Recent and forecasted advances in microbiology, molecular biology, and analytical chemistry have made it timely to reassess the current paradigm of relying predominantly or exclusively on traditional bacterial indicators for all types of waterborne pathogens. Nonetheless, indicator approaches will still be required for the foreseeable future because it is not practical or feasible to monitor for the complete spectrum of microorganisms that may occur in water, and many known pathogens are difficult to detect directly and reliably in water samples. This comprehensive report recommends the development and use of a "tool box" approach by the U.S Environmental Protection Agency and others for assessing microbial water quality in which available indicator organisms (and/or pathogens in some cases) and detection method(s) are matched to the requirements of a particular application. The report further recommends the use of a phased, three-level monitoring framework to support the selection of indicators and indicator approaches.Â

Detailed interpretation of the environmental consequences of the latest findings from genome sequencing studies—presenting both scientific and public health opportunities. • Explains how understanding pathogen genomics can help ensure the safety of global food and water supplies. • Focuses on specific food- and waterborne pathogens that represent major public health threats. • Examines how global trends, such as climate change, increasing human populations, and rising levels of pollution, are stressing the ecosystems that food- and waterborne pathogens encounter, forcing them to adapt. • Serves as an excellent text for microbiology and genomics researchers, public health officials, regulators, food scientists, and other applicable professionals.

Food-borne viruses are recognized as a major health concern, but their distribution, definition, and impact are poorly understood. The volume Food-Borne Viruses goes a long way in correcting that problem. Written by leading scientists in the field, it brings together the latest knowledge on these viral strains, their detection and control, and associated challenges.

Developments such as the increasing globalization of the food industry, constant innovations in technologies and products, and changes in the susceptibility of populations to disease have all highlighted the problem of emerging pathogens, either newly discovered through more sensitive analytical methods, linked for the first time to disease in humans, or newly associated with a particular food. Designed for microbiologists and quality assurance professionals and for government and academic food safety scientists, this timely reference discusses ways of identifying emerging pathogens and includes chapters on individual pathogens, their epidemiology, methods of detection, and means of control.

As the human population grows-tripling in the past century while, simultaneously, quadrupling its demand for water-Earth's finite freshwater supplies are increasingly strained, and also increasingly contaminated by domestic, agricultural, and industrial wastes. Today, approximately one-third of the world's population lives in areas with scarce water resources. Nearly one billion people currently lack access to an adequate water supply, and more than twice as many lack access to basic sanitation services. It is projected that by 2025 water scarcity will affect nearly two-thirds of all people on the planet. Recognizing that water availability, water quality, and sanitation are fundamental issues underlying infectious disease emergence and spread, the Institute of Medicine held a two-day public workshop, summarized in this volume. Through invited presentations and discussions, participants explored global and local connections between water, sanitation, and health; the spectrum of water-related disease transmission processes as they inform intervention design; lessons learned from water-related disease outbreaks; vulnerabilities in water and sanitation infrastructure in both industrialized and developing countries; and opportunities to improve water and sanitation infrastructure so as to reduce the risk of water-related infectious disease.

Foodborne illnesses continue to be a major public health concern. All members of a particular bacterial genera (e.g., Salmonella, Campylobacter) or species (e.g., Listeria monocytogenes, Cronobacter sakazakii) are often treated by public health and regulatory agencies as being equally pathogenic; however, this is not necessarily true and is an overly conservative approach to ensuring the safety of foods. Even within species, virulence factors vary to the point that some isolates may be highly virulent, whereas others may rarely, if ever, cause disease in humans. Hence, many food safety scientists have concluded that a more appropriate characterization of bacterial isolates for public health purposes could be by virotyping, i.e., typing food-associated bacteria on the basis of their virulence factors. The book is divided into two sections. Section I, “Foodborne Pathogens and Virulence Factors,” hones in on specific virulence factors of foodborne pathogens and the role they play in regulatory requirements, recalls, and foodborne illness. The oft-held paradigm that all pathogenic strains are equally virulent is untrue. Thus, we will examine variability in virulence between strains such as Listeria, Salmonella, Campylobacter, Cronobacter, etc. This section also examines known factors capable of inducing greater virulence in foodborne pathogens. Section II, “Foodborne Pathogens, Host Susceptibility, and Infectious Dose” , covers the ability of a pathogen to invade a human host based on numerous extraneous factors relative to the host and the environment. Some of these factors include host age, immune status, genetic makeup, infectious dose, food composition and probiotics. Readers of this book will come away with a better understanding of foodborne bacterial pathogen virulence factors and pathogenicity, and host factors that predict the severity of disease in humans.

Globalization of the food supply has created conditions favorable for the emergence, reemergence, and spread of food-borne pathogens-compounding the challenge of anticipating, detecting, and effectively responding to food-borne threats to health. In the United States, food-borne agents affect 1 out of 6 individuals and cause approximately 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths each year. This figure likely represents just the tip of the iceberg, because it fails to account for the broad array of food-borne illnesses or for their wide-ranging repercussions for consumers, government, and the food industry-both domestically and internationally. A One Health approach to food safety may hold the promise of harnessing and integrating the expertise and resources from across the spectrum of multiple health domains including the human and veterinary medical and plant pathology communities with those of the wildlife and aquatic health and ecology communities. The IOM's Forum on Microbial Threats hosted a public workshop on December 13 and 14, 2011 that examined issues critical to the protection of the nation's food supply. The workshop explored existing knowledge and unanswered questions on the nature and extent of food-borne threats to health. Participants discussed the globalization of the U.S. food supply and the burden of illness associated with foodborne threats to health; considered the spectrum of food-borne threats as well as illustrative case studies; reviewed existing research, policies, and practices to prevent and mitigate foodborne threats; and, identified opportunities to reduce future threats to the nation's food supply through the use of a "One Health" approach to food safety. Improving Food Safety Through a One Health Approach: Workshop Summary covers the events of the workshop and explains the recommendations for future related workshops.