serious dilemma no American city had
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ever faced this type of Crisis before
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the concern in the health department was
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the beginning of you know a real concern
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what is this you know how can so many
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people get sick all at one time if the
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outbreak was caused by a contaminated
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food source stool samples would contain
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the bacteria which caused it and health
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officials could find no common food
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source that all of the sick individuals
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use food illnesses usually center around
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a common food distribution center
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processing plant
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restaurant or grocery store but one
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common element among all of the infected
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individuals was
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water officials analyzed the water
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quality records at the city's Municipal
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Water Supply but all of the water
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quality levels were within guidelines
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established by the Environmental
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Protection Agency for Safe Drinking
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Water we went back and indicated that to
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the health department and they continued
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on with their investigation into other
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areas but when scientists looked at the
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distribution pattern of the outbreak
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they noticed that most of the cases were
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clustered in the south side of the city
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we believed we would have witnessed a
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more normal uniform distribution of
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illness had it been an Airborne virus
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because it would have started at a point
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and moved outward since the outbreak
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seemed to be centered in Milwaukee South
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Side this narrowed the focus of the
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investigation Becky Ferman lived on
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Milwaukee's South Side her doctor had no
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idea what caused her illness and soon
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discovered they couldn't cure it in
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individuals like Becky who had
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HIV one of the things was that she was
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limited in what she could do as far as
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where we could go and what we could do
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with her as far as playing because she
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would have these accidents another thing
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was the General
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weakness uh because of the constant
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diarrhea gastrointestinal illness is
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usually caused by something that is
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ingested once again pointing to food or
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water the water plant which supplied
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Milwaukee's South Side reported that the
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only unusual readout was a peak in
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turbidity one week before the outbreak
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turbidity measures the amount of foreign
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particles in the
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water after a rainstorm or when snow
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melts turbidity levels will temporarily
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rise storms churn River and Creek
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bottoms and melting snow will often
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gather particles as it runs into streams
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Health officials wondered if the
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increase in turbidity levels was caused
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for concern the Municipal Water Supply
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was disinfected with chlorine was it
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possible that the city's water supply
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was contaminated with something that
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didn't show up in water tests and that
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chlorine would not kill if so the entire
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city would be at risk and one of the
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city's largest Industries could also be
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affected the Brewing
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industry the breweries were among the
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largest users of Municipal Water if
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there was an unknown organism in the
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water was it being shipped all across
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the country by the tens of thousands of
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gallons a day
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[Music]
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Health officials suspected that
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something in Milwaukee's water supply
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was causing the outbreak of thousands of
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cases of gastrointestinal illness the
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water department insisted that the water
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quality levels were all within standards
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set by the Environmental Protection
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Agency and that the water was safe to
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drink hospitals and Laboratories
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throughout Milwaukee continued to
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analyze to samples from the thousands of
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individuals affected everything pretty
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much was a dead end everywhere we looked
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was everything was negative Sandy sheris
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was doing some of those tests at a local
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hospital as a microbiologist she was
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performing the routine tests on patients
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hospitalized with the mysterious illness
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the standard test was an iodine stain
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when added to the stool samples the
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iodine would show if if parasites were
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present but all of the iodine tests were
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negative on her own Sandy shrus decided
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to go one step further she remembered
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something she learned earlier in her
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training that microbiology should be on
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the lookout for parasites which do not
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show up on standard tests with that in
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mind she noticed a number of unusual
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structures in the samples structures
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which didn't react with the iodine stain
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at that point I don't know exactly what
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it is yet but it means something that's
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your first clue so she performed an acid
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fast stain she flooded the stool sample
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with a red
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stain then washed the sample with
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alcohol and sulfuric acid during the
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final step and additional green stain is
