Recent Papers on Water-based Diseases
Content Table
- Water quality and occurrence of water-borne diseases in the Douala4th District, Cameroon
- Addressing disease surveillance needs for marine recreational bathers
- Exploring intra-household factors for diarrhoeal diseases: a study in slums of Delhi, India
- Legionnaires' disease: evaluation of a quantitative microbial risk assessment model
- The Global Challenge of Water Quality and Health
- History of water and health from ancient civilizations to modern times
- Fault tree analysis of the causes of waterborne outbreaks
- Surveillance of waterborne disease in European member states: a qualitative study
- A toast to our health: our journey toward safe water
- Water reclamation, reuse and public health
- A review of household drinking water intervention trials and an approach to the estimation of endemic waterborne gastroenteritis in the United States
Water quality and occurrence of water-borne diseases in the Douala4th District, Cameroon
Water Science & Technology—WST Vol 59 No 12 pp 2321–2329 © IWA Publishing 2009 doi:10.2166/wst.2009.268
Andrew Ako Ako, George Elambo Nkeng and Gloria Eyong Eneke Takem
Hydrological Research Centre, P.O Box 4110, Yaounde, Cameroon E-mail: akoandrew@yahoo.com; gloriatakem@yahoo.com
National Advanced School of Public works, P.O Box 510, Yaounde, Cameroon E-mail: gnkeng@yahoo.com
Abstract
The monthly occurrence and mean age distribution of water-borne diseases in the Douala 4th District, Cameroon (1995–2006) were studied and probable causes of diseases spread were established. Diseases of interest included gastroenteritis, amoebic dysentery, typhoid fever and cholera. Water-borne disease occurrence was observed to follow a seasonal pattern with peaks occurring between the months of January and May followed by drops between June and October and rose again from November. Children below 5 years were found to be more vulnerable to diarrhoea, gastroenteritis, amoebic dysentery while persons between 15–44 years were more vulnerable to typhoid and cholera. Physico-chemically, water samples had turbidities varying between 5.5–86 NTU, pH values between 4.2 and 7.1 and zero residual chlorine. Bacteriological analysis showed that the total coliform count was averagely 74/100 ml, the faecal colform count was 43/100 ml and the faecal streptococci count was 27/100 ml. Lack of access to potable water, absence of sanitation facilities and environmental factors could be advanced as the probable causes of water-borne disease spread.
Addressing disease surveillance needs for marine recreational bathers
Journal of Water and Health Vol 07 No 1 pp 45–54 © IWA Publishing 2009 doi:10.2166/wh.2009.077
David Turbow
College of Health Sciences, TUI University, 5665 Plaza Drive, 3rd Floor, Cypress, CA 90630, USA E-mail: dturbow@tuiu.edu
Abstract
Contamination of the nearshore marine environment contributes to a high burden of illness among recreational bathers. Disease surveillance activities carried out by local, state, and territorial agencies in the United States are at present voluntary and passive. Several gaps in the existing regulatory framework for beach management and public health protection are highlighted in this paper. The need for disease surveillance of marine bathers is established. A demonstration is made of how surveillance activities can be used to guide risk management and gauge the effectiveness of current water contact standards. Recommendations are offered for agencies to improve surveillance and protect public health. A foundation is presented on which to develop a model marine health code.
Exploring intra-household factors for diarrhoeal diseases: a study in slums of Delhi, India
Journal of Water and Health Vol 06 No 2 pp 289–299 © IWA Publishing 2008 doi:10.2166/wh.2008.025
Rajib Dasgupta
Abstract
While infrastructure conditions constitute ‘primary routes’, contamination of water within households and other behavioural determinants are considered as ‘secondary routes’. However, recontaminated water has been considered not to constitute a serious risk though it occurs commonly in poorer societies. A study was conducted in Delhi where individual risk factors were located within a larger socio-economic, political and administrative framework, as they were often independent variables. This component of the larger study hypothesised that behavioural factors at individual household levels lose significance as major determinants of diarrhoeal diseases once they are analysed in a holistic epidemiology frame. Determinants at the household level were explored through a dataset based on a primary survey of 300 households in three slum clusters. Amongst households storing municipal water (proven to be safe at source), adhering to the best storage practices did not translate into lower incidence rates as compared to those with relatively unsafe practices. The explanation lay in factors which were external to the home and beyond the control of the affected household. Thus, household level behavioural factors such as storage practises should not be analysed in isolation as determinants of diarrhoeal illness particularly when pitted against stronger neighbourhood and external determinants.
