Pathogens and risk factors associated with freshwater-exposure outbreaks: A systematic review

Brainard, Julii ORCID: https://orcid.org/0000-0002-5272-7995, Bernard, Grace, Rowland, Ben W, Commandeur, Theodora, Lam, Edward K., Thompson, Vasilia, Swindells, Isabel C., Love, Nicola, Vivancos, Roberto, Decraene, Valerie, McIntyre, K. Marie, Stewart, Gavin and Hunter, Paul R. ORCID: https://orcid.org/0000-0002-5608-6144 (2026) Pathogens and risk factors associated with freshwater-exposure outbreaks: A systematic review. In: UNSPECIFIED.

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Abstract

Context: There is widespread concern about microbiological hazards in freshwater bodies, especially when accessed for recreational bathing. Research Objective : Identify and characterise disease outbreaks linked to contact with outdoor freshwater bodies, using scientific reports, grey literature and government datasets. Design: Systematic review with descriptive summary and frequency counts. Focus on gastrointestinal (GI) illness in humans. Results: 406 unique outbreaks documented in 80 sources. Pathogens: Viruses, bacteria or protozoa. Six pathogens (on chart) were linked to 71% of the 406 outbreaks.The most consistent risk factor evidence was: Risk of GI illness was often higher after facial contact with lake/river water, especially if water entered the mouth. Information gaps : Most potential risk factors for GI illness were only considered in a single study, and there was often missing information about whether commonly collected attributes such as age or gender could be associated with risk of illness.

Item Type:	Conference or Workshop Item (Poster)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School University of East Anglia Research Groups/Centres > Theme - ClimateUEA
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Public Health Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Social Sciences > Research Centres > Water Security Research Centre
Depositing User:	LivePure Connector
Date Deposited:	16 Sep 2026 09:03
Last Modified:	20 Sep 2026 05:34
URI:	https://ueaeprints.uea.ac.uk/id/eprint/104552
DOI:

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