Quantitative microbial risk assessment to estimate the public health risk from exposure to enterotoxigenic E. coli in drinking water in the rural area of Villapinzon, Colombia

The consumption of contaminated water is a major cause of acute diarrheal disease (ADD), particularly in rural areas where treatment and control are limited. The aim of this study was to characterize the epidemiological situation and microbiological risk linked to water consumption in the rural area near the capital of Colombia. A cross-sectional study was carried out using secondary data analysis about water quality records and survey information. We described the epidemiological situation of ADD in the municipality and we estimated the risk of ADD by enterotoxigenic E. coli (ETEC) from drinking water in that region using Quantitative Microbial Risk Assessment (QMRA). During the study period, 1318 cases of ADD were reported, with 33% in children under 5. For all zones evaluated the risk exceeds commonly used acceptable risk levels. Inadequate protocols for thermal treatment and subsequent storage increase the risk of illness. The study highlights the need to strengthen intersectoral work, improve water infrastructure, and implement protocols and education about the management of drinking water to reduce health risks.