DISEASE-CAUSING AGENTS
While EPA no longer mentions pathogens in the part  503 sludge policy guideline, The
Department of Transportation does define the term.

EPA and its sludge scientists, including the National Academy of Science, do not want to
admit that the bacteria, viruses, helminth, protozoan, and fungi (pathogens) in sludge will
cause any human health effects besides gastrointestinal problems. At best, we seem to have
soil scientists telling us about a few disease-causing agents that were included in a limited

When EPA left this small amount of information out of the final 1993 sludge policy regulation
it had to be with the deliberate intent to put farmers, home gardeners and the public at risk.
EPA knew people were going to be exposed and knew some were going to die. EPA knew
that with even the best treatment processes, these disease-causing agents were subject to
explosive regrowth when placed on the land or after the sludge was composted.

The EPA's own research, which was stated in the preamble to the 1989 proposed (Coded
Federal Regulation Section 40, Parts 257 and 503) sludge regulation, has documented in
addition to the toxic heavy metals, a list of 25 primary pathogens in sewage sludge.  For the
most part the implication was that the worse health effect that could happen was a bad case
of diarrhea.

Among the disease-causing agents mentioned are: 1) five bacteria pathogens
(Campylobacter, Escherichia, Salmonella, Shigella
(coliform bacteria), and Vibrio
Cholerae), 2) nine viruses pathogens (Entroviruses, Poliovirus, Coxsackieviruses, Echovirus,
Hepatitis A, Norwalk and Norwalk like viruses, Reovirus, and Rotavirus), 3) five helminth
pathogens (among them are Hookworms, Tapeworms, and Nematode worms), 4) five
protozoans pathogens (Toxoplasma gondii, Balantidium, Entamoeba histolyca, Giardia
lambia, and Crytosporidium), and 5) one fungi pathogen (Aspergillus).

A little help from the Thomas Medical Dictionary in 1992, showed otherwise. Most of these
pathogens are very deadly to humans and animals. Although the bacteria pathogens
Campylobacter Jejuni and Escherichia primarily cause a relative mild case of diarrhea,
Salmonella, Shigetla and Vibrio cholerae effect the gastrointestinal tract and can be fatal. Of
the nine viruses, Entroviruses or Picornaviruses (152 species) pathogens can cause
gastrointestinal problems, respiratory problems and can also be fatal. Poliovirus (3 species)
pathogens cause inflammation of the grey matter of the spinal cord.  Coxsackievirus A (23
species), B (6 species) pathogens are mostly mild, but they can cause inflammation of the
heart in newborns. While Echovirus (31 species) pathogens primarily cause inflammation of
the heart, spinal cord and brain, Hepatitis A virus pathogens cause liver problems and can
lead to death. Norwalk viruses and Norwalk like virus pathogens cause mostly diseases of
the gastrointestinal tract and Rotavirus causes acute gastroenteritis.

The five Helminth pathogens (primarily, Hookworms, Tapeworms and Nematode Worms)
cause damage to vital organs, brain, retina vessels, liver, lung and heart.  The five
Protozoan pathogens cause intestinal, respiratory, and liver problems.  The one fungi
pathogen, Aspergillus, causes inflamed tissues in bronchi, lungs, aural canal, skin and
membranes of the eye, nose or urethra (Federal Register (FR), 54, P.5829 & Thomas 1988).

(This information was adapted from the paper, SLUDGE DISPOSAL: Sanitary Landfill-Open
Dump-Superfund Site, by James W. Bynum, published in Conference Proceedings, New
Mexico Governors Conference on the Environment, Vol 2, February 1993, New Mexico
Environmental Department)

Today we know that "Most cases of meningitis are caused by infections from viruses or
bacteria. A small portion of cases may be caused by fungi, reactions to medication or
medical conditions associated with inflammation such as lupus, sarcoidosis or malignancy."
The scientists at the National Academy of Science who reviewed the science behinded EPA's
Part 503 sludge policy would have us believe that no one has every died from being exposed
to any of the disease-causing agents we are exposed too, except: "Acid Reflux Disease"?
The Use of Reclaimed Water and Sludge in Food Crop Production p.90 - p.2 on the
EPA website.
TABLE 5.1 Examples of Pathogens Associated With Raw Domestic Sewage and Sewage
Shigella sp.
Salmonella sp.
Salmonella typhi
Vibrio cholerae

