Worldwide Rating of Drinking Water Safety What is SWIT Rating?

The Worldwide Rating of Drinking Water Safety, prepared by Safe Water for International Travelers and nicknamed SWIT Rating, is a classification of drinking water safety that gives a broad indication of the health risks related with drinking water, to which international travelers may be exposed in every country of the world. The rating is based on significant indicators produced by WHO, Unicef, World Bank & UN Dev Prgm. There are defined 5 classes of drinking water safety: 5 Drops Countries All cities have safe water supplies, which are monitored and regularly tested by an independent and qualified board.

 Drinking water quality is the standard in developed countries. Waterborne diseases are almost inexistent. Only about 20% of the world countries have this top classification. 4 Drops Countries Main cities have generally safe water supplies, which are monitored and regularly tested by an independent board. But level of service of rural & small towns systems could be substandard. Prevalence of waterborne diseases is low. 3 Drops Countries The level of service quality varies considerably between urban and rural residence, and between regions.

 Some systems comply with WHO Guidelines, but many of them have intermittent service and lack of disinfection. Monitoring and testing is not fully reliable. Some waterborne diseases are endemic. 2 Drops Countries Some water supplies comply with WHO Guidelines, but most of them not. There is not permanent monitoring and testing. Usually water quality is not good. Prevalence of waterborne diseases is high. 1 Drop Countries Is almost impossible to find drinking water that complies with WHO Guidelines. There is not monitoring and testing. Waterborne diseases are the main cause of infant mortality. Usually is dangerous for foreign visitors to drink tap water.

Below is the complete list of the Rating of Drinking Water Safety Worldwide.
COUNTRY Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan RATING REGION Middle South Asia West Europa Northern Africa Melanesia and Micronesia-Polynesia West Europa Sub-Saharan Africa Caribbean Caribbean Temperate South America Middle South Asia Caribbean Main Oceania West Europa Middle South Asia

Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi

Caribbean Western South Asia Middle South Asia Caribbean Eastern Europe Western Europe Central America Sub-Saharan Africa North America Middle South Asia Tropical South America Eastern Europe Southern Africa Tropical South America Caribbean Eastern South Asia Eastern Europe Sub-Saharan Africa Sub-Saharan Africa

Cambodia Cameroon Canada Cape Verde Cayman Islands Chad Chile China Colombia Comoros Congo Congo, Democratic Republic of the Cook Islands Costa Rica Cte dIvoire Croatia Cuba Cyprus Czech Republic

Eastern South Asia Sub-Saharan Africa North America Sub-Saharan Africa Caribbean Sub-Saharan Africa Temperate South America East Asia Tropical South America Sub-Saharan Africa Sub-Saharan Africa Sub-Saharan Africa Melanesia and Micronesia-Polynesia Central America Sub-Saharan Africa Eastern Europe Caribbean Western South Asia Eastern Europe

Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Falkland Islands(Malvinas) Fiji Finland France French Guiana French Polynesia

Western Europe Sub-Saharan Africa Caribbean Caribbean Eastern South Asia Tropical South America Northern Africa Central America Sub-Saharan Africa Sub-Saharan Africa Eastern Europe Sub-Saharan Africa Western Europe Temperate South America Melanesia and Micronesia-Polynesia Western Europe Western Europe Tropical South America Melanesia and Micronesia-Polynesia

Gabon Gambia Gaza Strip Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea Bissau Guyana Haiti Holy See Honduras Hong Kong Hungary

Sub-Saharan Africa Sub-Saharan Africa Western South Asia Middle South Asia Western Europe Sub-Saharan Africa Western Europe Eastern Europe North America Caribbean Caribbean Melanesia and Micronesia-Polynesia Central America Sub-Saharan Africa Sub-Saharan Africa Tropical South America Caribbean Europe Central America East Asia Eastern Europe

Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic PeoplesRepublic of Korea, Republic of Kuwait Kyrgyzstan

Western Europe Middle South Asia Eastern South Asia Middle South Asia Western South Asia Western Europe Western Europe Western South Asia Western Europe Caribbean East Asia Western South Asia Middle South Asia Sub-Saharan Africa Melanesia and Micronesia-Polynesia East Asia East Asia Western South Asia Middle South Asia

