Lake Acworth
 

In early 1990's Lake Acworth's swim beach was closed because fecal coliform bacterial levels typically exceeded state standards.

Historical background on water-borne disease organisms:
Micro-organisms in water were not clearly linked to disease (e.g. typhoid and cholera) until the end of the late 1800's.
Primary sewage treatment usually kills pathogens through chlorination. However: The problem with monitoring for disease-causing pathogens is that it only takes a very few, very small organisms to infect a person.  The strategy is to look for more common micro-organisms of sewage that are potentially associated with pathogens.
 
 

Fecal coliform bacteria are used as indicators. They are not usually harmful, but are very common in the human gut. They do not reproduce outside of the gut, so their presence in the environment indicates the input of feces.
However, fecal coliform as an indicator is not a perfect indicator of sewage because it occurs in the guts of all warm-blooded animals (birds and mammals).

How does one establish the source of a pollutant given the complexity of the environment and the difficulties in measuring that pollutant?

 
Acworth study conclusions:
Major source of bacteria was not from ducks and geese along the lake, but from water enterng the lake from the creeks that drain the watershed. For example:
 

There were no big, single sources found, but instead the data suggest many, small sources scattered throughout the watershed.  Spatial patterns in bacteria and conductivity in tributaries suggest leaky sewage systems contributed significantly to bacterial levels in creeks.
 

Bottom line: There are many small inefficiencies (leaks) relative to size of the system, but given the increase in population, the environment can not assimilate all those sources of bacteria.