Escherichia coli

Yersinia sp.
Campylobacter jejuni
Bacillary dysentery
Salmonellosis gastroenteritis)
Typhoid fever

A variety of gastroenteric diseases

Yersiniosis (gastroenteritis)
Campylobacteriosis (gastroenteritis)
50,000 - 700
40,000 - 500 to 10,000

2,100 - 61

46,000(R) -100
Hepatitis A virus
Norwalk viruses
Coxsackie viruses
Infectious hepatitis
Acute gastroenteritis
Acute gastroenteritis
"flu-like" symptoms
"flu-like" symptoms
Entamoeba histolytica
Giardia lamblia
Cryptosporidium sp.
Balantidium coli
Amebiasis (amoebic dysentery)
Giardiasis (gastroenteritis)
Cryptosporidiosis (gastroenteritis)
Balantidiasis (gastroenteritis)

400 in Milwaukee
Ascaris sp.
Taenia sp.
Necator americanus
Trichuris trichuria
Ascariasis (roundworm infection)
Taeniasis (tapeworm infection)
Ancylostomiasis (hookworm infection)
Trichuriasis (whipworm infection)
Corps of Engineers does list a few diseases that will cause death.
-- Water Quality Technical Note PD-03 --July 1999
Table 1
Microbial Pathogens of Concern to Quality of Water Resource Projects
(Modified from Metcalfe and Eddy (1991))
Aeromonas hydrophila     
Aeromonas salmonica
Furniculosis (Lesions on fish)
Lesions, death
Campylobacter spp.
Vomiting, diarrhea, death
Clostridium botulinum
Tetany, death
Escherichia coli
Vomiting, diarrhea, death
Legionella pneumonophila
Acute respiratory illness
Jaundice, fever
Pseudomonas aeruoginosa
Lesions in fish
Skin ulcerations, death
Salmonella typhi
Typhoid Fever
Fever, diarrhea, ulceration of  
small intestine
Diarrhea, dehydration
Vibrio cholerae
Extreme diarrhea,                   
Yersinia enterolitica
Respiratory disease
Heart anomalies, meningitis
Hepatis A
Infectious hepatitis
Jaundice, fever, eventual  
small round         
Gastroenteritis, Vomiting,
Vomiting, diarrhea
Vomiting, diarrhea
Entamoeba histolytica
Mild to severe diarrhea,
nausea, indigestion
Giardia lamblia
Mild to severe diarrhea,           
nausea, indigestion
Naegleria fowleri
Amoebic  Meningoencephalitis
Fatal brain inflammation

Disease-Causing Agents

Appendix B-II.   Risk Group 2 (RG2) Agents

With all the people that die from these disease-causing agents in food and water
contamination incidents, the government still says they are rarely serious and treatment is
often available.

In 1996, Dr. Ralph J. Touch, Chief Sanitarian at U.S. Department of Health and Human
Services discussed some of the problems in a paper for  the Fourth World Congress on
Environmental Health. However, even he doesn't like to talk about death in the United States
associated with food and water contamination. He doesn't mention the over 400 deaths in
the CRYPTOSPORIDIOSIS outbreak, which was shown to be a human strain. He doesn't talk
about the deaths associated with the 80 million food contaminated incidents. Nor does he
discuss the millions of tons of infectious sludge/biosolids disposed of as a fertilizer on food
crops, on home lawns and gardens,on wetlands, on parks, golf courses, school yards, and
within 30 meters of streams and rivers. The government position is that if you wash your
hands enough, you are not going to inhale any infectious disease-causing agents, your are
not going to drink any infectious agent contaminated water, and you are not going to eat
any infectious contaminated food, unless you happen to be in a hospital.

Infectious and parasitic diseases are still the leading cause of death worldwide in 1990s.
According to the World Health Organization nineteen and a half million adults and children
died of infectious diseases in 1992.

According to the Centers for Disease Control and prevention, food poisoning affects as
many as 80 million people in the U.S. each year at a cost of 7.6 billion dollars. Restaurant,
hospitals, nursing home and child/day care workers fail to wash there hands over 60 percent
of the required time. Each year there are over 2 million health care acquired infections in the
U.S. resulting in over 30,000 deaths.

