Ana Maria de Roda Husman

• Prof.dr.
• Head of Department at National Institute for Public Health and the Environment

Background Enteric hepatitis A virus (HAV) infections during childhood are often asymptomatic but may cause severe illness in adults. To improve public health surveillance we assessed the applicability of sewage monitoring during an HAV outbreak at a primary school. Methods Between October 19 and December 27, 2022, five symptomatic HAV cases were...

Background Infectious disease surveillance and outbreak investigations have significantly benefited from sewage monitoring as an indicator for pathogen circulation in human populations. The use of sewage surveillance accelerated during the COVID-19 pandemic with the quantification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in s...

Background Many respiratory viruses and their associated diseases are sensitive to meteorological factors. For SARS-CoV-2 and COVID-19, evidence on this sensitivity is inconsistent. Understanding the influence of meteorological factors on SARS-CoV-2 transmission and COVID-19 epidemiology can help to improve pandemic preparedness. Objectives This r...

Wearing face masks is considered as one of the infection prevention and control options for respiratory viruses (e.g., SARS-CoV-2) that acts by blocking virus-laden aerosols. It is generally thought that aerosol blockage occurs when air passes through the face mask fabric. We calculated air flows through face masks and through peripheral leakages,...

Due to the impact respiratory viruses have on human health, a lot of data has been collected and visualised in tools such as dashboards that provide retrospective insights into the course of an epidemic or pandemic. Two well-known respiratory viruses, influenza virus and SARS-CoV-2, are the causative agents of influenza and COVID-19, respectively....

Micro- and nanoplastics (MNPs) are everywhere: in the air we breathe, in our food and in virtually every type of water. Currently, it is unknown whether, and to what extent, these MNPs are hazardous to human health. Identifying risks of physical and chemical aspects of MNPs has gained a lot of attention over the last few years, and efforts have bee...

The WHO recommends a risk management approach to ensure safe drinking-water and sanitation, so-called Water Safety Planning and Sanitation Safety Planning. However, applying these risk management approaches separately in small-scale drinking-water supply and sanitation systems might be challenging for rural communities with limited human, financial...

Urban wastewater treatment plants harbor a large collection of antibiotic resistant enteric bacteria. It is therefore reasonable to hypothesize that workers at such plants would possess a more diverse set of resistant enteric bacteria, compared to the general population. To address this hypothesis, we have compared the fecal microbiome and resistom...

Legionnaires’ disease (LD) is a severe pneumonia mainly caused by the bacterium Legionella pneumophila. Although many environmental sources of LD have been described, the sources of the majority of non-outbreak LD cases have not been identified. In several outbreaks in the Netherlands, wastewater treatment plants (WWTPs) were identified as the most...

SARS-CoV-2 can be effectively transmitted between individuals located in close proximity to each other for extended durations. Aircraft provide such conditions. Although high attack rates during flights were reported, little was known about the risk levels of aerosol transmission of SARS-CoV-2 in aircraft cabins. The major objective was to estimat...

Background Surveillance of SARS-CoV-2 in wastewater offers a near real-time tool to track circulation of SARS-CoV-2 at a local scale. However, individual measurements of SARS-CoV-2 in sewage are noisy, inherently variable and can be left-censored.AimWe aimed to infer latent virus loads in a comprehensive sewage surveillance programme that includes...

Rapport over de gevolgen van leefomgevingsveranderingen waardooraandacht voor infectieziekten belangrijk en urgent is bij het omgaan met die veranderingen.

The intensive use of antibiotics in the veterinary sector, linked to the application of manure-derived amendments in agriculture, translates into increased environmental levels of chemical residues, AR bacteria (ARB) and antibiotic resistance genes (ARG). The aim of this review was to evaluate the current evidence regarding the impact of animal far...

Although cities can be characterised as sources of economic, environmental and social challenges, they can also be part of the solution for healthy and sustainable societies. While most cities are situated close to water, whether inland waterways, lakes, or the sea, these blue spaces are not integrated into urban planning to their full potential an...

Antibiotic resistance (AR) is currently a major threat to global health, calling for a One Health approach to be properly understood, monitored, tackled, and managed. Potential risk factors for AR are often studied in specific high-risk populations, but are still poorly understood in the general population. Our aim was to explore, describe, and cha...

Antibiotic resistance (AR) is currently a major threat to global health, calling for a One Health approach to be properly understood, monitored, tackled, and managed. Potential risk factors for AR are often studied in specific high-risk populations, but are still poorly understood in the general population. Our aim was to explore, describe, and cha...

Projected plastic production volumes are rising, as is societal and political attention to plastic pollution and possible health impacts. In line with ambitions for climate mitigation and the circular economy, various national and international policies and action plans address the reduction of impacts of plastics. Quantitative scenario analyses sh...