Laos Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania

Eastern South Asia Eastern Europe Western South Asia Southern Africa Sub-Saharan Africa Northern Africa Western Europe Eastern Europe Western Europe East Asia Eastern Europe Sub-Saharan Africa Sub-Saharan Africa Eastern South Asia Middle South Asia Sub-Saharan Africa Western Europe Melanesia and Micronesia-Polynesia Caribbean Sub-Saharan Africa

Mauritius Mexico Micronesia (Federated States of) Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria

Sub-Saharan Africa North America Melanesia and Micronesia-Polynesia Eastern Europe Western Europe East Asia Caribbean Northern Africa Sub-Saharan Africa Eastern South Asia Southern Africa Melanesia and Micronesia-Polynesia Middle South Asia Western Europe Caribbean Melanesia and Micronesia-Polynesia Main Oceania Central America Sub-Saharan Africa Sub-Saharan Africa

Niue Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Runion Romania Russian Federation Rwanda

Melanesia and Micronesia-Polynesia elanesia and Micronesia-Polynesia Western Europe Western South Asia Middle South Asia Melanesia and Micronesia-Polynesia Central America Melanesia and Micronesia-Polynesia Tropical South America Tropical South America Eastern South Asia Melanesia and Micronesia-Polynesia Eastern Europe Western Europe Caribbean Western South Asia Sub-Saharan Africa Eastern Europe Eastern Europe Sub-Saharan Africa

Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka

Southern Africa Caribbean Caribbean North America Caribbean Melanesia and Micronesia-Polynesia Western Europe Sub-Saharan Africa Western South Asia Sub-Saharan Africa Sub-Saharan Africa Sub-Saharan Africa Eastern South Asia Eastern Europe Eastern Europe Melanesia and Micronesia-Polynesia Sub-Saharan Africa Southern Africa Western Europe Middle South Asia

Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda

Sub-Saharan Africa Tropical South America Southern Africa Western Europe Western Europe Western South Asia East Asia Middle South Asia Sub-Saharan Africa Eastern South Asia Sub-Saharan Africa Melanesia and Micronesia-Polynesia Melanesia and Micronesia-Polynesia Caribbean Northern Africa Western South Asia Middle South Asia Caribbean Melanesia and Micronesia-Polynesia Sub-Saharan Africa

Ukraine United Arab Emirates United Kingdom United States of America Uruguay US Virgin Islands Uzbekistan Vanuatu Venezuela Vietnam Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe

Eastern Europe Western South Asia Western Europe North America Temperate South America Caribbean Middle South Asia Melanesia and Micronesia-Polynesia Tropical South America Eastern South Asia Melanesia and Micronesia-Polynesia Northern Africa Western South Asia Eastern Europe Sub-Saharan Africa Sub-Saharan Africa

 How is SWIT Rating defined? To assess drinking water quality is among the most difficult problems on a nationwide basis, due to the lack of available data and the magnitude and complexity of measuring drinking water quality every time and everywhere. In practice, to define the degree of risk likely in each country trough direct indicators is extremely difficult. But there are indirect indicators that could serve as signals of how safe is water in a country or a region. A factor taken into account in the definition of the SWIT Rating is that tourism is an important source of income for many countries and to label specific areas as being of high risk for waterborne diseases may be misinterpreted.

 For this reason only data published by reliable international sources like WHO, UNICEF, UNDP or World Bank are used for that. However, this does not absolve national health administrations, tourism authorities and hotel and resort managers, from their responsibility to provide a more accurate picture of the risks from waterborne diseases that may be encountered in various parts of their countries. Which are the indicators SWIT Rating is based on? SWIT rating is based on the following indirect but significant indicators: Income Level, measured by the World Bank in U$S per capita, and expressed as Gross Net Product (GNP) or Purchasing Power Parity (PPP), published by the World Bank.

