LiteHedded
Contributor
There are a lot of windows into these systems. Something to keep in mind
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Well, there's a "sip" and a "big 'ol drink," and the difference may well make the difference between illness and no effect at all. While, in theory, it only takes one organism, in practice, the likelihood of contracting something requires some larger number.
In outdoor settings, we are mostly talking about giardia. Some truths: It's everywhere, most especially where humans have been. But it's not too often found in concentration. Unless you're almost intentionally drinking from a clearly dangerous place, in a lot if not most lakes, you'd have to drink gallons to have a good chance of one giardia bug if you weren't near a heavily used camp site. And most people who acquire an infection are asymptomatic. (But can pass it on to others if they don't hand wash well.) In fact, before properly treated water was the norm in cities and towns, everyone ingested plenty of giardia all the time, as did many thousands of folks drinking well water on farms with stock and privies contributing pathogens. A deep artesian spring is unlikely to be heavily infested. But any number of springs that were mistakenly thought to be deep artesian produced regular cases of giardia infections for years and were later found to actually have a surface river as their main source. Bottom line is that giardia is not quite the inevitable hazard that you might expect from some warnings, is unlikely to be a problem if you know the body of water isn't being polluted, but is always a possibility outdoors.
A cave system with a lot of water should not harbor a high concentration of organisms, unless it is getting dosed by sewage/pet feces/camp run-off nearby. I personally have never hesitated to drink from springs when I knew they aren't subject to highly contaminated infection sources. (I don't count normal populations of animals defecating in the area, considering that likely to produce rather small concentrations in underground water.) And I once rather foolishly managed to get stuck for water on the way out of way back in Bandolier in New Mexico and had to drink what amounted to thin yellow mud from the Rio Grande, and since it's below Santa Fe, if it wasn't wall-to-wall giardia, it was only because the giardia had to compete with a dozen other nasty bugs. No bad effects, then or ever, from judicious use of outdoor water sources. And I dislike dry mouth enough that I will rinse with and no doubt ingest a bit of water from time to time while diving.
Obviously, anyone with any immune system compromise shouldn't try this. But proximity of human populations is definitely a factor, which is why most of urban humanity stayed drunk through most of history to avoid drinking the water. (Well, that's what they said, anyway.)
Which cave has known septic intrusion? I'll keep it off my list (it wouldn't be on there if it doesn't have a cavern anyhow).