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Over the last couple of decades, those of us interested in drinking water microbiology have been intrigued by the environmental pathogens that not only survive, but are often thought to proliferate in drinking water, often associated with biofilms. These pathogens are often protected by those biofilms from most forms of water treatment. While the environmental pathogens primarily cause a health burden to the immunologically compromised, what happens in microgravity is not fully understood. Is the astronaut's immunity sufficiently compromised that these pathogens may become a significant health risk. The other, not unconnected question is what constitutes an emerging waterborne pathogen. Are environmental pathogens likely to increase in virulence under microgravity. At what point does a non-pathogenic microbe become pathogenic. Will rates of transfer of virulence factors increase. Using Earth-based examples, this presentation will raise more questions than answers, but highlight the fact that there is more to risk management of human health than simply monitoring and control of known pathogens.