Sewage can make you sick when the bacteria, viruses and parasites it carries reach your mouth, eyes or broken skin. The illnesses it causes range from gastrointestinal infection and hepatitis A to skin, eye and wound infections, with diarrhea, vomiting and fever the most common symptoms. Young children, older adults and people with weakened immune systems face the highest risk. Boots, gloves, goggles and careful handwashing prevent most infections during cleanup.
How Does Sewage Make People Sick?
Sewage makes people sick when bacteria, viruses or parasites in it reach the mouth, eyes or broken skin, most often through hands touching the face. Sewage carries 3 groups of germs: bacteria such as E. coli, viruses such as norovirus and hepatitis A, and parasites such as Giardia. The Arkansas Department of Health warns that sewer water can contain bacteria, fecal material, viruses and other organisms that cause disease (Arkansas Department of Health, 2023).
Infection follows contact, not proximity. A gloved hand that rubs an eye, a sandwich eaten in the cleanup room, or a scrape on a shin is the usual route in.
Can you get sick from just smelling sewage?
No, the smell itself does not carry an infection, because odor comes from gases, not germs. Splashing, scrubbing and spraying do throw germ-laden droplets into the air, which is why an N95 mask is worn during cleanup. The gases behind the smell carry their own risks, covered in the guide to sewer gas.
Which Illnesses Can Sewage Cause?
The 5 illness types linked to sewage exposure are gastrointestinal illness, hepatitis A, skin and wound infections, eye infections and leptospirosis. Each one starts with the same contact routes.
| Illness | Usual cause | Common symptoms | Source |
|---|---|---|---|
| Gastrointestinal illness | E. coli, norovirus, Giardia, Cryptosporidium | Diarrhea, vomiting, stomach cramps, fever | CDC |
| Hepatitis A | Hepatitis A virus from feces | Fatigue, nausea, stomach pain, yellow skin or eyes | CDC |
| Skin and wound infections | Bacteria entering cuts and scrapes | Redness, swelling, warmth, pus at a wound | CDC |
| Eye infections | Splashes or rubbing eyes with dirty hands | Red, sore, watery or sticky eyes | CDC |
| Leptospirosis | Bacteria from animal urine in sewage and floodwater | Fever, headache, muscle aches, chills | CDC |
Gastrointestinal illness is the most common outcome of household sewage contact. Leptospirosis is rare in household backups but is linked to sewage-contaminated areas where rodents live.
What Symptoms Should You Watch For After Sewage Contact?
The symptoms to watch for after sewage contact are diarrhea, vomiting, stomach cramps, fever, rashes and red or sore eyes. Write down the date of the backup, because symptoms can show up days or weeks later.
These 6 symptoms are the ones to report to a doctor after sewage contact:
- Diarrhea, especially if bloody
- Vomiting
- Stomach cramps
- Fever
- A red, swollen or warm wound
- Red, sore or sticky eyes
Tell the doctor about the sewage exposure, because it changes which tests they order. Children and older adults lose fluids fast with diarrhea and vomiting, so call sooner for them.
How soon do symptoms appear after sewage exposure?
Symptoms appear anywhere from 12 hours to about 7 weeks after exposure, depending on the germ. The CDC puts norovirus at 12 to 48 hours, most E. coli infections at 3 to 4 days and Giardia at 1 to 2 weeks (CDC). Hepatitis A takes 15 to 50 days to cause symptoms, so a late illness can still trace back to a backup (CDC).
Who Is Most at Risk From Sewage Exposure?
The people most at risk from sewage exposure are young children, older adults, pregnant people and anyone with a weakened immune system. These groups get sicker from the same germs and recover more slowly.
- Children under 5, who touch everything and put hands in their mouths
- Adults over 65
- Pregnant people
- People on chemotherapy, transplant drugs or steroids
- People with chronic illness such as diabetes or kidney disease
- Anyone with open wounds or skin conditions
Keep everyone in these groups out of the house, or at least out of the affected rooms, until cleanup and disinfection are finished. Pets stay out too, because they track sewage into clean rooms.
How Do You Protect Yourself During Sewage Cleanup?
You protect yourself during sewage cleanup by covering cuts, wearing boots, gloves and goggles, keeping hands away from your face and washing thoroughly afterward. The CDC lists goggles, a face shield, waterproof gloves and rubber boots as protective gear for handling sewage (CDC).
- Cover every cut and scrape with a waterproof bandage before you start.
- Wear rubber boots, waterproof gloves, goggles and an N95 mask.
- Keep your hands away from your eyes, nose and mouth.
- Eat and drink only outside the work area, after washing up.
- Wash your hands with soap and clean water after every break and at the end.
- Launder cleanup clothes separately in hot water.
Seattle Public Utilities advises talking to a doctor about a tetanus shot if you get cut during cleanup (Seattle Public Utilities). The protective gear and supplies for sewage cleanup cover each item in the kit.
Can Sewage Lead to Long-Term Problems Like Mold or Cancer?
The lasting health problem after a backup is usually mold, not the sewage itself. Materials left wet for more than 24-48 hours start growing mold, which brings its own allergy and asthma risks (EPA). Mold growth after a sewage backup covers how fast it starts and where it hides.
Is There a Link Between Sewage Cleanup and Cancer?
No direct link between household sewage cleanup and cancer is established by health agencies; the documented risks are infections and, after poor drying, mold. CDC and state health department guidance on sewage backups focuses on infection, injury and chemical safety.
The chemical risk in cleanup comes from mixing products. Bleach mixed with ammonia releases a toxic gas, so use one product at a time (Arkansas Department of Health, 2023).
Can Sewage Get Into Drinking Water at Home?
Sewage rarely reaches a home’s drinking water, because municipal supply lines are pressurized and separate, but a backflow event or a private well near a failing septic system can contaminate it. Gilbert’s town water system keeps supply lines under pressure, which pushes water out rather than letting sewage in.
The EPA advises having a private well tested after flooding or any sign of contamination (EPA). Some homes in Gilbert’s county islands use septic systems, and a few have wells. Those homes use bottled water until a test confirms the well is safe.