title: Microbial Contamination of Drinking Water and Human Health from Community Water Systems.
abstract: A relatively short list of reference viral, bacterial and protozoan pathogens appears adequate to assess microbial risks and inform a system-based management of drinking waters. Nonetheless, there are data gaps, e.g. human enteric viruses resulting in endemic infection levels if poorly performing disinfection and/or distribution systems are used, and the risks from fungi. Where disinfection is the only treatment and/or filtration is poor, cryptosporidiosis is the most likely enteric disease to be identified during waterborne outbreaks, but generally non-human-infectious genotypes are present in the absence of human or calf fecal contamination. Enteric bacteria may dominate risks during major fecal contamination events that are ineffectively managed. Reliance on culture-based methods exaggerates treatment efficacy and reduces our ability to identify pathogens/indicators; however, next-generation sequencing and polymerase chain reaction approaches are on the cusp of changing that. Overall, water-based Legionella and non-tuberculous mycobacteria probably dominate health burden at exposure points following the various societal uses of drinking water.
authors.affiliation: School of Public Health, University of Alberta, Edmonton, Room 3-57D, South Academic Building, Alberta, T6G 2G7 Canada.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Ashbolt
mesh_terms: D000818:Animals; D002417:Cattle; D003141:Communicable Diseases / Q000635:transmission / Q000662:veterinary; D004196:Disease Outbreaks / Q000517:prevention & control; D060766:Drinking Water / Q000382:microbiology*; D004781:Environmental Exposure; D006801:Humans; D011634:Public Health; D014871:Water Microbiology / Q000592:standards*; D018508:Water Purification / Q000379:methods; D014881:Water Supply / Q000592:standards*
chemical_list: D060766:Drinking Water
keywords: Antimicrobial resistance; Bacteria; Enteric pathogen; Fungi; HACCP; Indicator; Opportunistic pathogen; Parasitic protozoa; QMRA; Risk management; Surrogate; Viruses; Water safety plans; Water-based; Waterborne
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