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Profiling bathing waters supported by Quantitative Microbial Risk Assessment (QMRA) is key to the WHO's recommendations for the 2020/2021 revision of the European Bathing Water Directive. We developed an area-specific QMRA model on four pathogens, using fecal indicator concentrations (E. coli , enterococci) for calculating pathogen loads. The predominance of illness was found to be attributable to Human Adenovirus, followed by Salmonella , Vibrio , and Norovirus. Overall, the cumulative illness risk showed a median of around 1 case/10000 exposures. The risk estimates were strongly influenced by the indicators that were used, suggesting the need for a more detailed investigation of the different sources of fecal contamination. Area-specific threshold values for fecal indicators were estimated on a risk-basis by modelling the cumulative risk against E. coli and enterococci concentrations. To improve bathing waters assessment, we suggest considering source apportionment, locally estimating of pathogen/indicator ratios, and calculating site-specific indicators thresholds based on risk assessment. • Development of QMRA model to improve bathing water profiling • Use of fecal indicators monitoring data for pathogens load estimation • Calculation of fecal indicator threshold limits on a risk-basis [ABSTRACT FROM AUTHOR]

Abstract: Salmonella is one of the leading causes of intestinal illness all over the world as well as the etiological agent of more severe systemic diseases such as typhoid and paratyphoid fevers. While water is known to be a common vehicle for the transmission of typhoidal Salmonella serovars, non-typhoidal salmonellae are mainly known as foodborne pathogens. This paper provides a brief review of the last ten years of peer reviewed publications on the prevalence of Salmonella in natural freshwaters and drinking waters, and on the relevance of these sources for Salmonella dissemination. In industrialized countries, Salmonella was rarely reported in water-borne outbreaks despite it being frequently detected in surface waters including recreational waters and waters used for irrigation or as a drinking water source. Consistent contamination with irrigation waters has been shown to be a common route of crop contamination in produces related Salmonella outbreaks. Multiple drug resistant (MDR) Salmonella strains, that represent an increased hazard for human health and that may contribute to the dissemination of drug resistances were also detected in surface water in developed countries. Surface runoff was shown to play a main role as driver of Salmonella load in surface waters. Accordingly, analysis of serovars indicated a mixed human and animal origin of Salmonella contribution to surface waters, emphasizing the role of wild life animals in water contamination. Data relating to Salmonella prevalence in surface and drinking water in developing countries are quite rare. Nevertheless, data on water-borne outbreaks as well as case control studies investigating the risk factors for endemic typhoid fever confirmed the relevance of water as source for the transmission of this disease. In addition epidemiological studies and Salmonella surveys, consistently provided an undeniable evidence of the relevance of MDR Salmonella Typhi strains in water-borne typhoid fever in developing countries. [Copyright &y& Elsevier]