Waterborne Pathogens and Disease Introduction
Bacteria, viruses, and protozoan that cause disease are known as pathogens. Most pathogens are generally associated with diseases that cause intestinal illness and affect people in a relatively short amount of time, generally a few days to two weeks. They can cause illness through exposure to small quantities of contaminated water or food, or from direct contact with infected people or animals.

How Diseases are Transmitted
Pathogens that may cause waterborne outbreaks through drinking water have one thing in common: they are spread by the fecal-oral or feces-to-mouth route. Pathogens may get into water and spread when infected humans or animals pass the bacteria, viruses, and protozoa in their stool. For another person to become infected, he or she must take that pathogen in through the mouth. Waterborne pathogens are different from other types of pathogens such as the viruses that cause influenza (the flu) or the bacteria that cause tuberculosis. Influenza virus and tuberculosis bacteria are spread by secretions that are coughed or sneezed into the air by an infected person.

Chain of Transmission
Water is contaminated with feces. This contamination may be of human or animal origin. The feces must contain pathogens (disease-causing bacteria, viruses or protozoa). If the human or animal source is not infected with a pathogen, no disease will result. The pathogens must survive in the water. This depends on the temperature of the water and the length of time the pathogens are in the water.

Some pathogens will survive for only a short time in water, others, such as Giardia or Cryptosporidium, may survive for months.

The pathogens in the water must enter the water system’s intake and in numbers sufficient to infect people. The water is either not treated or inadequately treated for the pathogens present. A susceptible person must drink the water that contains the pathogen. Illness (disease) will occur.
This chain lists the events that must occur for the transmission of disease via drinking water. By breaking the chain at any point, the transmission of disease will be prevented.

Backflow Prevention
Backflow Prevention, also referred to as Cross-Connection Control, addresses a serious health issue. This issue was addressed on the federal level by passage of the “Federal Safe Drinking Water Act” as developed by the Environmental Protection Agency (E.P.A.) and passed into law on December 16, 1974. This Act tasked each state with primary enforcement responsibility for a program to assure access to safe drinking water by all citizens. Such state program regulations as adopted are required to be at least as stringent as the federal regulations as developed and enforced by the E.P.A.

The official definition of a cross-connection is “the link or channel connecting a source of pollution with a potable water supply.” There are two distinct levels of concern with this issue. The first is protection of the general public and the second is protection of persons subject to such risks involving service to a single customer, be that customer an individual residence or business.

Sources of pollution which may result in a danger to health are not always obvious and such cross-connections are certainly not usually intentional. They are usually the result of oversight or a non-professional installation. As source examples, within a business environment the pollutant source may involve the unintentional cross-connection of internal or external piping with chemical processes or a heating boiler. In a residential environment the pollutant source may be an improper cross-connection with a landscape sprinkler system or reserve tank fire protection system. Or, a situation as simple as leaving a garden hose nozzle submerged in a bucket of liquid or attached to a chemical sprayer.

Another potential hazard source within any environment may be a cross-connection of piping involving a water well located on the property. This is a special concern with older residences or businesses, which may have been served by well water prior to connection to the developed water system. There are many other potential sources of pollutant hazards. Control of cross-connections is possible but only through knowledge and vigilance. Public education is essential, for many that are educated in piping and plumbing installations fail to recognize cross-connection dangers.