Integrating quantitative PCR and Bayesian statistics in quantifying human adenoviruses in small volumes of source water

Rapid quantification of viral pathogens in drinking and recreational water can help reduce waterborne disease risks. For this purpose, samples in small volume (e.g. 1L) are favored because of the convenience of collection, transportation and processing. However, the results of viral analysis are often subject to uncertainty. To overcome this limitation, we propose an approach that integrates Bayesian statistics, efficient concentration methods, and quantitative PCR (qPCR) to quantify viral pathogens in water. Using this approach, we quantified human adenoviruses (HAdVs) in eighteen samples of source water collected from six drinking water treatment plants. HAdVs were found in seven samples. In the other eleven samples, HAdVs were not detected by qPCR, but might have existed based on Bayesian inference. Our integrated approach that quantifies uncertainty provides a better understanding than conventional assessments of potential risks to public health, particularly in cases when pathogens may present a threat but cannot be detected by traditional methods.

Performance of viruses and bacteriophages for fecal source determination in a multi-laboratory, comparative study

An inter-laboratory study of the accuracy of microbial source tracking (MST) methods was conducted using challenge fecal and sewage samples that were spiked into artificial freshwater and provided as unknowns (blind test samples) to the laboratories. The results of the Source Identification Protocol Project (SIPP) are presented in a series of papers that cover 41 MST methods. This contribution details the results of the virus and bacteriophage methods targeting human fecal or sewage contamination. Human viruses used as source identifiers included adenoviruses (HAdV), enteroviruses (EV), norovirus Groups I and II (NoVI and NoVII), and polyomaviruses (HPyVs). Bacteriophages were also employed, including somatic coliphages and F-specific RNA bacteriophages (FRNAPH) as general indicators of fecal contamination. Bacteriophage methods targeting human fecal sources included genotyping of FRNAPH isolates and plaque formation on bacterial hosts Enterococcus faecium MB-55, Bacteroides HB-73 and Bacteroides GB-124. The use of small sample volumes (≤50 ml) resulted in relatively insensitive theoretical limits of detection (10-50 gene copies or plaques × 50 ml(-1)) which, coupled with low virus concentrations in samples, resulted in high false-negative rates, low sensitivity, and low negative predictive values. On the other hand, the specificity of the human virus methods was generally close to 100% and positive predictive values were ∼40-70% with the exception of NoVs, which were not detected. The bacteriophage methods were generally much less specific toward human sewage than virus methods, although FRNAPH II genotyping was relatively successful, with 18% sensitivity and 85% specificity. While the specificity of the human virus methods engenders great confidence in a positive result, better concentration methods and larger sample volumes must be utilized for greater accuracy of negative results, i.e. the prediction that a human contamination source is absent.

Recommendations following a multi-laboratory comparison of microbial source tracking methods

Microbial source tracking (MST) methods were evaluated in the Source Identification Protocol Project (SIPP), in which 27 laboratories compared methods to identify host sources of fecal pollution from blinded water samples containing either one or two different fecal types collected from California. This paper details lessons learned from the SIPP study and makes recommendations to further advance the field of MST. Overall, results from the SIPP study demonstrated that methods are available that can correctly identify whether particular host sources including humans, cows and birds have contributed to contamination in a body of water. However, differences between laboratory protocols and data processing affected results and complicated interpretation of MST method performance in some cases. This was an issue particularly for samples that tested positive (non-zero Ct values) but below the limits of quantification or detection of a PCR assay. Although false positives were observed, such samples in the SIPP study often contained the fecal pollution source that was being targeted, i.e., the samples were true positives. Given these results, and the fact that MST often requires detection of targets present in low concentrations, we propose that such samples be reported and identified in a unique category to facilitate data analysis and method comparisons. Important data can be lost when such samples are simply reported as positive or negative. Actionable thresholds were not derived in the SIPP study due to limitations that included geographic scope, age of samples, and difficulties interpreting low concentrations of target in environmental samples. Nevertheless, the results of the study support the use of MST for water management, especially to prioritize impaired waters in need of remediation. Future integration of MST data into quantitative microbial risk assessments and other models could allow managers to more efficiently protect public health based on site conditions.

