The waterborne route of Vero cytotoxin-producing E. coli (VTEC) O157 infect
ion was first suggested in two unconnected human cases in 1985. Since then,
waterborne VTEC O157 has been identified in sporadic cases and in outbreak
s of illness. Recreational waters, private and municipal supplies have been
implicated from microbiological, environmental and epidemiological studies
of cases. In addition, a research cohort study of farm workers identified
exposure to private water supplies as a risk factor for having antibodies t
o E. coli O157. Sources of contamination are thought to be animal and human
faeces or sewage. The presence of low numbers of target organisms in water
makes microbiological confirmation difficult, therefore epidemiological ev
idence has been essential in outbreak investigations. Despite the potential
for contamination of water with VTEC O157, waterborne infection is relativ
ely rare largely due to the susceptibility of the organism to water treatme
nt processes. This paper presents the evidence for waterborne VTEC O157 inf
ection, considering current microbiological, environmental and particularly
epidemiological information.