Thread by @dr_anne_leonard

There’s an explosion of interest about #sewage in our rivers and seas, and concerns about what this means for people swimming in our rivers and seas. We’ve been working on this and the threat that antibiotic resistant bacteria #AMR poses to human health. A 🧵of key results:

1/8 Our systematic review of the risk of experiencing symptoms of infection after sea bathing in high-income countries found people who bathe in the sea are more likely to feel ill afterwards, compared to people who stay on land. tinyurl.com/mr27p6bs

2/8 Our recent epidemiological survey of English and Welsh beach goers in 2014-2015 also showed that the risk of illness (like diarrhoea and vomiting) was higher in bathers compared to non-bathers. tinyurl.com/4tzebj8s

3/8 Clinically important #AMR bacteria are in our bathing waters at levels high enough for people to be at risk of swallowing them. We estimated that >6 million water sports sessions occurred which involved the ingestion of these #AMR bacteria. tinyurl.com/mr3658k6

4/8 We measured thousands of known #AMR genes in E. coli bacteria in our bathing waters and estimated that more than 123 million exposure events to E. coli harbouring one or more resistance genes happen in England each year tinyurl.com/23c85sre

5/8 Surfers are nearly x3 as likely as non-bathers to have E. coli in their gut resistant to clinically important antibiotics, and x4 more likely to have E. coli with mobile genes conferring resistance to multiple antibiotics. tiny.cc/wunxsz

6/8 #AntibioticResistance is complex. The contribution that bathing waters play in the spread of #AMR in human populations is currently underestimated tinyurl.com/sckv7ywz

7/8 Yet our systematic map on the evidence of AMR exposure and transmission via the environment highlights the concern that exposure to AMR in water results in colonisation and infection by AMR tinyurl.com/bdkj4ykh @isobelcstanton @Ruth_Garside @AlisonBethel @WillHGaze

8 We’ve known for over 100 years that sewage contains disease-causing microorganisms, and that ingesting 💩polluted water --> disease. Keeping sewage out of our water is a crucial public health intervention to reduce preventable infections and limit our reliance on antibiotics.

9/8 More results in the pipeline from my @NERC-funded research in local processes driving the transmission of #AMR bacteria in bathing waters, as well as from work with @EnvAgency on #AMR surveillance in bathing waters. Our new report on AMR surveillance: tinyurl.com/2yafxkcs

@NERC @EnvAgency 10/8 To support people working in the complex area of #AMR @AimeeKMurray and I have developed a short course starting in November. We cover environmental as well as human and animal processes that affect the emergence and spread of #AMR. For latest info: bit.ly/3IgnZWq