Pathogens in Water Sicken Tens of Millions

by | Nov 8, 2020

Real-time water monitoring technologies can save lives and prevent illness. 

In a 2015 TED talk about pandemics, Bill Gates famously said, “not missiles, but microbes” pose the greater threat to human life.[i] His warning applies equally to water.
Microbes contaminated Milwaukee drinking water in 1993, sickening 403,000 people, and killing 69.[ii] Illnesses due to pathogenic contamination are endemic in the U.S.,[iii] and another mass outbreak is possible.[iv] Unfortunately, innovation of detection technologies lags far behind need

  • Pathogens in drinking water cause 19.5 million illnesses annually throughout the U.S.[v]
  • Pathogens cause 90 million illnesses in swimmers, and other water recreators.[vi]
  • Illnesses associated with waterborne pathogens cause $3.8B in hospital costs annually.[vii]

The need for innovation. Brief exposure to a pathogen can cause illness – during the 1993 event, some travelers were made ill by a public water fountain in Milwaukee’s Mitchell Airport.[viii] Detection technologies have advanced, but are not commercially available for pathogens.[ix

  • As was true in 1993, sampling for pathogens in drinking water is required only periodically, and analyses are by EPA-mandated laboratory methods that can take days.
  • There is a reluctance by businesses to make large investments in R&D for real-time pathogen detection due to reservations about marketability.[x]
  • Technology standards for the Federal Clean Water Act[xi] and Safe Drinking Water Act[xii] were written to advance innovations in treatment, but not monitoring.

A time for action. Bill Gates’ call for a global conversation about pandemics went unheeded, with terrible consequences. There is an immediate need for a national conversation about pathogens in water, and the innovations in tech, science, policy and business that can prevent tens of millions of illnesses.


[i]  Gates, Bill. “The next outbreak? We’re not ready.” TED, Mar 2015.

[ii] Gradus, Stephen. Milwaukee, 1993: The Largest Documented Waterborne Disease Outbreak in U.S. History. Water and Health. Water Quality and Health Council. 10 Jan 2014.

[iii] Bylund J, Toljander J, Lysén M, Rasti N, Engqvist J, Simonsson M. Measuring sporadic gastrointestinal illness associated with drinking water – an overview of methodologies. J Water Health. 2017;15(3):321‐340. doi:10.2166/wh.2017.261

[iv] Gradus, Stephen, Director, Milwaukee Public Health Laboratory (Ret). w/John Cronin. 19 Apr 2020.

[v] Reynolds KA, Mena KD, Gerba CP. Risk of waterborne illness via drinking water in the United States. Rev Environ Contam Toxicol. 2008;192:117‐158. doi:10.1007/978-0-387-71724-1_4.

[vi] DeFlorio-Barker, S., Wing, C., Jones, R.M. et al. Estimate of incidence and cost of recreational waterborne illness on United States surface waters. Environ Health. 2018 17, 3

[vii] Adam EA, Collier SA, Fullerton KE, Gargano JW, Beach MJ. Prevalence and direct costs of emergency department visits and hospitalizations for selected diseases that can be transmitted by water, United States. J Water Health. 2017;15(5):673‐683. doi:10.2166/wh.2017.083

[viii] Gradus, Stephen, w/John Cronin

[ix] Gradus, Stephen, w/John Cronin

[x] Phone interviews by John Cronin with representatives from two companies in the real-time technology field.

[xi] USEPA. Levels of Control. Effluent Guidelines. N.D.

[xii] USEPA. Drinking Water Regulations. Drinking Water Requirements for States and Public Water Systems. N.D.

John Cronin

John Cronin is director of Blue CoLab and executive director of the Center for Technology, Policy and the Environment in the Seidenberg School of Computer Science and Information Systems at Pace University.  

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