pathogens

PATHOGENIC

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
study.

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."
http://musa.org/

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
Solids

Pathogen Class	Examples	Disease	Hospitalization, Deaths USA
Bacteria	Shigella sp. Salmonella sp. Salmonella typhi Vibrio cholerae Enteropathogenic- Escherichia coli Yersinia sp. Campylobacter jejuni	Bacillary dysentery Salmonellosis gastroenteritis) Typhoid fever Cholera 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
Viruses	Hepatitis A virus Norwalk viruses Rotaviruses Polioviruses Coxsackie viruses Echoviruses	Infectious hepatitis Acute gastroenteritis Acute gastroenteritis Poliomyelitis "flu-like" symptoms "flu-like" symptoms
Protozoa	Entamoeba histolytica Giardia lamblia Cryptosporidium sp. Balantidium coli	Amebiasis (amoebic dysentery) Giardiasis (gastroenteritis) Cryptosporidiosis (gastroenteritis) Balantidiasis (gastroenteritis)	400 in Milwaukee
Helminths	Ascaris sp. Taenia sp. Necator americanus Trichuris trichuria	Ascariasis (roundworm infection) Taeniasis (tapeworm infection) Ancylostomiasis (hookworm infection) Trichuriasis (whipworm infection)

http://216.239.39.104/search?q=cache:4UwTtht5ZHMJ:www.epa.gov/owm/pipes/sludmis/m
str-ch5.pdf+sewage+workers+disease&hl=en&ie=UTF-8

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))

Category

Disease

Effects

Bacteria
Aeromonas hydrophila Aeromonas salmonica	Furniculosis (Lesions on fish)	Lesions, death
Campylobacter spp.	Gastroenteritis	Vomiting, diarrhea, death
Clostridium botulinum	Botulism	Tetany, death
Escherichia coli	Gastroenteritis	Vomiting, diarrhea, death
Legionella pneumonophila	Legionellosis	Acute respiratory illness
Leptospira	Leptospirosis	Jaundice, fever
Pseudomonas aeruoginosa	Lesions in fish	Skin ulcerations, death
Salmonella typhi	Typhoid Fever	Fever, diarrhea, ulceration of small intestine
Salmonella	Samonellosis	Diarrhea, dehydration
Shigella	Shigellosis	Dysentery
Vibrio cholerae	Cholera	Extreme diarrhea, dehydration
Yersinia enterolitica	Yersinosis	Diarrhea
Viruses
Adenoviruses	Respiratory disease
Enteroviruses	Gastroenteritis	Heart anomalies, meningitis
Hepatis A	Infectious hepatitis	Jaundice, fever, eventual death
Norwalk/Snow/Mountain/ small round	viruses	Gastroenteritis, Vomiting, diarrhea
Reovirus	Gastroenteritis	Vomiting, diarrhea
Rotavirus	Gastroenteritis	Vomiting, diarrhea
Protozoans
Cryptosporidium	Cryptosporidiosis	Diarrhea
Entamoeba histolytica	Giardiasis	Mild to severe diarrhea, nausea, indigestion
Giardia lamblia	Giardiasis	Mild to severe diarrhea, nausea, indigestion
Naegleria fowleri	Amoebic Meningoencephalitis	Fatal brain inflammation

http://64.233.179.104/search?q=cache:HZdxwkfLwLMJ:el.erdc.usace.army.mil/elpubs/pdf/wqtnp
d03.pdf+Naegleria+fowleri,+sewage+sludge&hl=en&ie=UTF-8

Disease-Causing Agents
http://www4.od.nih.gov/oba/rac/guidelines_02/APPENDIX_B.htm

APPENDIX B.     CLASSIFICATION OF HUMAN ETIOLOGIC AGENTS ON THE BASIS OF
HAZARD
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.
http://www.atsdr.cdc.gov/SO/emergdis.html

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)

--Actinobacillus

--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
(RG3))

--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

--Listeria

--Moraxella

--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)

--Epidermophyton

--Exophiala (Wangiella) dermatitidis

--Fonsecaea pedrosoi

--Microsporum

--Paracoccidioides braziliensis

--Penicillium marneffei

--Sporothrix schenckii

--Trichophyton

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

--Coccidia

--Cryptosporidium including C. parvum

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

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

--Entamoeba histolytica

--Enterobius

--Fasciola including F. gigantica, F. hepatica

--Giardia including G. lamblia

--Heterophyes

--Hymenolepis including H. diminuta, H. nana

--Isospora

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

--Loa loa filaria worms

--Microsporidium

--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.
mekongi

--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.
cruzi

--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

Arenaviruses

--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)

Bunyaviruses

--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)

Caliciviruses

Coronaviruses

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)

--Cytomegalovirus

--Epstein Barr virus

--Herpes simplex types 1 and 2

--Herpes zoster

--Human herpesvirus types 6 and 7

Orthomyxoviruses

--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)

Papovaviruses

--All human papilloma viruses

Paramyxoviruses

--Newcastle disease virus

--Measles virus

--Mumps virus

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

--Respiratory syncytial virus

Parvoviruses

--Human parvovirus (B19)

Picornaviruses

--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)

Rhabdoviruses

--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.