Neutron scattering and μSR investigations of the low temperature state of LuCuGaO₄

LuCuGaO₄ has magnetic Cu(2+) and diamagnetic Ga(3+) ions distributed on a triangular bilayer and is suggested to undergo a spin glass transition at Tg ∼ 0.4 K. Using μSR (muon spin rotation) and neutron scattering measurements, we show that at low temperature the spins form a short range correlated state with spin fluctuations detectable over a wide range of timescales: at 0.05 K magnetic fluctuations can be detected in both the μSR time window and also extending beyond 7 meV in the inelastic neutron scattering response, indicating magnetic fluctuations spanning timescales between ∼10(-5) and ∼10(-10) s. The dynamical susceptibility scales according to the form χ″(ω)T(α), with α = 1, throughout the measured temperature range (0.05-50 K). These effects are associated with quantum fluctuations and some degree of structural disorder in ostensibly quite different materials, including certain heavy fermion alloys, kagome spin liquids, quantum spin glasses, and valence bond glasses. We therefore suggest that LuCuGaO₄ is an interesting model compound for the further examination of disorder and quantum magnetism.

Generalization of the classical xyz-polarization analysis technique to out-of-plane and inelastic scattering

The technique of longitudinal ("xyz") polarization analysis has been used successfully for many years to study disordered magnetic materials in thermal and cold neutron diffraction experiments. The technique allows the simultaneous and unambiguous separation of the nuclear, magnetic, and nuclear spin-incoherent contributions to the scattering. The technical advances seen in recent years, such as the availability of polarized (3)He analyzer cells to cover a large detector solid angle, the ability to detect out-of-plane scattering in a multi-detector, and a significant increase of the usable beam divergence, call for a generalization of the method. A general treatment of the formalism for carrying out neutron polarization analysis will be given in this paper, which describes a possible method of usage at a future, modern diffractometer or inelastic spectrometer with large area multi-detector coverage.

Medical and household characteristics associated with methicillin resistant Staphylococcus aureus nasal carriage among patients admitted to a rural tertiary care hospital

BACKGROUND

Methicillin resistant Staphylococcus aureus (MRSA) poses a threat to patient safety and public health. Understanding how MRSA is acquired is important for prevention efforts. This study investigates risk factors for MRSA nasal carriage among patients at an eastern North Carolina hospital in 2011.

METHODS

Using a case-control design, hospitalized patients ages 18 - 65 years were enrolled between July 25, 2011 and December 15, 2011 at Vidant Medical Center, a tertiary care hospital that screens all admitted patients for nasal MRSA carriage. Cases, defined as MRSA nasal carriers, were age and gender matched to controls, non-MRSA carriers. In-hospital interviews were conducted, and medical records were reviewed to obtain information on medical and household exposures. Multivariable conditional logistic regression was used to derive odds ratio (OR) estimates of association between MRSA carriage and medical and household exposures.

RESULTS

In total, 117 cases and 119 controls were recruited to participate. Risk factors for MRSA carriage included having household members who took antibiotics or were hospitalized (OR: 3.27; 95% Confidence Interval (CI): 1.24-8.57) and prior hospitalization with a positive MRSA screen (OR: 3.21; 95% CI: 1.12-9.23). A lower proportion of cases than controls were previously hospitalized without a past positive MRSA screen (OR: 0.40; 95% CI: 0.19-0.87).

CONCLUSION

These findings suggest that household exposures are important determinants of MRSA nasal carriage in hospitalized patients screened at admission.

Determination of specific types and relative levels of QPCR inhibitors in environmental water samples using excitation-emission matrix spectroscopy and PARAFAC

Assays that utilize PCR offer powerful tools to detect pathogens and other microorganisms in environmental samples. However, PCR inhibitors present in nucleic acid extractions can increase a sample's limit of detection, skew calculated marker concentrations, or cause false-negative results. It would be advantageous to predict which samples contain various types and levels of PCR inhibitors, especially the humic and fulvic acids that are frequently cited as PCR inhibitors in natural water samples. This study investigated the relationships between quantitative PCR (qPCR) inhibition and the humic and fulvic content of dissolved organic matter (DOM), as well as several other measures of DOM quantity and quality, in water samples. QPCR inhibition was also compared to water quality parameters, precipitation levels, and land use adjacent to the sampling location. Results indicate that qPCR inhibition in the tested water samples was correlated to several humic substance-like, DOM components, most notably terrestrially-derived, humic-like DOM and microbially-derived, fulvic-like DOM. No correlation was found between qPCR inhibition and water quality parameters or land use, but a relationship was noted between inhibition and antecedent rainfall. This study suggests that certain fractions of humic substances are responsible for PCR inhibition from temperate, freshwater systems. PARAFAC modeling of excitation-emission matrix spectroscopy provides insight on the components of the DOM pool that impact qPCR success and may be useful in evaluating methods to remove PCR inhibitors present in samples.