To investigate whether wastewater treatment plant (WWTP) workers and residents living in close proximity to a WWTP have elevated carriage rates of ESBL-producing Enterobacterales, as compared to the general population. From 2018 to 2020, we carried out a cross-sectional study in Germany, the Netherlands, and Romania among WWTP workers (N = 344), ne...

Antimicrobial resistance (AMR) is a growing global health threat that requires coordinated action across One Health sectors (humans, animals, environment) to stem its spread. Environmental surveillance of AMR is largely behind the curve in current One Health surveillance programs, but recent momentum in the establishment of infrastructure for monit...

Background: Hospital wastewater is a major source of antimicrobial resistance (AMR) outflow into the environment. This study uses metagenomics to study how hospital clinical activity impacts antimicrobial resistance genes (ARGs) abundances in hospital wastewater. Methods: Sewage was collected over a 24-h period from multiple wastewater collection p...

Legionnaires Disease incidence has risen in the Netherlands in recent years. For the majority of the cases, the source of infection is never identified. Two Dutch wastewater treatment plants (WWTPs) have previously been identified as source of outbreaks of Legionnaires Disease (LD) among local residents. The objective of this study is to examine if...

Purpose. To investigate whether wastewater treatment plant (WWTP) workers and residents living in close proximity to a WWTP have elevated carriage rates of ESBL-producing Enterobacterales, as compared to the general population. Methods. From 2018 to 2020, we carried out a cross-sectional study in Germany, the Netherlands, and Romania among WWTP wor...

While the burden of disease from well-studied drinking water contaminants is declining, risks from emerging chemical and microbial contaminants arise because of social, technological, demographic and climatological developments. At present, emerging chemical and microbial drinking water contaminants are not assessed in a systematic way, but reactiv...

The toxicity towards viruses of silver nanoparticles (AgNPs) has been reported to be dependent on several factors such as particle concentration, size, and shape. Although these factors may indeed contribute to the toxicity of AgNPs, the results presented in this work demonstrate that surface chemistry and especially surface charge is a crucial fac...

Antibiotic resistance has become a serious global health threat. Wastewater treatment plants may become unintentional collection points for bacteria resistant to antimicrobials. Little is known about the transmission of antibiotic resistance from wastewater treatment plants to humans, most importantly to wastewater treatment plant workers and resid...

Background: Evidence for indoor airborne transmission of SARS-CoV-2 is accumulating. Objectives: We assessed of the risk of illness due to airborne SARS-CoV-2 particles from breathing, speaking, singing, coughing, and sneezing in indoor environments. Methods: A risk assessment model, AirCoV2, for exposure to SARS-CoV-2 particles in aerosol dro...

Background: Antibiotic resistance has become a serious global health threat. Wastewater treatment plants (WWTPs) may become unintentional collection points for bacteria resistant to antimicrobials. Little is known about the transmission of antibiotic resistance from wastewater treatment plants to humans, most importantly to WWTP workers and residen...

Carbapenemase-producing Enterobacterales (CPE) pose a threat to public health necessitating restriction of further spread. Tools to efficiently monitor the prevalence of these still relatively rare resistant bacteria and insight in routes of dissemination are pivotal for the development of prevention strategies. By analysis of untreated and treated...

Plastic pollution in aquatic environments, particularly microplastics (<5mm), is an emerging health threat. The buoyancy, hydrophobic hard surfaces, novel polymer carbon sources and long-distance transport make microplastics a unique substrate for biofilms, potentially harbouring pathogens and enabling antimicrobial resistance (AMR) gene exchange....

The emergence and spread of antimicrobial resistance (AMR), including clinically relevant antimicrobial-resistant bacteria, genetic resistance elements, and antibiotic residues, presents a significant threat to human health. Reducing the incidence of infection by improving water, sanitation, and hygiene (WASH) is one of five objectives in the World...

Background Evidence for indoor airborne transmission of SARS-CoV-2 is accumulating. If SARS-CoV-2 also spreads via aerosols, this has implications for measures taken to limit transmission. Objectives The aim of this study is to assess exposure to airborne SARS-CoV-2 particles from breathing, speaking, coughing and sneezing in an indoor environment...

As well as known contaminants, surface waters also contain an unknown variety of chemical and microbial contaminants which can pose a risk to humans if surface water is used for the production of drinking water. To protect human health proactively, and in a cost-efficient way, water authorities and drinking water companies need early warning system...

In the Southern Nations, Nationalities, and Peoples’ Region of Ethiopia, improved water is the main source of water for household purposes. Access to improved water closer to their homes benefits the community in many ways. It improves their health status, saves their time and energy, and improves their productivity in jobs and education they are e...

