At a glance
Flooding can contaminate the ground, soil, and other outdoor areas with both bacteria and viruses, but limited guidance exists on how to determine when these areas are safe to use. Increased levels of microbes in floodwaters increase the risk of human exposure and the likelihood for infection. Learn more about how to assess the level of risk posed by microbial contamination after a flood event.
Flooding can spread contaminants that can cause illnesses
Floodwater can overflow into human use spaces like ball fields, playgrounds, and residential yards. It can come from wastewater treatment plants, sewer lift stations, sewer collection systems (e.g., manholes and sewer mains), and septic systems.
These floodwaters may spread bacteria, viruses, protozoa, and other microbial contaminants that can cause illnesses.1 These illnesses range from mild stomach upset to serious diseases such as dysentery, infectious hepatitis, and severe gastroenteritis. Typically, it takes 2–3 months for enteric bacteria to significantly reduce in soil, with certain exceptions. But due to different microbial responses to the environment, providing universal guidance is difficult.
Note: This guidance does not address chemical contamination issues associated with flood events. Get information about chemicals released during a natural disaster.
Assess risk with a systematic approach
Different microbes can survive in a variety of different environmental conditions, so providing universal guidance is difficult. Instead, health authorities should use a risk-assessment approachA that considers all variables to characterize potential risks on a case-by-case basis.
Floodwater microbe concentration depends on several factors
Hazard identification
Can any of the contaminants found affect human health?
- Identify potential sources of contamination.
- Determine likelihood of microorganisms in the water.
Dose-response assessment
Are contaminants found at a level that can affect health?
- Estimate the concentration of microorganisms and their ability to cause illness.
- Consider the extent and duration of flooding and effects on surrounding areas.
- Consider location of potential contamination sources and proximity to flooded areas.
Exposure assessment
Who may be exposed, for how long or how frequently, and how much?
- Consider environmental conditions such as soil drying out, sunlight, and temperature.
- Conduct a site assessment and environmental sampling to determine the degree of soil saturation, debris, etc.
Risk characterization
What can you conclude about human risk?
- Consider all information gathered in previous steps and determine the magnitude of the public health problem.
- Identify potential contamination sources.
- Determine factors that may influence microbial concentration and survival.
- Determine the potential effect on exposed populations.
- Consider the intended use for flooded outdoor areas.
- Identify potential contamination sources.
- Consider how remedial action could affect human health and the environment, including risks to plants and animals.
Decision and actions or interventions
What are the first priorities?
- Determine whether to allow occupancy of flooded areas.
- Decide if intervention or other precautionary actions are necessary. Examples include promoting personal hygiene, adding signage, taking remedial actions, etc.
Reduce public health risk with key steps
It can take up to several months for microbes to naturally die off in contaminated soil. For this reason, personal hygiene is key to reducing the risk to public health. Cleaning up the contamination and educating the public will help reduce the risk of disease spreading from floodwaters.
Managing pests before safely reopening public spaces
You may need to manage pests before safely reopening public spaces.
Standing water and sewage can harbor flies and mosquitoes.
Floods can displace rodents and other vectors.
Educate the public on keeping safe and healthy
Signs can help discourage use of potentially hazardous areas and raise awareness about public health and safety concerns.
- Warn to avoid standing water, areas with visible debris, and areas where floodwater has accumulated.
- Emphasize proper handwashing. Providing adequate washing and drying supplies and equipment in restrooms and facilities is key.
Clean or throw away anything that came in contact with floodwater
Floodwater can cause illness if items are not cleaned or discarded.
- Pay attention to areas where young children are likely to play.
- Consider replacing:
- Soil
- Mulch
- Sand in sandboxes
- Wood chips around outdoor playground equipment.
- Soil
Clean small areas of heavy contamination (for example, sewage with visible solids)
Hydrated lime can control and remediate microbial hazards in affected areas.
- Consider treatment with hydrated lime (also called slaked lime).
- Use lime safely45 to prevent health hazards and damage to personal property. Wear protective clothing and eye protection.
Consider other remedial and control options
- Spread new soil on top of the affected soil, and compact it down, plant new grass, etc.
- Water heavily to flush organisms out of upper soil layers.
- Improve grading and drainage to avoid standing water.
- Apply dust-suppressant products if waters leave behind sand and silt that can blow in wind.
Frequently asked questions
How common are harmful levels of microbial contaminants in floodwater?
Floodwaters commonly contain microbial contaminants and can directly affect public health. Municipal water system supplies include groundwater wells and surface water. These are more likely to be compromised during and shortly after flood events.2
- After Hurricane Katrina,6 elevated microbial contaminants, specifically fecal coliforms, were consistent with levels detected in previous stormwater discharges in the area.
- During the Midwest flooding of 2001,7 researchers identified increased incidence of gastrointestinal illness.
Why is it difficult to determine when microbes are no longer surviving in soil?