Identification of Staphylococcus aureus from enriched nasal swabs within 24 h is improved with use of multiple culture media

Nasal carriage of Staphylococcus aureus is commonly evaluated via culture-based methods. We found that parallel use of two media, Baird-Parker and CHROMagar™ Staph aureus, increased detection of S. aureus from a healthy population by 29 %. We suggest use of both media for optimal identification of S. aureus from healthy cohorts.

Low-energy spin dynamics of the s = 1/2 kagome system herbertsmithite

The low-energy (ε = ħω < 1 meV), low-temperature (T = 0.05 K) spin dynamics of the s = 1/2 kagome candidate herbertsmithite are probed in the presence of magnetic fields up to 2.5 T. The zero-field spectra reveal a very weak continuum of scattering at T = 10 K and a broad inelastic peak centred at ε(max) = 0.2 meV at lower temperatures, T < 1 K. The broad peak is found to be strongly damped, with a liquid-like structure factor implying correlations at length scales up to r = 6 Å. The field dependence of the peak appears to follow the Zeeman splitting of s = 1/2 excitations, consistent with the weakly split 'doublets' observed in low-temperature specific heat. A possible explanation of these observations is a short-range correlated state involving defect spins between the kagome planes and moments in the kagome layers.

Similar concentration and extraction recoveries allow for use of turnip crinkle virus as a process control for enteroviruses in water

Enteric viruses are etiological agents of waterborne disease that may be detected using molecular techniques such as PCR. However, processing water samples in preparation for PCR typically involves concentration of samples and extraction of nucleic acids, steps that have low and variable recovery efficiencies. This study evaluated a plant virus, turnip crinkle virus (TCV), for its ability to serve as a process control for human enteroviruses during concentration and extraction procedures. Enteroviruses and TCV have similar sizes and morphologies, and both contain single stranded, positive-sense RNA genomes. Results from the study demonstrate that the tested viruses experience similar losses during sample processing. Virus recoveries averaged 0.03% for EV and 0.02% for TCV from DI water, and 0.004% for EV and 0.009% for TCV from a creek sample. Surface water and wastewater samples from around the U.S. were evaluated for the presence of TCV to ensure the virus is not present in environmental samples. All were negative. With similar recovery efficiencies to EV, TCV may be a suitable process control for enteroviruses in environmental water samples in the U.S. Use of process controls as proposed in this study would allow better detection and quantitation methods to be employed in water quality monitoring.

Probabilistic analysis showing that a combination of Bacteroides and Methanobrevibacter source tracking markers is effective for identifying waters contaminated by human fecal pollution

Microbial source tracking assays to identify sources of waterborne contamination typically target genetic markers of host-specific microorganisms. However, no bacterial marker has been shown to be 100% host-specific, and cross-reactivity has been noted in studies evaluating known source samples. Using 485 challenge samples from 20 different human and animal fecal sources, this study evaluated microbial source tracking markers including the Bacteroides HF183 16S rRNA, M. smithii nifH, and Enterococcus esp gene targets that have been proposed as potential indicators of human fecal contamination. Bayes' Theorem was used to calculate the conditional probability that these markers or a combination of markers can correctly identify human sources of fecal pollution. All three human-associated markers were detected in 100% of the sewage samples analyzed. Bacteroides HF183 was the most effective marker for determining whether contamination was specifically from a human source, and greater than 98% certainty that contamination was from a human source was shown when both Bacteroides HF183 and M. smithii nifH markers were present. A high degree of certainty was attained even in cases where the prior probability of human fecal contamination was as low as 8.5%. The combination of Bacteroides HF183 and M. smithii nifH source tracking markers can help identify surface waters impacted by human fecal contamination, information useful for prioritizing restoration activities or assessing health risks from exposure to contaminated waters.

Characterization of nonpoint source microbial contamination in an urbanizing watershed serving as a municipal water supply