Swimming ponds are artificial ecosystems for bathing in which people imitate the conditions of natural waters. Swimming in natural water may pose health risks if the water quality is microbiologically poor. Swimming ponds are small water bodies that may be used by relatively large groups of people, moreover, the water is not disinfected, e.g. by us...

Abstract Chemical and microbial contaminants in the aquatic environment pose a potential threat to humans and to ecosystems. Humans may be exposed to contaminants in water resources when used for drinking water production, agriculture, aquaculture or recreation. Climatological, social and demographic changes, as well as the increasing sensitivity o...

Background Antimicrobial resistance (AMR) is a global health crisis. It is well established that hospital wastewater can contain organisms that are on the WHO priority list of antibiotic-resistant organisms. We aimed to use metagenomics to study whether the abundances of resistance genes in hospital wastewater reflects clinical activity within the...

Unsafe drinking water is a recognized health threat in Ethiopia, and climate change, rapid population growth, urbanization and agricultural practices put intense pressure on availability and quality of water. Climate change-related health problems due to floods and waterborne diseases are increasing. With increasing insight into impacts of climate...

Introduction Hospital wastewater is a potential major source of antimicrobial resistance (AMR). This study uses metagenomics to ask how abundances of AMR genes in hospital wastewater are related to clinical activity. Methods Sewage was collected over a 24-hour period from multiple wastewater collection points representing different specialties with...

In the Netherlands, safe and sufficient drinking water is provided to the general population by ten drinking water companies. To guarantee safe drinking water the World Health Organization (WHO) developed a Water Safety Plan (WSP), a Risk Assessment and a Risk Management (RA/RM) framework. The objective of the study was to identify legally required...

Wastewater treatment plants (WWTPs), linking human fecal residues and the environment, are considered as hotspots for the spread of antimicrobial resistance (AMR). In order to evaluate the role of WWTPs and underlying operational parameters for the removal of AMR, the presence and removal efficiency of a selected set of 6 antimicrobial resistance g...

In recent years, the water safety plan approach has been extended towards climate-resilient water safety planning. This happened in response to increasing insight into impacts of climate on drinking-water and required adaptation to anticipated climate change. Literature was reviewed for published guidance and case examples, documenting how to consi...

Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use meta-genomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AM...

Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use meta-genomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AM...

Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use meta-genomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AM...

Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR...

A biologic wastewater treatment plant was identified as a common source for 2 consecutive Legionnaires’ disease clusters in the Netherlands in 2016 and 2017. Sequence typing and transmission modeling indicated direct and long-distance transmission of Legionella, indicating this source type should also be investigated in sporadic Legionnaires’ disea...

Possible transmission pathways of fungi in indoor swimming pool facilities were assessed through fungal counting in different areas of the facilities and typing of the collected fungal isolates. Air, water and surface samples were collected from seven different indoor swimming pool facilities. Fungal species were identified based on their internal...

The presence of emerging contaminants in the aquatic environment may affect human health via exposure to drinking water. And, even if some of these emerging contaminants are not a threat to human health, their presence might still influence the public perception of drinking water quality. Over the last decades, much research has been done on emergi...

There is growing understanding that the environment plays an important role both in the transmission of antibiotic resistant pathogens and in their evolution. Accordingly, researchers and stakeholders world-wide seek to further explore the mechanisms and drivers involved, quantify risks and identify suitable interventions. There is a clear value in...

Tularemia is an emerging zoonosis caused by the Gram-negative bacterium Francisella tularensis, which is able to infect a range of animal species and humans. Human infections occur through contact with animals, ingestion of food, insect bites or exposure to aerosols or water, and may lead to serious disease. F. tularensis may persist in aquatic res...

Virus penetration is a significant problem in water treatment membrane filtration. To effectively remove waterborne viruses nano-filtration, reverse osmosis or ultrafiltration must be used, all of which are high energy filtration schemes. Novel approaches and technologies for the production of virus-free drinking water are therefore warranted. In t...

To study whether broiler and layer farms contribute to the environmental Campylobacter load, environmental matrices at or close to farms, and caecal material from chickens, were examined. Similarity between Campylobacter from poultry and environment was tested based on species identification and Multilocus Sequence Typing. Campylobacter prevalence...

Tularaemia, a disease caused by the bacterium Francisella tularensis, is a re-emerging zoonosis in the Netherlands. After sporadic human and hare cases occurred in the period 2011 to 2014, a cluster of F. tularensis-infected hares was recognised in a region in the north of the Netherlands from February to May 2015. No human cases were identified, i...