Microbial survival in soil and the resulting potential for human exposure is difficult to predict. This is because of natural variability in environmental factors and varying microbial susceptibilities. This reinforces the need to implement a risk-assessment approach that considers all variables that could influence potential exposure.
- Environmental factors3891011 such as temperature, soil desiccation, pH, soil characteristics, and sunlight influence microbial survival and persistence.
- Intensity of sunlight exposure, level of soil desiccation, and ambient temperatures necessary to effectively kill all microbes within a specified time vary among microbes.
- Certain microbes can get into stable soil, which may help them survive longer.
- Some nutrients in the soil may help microbes survive and even multiply in some cases.
- Certain microbes can get into stable soil, which may help them survive longer.
What do we know about specific pathogens surviving in the soil?
Survival characteristics for microbes under specified conditions have been reported, but microbial responses differ.
Here's what we know:
- Shigella has survived in soil at room temperature for 9–12 days.12
- Cryptosporidium oocysts may survive in a moist environment for 60–180 days.2
- Spore-forming microbes such as coccidioides, 13 a fungus in semiarid southwestern U.S. soil, and anthrax spores can survive in soil for many years.14
What pH is necessary to treat sewage sludge for land application?
The U.S. Environmental Protection Agency (EPA)15 requires the following:
- To kill microbes: a pH of 12 for at least 2 hours.
- To deter vectors: a pH of at least 11.5 for an additional 22 hours or more.
- Steps adapted from Risk assessment in the federal government: Managing the process (National Research Council 1983).
- U.S. Environmental Protection Agency. Source water protection practices bulletin: Managing sanitary sewer overflows and combined sewer overflows to prevent contamination of drinking water. EPA 916-F-01-032. Washington, DC: U.S. Environmental Protection Agency Office of Water; 2001.
- Salvato J, Nemerow N, Agardy F. Environmental engineering. 5th ed. Hoboken, NJ: John Wiley & Sons, Inc.; 2003.
- Hurst C, Knudsen G, McInerney M, Stetzenbach L, Walter M. Manual of environmental microbiology. Washington, DC: ASM Press; 1997.
- National Lime Association. Fact sheet—lime safety precautions. Arlington, VA: National Lime Association; 2004. Available from URL http://www.lime.org/documents/lime_basics/fact-safety_precautions.pdf [accessed 2021 Jan 29].
- Lim S, Jeon W, Lee J, Kim N. Engineering properties of water/wastewater-treatment sludge moderated by hydrated lime, fly ash and loess. Wat Res; 36(17):4177-4184.
- Pardue J, Moe W, McInnis D, Thibodeaux L, Valsaraj K, Maciasz E, et al. Chemical and microbiological parameters in New Orleans floodwater following Hurricane Katrina. Environ Sci Technol. 2005;39(22):8591-9.
- Wade T, Sandhu S, Levy D, Lee S, LeChevallier M, Katz L, et al. Did a severe flood in the Midwest cause an increase in the incidence of gastrointestinal symptoms? Am J Epidemiol. 2004;159(4):398–405.
- Bitton G, Gerba C. Groundwater pollution microbiology. New York: John Wiley & Sons; 1984.
- Gantzer C, Gillerman L, Kuznetsov M, Oron G. Adsorption and survival of fecal coliforms, somatic coliphages and F-specific RNA phages in soil irrigated with wastewater. Wat Sci Technol. 2001;43(12):117–24.
- Manios T, Moraitaki G, Mantzavinos D. Survival of total coliforms in lawn irrigated with secondary wastewater and chlorinated effluent in the Mediterranean region. Wat Environ Res. 2006;78(3):330–4.
- Yeager J, O’Brien R. Enterovirus inactivation in soil. Appl Environ Microbiol. 1979;38(4):694–701.
- Percival S, Chalmers R, Embrey M, Hunter P, Sellwood J, Wyn-Jones P. Microbiology of waterborne diseases. Boston: Elsevier Academic Press; 2004.
- Centers for Disease Control and Prevention. Valley fever (coccidioidomycosis). Atlanta: U.S. Department of Health and Human Services; 2020. Available from URL https://www.cdc.gov/valley-fever/ [accessed 2021 Jan 29].
- Centers for Disease Control and Prevention. Anthrax. Atlanta: U.S. Department of Health and Human Services; 2020. Available from URL https://www.cdc.gov/anthrax/index.html [accessed 2021 Jan 29].
- U.S. Environmental Protection Agency. Environmental regulations and technology: control of pathogens and vector attraction in sewage sludge. EPA/625/R-92/013. Cincinnati, OH: U.S. Environmental Protection Agency Office of Research and Development; 2003.
- Suggested citation: Centers for Disease Control and Prevention. Reopening outdoor public spaces after flooding. Atlanta: U.S. Department of Health and Human Services; 2021.