- E. COLI O157:H7: Commonly consumed food items contaminated with infectious agents
place large numbers of persons at risk. Although escherichia coli is a common bacterium
that all human beings have in their intestines, one strain of E. coli called E. coli O157:H7 is
especially virulent. In 1993, hamburgers contaminated with this bacterial strain caused a
multi-state outbreak of severe bloody diarrhea and several deaths in the USA.

- CRYPTOSPORIDIOSIS: We are so accustomed to, safe, clean and plentiful water supplies
that we think about water only when a problem arises. The largest recorded waterborne
disease outbreak in our nation's history occurred in Milwaukee, Wisconsin in April 1993. A
parasitic infection of the small intestine which can produce severe watery diarrhea.
Outbreaks of gastro-intestinal illness due to contaminated municipal water still occur. This
out-break of cryptosporidiosis affected over 400,000 people, and more than 4,400 people
were hospitalized.

- BACTERIAL MENINGITIS: In May 1996 infected more than 100,000 people in West Africa,
killing more than 10,000.

The Government says:
RG2 agents are associated with human disease which is rarely serious and for which
preventive or therapeutic interventions are often available.

Appendix B-II-A.   Risk Group 2
(RG2) -
Bacterial Agents Including Chlamydia

--Acinetobacter baumannii (formerly Acinetobacter calcoaceticus)


--Actinomyces pyogenes (formerly Corynebacterium pyogenes)

--Aeromonas hydrophila

--Amycolata autotrophica

--Archanobacterium haemolyticum (formerly Corynebacterium haemolyticum)

--Arizona hinshawii - all serotypes

--Bacillus anthracis

--Bartonella henselae, B. quintana, B. vinsonii

--Bordetella including B. pertussis  

--Borrelia recurrentis, B. burgdorferi

--Burkholderia (formerly Pseudomonas species) except those listed in Appendix B-III-A

--Campylobacter coli, C. fetus, C. jejuni

--Chlamydia psittaci, C. trachomatis, C. pneumoniae

--Clostridium botulinum, Cl. chauvoei, Cl. haemolyticum, Cl. histolyticum, Cl. novyi, Cl.
septicum, Cl. tetani

--Corynebacterium diphtheriae, C. pseudotuberculosis, C. renale

--Dermatophilus congolensis

--Edwardsiella tarda

--Erysipelothrix rhusiopathiae

--Escherichia coli - all enteropathogenic, enterotoxigenic, enteroinvasive and strains bearing
K1 antigen, including E. coli O157:H7

--Haemophilus ducreyi, H. influenzae

--Helicobacter pylori

--Klebsiella - all species except K. oxytoca (RG1)

--Legionella including L. pneumophila

--Leptospira interrogans - all serotypes



--Mycobacterium (except those listed in Appendix B-III-A (RG3)) including M. avium complex,
M. asiaticum, M. bovis BCG vaccine strain, M. chelonei, M. fortuitum, M. kansasii, M. leprae,
M. malmoense, M. marinum, M. paratuberculosis, M. scrofulaceum, M. simiae, M. szulgai, M.
ulcerans, M. xenopi

--Mycoplasma, except M. mycoides and M. agalactiae which are restricted animal pathogens

--Neisseria gonorrhoeae, N. meningitidis

--Nocardia asteroides, N. brasiliensis, N. otitidiscaviarum, N. transvalensis

--Rhodococcus equi

--Salmonella including S. arizonae, S. cholerasuis, S. enteritidis, S. gallinarum-pullorum, S.
meleagridis, S. paratyphi, A, B, C, S. typhi, S. typhimurium

--Shigella including S. boydii, S. dysenteriae, type 1, S. flexneri, S. sonnei

--Sphaerophorus necrophorus

--Staphylococcus aureus

--Streptobacillus moniliformis

--Streptococcus including S. pneumoniae, S. pyogenes

--Treponema pallidum, T. carateum

--Vibrio cholerae, V. parahemolyticus, V. vulnificus

--Yersinia enterocolitica

Appendix B-II-B.   Risk Group 2 (RG2) - Fungal Agents

--Blastomyces dermatitidis

--Cladosporium bantianum, C. (Xylohypha) trichoides

--Cryptococcus neoformans

--Dactylaria galopava (Ochroconis gallopavum)


