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Water Borne Diseases

Suratman, S.KM., M.Kes., Ph.D

Water-Borne Diseases

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20% Of The Earth’s Liquid Fresh Water Is In Just One Place

Courtesy NASA

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Lake Baikal, Siberia

Bathymetry

Maximum depth: 1,632 m

USAID Save The Children Program

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 Of the 56.4 million deaths worldwide in 2015, more than half (54%)
were due to the top 10 causes.
 Ischaemic heart disease and stroke are the world’s biggest killers,
accounting for a combined 15 million deaths in 2015.
 These diseases have remained the leading causes of death globally
in the last 15 years.
 Chronic obstructive pulmonary disease claimed 3.2 million lives in
2015, while lung cancer (along with trachea and bronchus cancers)
caused 1.7 million deaths.
 Diabetes killed 1.6 million people in 2015, up from less than 1 million
in 2000. Deaths due to dementias more than doubled between 2000
and 2015, making it the 7th leading cause of global deaths in 2015.

 Lower respiratory infections remained the most deadly communicable

disease, causing 3.2 million deaths worldwide in 2015.
 The death rate from diarrhoeal diseases almost halved between 2000
and 2015, but still caused 1.4 million deaths in 2015.
 Similarly, tuberculosis killed fewer people during the same period, but
is still among the top 10 causes with a death toll of 1.4 million.
 HIV/AIDS is no longer among the world’s top 10 causes of death,
having killed 1.1 million people in 2015 compared with 1.5 million in
2000.
 Road injuries killed 1.3 million people in 2015, about three-quarters
(76%) of whom were men and boys.

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 More than half (52%) of all deaths in low-income countries in

2015 were caused by the so-called “Group I” conditions, which
include communicable diseases, maternal causes, conditions
arising during pregnancy and childbirth, and nutritional
deficiencies.
 By contrast, less than 7% of deaths in high-income countries
were due to such causes.
 Lower respiratory infections were among the leading causes of
death across all income groups.

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 Non-communicable diseases (NCDs) caused 70% of deaths globally,

ranging from 37% in low-income countries to 88% in high-income countries.
 All but 1 of the 10 leading causes of death in high-income countries were
NCDs.
 In terms of absolute number of deaths, however, 78% of global NCD deaths
occurred in low- and middle-income countries.
 Injuries claimed nearly 5 million lives in 2015.
 More than a quarter (27%) of these deaths were due to road traffic injuries.
 Low-income countries had the highest mortality rate due to road traffic
injuries with 28.5 deaths per 100 000 population – the global rate was 18.3.
 Road injuries were also among the leading 10 causes of death in both lower-
middle- and upper-middle-income countries.

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Diseases Related to Water

Water-borne Water-based
Diseases Diseases

Water-washed Water-related
Diseases Diseases

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Water-borne Diseases

Diseases caused by ingestion of water

contaminated by human or animal excrement,
which contain pathogenic microorganisms.

Include cholera, typhoid, amoebic and bacillary

dysentery and other diarrheal diseases

Clinical Syndromes
Type I Type II
a. Noninflammatory (enterotoxin, etc.) a. Inflammatory (invasive, cytotoxin)
b. Proximal small bowel b. Colon
c. Dysentery (bloody diarrhea)
c. Watery diarrhea
d. Examples:
d. Examples:
Salmonella enteriditis
Rotavirus Clostridium difficile
Vibrio cholerae Campylobacter pylori
Giardia lamblia Enatmeba histolytica
Giardia lamblia
Cryptosporidium parvum
Cyclopsora cayetanensis

Cholera toxin

Type III
a. Penetrating Entameba histolytica
b. Distal small bowel
c. Examples: Salmonella typhi
Salmonella typhi
Yersinia enterococolithica

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Discoverer Of The First Water Borne

Infectious Disease: Giardia lamblia

Anton Von Leeuwenhoek

Water Borne Infectious Diseases:

Viruses
Rotavirus
Polio
Hepatitis A
Hepatitis E
Rotavirus

Polio virus

Hepatitis virus

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Water Borne Infectious Diseases:

