Short answers, pulled from the story.
The Cloaca Maxima was ancient Rome's greatest sewer, most likely built in the sixth century BC under the reign of the three Etruscan kings to drain the low-lying land around the Forum. Some scholars estimate it carried away as much as one million pounds of human waste and water, though others argue there is not enough evidence to judge its effectiveness.
The first sewers in ancient Rome are estimated to date to around 500 BC, built in imitation of methods the Etruscans had already used. These early channels mainly drained rainwater and helped dry out swampy ground such as the Pontine Marshes.
Eleven aqueducts supplied Rome with water of varying quality, with the best reserved for drinking. The first was the Aqua Appia, built in 312 BC by the censor Appius, and eight of the eleven aqueducts entered the city close together on the Esquiline Hill.
Frontinus was a general appointed by the emperor Nerva as water commissioner toward the end of the first century AD. He surveyed and mapped the aqueduct system, investigated illegal tapping into pipes, and described his work in a text called De aquaeductu.
Romans used a xylospongium, though newer research suggests it may have been a toilet brush, or a sea sponge on a stick called a tersorium. Sponges were often shared and cleaned in a bucket of water with salt or vinegar, which could breed bacteria and spread disease.
Disease remained rampant in ancient Rome because most homes were not connected to street drains or sewers, and there was no street cleaning service to manage waste dumped from upper floors. Shared bathwater and shared latrine sponges also helped spread illness between the sick and the healthy, and intestinal worms called helminths caused widespread dysentery.