Food Safety Food Manager

Dive Deeper: 13 Water-Related Foodborne Illnesses You Need to Know

Posted by
Trust20 Contributors • 9 minute read

You put a lot of thought into the food you serve your customers. It’s a point of pride, as it should be for the foodservice industry!

However, many fail to realize that even if you go above and beyond to prevent foodborne illnesses, it’s not just the food you need to think about. You also need to consider the water.

Waterborne illnesses are often overshadowed by more recognizable (and common) foodborne pathogens, yet they still pose a significant risk.

In this post, we’ll take a closer look at some common waterborne diseases–and how you can prevent them.

What Foodborne Illnesses Can Be Spread From Water?

Preventing Water-Related Diseases in Your Foodservice Establishment

What Foodborne Illnesses Can Be Spread From Water?

Waterborne illnesses are those that occur from ingesting contaminated water or food that’s prepared with contaminated water.

The good news is that most of these illnesses aren’t very common in developed countries. They tend to be more common in rural areas and developing countries.

However, outbreaks can and do occur worldwide. The Centers for Disease Control has listed numerous pathogens, and even chemical and physical contaminants, that can be spread through our water.

Here’s a closer look at the microbes and contaminants that can survive (and thrive) in water:

1. Salmonella 

Salmonella is a bacterial infection notorious for causing gastroenteritis in humans and is especially concerning in foodservice settings due to its high potential for waterborne transmission.1

The most common symptoms include diarrhea, fever, and abdominal cramps, which can last up to seven days.

While most individuals recover without specific treatment other than hydration, in vulnerable populations, like older adults, infants, and those with compromised immune systems, the illness can progress to more severe complications.

2. Shigella

Shigella is a highly infectious bacteria that causes shigellosis, a type of diarrhea laden with blood and mucus.1 It's typically contracted through contaminated water or surfaces within foodservice operations. 

The symptoms (stomach cramps, diarrhea, fever, and headaches) generally last four to seven days. While most individuals will recuperate with proper hydration, others may require antibiotics.

Those most vulnerable to Shigella infections include young children, travelers to certain countries, and individuals with weakened immune systems. 

3. E.Coli

E. coli, particularly the pathogenic strains, can be transmitted through feces-contaminated water and surfaces in foodservice settings, leading to illnesses with symptoms such as stomach cramps, bloody diarrhea, and vomiting.1

While most cases of E. coli infections are mild, some can be life-threatening, particularly for vulnerable groups like very young children and older adults, resulting in hemolytic uremic syndrome that leads to kidney failure. 

4. Campylobacteriosis

Campylobacter is one of the leading bacterial causes of diarrheal diseases in the United States and can be transmitted via untreated water in foodservice establishments.2 It often leads to inflammatory, occasionally bloody diarrhea, accompanied by fever.

Typically, this illness resolves within one week but can pose a higher risk to immunocompromised customers or staff. 

5. Cholera 

Cholera is a severe waterborne disease caused by the consumption of water contaminated with the Vibrio cholerae bacterium.1 In food service settings, cholera can cause a rapid onset of extreme watery diarrhea and dehydration, which, if left untreated, can be fatal within hours. 

The disease is rare in developed countries with advanced water treatment facilities but poses a significant threat where water sanitation is inadequate. 

6. Typhoid Fever

Typhoid fever is a life-threatening infection caused by the bacterium Salmonella typhi and is often associated with poor water and sanitation conditions, which can be present in underdeveloped areas of large urban centers.3 

The symptoms can be severe, including high and sustained fever, weakness, and stomach pains. 

7. Giardia

Giardiasis, an infection caused by the parasite Giardia, can occur through water contamination with feces.2 In foodservice, giardiasis can provoke symptoms that include diarrhea, gas, stomach cramps, and nausea for up to two weeks. 

8. Dysentery 

Dysentery, often caused by Shigella or the amoeba Entamoeba histolytica, leads to severe inflammatory bowel movements with blood and mucus.3 

In food service scenarios, it generally spreads through sanitation failures and can lead to drastic staff illness and customer outbreaks. 

9. Hepatitis A

Hepatitis A is a viral infection that targets the liver and is spread through ingestion of contaminated water, posing a significant risk in food service environments.3

Its symptoms can range from mild to severe, including fever, fatigue, and jaundice. 

10. Legionella

Legionella, responsible for Legionnaires’ disease, can proliferate in water systems like cooling towers as well as in hot water tanks found in foodservice operations.3

The primary transmission route is inhaling aerosols containing the bacteria, which leads to symptoms such as high fever, chills, and cough. 

11. Norovirus

Norovirus is perhaps the most common–and incredibly contagious–virus that can quickly spread through water contaminated by an infected person.2 Its symptoms, including diarrhea and vomiting, surface within 12 to 48 hours of exposure and persist for up to three days.

12. Cryptosporidiosis (Crypto)

Cryptosporidiosis, commonly known as Crypto, is a waterborne disease caused by the Cryptosporidium parasite.2 Contamination of water sources with this microscopic parasite can lead to severe intestinal issues, primarily watery diarrhea. 

Cryptosporidium poses a significant threat in foodservice settings, where water quality is crucial for food preparation and hygiene.

Individuals exposed to contaminated water risk developing symptoms such as abdominal cramps, dehydration, nausea, and fever. Those with weakened immune systems, young children, and older adults are particularly vulnerable to severe complications from Cryptosporidiosis.

13. Chemical or Physical Contaminants

Chemical or physical contaminants can enter the water supply through various routes, including agricultural runoff, industrial discharge, and decrepit plumbing systems. Contaminants can also originate from natural sources, like heavy metals in bedrock. 