Bacteria
Vibrio cholerae
Escherichia coli 0157
Salmonella typhi
Shigella flexneri
Campylobacter pylori
Chlamydia trachomatis
Chlamydia trachomatis
Vibrio cholerae

Salmonella typhi Escherichia coli

Shigella flexneri
Campylobacter pylori

Water Borne Infectious Diseases:

Protozoa
Giardia lamblia
Entameba histolytica
Cryptosporidium parvum
Giardia lamblia Cyclospora cayetanensis
Balantidium coli
Entameba histolytica

Cyclospora cayetanensis
Balantidium coli
Cryptosporidium parvum

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Water Borne Infectious Diseases:

Helminths
Strongyloides stercoralis
Dracunculus medinensis
Schistosoma mansoni
Schistosoma japonicum
Schistosoma haematobium
Strongyloides stercoralis

Schistosome adult

Water Borne Infectious Diseases:

Bacteria
Vibrio cholerae
Escherichia coli 0157
Salmonella typhi
Shigella flexneri
Campylobacter pylori
Chlamydia trachomatis Chlamydia trachomatis

Vibrio cholerae

Salmonella typhi Escherichia coli

Shigella flexneri
Campylobacter pylori

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Water-borne infectious diseases worsen with global

warming
• Infectious diarrhea is one of the most prevalent of the world’s water-
borne diseases.
• It is usually a symptom of gastrointestinal infection, which can be
caused by a variety of bacterial, viral and parasitic organisms.
• Infection is spread through contaminated food or drinking-water, or
from person to person as a result of poor hygiene.
• Severe diarrhea leads to fluid loss and may be life-threatening,
particularly in young children and people who are malnourished or
have impaired immunity.
• Globally, it is the second-leading cause of mortality in young
children.

Water-borne infectious diseases worsen with global warming (Continued…)

• This is only expected to worsen with climate change, driven by

factors including increased temperatures, flooding, and other
changes in the water cycle.
• Cholera is a diarrheal disease caused by bacteria that occur
naturally in rivers, estuaries, and coastal waters.
• Scientists have observed a relationship between the increase in
sea-surface temperature and the onset of cholera epidemics.
• Strong El Nino cycles and other climate variables provide a
predictive capacity for cholera epidemics.

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Increased risk of water-borne diseases in the U.S.

• In countries with reliable sources of potable water, contamination of
recreational waters from extreme weather events remains a
significant means of disease transmission.
• Ear, nose, and throat, respiratory, and gastrointestinal illnesses are
commonly associated with recreational swimming in fresh and
oceanic waters.
• Other, potentially more severe waterborne diseases are also
transmitted in recreational waters, although with less frequency, such
as hepatitis, giardiasis, and cryptosporidiosis.
• A study of water contamination of the Great Lakes projected that as
extremely heavy precipitation events become stronger, there will be
a resulting greater potential for flooding and sewer overflow, with a
corresponding greater potential for waterborne diseases.
• It stated, “The Great Lakes, which serve as a drinking water source
for more than 40 million people, are particularly susceptible to fecal
pollution and can become reservoirs for waterborne diseases.

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Prevention

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In addition, water-borne disease can be

caused by the pollution of water with
chemicals that have an adverse effect on
health

• Arsenic
• Flouride
• Nitrates from fertilizers
• Carcinogenic pesticides (DDT)
• Lead (from pipes)
• Heavy Metals

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Water-washed Diseases
 Diseases caused by poor personal hygiene and skin and eye
contact with contaminated water.
 These include scabies, trachoma, typhus, and other flea, lice
and tick-borne diseases.

Water-based Diseases
 Diseases caused by parasites found in intermediate organisms
living in contaminated water.
 Includes Schistosomiasis and Dracunculiasis.

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Water-related Diseases
 Water-related diseases are caused by insect vectors, especially
mosquitoes, that breed or feed near contaminated water.
 They are not typically associated with lack of access to clean
drinking water or sanitation services.
 Include dengue, filariasis, malaria, onchocerciasis,
trypanosomiasis and yellow fever.

Other Water-borne diseases

• Bathing
• Swimming
• Other recreational activities that have water contact
• Agriculture
• Aquaculture

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