Een groot deel van de wereld heeft geen toegang tot microbiologisch veilig drinkwater. Maar ook in landen met veilig drinkwater moeten we alert zijn op ziekteverwekkende virussen en bacteriën in water als dat wordt gebruikt voor recreatie, landbouw of als bron voor drinkwater. Naast de bekende microbiologische bedreigingen zijn er ook nieuwe bedrei...

This study condenses data acquired during investigations of the virological quality of irrigation water used in production of fresh produce. One hundred and eight samples of irrigation water were collected from five berry fruit farms in Finland (1), the Czech Republic (1), Serbia (2), and Poland (1), and sixty-one samples were collected from three...

Clinically relevant antimicrobial resistant bacteria, genetic resistance elements, and antibiotic residues (so-called AMR) from human and animal waste are abundantly present in environmental samples. This presence could lead to human exposure to AMR. In 2015, the World Health Organization (WHO) developed a Global Action Plan for Antimicrobial Resis...

In May 2015, WHO launched the Global action plan on antimicrobial resistance. Antimicrobial-resistant bacteria and their antimicrobial resistance genes are common and widespread contaminants fecal wastes and water. Understanding and addressing the role of water and waste in combatting antimicrobial resistance is an important element of the Global A...

Climate change is expected to influence infection risks while bathing downstream of sewage emissions from combined sewage overflows (CSOs) or waste water treatment plants (WWTPs) due to changes in pathogen influx, rising temperatures and changing flow rates of the receiving waters. In this study, climate change impacts on the surface water concentr...

Garden soils were investigated as reservoirs and potential sources of pathogenic Legionella bacteria. Legionella bacteria were detected in 22 of 177 garden soil samples (12%) by amoebal coculture. Of these 22 Legionella-positive soil samples, seven contained L. pneumophila. Several other species were found including the pathogenic L. Longbeachae (4...

Protection of drinking water resources requires addressing all relevant fecal pollution sources in the considered catchment. A freely available simulation tool, QMRAcatch, was recently developed to simulate concentrations of fecal indicators, a genetic microbial source tracking (MST) marker, and intestinal pathogens in water resources and to conduc...

On 6 September 2014, the accidental release of 1013 infectious wild poliovirus type 3 (WPV3) particles by a vaccine production plant in Belgium was reported. WPV3 was released into the sewage system and discharged directly to a wastewater treatment plant (WWTP) and subsequently into rivers that flowed to the Western Scheldt and the North Sea. No po...

Faeces originating from wildlife, domestic animals or manure-fertilized fields, is considered an important source of zoonotic pathogens to which people may be exposed by, for instance, bathing or drinking-water consumption. An increase in runoff, and associated wash-off of animal faeces from fields, is assumed to contribute to the increase of disea...

Monitoring of the microbiological quality of water is done to verify whether a specific water body or water source is suitable for its intended use. The public health impact of microbial contaminants in water is high. Targets of the microbiological analysis of water may be bacteria, viruses or protozoa, that may either be pathogenic to man or harml...

Extreme rainfall events may cause pluvial flooding, increasing the transmission of several waterborne pathogens. However, the risk of experiencing clinically overt infections following exposure to pluvial floodwater is poorly estimated. A retrospective cross-sectional survey was performed to quantify the occurrence of self-reported gastrointestinal...

Given the complex hydrologic dynamics of water catchments and conflicts between nature protection and public water supply, models may help to understand catchment dynamics and evaluate contamination scenarios and may support best environmental practices and water safety management. A catchment model can be an educative tool for investigating water...

To assess public health risks from environmental exposure to Extended-Spectrum β-Lactamases (ESBL)-producing bacteria, it is necessary to have insight in the proportion of relative harmless commensal variants and potentially pathogenic ones (which may directly cause disease). In the current study, 170 ESBL-producing E. coli from Dutch wastewater (n...

To establish a possible role for the natural environment in the transmission of clinically relevant AMR bacteria to humans, a literature review was conducted to systematically collect and categorize evidence for human exposure to extended-spectrum β-lactamase-producing Enterobacteriaceae, methicillin-resistant Staphylococcus aureus, and vancomycin-...

The goal of this study was to determine the fate of ESBL-producing E. coli (ESBL-EC) emitted from faecal sources in surface water, and the probability of human exposure through swimming. Concentrations of ESBL-EC were measured in recreational waters and in source waters, being water in ditches surrounding poultry farms and municipal wastewater. Add...

This study aimed to discern the contribution of poultry farms to the contamination of the environment with ESBL-producing Escherichia coli and therewith, potentially to the spread of these bacteria to humans and other animals. ESBL-producing E. coli were detected at all investigated laying hen farms (n = 5) and broiler farms (n = 3) in 65% (46/71)...