Sewage can enter the river in many ways, from waste water treatment plant, livestock operations, illegal sewer hookups, failing septic systems and illegal dumping from vessels. Regardless of how it enters the river, pathogens in sewage can make the water unsafe and unenjoyable for recreation. Swimming, boating and other water-contact activities in fecal-contaminated streams and rivers can result in a variety of illnesses from minor infections to serious illnesses. Because sewage is such a major issue that poses a direct public threat, we operate a bacteria monitoring program called Swim Guide every summer at popular swimming holes and stay busy in the off season working to reduce sources of fecal pollution.