Inland watersheds in the southeastern United States are transitioning from agricultural and forested land uses to urban and exurban uses at a rate greater than the national average. This study sampled creeks representing a variety of land use factors in a rapidly urbanizing watershed that also serves as a drinking water supply. Samples were collected bimonthly under dry-weather conditions and four times during each of three storm events and assessed for microbial indicators of water quality. Concentrations of fecal indicator bacteria (FIB) including fecal coliforms and Escherichia coli were measured using standard membrane filtration techniques. Results showed that FIB concentrations varied between 10(0) and 10(4) colony forming units (CFU) per 100 mL. An analysis of variance (ANOVA) showed that FIB were generally higher in more developed watersheds (p < 0.01). Concentrations were also significantly greater during storm events than during dry-weather conditions (p < 0.02), although concentrations demonstrated both intra and inter-storm variability. These results indicate that the magnitude of microbial contamination is influenced by intensity of watershed development, streamflow and antecedent precipitation. Dry-weather FIB loads showed considerable seasonal variation, but the average storm event delivered contaminant loads equivalent to months of dry-weather loading. Analysis of intra-storm loading patterns provided little evidence to support "first-flush" loading of either FIB, results that are consistent with environmental reservoirs of FIB. These findings demonstrate that single sampling monitoring efforts are inadequate to capture the variability of microbial contaminants in a watershed, particularly if sampling is conducted during dry weather. This study also helps to identify timing and conditions for public health vulnerabilities, and for effective management interventions.

HuBac and nifH source tracking markers display a relationship to land use but not rainfall

Identification of the source of fecal pollution is becoming a priority for states and territories in the U.S. in order to meet water quality standards and to develop and implement total maximum daily loads. The goal of this research was to relate microbial source tracking (MST) assay concentrations to land use and levels of impervious surfaces in order to gauge how increasing development is associated with human fecal contamination in inland watersheds. The concentrations of two proposed MST markers, targeting nifH of Methanobrevibacter smithii and HuBac of Bacteroides sp., were positively correlated with increasing anthropogenic development and impervious surfaces. Higher concentrations of these MST markers in more urbanized watersheds suggest that increasing development negatively affects water quality. Neither MST marker concentration was correlated with antecedent rainfall levels, and detection of markers did not differ between dry weather and rain events. Water samples were also analyzed for norovirus and enterovirus, but these enteric viruses were rarely detected. These MST results differ from previous studies that have found correlations between traditional fecal indicator bacteria (FIB) and antecedent rainfall. This difference suggests that the MST markers used in this study may be more specific for recent, land-based contamination events as opposed to resuspension of particle-associated organisms in waterways. HuBac was detected in 98% of samples, correlating with fecal coliform and Escherichia coli concentrations. The ubiquity of the HuBac marker in our samples suggests that this marker does not provide sufficiently different or additional information than FIB, and it is likely this marker was amplifying non-human targets. The nifH marker was detected in 30% of samples. Less than half of the nifH-positive samples contained levels of fecal coliforms or E. coli above regulatory thresholds, suggesting that nifH would be more useful when utilized simultaneously with FIB than in a tiered monitoring strategy. The results of this research suggests that land use factors play an important role in characterizing and mitigating fecal contamination in watersheds.

Magnetic excitations in EuCu2(Si(x)Ge(1-x))2: from mixed valence towards magnetism

We report the inelastic neutron scattering study of spin dynamics in EuCu(2)(Si(x)Ge(1-x))(2) (x = 1, 0.9, 0.75, 0.6), performed in a wide temperature range. At x = 1 the magnetic excitation spectrum was found to be represented by the double-peak structure well below the energy range of the Eu(3+) spin-orbit (SO) excitation (7)F(0)→(7)F(1), so that at least the high-energy spectral component can be assigned to the renormalized SO transition. Change of the Eu valence towards 2 + with increased temperature and/or Ge concentration results in further renormalization (lowering the energy) and gradual suppression of both inelastic peaks in the spectrum, along with developing sizeable quasielastic signal. The origin of the spectral structure and its evolution is discussed in terms of excitonic model for the mixed valence state.

Waterborne Pathogens

A variety of microorganisms occur in the marine environment which are capable of infecting humans. This chapter, focused on waterborne pathogens, summarizes the types of pathogens that are a threat to human health, as well as the fecal indicator bacteria that are commonly used as surrogates for pathogens in regulatory and research applications. Limitations and alternatives to traditional fecal indicator bacteria are explored, highlighting challenges and policy implications for protecting public health. Methodological advances and challenges are also reviewed, with an emphasis on research designed to fill gaps and provide scientific support for management of marine resources, particularly bathing beaches. Accordingly, recent and previous epidemiology studies linking microbial measures of water quality to health outcomes are discussed in detail. As an alternative to the measurement of individual water samples, modeling of pathogens in marine waters is introduced. Overall, this chapter provides an overview of the pathogens, microbial measures and policy implications important for protecting humans from exposure to pathogens in marine waters.