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added under the
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microscope she thought what she saw a
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highly infectious potentially deadly
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parasite first acid Fain wasn't real
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definitive this is probably our first
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line it's easiest it's quickest it's
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done in about 10 minutes and I didn't
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feel comfortable calling it on that so
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we went on and did a fluorescent stain
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the fluorescent stain introduces the
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parasites antibod to the sample along
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with the fluorescent agent under the
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microscope Sandy sheris noticed a bright
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green glow if it was the fluorescent
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agent attached to the antibody proof
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that a parasite was present it was
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cryptos peridium little is known about
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cryptos peridium since it first infected
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humans just over 20 years ago it's a
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one- celled organism a protozoan
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parasite which is found in feces from
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Young farm animals particularly Cales
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kryptos peridium is an 80% cent of
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surface water largely due to animal
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feces washed from farms into nearby
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streams by heavy rains and melting
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snow here you can see the tiny
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cryptosporidia escaping from their
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shells once they do they multiply by the
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millions when they spread throughout the
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gastrointestinal system they absorb
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nourishment preventing the body from
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retaining fluids and causing severe
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cramps explosive diarrhea and other flu
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like symptoms a healthy individual with
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a healthy immune system can usually get
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rid of the parasite within a week with
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no lasting effects but it can be deadly
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for those with weakened immune systems
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like the elderly AIDS and cancer
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patients and individuals with organ and
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bone marrow transplants when lab
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technicians retested other stool samples
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they could confirmed what Sandy sheris
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first discovered cryptosporidium was
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found in seven more stool samples once
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you knew what you're looking for it was
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everywhere I mean we knew then now we
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had the agent now where was it coming
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from that was the next step since
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cryptos peridium is a waterborne
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parasite it renewed fears that the
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city's water supply was
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contaminated the mayor called an
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emergency meeting of both city and state
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health officials during that meeting the
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mayor noticed one of the participants Dr
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Jeffrey Davis the state's epidemiologist
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was drinking diet soda and not water
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when the mayor turned to Dr Davis and
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asked if he would drink the city's water
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Dr Davis said no it wasn't difficult
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once I asked Dr Davis if he drank the
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water I mean if he suspect he's a
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scientist he's an expert and and a very
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honest person uh
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you know if he suspected that there
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could be problems with the water that's
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pretty good test right there since
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boiling was the only way to get rid of
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crypt peridium the mayor immediately
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issued a boil water advisory
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recommending that all water be boiled
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for at least 5 minutes before use it was
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a bold recommendation with wide ranging
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implications since tests for cryptos
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peridium in the city's water supply had
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not yet been completed
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dental offices were closed since their
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drills were water cooled restaurants
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were also affected since they use water
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for ice and washing dishes 3 Days Later
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tests on Milwaukee's water done by an
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independent laboratory confirmed that
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krypto's peridium was present in the
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purified water from the Howard Avenue
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Water Plant the news of kryptos peridium
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contamination was especially terrifying
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Ling to one segment of the population
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people with HIV infections or aids for
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these patients it was life-threatening
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immediately they knew what crypto was
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this was not a new illness to them
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cryptosis for someone with a severely
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compromised immune system is a death
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sentence Doug Nelson and the
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organization he directs the AIDS
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Resource Center of Wisconsin went into
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crisis mode he knew that individuals
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with HIV aids would never get rid of the
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parasite but his goal was to make sure
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no one else became infected the Howard
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Avenue Water Plant was immediately
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closed the water flushed out and the
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entire plant disinfected from top to
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bottom to remove any traces of kryptos
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peridian a few days after the boil water
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advisory the number of cryptosporidiosis
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cases dropped significantly but the
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levels discovered in Milwaukee's water
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supply had been potent
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one businessman traveling through
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Milwaukee's airport reported getting
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sick after drinking just enough water to
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swallow a few
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aspirin Antonio claudo was living in
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Houston when he tested positive for
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cryptosporidiosis he believes he was
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infected while visiting his mother who
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lived on the south side of Milwaukee