Legionnaires' disease: evaluation of a quantitative microbial risk assessment model
Journal of Water and Health Vol 06 No 2 pp 149–166 © IWA Publishing 2008 doi:10.2166/wh.2008.026
Thomas W. Armstrong and Charles N. Haas
Abstract
Background: The quantities of Legionella vary considerably from natural waters to water in contaminated domestic hot water supplies, whirlpool spas and cooling towers, with the risk for LD rising as the Legionella counts grow. We currently report the results from our Quantitative Microbial Risk Assessment (QMRA) model evaluation. We developed the LD QMRA model to better understand Legionella exposure risks.
Methods: Using an animal data derived model for LD, we calculated risks from estimated exposures for a whirlpool spa outbreak, two hot spring spa outbreaks and compared the results to the reported LD risks.
Results: The QMRA model shows agreement (generally less than an order of magnitude discrepancy) with the reported Legionnaires' disease sub-clinical severity infection, clinical severity infection, and mortality risks.
Conclusions: The LD QMRA model may lead to risk based limits to supplement the current guidance on Legionella control in cooling towers, whirlpool spas and other potential exposure sources. The verification of QMRA for LD also suggests the techniques, given suitable animal model data, may be useful in quantifying human response to other airborne pathogens.
The Global Challenge of Water Quality and Health
Water Practice & Technology © World Health Organisation 2008 | doi:10.2166/wpt.2008.090
J. Bartram and B. Gordon
Abstract
Unsafe water, together with inadequate sanitation and hygiene, is the overwhelming contributor to the 4 billion illnesses and 1.8 million deaths caused by diarrhoea every year. 90% of this toll is borne by children under five. Every diarrhoeal episode reduces calorie and nutrient uptake and sets back a child's growth and development. Millions also are exposed to unsafe levels of arsenic and fluoride, and the most vulnerable suffer from cancer and crippling skeleton damage as a result.
Water can transmit disease when it is contaminated by pathogenic microbes and chemicals. Bacteria, viruses and parasites can enter drinking water in many ways, for example as a result of animals excreting into a catchment area, from seepage of contaminated water into “leaky” pipes in a distribution system, and from unhygienic handling of stored household water. Chemical contamination may come from natural or anthropomorphic sources.
Water safety can be assured through a variety of interventions at the level of households, community, water supplier and regulator, often with an excellent cost-benefit ratio. For example, families can reduce diarrhoea incidence in households by about half using simple, inexpensive technologies. WHO estimates that 94% of diarrhoeal cases are preventable through modifications to the environment, including through interventions to increase the availability of clean water.
History of water and health from ancient civilizations to modern times
Water Science & Technology: Water Supply Vol 7 No 1 pp 49–57 © IWA Publishing 2007 doi:10.2166/ws.2007.006
H.S. Vuorinen*, P.S. Juuti** and T.S. Katko***
*Department of Public Health,University of Helsinki, Finland , (E-mail: heikki.vuorinen@helsinki.fi)
**Department of History, University of Tampere, Finland
***Tampere University of Technology, Finland
Abstract
This paper examines the influence of water on public health throughout history. Farming, settling down and building of villages and towns meant the start of the problems mankind suffers from this very day – how to get drinkable water for humans and cattle and how to manage the waste we produce. The availability of water in large quantities has been considered an essential part of a civilized way of life in different periods: Roman baths needed a lot of water as does the current Western way of life with water closets and showers. The importance of good quality drinking water was realized already in antiquity, yet the importance of proper sanitation was not understood until the 19th century.