Daily measures of microbes and human health at a non-point source marine beach

Studies evaluating the relationship between microbes and human health at non-point source beaches are necessary for establishing criteria which would protect public health while minimizing economic burdens. The objective of this study was to evaluate water quality and daily cumulative health effects (gastrointestinal, skin, and respiratory illnesses) for bathers at a non-point source subtropical marine recreational beach in order to better understand the inter-relationships between these factors and hence improve monitoring and pollution prevention techniques. Daily composite samples were collected, during the Oceans and Human Health Beach Exposure Assessment and Characterization Health Epidemiologic Study conducted in Miami (Florida, USA) at a non-point source beach, and analyzed for several pathogens, microbial source tracking markers, indicator microbes, and environmental parameters. Analysis demonstrated that rainfall and tide were more influential, when compared to other environmental factors and source tracking markers, in determining the presence of both indicator microbes and pathogens. Antecedent rainfall and F+ coliphage detection in water should be further assessed to confirm their possible association with skin and gastrointestinal (GI) illness outcomes, respectively. The results of this research illustrate the potential complexity of beach systems characterized by non-point sources, and how more novel and comprehensive approaches are needed to assess beach water quality for the purpose of protecting bather health.

Indicator microbes correlate with pathogenic bacteria, yeasts and helminthes in sand at a subtropical recreational beach site

AIMS

Research into the relationship between pathogens, faecal indicator microbes and environmental factors in beach sand has been limited, yet vital to the understanding of the microbial relationship between sand and the water column and to the improvement of criteria for better human health protection at beaches. The objectives of this study were to evaluate the presence and distribution of pathogens in various zones of beach sand (subtidal, intertidal and supratidal) and to assess their relationship with environmental parameters and indicator microbes at a non-point source subtropical marine beach.

METHODS AND RESULTS

In this exploratory study in subtropical Miami (Florida, USA), beach sand samples were collected and analysed over the course of 6 days for several pathogens, microbial source tracking markers and indicator microbes. An inverse correlation between moisture content and most indicator microbes was found. Significant associations were identified between some indicator microbes and pathogens (such as nematode larvae and yeasts in the genus Candida), which are from classes of microbes that are rarely evaluated in the context of recreational beach use.

CONCLUSIONS

Results indicate that indicator microbes may predict the presence of some of the pathogens, in particular helminthes, yeasts and the bacterial pathogen Staphylococcus aureus including methicillin-resistant forms. Indicator microbes may thus be useful for monitoring beach sand and water quality at non-point source beaches.

SIGNIFICANCE AND IMPACT OF THE STUDY

The presence of both indicator microbes and pathogens in beach sand provides one possible explanation for human health effects reported at non-point sources beaches.

A neutron polarization analysis study of moment correlations in (Dy(0.4)Y(0.6))T(2) (T = Mn, Al)

We present a study of the magnetic moment correlations of two pseudo-binary C15 Laves phase compounds, (Dy(0.4)Y(0.6))Mn(2) and (Dy(0.4)Y(0.6))Al(2), both of which have spin-glass-like magnetic ground states at low temperature. We use neutron powder diffraction with polarization analysis to isolate the diffuse scattering associated with the correlated spin-glass ground state, and compare and contrast the two systems. Despite there being differences of correlation length scale, we discover that the moment-moment correlations of these two disordered magnets are quite similar over a short range, and hence conjecture that the Mn ions in (Dy(0.4)Y(0.6))Mn(2) have little influence on the ground-state magnetic properties.

Slow and static spin correlations in Dy(2 + x)Ti(2 - x)O(7 - δ)

The static and dynamic spin correlations in the spin ices Dy(2.3)Ti(1.7)O(6.85) and Dy(2)Ti(2)O(7) have been studied in polarized neutron diffraction and neutron spin echo experiments. The measurements reveal that, below 100 mK, the magnetic scattering broadens and shifts to higher |Q| upon stuffing the pyrochlore lattice with additional Dy(3+) ions. These observations can be related, by means of reverse Monte Carlo simulation, to the modified distribution of near-neighbour distances and an overall more antiferromagnetic character of the near-neighbour couplings. The dynamic measurements show that the spin correlations are slower in the stuffed system. These results will be discussed and compared to the holmium analogues.

A real-time qPCR assay for the detection of the nifH gene of Methanobrevibacter smithii, a potential indicator of sewage pollution

AIMS

To develop a quantitative, real-time PCR assay to detect the nifH gene of Methanobrevibacter smithii. Methanobrevibacter smithii is a methanogenic archaea found in the intestinal tract of humans that may be a useful indicator of sewage pollution in water.