In foodservice, this kind of waterborne contamination can have significant implications, affecting not just the safety of the water consumed directly but also the integrity of every single type of food and beverage served.

The symptoms and risks associated with chemical or physical contaminants will vary widely depending on the substance. They can range from acute effects, such as gastrointestinal discomfort, to chronic health impacts, including neurological disorders and increased risk of cancer with long-term exposure.

While everyone is at risk from exposure to waterborne chemical and physical contaminants, people with compromised immunity, chronic illnesses, and those undergoing certain treatments like dialysis or chemotherapy may be more vulnerable. Pregnant women and children are also particularly susceptible to the harmful effects of contaminants.

Preventing Water-Related Diseases in Your Foodservice Establishment

Now that you know the risks, here are some best practices you should follow to protect your customers and staff. 

1. Treat Your Water

While most community water systems meet standard regulatory requirements in developed countries, there can still be a danger of contaminants that might slip through, posing a health risk in a foodservice setting. 

To avoid these risks, you may want to consider investing in advanced water treatment systems, such as filtration, ultraviolet light purification, or reverse osmosis. These systems can greatly enhance water quality. 

These systems can remove physical impurities, chemical contaminants, and pathogens that might cause illnesses or other problems. 

Once you have a water treatment or purification system in place, make sure that your equipment undergoes regular checks and maintenance to keep these systems effectively guarding against disease.

2. Clean Your Bathrooms

Maintaining impeccable bathroom cleanliness may seem like an obvious norm. However, staff may overlook this process–with dire consequences that go far beyond a litany of negative Yelp reviews.

For one, restroom facilities can be breeding grounds for pathogens when they aren’t regularly (and thoroughly) cleaned and disinfected. 

Implementing rigorous cleaning schedules and ensuring you train all staff members on proper sanitation techniques is a must. 

Anyone designated to clean the bathrooms should also use antibacterial agents and cover all touchpoints, such as faucets, door handles, and toilet flush levers. The cleanliness of these shared spaces plays a central role in reducing the spread of contaminants to other parts of your establishment, including the kitchen and dining areas.

3. Follow Good Hand Hygiene

Effective hand hygiene is a foundational rule in any food service establishment's health and safety playbook–it’s a big tenant of ours here at Trust20. 

Remember, hands come into regular contact with food, utensils, and surfaces and are common transmitters of germs. A strict handwashing routine–one that involves the use of soap, warm water, and robust scrubbing techniques for at least 20 seconds–should be established and followed.

Hand sanitizer can be a helpful addition to your routine, but it shouldn’t replace good (and frequent!) handwashing. Handwashing needs to be mandatory after using the restroom, handling waste, switching between handling raw foods and ready-to-eat foods, and entering the kitchen from outside the building.

4. Do Some Research Into Your Water Supply

Understanding your water supply chain is more important than you may realize, and few of us spend any time thinking about it.

Learn about the source of your community water system—whether groundwater, a municipal reservoir, or a combination.

Once you know where your kitchen’s water comes from and how it’s treated, you’ll have more information about how to assess potential risks and threats. Contact local authorities or water providers to get an idea of your water’s origin and safety. 

5. Pay Attention to Water Advisories

Water advisories, whether boil orders or notices of potential contamination, are issued by local public health agencies for a reason and should be followed to a T–without exception. 

Set up a system to receive immediate notifications of such advisories so you can take swift action to protect your customers. Depending on the severity of these notices, the recommended actions may include boiling water before use, temporarily using bottled water, or modifying your operational procedures to mitigate risks.

6. Maintain and Monitor Your Plumbing Systems

The state of your establishment's plumbing systems can be quite telling about the purity of your water.4 Cracks, leaks, or outdated infrastructure can introduce contaminants into your water supply. 

Because of this, regular plumbing inspections and preventive maintenance are indispensable. Pay close attention to equipment that comes into direct contact with water, such as ice machines and beverage dispensers.

Also, be vigilant about potential signs of system failures, including unexplained water pressure fluctuations or discolored water, and address any issues without delay. Calling in a plumber might be expensive–but nothing’s more costly (financially and otherwise) than a waterborne illness outbreak.

7. Be Mindful of Cross Connections

Cross-connections in your plumbing system present one of the most serious risks to the purity of your water.1 They occur when potable water lines are connected to non-potable water sources, which can lead to backflow events and, consequently, contamination.

You must implement specific control measures, such as vacuum breakers and air gaps, to prevent this. These devices are designed to create an intentional space in the system that stops tainted water from moving backward into the clean water supply.

Conduct an audit to identify potential cross-connections and consult with a certified plumber to ensure that appropriate backflow prevention devices are installed and functioning properly.

Final Thoughts

Water plays a pivotal role in food service establishments, whether it stems from contaminated irrigation practices, a water main break, or poor hygiene in food handling.

Knowledge is power, and awareness of potential issues (no matter how uncommon they might be) is your frontline defense against these issues. 

Don’t wait until you find yourself in troubled waters. Turn to Trust20 for top-notch food safety training products to give your team the basic understanding they need to keep everyone safe.

A good defense will always be the best offense against foodborne (and waterborne) illnesses. Take the plunge with Trust20 today!

New call-to-action


  1. Illinois Department of Public Health: Food-and Water-Borne Illnesses
  2. UC Davis Health: Foodborne and Waterborne Illnesses
  3. CDC: Legionnaires Disease Cause and Spread
  4. Penn State Extension: Safe Water and Your Foodservice Operation