Traditionally, regulators, dischargers, and even water suppliers believed that wastewater discharge meeting the levels of 200 cfu/ 100 mL of fecal coliforms in wastewater effluent was sufficient to protect against downstream microbial effects. However, these beliefs are now being challenged by emerging pathogens that are resistant to standard water and wastewater treatment processes, exhibit extended survival periods in the environment, can adversely affect sensitive subpopulations, and require extremely low doses for human infection. Based on this new information, it is estimated that discharges of emerging pathogens from conventional wastewater treatment plants as far as 160 km upstream and cumulative amounts of wastewater discharge ranging from 2 to 20 ML/d have the potential to reach a water supply intake in a viable state at significant concentrations that could exceed regulatory limits for drinking water supplies, increase endemic risk from drinking water, and/or require additional drinking water treatment. Wastewater dischargers may be able mitigate this potential effect and achieve upwards of 6 log combined removal and inactivation of emerging pathogens to mitigate drinking water effects by using alternative treatment processes, such as filtration or UV light disinfection, or optimizing these processes based on site-specific conditions.