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Feces and Urine-Human Biological Agent Reference Sheets (BARS)

Updated December 1, 2023

Disclaimer: Risk group, biosafety level, and all other precautions noted here are subject to change after a risk assessment by EHS.

Summary

Agent TypeRisk GroupBiosafety LevelAnimal Housing Biosafety Level
BiohazardRG-2BSL-2ABSL-2

Special Considerations - Polio and Materials that may Contain Poliovirus

Samples that may contain poliovirus or PIM can be obtained from various geographic regions and time periods. Poliovirus is still endemic in specific areas of the world, including parts of Africa, Asia, and the Middle East. Hence, any samples like feces or sewage collected from these regions, or from people who have visited these areas, might have the virus. It's important to note that the virus was once prevalent in many regions worldwide; therefore, older samples from different areas may also be at risk of containing poliovirus. To ensure the samples are handled safety, it is critical that principal investigators handling any human materials, particularly feces and urine, report the presence of poliovirus or PIM to the Cornell Biosafety Officer, as per the WHO GAPIII guidelines for poliovirus containment.

For more complete guidance on what is considered to be potentially infectious materials, please see the definitions provided by the CDC National Authority for the Containment of Poliovirus or contact the Biosafety Officer.

Agent Characteristics 

Risk Group:  RG-2 associated with human disease, rarely serious; preventive or therapeutic interventions often available.

Agent Type:  Biohazard

Description: Human fecal material may contain a variety of pathogens, including bacteria, viruses, and parasites. Pathogens potentially present in human feces include Bacterioides spp., Salmonella, Shigella, Yersinia, Campylobacter, Aeromonas, Candida, E. coli 0157:H7, Klebsiella, Cryptosporidium, Entamoeba histolytica, viruses including Norovirus and Hepatitis A, and intestinal parasites. Additionally, visible blood in feces may indicate the presence of bloodborne pathogens including HIV, Hepatitis B, and Hepatitis C. Human urine is typically not hazardous. It can be potentially hazardous if there is visible blood or if originating from an individual with a urinary tract infection. As such, urine should be treated with universal precautions.

Host Range: Varies                                    Host Shedding: Feces, Urine (with visible blood)                            

Route of Exposure to Humans: Direct Contact, Mucous Membranes, Animal Bites, Ingestion, Percutaneous

Infectious Dose: Varies                             Incubation Period: Varies


Health Hazards

Signs and symptoms of infection will vary. 

Immunizations: Available, depending on agent                  Prophylaxis*: Available, depending on the agent

*Formal medical advice is obtained during medical consultations with Cornell Health or primary healthcare provider as needed.


Agent Viability 

Survival Outside HostDisinfection
Fecal material can harbor various pathogens for a number of days or weeks, depending on the pathogens present. Good disinfection practices and hygiene are critical.1:10 Bleach Dilution 

For more guidance on disinfection see: disinfectant selection.


Laboratory Hazards 

  • High energy-creating activities (centrifugation, sonication, high pressure systems, vortexing, tube cap popping)
  • Handling of sharps (needles, scalpels, microtome blades, broken glass, etc.)
  • Splash/droplet-creating activities (shaking incubators, liquid culturing, mechanical pipetting)
  • Equipment contamination
  • Exposed skin/uncovered wounds

Laboratory Acquired Infection (LAI) History: One case of giardiasis was reported in a clinical laboratory technologist who processed specimens, many of which were in leaky containers. One case of Isospora belli infection occurred in a technologist who examined numerous stool specimens from a patient infected with I. belli. Occupational illnesses associated with direct handling of fecal material are not well tracked in the literature, whereas specific pathogen-related infections are. 


Laboratory Handling Guidelines 

Laboratory Biosafety Level (BSL): BSL-2

TrainingLab Engineering ControlsPersonal Protective Equipment
  • Eye Protection
  • Single gloves
  • Snap-front lab coat with cinch cuffs

Waste Management: Regulated Medical Waste (RMW)

Shipping Guidance: Refer to EHS Biological Materials Shipping 


Animal Vivarium Guidance

Animal Housing Biosafety Level (ABSL): ABSL-2

Animal Biosecurity: Information not available.          

Perform Inoculations: Biosafety Cabinet, Benchtop, Cage Changing Station

Change Cages: Biosafety Cabinet, Benchtop, Cage Changing Station


Exposure and Spill Procedures 

Mucous Membranes: Flush eyes, mouth, or nose for 15 minutes at an eyewash station. See: responding to exposures.

Other Exposures: Wash with soap and water for 15 minutes (open wounds, sores, etc.) or a minimum of 20 seconds for areas with intact skin. See: responding to exposures

Small Spills: Notify others working in the lab. Evacuate area and allow 30 minutes for aerosols to settle. Don appropriate PPE. Cover area of the spill with paper towels and apply disinfectant, working from the perimeter toward the center. Allow 30 minutes of contact time before disposal and cleanup of spill materials. See: spill cleanup.

Large Spills: Request assistance from the EHS Spill Team by calling CUPD dispatch. Call 911 from a campus phone or 607-255-1111 from a mobile phone.

Incident Reporting: Immediately report the incident to supervisor and complete the EHS online injury/illness report as soon as possible.

Medical Follow-Up:

  • For students, seek medical attention at Cornell Health or local primary care provider. Call Cornell Health at 607-255-5155 (24-hour phone consultation line) or a local urgent care. 
  • For faculty and staff, seek medical evaluation with a local primary care provider or urgent care. Cornell Health does not see employees for post-exposure care. 
  • Emergencies: Call 911 from a campus phone or 607-255-1111 from a mobile phone. 
Cornell EHS would like to thank Emory University for the use of their Biological Agent Reference Sheet (BARS) format and some content. 

More Information

References:

  1. Mermel LA, Allon M, Bouza E, et al. Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2009;49(1):1-45.  
  2. Stool Specimens – Safety. DPDx - Laboratory Identification of Parasitic Diseases of Public Health Concern. Centers for Disease Control and Prevention. 
  3. Diseases Involving Sewage. Indiana State Department of Health..