Fault tree analysis of the causes of waterborne outbreaks
Journal of Water and Health Vol 5 No Suppl 1 pp S1–S18 © IWA Publishing 2007 doi:10.2166/wh.2007.136
Helen L. Risebro, Paul R. Hunter, Miguel F. Doria, Yvonne Andersson, Gertjan Medema, Keith Osborn and Olivier Schlosser
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, NR4 7TJ, UK Tel.: +44 1603 591004 Fax: +44 1603 593752 h.risebro@uea.ac.uk
UNESCO/International Hydrological Programme (IHP), 1 rue Miollis, F-75732, Paris, Cedex 15 France
Swedish Institute for Infectious Disease Control (SMI), SE-17182, Solna, Sweden
Kiwa Water Research, PO Box 1072, 3430 BB, Nieuwegein, The Netherlands
United Utilities Water PLC, Thirlmere House, Lingley Mere Business Park, Greta Sankey, Warrington, WA5 3LP, UK
Suez Environnement/CIRSEE, Water Quality Technical & Research Division, 38 rue du Président Wilson, F78230, Le Pecq, France
Abstract
Prevention and containment of outbreaks requires examination of the contribution and interrelation of outbreak causative events. An outbreak fault tree was developed and applied to 61 enteric outbreaks related to public drinking water supplies in the EU. A mean of 3.25 causative events per outbreak were identified; each event was assigned a score based on percentage contribution per outbreak. Source and treatment system causative events often occurred concurrently (in 34 outbreaks). Distribution system causative events occurred less frequently (19 outbreaks) but were often solitary events contributing heavily towards the outbreak (a mean % score of 87.42). Livestock and rainfall in the catchment with no/inadequate filtration of water sources contributed concurrently to 11 of 31 Cryptosporidium outbreaks. Of the 23 protozoan outbreaks experiencing at least one treatment causative event, 90% of these events were filtration deficiencies; by contrast, for bacterial, viral, gastroenteritis and mixed pathogen outbreaks, 75% of treatment events were disinfection deficiencies. Roughly equal numbers of groundwater and surface water outbreaks experienced at least one treatment causative event (18 and 17 outbreaks, respectively). Retrospective analysis of multiple outbreaks of enteric disease can be used to inform outbreak investigations, facilitate corrective measures, and further develop multi-barrier approaches.
Surveillance of waterborne disease in European member states: a qualitative study
Journal of Water and Health Vol 5 No Suppl 1 pp S19–S38 © IWA Publishing 2007 doi:10.2166/wh.2007.135
Helen L. Risebro and Paul R. Hunter
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, NR4 7TJ, UK Tel.: +44 1603 591004; Fax: +44 1603 593752; paul.hunter@uea.ac.uk
Abstract
We sought to explore perceived strengths and weaknesses of surveillance systems for the detection of drinking-water-related illness in Europe based on the experience of individuals utilising such systems. We designed and conducted a qualitative semi-structured interview study with thematic analysis. Interviews took place in six European countries with seven experts in epidemiology, water and public health. Interviewees remarked upon variation between and within countries in laboratory and sampling protocols and reporting practice; these were felt to influence timeliness and sensitivity of laboratory- and clinician-report-based surveillance. Electronic reporting, reminders to report and direct report relay to national level were considered strengths of report-based surveillance. A need was expressed for more detailed case demographic information to facilitate outbreak detection. Existing infrastructure permitting, prescriptions data, anti-diarrhoeal pharmaceutical sales, absenteeism and consultations were cited as useful outbreak indicators. Information regarding consumer water quality complaints was highlighted as a potentially useful data source. Collaboration with water companies (concerning water distribution and incidents), and constructing and maintaining relationships with local and external data providers were cited as requisites of effective surveillance. Inter- and intra-organisational collaboration and information integration are likely to improve surveillance, leading to more astute estimates of the waterborne disease burden.
