Manure spills into streams are relatively frequent, but no studies have characterized stream contamination with zoonotic and veterinary pathogens, or fecal chemicals, following a spill. We tested stream water and sediment over 25 days and downstream for 7.6 km for the following: fecal indicator bacteria (FIB), the fecal indicator chemicals cholesterol and coprostanol, 20 genes for zoonotic and swine-specific bacterial pathogens by presence/absence PCR for viable cells, one swine-specific Escherichia coli toxin gene (STII gene) by quantitative PCR (qPCR), and nine human and animal viruses by qPCR or reverse transcription-qPCR. Twelve days postspill, and 4.2 km downstream, water concentrations of FIB, cholesterol, and coprostanol were 1 to 2 orders of magnitude greater than those detected before, or above, the spill, and genes indicating viable zoonotic or swine-infectious Escherichia coli were detected in water or sediment. STII gene levels increased from undetectable before or above the spill to 10 5 copies/100 ml of water 12 days postspill. Thirteen of 14 water (8/9 sediment) samples had viable STII-carrying cells postspill. Eighteen days postspill, porcine adenovirus and teschovirus were detected 5.6 km downstream. FIB concentrations (per gram [wet weight]) in sediment were greater than in water, and sediment was a continuous reservoir of genes and chemicals postspill. Constituent concentrations were much lower, and detections less frequent, in a runoff event (200 days postspill) following manure application, although the swine-associated STII and stx 2e genes were detected. Manure spills are an underappreciated pathway for livestock-derived contaminants to enter streams, with persistent environmental outcomes and the potential for human and veterinary health consequences.A cross the United States, animal agriculture accounts for the production of more than 1 billion tons of manure annually (1). Manure can contain numerous animal-specific and zoonotic (transferable between animals and humans) pathogens, including bacteria such as Salmonella, pathogenic Escherichia coli, Campylobacter, Leptospira spp., Listeria monocytogenes, vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) and zoonotic protozoa such as Cryptosporidium and Giardia spp. (1-4). Additionally, although viruses tend to be host-specific pathogens, there is some evidence that swine influenza viruses, hepatitis E virus (HEV), and possibly other porcine viruses may be transmitted to humans (4, 5). Thus, human and animal health is a common concern if swine (or other animal) manures are not properly managed (1, 4).Untreated manure is applied to land as fertilizer in agricultural settings; most U.S. states require manure application practices that minimize contamination of surface water or groundwater (1). Nevertheless, manure can enter water through inadvertent mechanisms, including equipment failures, overapplication, runoff from open feedlots, storage overflow, accidents with manuretransporting equipment, se...