METHODS AND RESULTS

Quantification standards were prepared from Meth. smithii genomic DNA dilutions, and a standard curve was used to quantify the target gene and calculate estimated genome equivalency units. A competitive internal positive control was designed and incorporated into the assay to assess inhibition in environmental extracts. Testing the assay against a panel of 23 closely related methanogen species demonstrated specificity of the assay for Meth. smithii. A set of 36 blind water samples was then used as a field test of the assay. The internal control identified varying levels of inhibition in 29 of 36 (81%) samples, and the Meth. smithii target was detected in all water samples with known sewage input.

CONCLUSIONS

The quantitative PCR assay developed in this study is a sensitive and rapid method for the detection of the Meth. smithii nifH gene that includes an internal control to assess inhibition. Further research is required both to better evaluate host specificity of this assay and the correlation with human health risks.

SIGNIFICANCE AND IMPACT OF THE STUDY

This research is the first description of the development of a rapid and sensitive quantitative assay for a methanogenic archaeal indicator of sewage pollution.

Scale-free antiferromagnetic fluctuations in the s = 1/2 kagome antiferromagnet herbertsmithite

Neutron spectroscopy and diffuse neutron scattering on herbertsmithite [ZnCu(3)(OH)(6)Cl(2)], a near-ideal realization of the s=1/2 kagome antiferromagnet, reveal the hallmark property of a quantum spin liquid: instantaneous short-ranged antiferromagnetic correlations in the absence of a time-averaged ordered moment. These dynamic antiferromagnetic correlations are weakly dependent of neutron-energy transfer and temperature, and persist up to 25 meV and 120 K. At low energy transfers a shift of the magnetic scattering to low Q is observed with increasing temperature, providing evidence of gapless spinons. It is argued that these observations provide important evidence in favor of resonating-valence-bond theories of (doped) Mott insulators.

Magnetic short-range order in β-Mn(1-x)Co(x)

We present a study of the magnetic ground state properties of β-Mn metal alloyed with Co, using neutron polarization analysis of the diffuse neutron scattering cross-section. We analyse the magnetic structure obtained using a reverse Monte Carlo procedure to extract the Mn-Mn spin correlations. The addition of Co leads to a static disordered magnetic structure with medium-range correlations. Our analysis of the spin correlations indicates that both 8c and 12d non-equivalent lattice sites present in the β-Mn structure contribute to the magnetic ground state, where previously it was thought that the 8c site was non-magnetic.

Effects of changing land use on the microbial water quality of tidal creeks

Population growth along the southeastern United States coast has precipitated the conversion of forested watersheds to suburban and urban ones. This study sampled creeks representing forested, suburban, and urban watersheds along a longitudinal gradient for indicators of water quality, including traditional indicator bacteria (fecal coliforms and enterococci) and alternative viral indicators (male-specific and somatic coliphages). Tested microorganisms were generally distributed with highest concentrations in creek headwaters and in more developed watersheds. The headwaters also showed the strongest predictive relationship between indicator concentrations and urbanization as measured by impervious cover. A seasonal pattern was observed for indicator bacteria but not for indicator viruses. Coliphage typing indicated the likely source of contamination was nonhuman. Results suggest that headwater creeks can serve as sentinel habitat, signaling early warning of public health concerns from land-based anthropogenic activities. This study also implies the potential to eventually forecast indicator concentrations under land use change scenarios.

The coastal environment and human health: microbial indicators, pathogens, sentinels and reservoirs

Innovative research relating oceans and human health is advancing our understanding of disease-causing organisms in coastal ecosystems. Novel techniques are elucidating the loading, transport and fate of pathogens in coastal ecosystems, and identifying sources of contamination. This research is facilitating improved risk assessments for seafood consumers and those who use the oceans for recreation. A number of challenges still remain and define future directions of research and public policy. Sample processing and molecular detection techniques need to be advanced to allow rapid and specific identification of microbes of public health concern from complex environmental samples. Water quality standards need to be updated to more accurately reflect health risks and to provide managers with improved tools for decision-making. Greater discrimination of virulent versus harmless microbes is needed to identify environmental reservoirs of pathogens and factors leading to human infections. Investigations must include examination of microbial community dynamics that may be important from a human health perspective. Further research is needed to evaluate the ecology of non-enteric water-transmitted diseases. Sentinels should also be established and monitored, providing early warning of dangers to ecosystem health. Taken together, this effort will provide more reliable information about public health risks associated with beaches and seafood consumption, and how human activities can affect their exposure to disease-causing organisms from the oceans.