--Exophiala (Wangiella) dermatitidis

--Fonsecaea pedrosoi


--Paracoccidioides braziliensis

--Penicillium marneffei

--Sporothrix schenckii


Appendix B-II-C.   Risk Group 2 (RG2) - Parasitic Agents

--Ancylostoma human hookworms including A. duodenale, A. ceylanicum

--Ascaris including Ascaris lumbricoides suum

--Babesia including B. divergens, B. microti

--Brugia filaria worms including B. malayi, B. timori


--Cryptosporidium including C. parvum

--Cysticercus cellulosae (hydatid cyst, larva of T. solium)

--Echinococcus including E. granulosis, E. multilocularis, E. vogeli

--Entamoeba histolytica


--Fasciola including F. gigantica, F. hepatica

--Giardia including G. lamblia


--Hymenolepis including H. diminuta, H. nana


--Leishmania including L. braziliensis, L. donovani, L. ethiopia, L. major, L. mexicana, L.
peruvania, L. tropica

--Loa loa filaria worms


--Naegleria fowleri

--Necator human hookworms including N. americanus

--Onchocerca filaria worms including, O. volvulus

--Plasmodium including simian species, P. cynomologi, P. falciparum, P. malariae, P. ovale,
P. vivax

--Sarcocystis including S. sui hominis

--Schistosoma including S. haematobium, S. intercalatum, S. japonicum, S. mansoni, S.

--Strongyloides including S. stercoralis

--Taenia solium

--Toxocara including T. canis

--Toxoplasma including T. gondii

--Trichinella spiralis

--Trypanosoma including T. brucei brucei, T. brucei gambiense, T. brucei rhodesiense, T.

--Wuchereria bancrofti filaria worms

Appendix B-II-D.   Risk Group 2 (RG2) - Viruses

Adenoviruses, human - all types

Alphaviruses (Togaviruses) - Group A Arboviruses

--Eastern equine encephalomyelitis virus

--Venezuelan equine encephalomyelitis vaccine strain TC-83

--Western equine encephalomyelitis virus


--Lymphocytic choriomeningitis virus (non-neurotropic strains)

--Tacaribe virus complex

--Other viruses as listed in the reference source (see Section V-C, Footnotes and
References of Sections I through IV)


--Bunyamwera virus

--Rift Valley fever virus vaccine strain MP-12

--Other viruses as listed in the reference source (see Section V-C, Footnotes and
References of Sections I through IV)



Flaviviruses (Togaviruses) - Group B Arboviruses

--Dengue virus serotypes 1, 2, 3, and 4

--Yellow fever virus vaccine strain 17D

--Other viruses as listed in the reference source (see Section V-C, Footnotes and
References of Sections I through IV)

Hepatitis A, B, C, D, and E viruses

Herpesviruses - except Herpesvirus simiae (Monkey B virus) (see Appendix B-IV-D, Risk
Group 4 (RG4) - Viral Agents)


--Epstein Barr virus

--Herpes simplex types 1 and 2

--Herpes zoster

--Human herpesvirus types 6 and 7


--Influenza viruses types A, B, and C

--Other tick-borne orthomyxoviruses as listed in the reference source (see Section V-C,
Footnotes and References of Sections I through IV)


--All human papilloma viruses


--Newcastle disease virus

--Measles virus

--Mumps virus

--Parainfluenza viruses types 1, 2, 3, and 4

--Respiratory syncytial virus


--Human parvovirus (B19)


--Coxsackie viruses types A and B

--Echoviruses - all types

--Polioviruses - all types, wild and attenuated

--Rhinoviruses - all types

Poxviruses - all types except Monkeypox virus (see Appendix B-III-D, Risk Group 3 (RG3) -
Viruses and Prions) and restricted poxviruses including Alastrim, Smallpox, and Whitepox
(see Section V-L, Footnotes and References of Sections I through IV)

Reoviruses - all types including Coltivirus, human Rotavirus, and Orbivirus (Colorado tick
fever virus)


--Rabies virus - all strains

--Vesicular stomatitis virus - laboratory adapted strains including VSV-Indiana, San Juan,
and Glasgow

Togaviruses (see Alphaviruses and Flaviviruses)

--Rubivirus (rubella)

Appendix B-III.    Risk Group 3 (RG3) Agents

RG3 agents are associated with serious or lethal human disease for which preventive or
therapeutic interventions may be available.