A toast to our health: our journey toward safe water
Water Science & Technology: Water Supply Vol 7 No 1 pp 41–48 © IWA Publishing 2007 doi:10.2166/ws.2007.005
J.B. Rose* and Y. Masago**
*Dept. of Fisheries and Wildlife, Michigan State Univ., 13 Natural Resources, E. Lansing, MI 48824, USA (E-mail: rosejo@msu.edu)
**Dept. of Civil Engin., Tohoku Univ., 6-6-06 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi 980-8579, Japan
Abstract
Human beings have been struggling against epidemics for centuries but the first recorded epidemic in Egypt goes back to 3180 BC. Historically, it was not recognized that many of these “plagues” were waterborne. Advancements in medicine and microbiological sciences which identified and isolated the pathogens were needed before “safer” water could be achieved through advances in engineering. Disinfection of drinking water, introduced at the end of 19th century, considerably reduced the spread of cholera and typhoid fever. However, despite these innovations, waterborne disease epidemics continue even in the 20th century. We contend that this is partly because little attention has been paid to sewage practices and these are directly related to our health as the source of contamination, while much attention has been focused on drinking water. We propose that to achieve “safe water” and an improvement in global health worldwide in the 21st century, we must address wastewater problems learning from the past and we must use new advances such as molecular microbiology for pathogen discovery, and characterization and control of emerging and re-emerging waterborne diseases.
Water reclamation, reuse and public health
Water Science & Technology Vol 55 No 1-2 pp 275–282 © IWA Publishing 2007 doi:10.2166/wst.2007.012
J.B. Rose
Homer Nowlin Chair in Water Research, Center for Water Sciences, Department of Fisheries and Wildlife, 13 Natural Resources Building, Michigan State University, East Lansing, MI 48824, USA (E-mail: rosejo@msu.edu)
Abstract
The number of people who have limited access to high-quality water has increased, and while this is a growing global crisis, water issues, problems and solutions are often seen as localised. Water reuse and reclamation will play a significant role in achieving sustainability and public health protection in the future. The wastewater and reuse community should be responsible for monitoring sewage impacts and improvements as demonstrated through pathogen reduction with appropriate treatment. Viruses, Cryptosporidium and Giardia can all be reduced during treatment anywhere from 99% to 99.9999%, achieving drinking water quality, if so desired. Recommendations to achieve better access to scientific information for decision making include: 1) developing a global data base for biological contaminant loading from wastewater and 2) defining the public health protection via reuse and reclamation.
A review of household drinking water intervention trials and an approach to the estimation of endemic waterborne gastroenteritis in the United States
Journal of Water and Health Vol 04 No Suppl 2 pp 71–88 © IWA Publishing 2006 doi:10.2166/wh.2006.018
John M. Colford, Sharon Roy, Michael J. Beach, Allen Hightower, Susan E. Shaw and Timothy J. Wade
Division of Epidemiology, School of Public Health, University of California, Berkeley, 140 Warren Hall, MC 7360, Berkeley, CA 94720, USA jcolford@berkeley.edu
Water and Environment Activity, Division of Parasitic Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, N.E., Mailstop F22, Atlanta GA 30341-3724, USA
Statistics and Data Management Branch, Centers for Disease Control and Prevention, Kenya Field Station, Unit 64112, APO AE 09831-4112, USA
Office of Ground Water and Drinking Water, United States Environmental Protection Agency, 1200 Pennsylvania Ave, N.W., MC 4607, Washington DC 20460, USA
Human Studies Division, United States Environmental Protection Agency, MD 58C, Research Triangle Park, NC 27711, USA
Abstract
The incidence of acute gastrointestinal illness (AGI) attributable to public drinking water systems in the United States cannot be directly measured but must be estimated based on epidemiologic studies and other information. The randomized trial is one study design used to evaluate risks attributable to drinking water. In this paper, we review all published randomized trials of drinking water interventions in industrialized countries conducted among general immunocompetent populations. We then present an approach to estimating the incidence (number of cases) of AGI attributable annually to drinking water. To develop a national estimate, we integrate trial results with the estimated incidence of AGI using necessary assumptions about the estimated number of residents consuming different sources of drinking water and the relative quality of the water sources under different scenarios. Using this approach we estimate there to be 4.26–11.69 million cases of AGI annually attributable to public drinking water systems in the United States. We believe this preliminary estimate should be updated as new data become available.