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since there is no cure for
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cryptosporidiosis besides a healthy
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immune system and Antonio lives each day
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with constant chronic diarrhea once you
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discover you have this dis disease your
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life changes and there's just no way to
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get around it prayer helps a
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lot but
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um you just can't erase it it's
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reality no matter what portion of
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it and you're just waiting to
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die little Becky Ferman lost her fight
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with
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cryptosporidiosis she died after
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battling its effects for many months
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Becky was in a coma eyes closed but she
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raised her hands to us and grabbed h of
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our hands took three
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breaths and a spirit and energy
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left ripped the
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heart
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um but a gratefulness because she wasn't
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in pain
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anymore she looked peaceful for for the
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first
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time investigators soon had a theory for
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how crypto peridium contaminated
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Milwaukee's water
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[Music]
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supply after an intensive investigation
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Health officials developed a theory as
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to how cryptos peridium contaminated
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Milwaukee's water supply in ear early
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April of
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1993 heavy rains and the spring snow
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melt caused water runoff the ground was
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still frozen and unable to absorb the
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water manure from the farms and Fields
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might have washed into nearby streams
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manure which contained cryptos peridium
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the cryptos peridia then made their way
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from the streams into Lake Michigan the
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source of Milwaukee's drinking water in
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199 3 there were no filters or mass
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disinfectants used anywhere in the
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United States which could eliminate the
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cryptos peridium and water plants
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chlorine was ineffective against it over
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400,000 people who ingested water from
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the Howard Avenue plant became ill 4,000
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were hospitalized
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104 died that theory held for 4 years
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during that time the the Centers for
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Disease Control in Atlanta Georgia
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continued to investigate Milwaukee's
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cryptos peridium outbreak since it was
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the largest waterborne outbreak in
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United States history in 1997 scientists
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retested four stool samples from
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individuals infected during that
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outrate they conducted DNA testing on
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the cryptos peridium and when they did
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there was a shocking Discovery the type
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of crypto peridium found in the four
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stool samples from the Milwaukee
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outbreak did not come from farm animals
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it was a new strain one which came from
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human waste our results suggest on the
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basis of The Limited number of samples
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that we looked at that the uh Milwaukee
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outbreak um was was not from pasture
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runoff but was from uh sewage
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contamination when investigators looked
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more closely at Milwaukee's water supply
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they found that the Howard Avenue new
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Water Plant's intake was less than 2 mi
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down current from a sewage treatment
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plant overflow valve in Lake Michigan
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the cdc's discovery suggested that human
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waste containing cryptos peridium was
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released from the sewage treatment plant
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traveled the 2 miles Downstream where it
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entered the water intake of the Howard
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Avenue Water Plant today sewage from
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that plant is no longer released into
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Lake m Michigan and the Howard Avenue
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Water Plant moved their intake further
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out into the lake away from possible
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pollutant and Milwaukee is building an
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ozonization facility ozone is a form of
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oxygen which kills more microorganisms
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than chlorine it's the only Mass
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disinfectant process known to kill
00:19:52
cryptos peridium in water when the
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facility is completed Milwaukee will be
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the only major city in the United States
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to ozonate its water every city around
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the country that relies on surface water
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for its drinking water must study the
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Milwaukee example and must follow our
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lead in making those extraordinary
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commitments to assure to their public
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that in fact the water that they consume
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is safe and that they will not get ill
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from it and and that they will not die
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from it I mean I I felt terrible about
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that I'm not an expert on water but I'm
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the mayor and uh you know you kind of
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rely on your City to provide you with
00:20:34
water it turns out that cryptos peridium
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has gotten in water supplies in other
00:20:39
parts of the country it's not that
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[Music]
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uncommon we went through a lot a lot of
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anger not only anger at the loss of our
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daughter but the anger loss of so many
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[Music]
00:21:00
friends as time passed we came to
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realize
00:21:05
that yes I we believe that public
00:21:08
officials were at fault for not knowing
00:21:10
more about it for not teaching us but
00:21:12
ultimately we all are corporately
00:21:14
responsible you and I and and the world
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for not caring about water until someone
00:21:20
dies
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[Music]
00:21:31
morning
00:21:33
[Music]
00:21:44
[Applause]
00:21:48
[Music]