 Human Development Index, calculated by the United Nations Development Program, in percentage of the highest level (in 2001 is Norway's , with 0.936) Infant Mortality, measured by the World Health Organization (WHO) and UNICEF, and expressed as children dead younger than 1 year old, per 1000 infants born. Existence or lack of it, of independent, qualified and reliable monitoring and testing of water supplies, as recommended and surveyed by the World Health Organization (WHO) and Pan American Health Organization (PAHO) . Uninterrupted supply and adequate disinfection (idem WHO and PAHO). How are countries rated ?

Countries are rated using the following criteria:

Criteria RATING INCOME LEVEL High or Upper Upper Middle Lower Low Middle (GNP>4900 Middle (GNP>1200 (GNP>9360 U$S or (GNP>2000 U$S or U$S or PPP> PPP> 8320 U$S or PPP>1800 11300U$S) U$S) PPP> 4880 U$S) U$S) More than 0.80 More than 0.7 More than 0.5 Very Low (GNP<1200 U$S or PPP <1800U$S) 5 Drops Countries 4 Drops Countries 3 Drops Countries 2 Drops Countries 1 Drop Countries

HUMAN More than 0.85 DEVELOPMENT INDEX INFANT MORTALITY MONITORING AND TESTING UNINTERRUPTE D SUPPLY AND ADEQUATE DISINFECTION

Less than 0.5

Less than 10 Less than 20 Less than Less than 80 More than 80 per 1000 per 1000 50 per 1000 per 1000 per 1000 infants born infants born infants born infants born infants born Independent Qualified Reliable Yes, in every city and town Independent Varies from Not city to city. independent nor reliable Yes, in main Varies from cities city to city Intermittent supply in many cities. Inadequate disinfection Inexistent

Intermittent supply and lack of disinfection almost anywhere.

 TAP WATER Is tap water safe around the world? In developed countries, piped water of high quality is continuously available to household connections. Nevertheless, in spite that most cities and large towns around the world have large piped water systems, tap water is only safe to drink if it has been fully treated & disinfected, and all the water system is well operated and maintained. These conditions of water supply are, globally in the world, the exception rather than the rule,quotting the World Health Organization (WHO),in their "Guidelines for drinking-water quality, 1993".

 It is estimated that over one-third of the urban water supplies in Africa, and in Latin America and the Caribbean, and more than half those in Asia, operate intermittently. Also, the United Nations Environmental Program (UNEP) said: "Every eight seconds, a child dies from a water-related disease 50 percent of people in developing countries suffer from one or more water related diseases; ; 80 percent of the diseases in the developing world are caused by contaminated water; 50 percent of people on Earth lack adequate sanitation;

 20 percent of freshwater fish species have been pushed to the edge of extinction by contaminated water" According to the "World Banks World Development Indicators 1997", between 1985 and 1993, 24 countries have seen their urban populations access to safe drinking water decrease. The safety of tap water needs to be determined on the basis of water quality monitoring, and evidence of effective treatment. This is not always guaranteed if you will be traveling in countries other than Western Europe, USA and Canada, Australia and New Zealand, Singapore and Japan.

 How do hotels and resorts get their tap water? Hotels & resorts located where piped water systems are safe, get their tap water from them. In other areas where the systems are not reliable, or there are not public systems, hotels and resorts have their own treatment systems. The source of water for them could be the public system or their own source, such as underground wells or springs. Is important the proper maintenance and operation of the own treatment & distribution systems. Can I find out if tap water is safe to drink by tasting or smelling it?

 You cannot see, smell or taste the germs and other contaminants. Because of waters different sources and the different ways in which water is treated, the taste and quality of drinking water varies from place to place. Even in areas where the tap water is safe to drink the level of chemical treatment may be sufficient to render it unpalatable to travelers from developed countries. Common complaints about water aesthetics include temporary cloudiness (typically caused by air bubbles) or chlorine taste How will a traveler know if tap water is safe to drink?

 The hotel or resort owner, or operator, must notify you if tap water meets internationally accepted drinking water standards (such EPA or WHO standards) or if there is a waterborne disease emergency. In the section "Is water Safe in?", SWIT brings public available information of water quality regarding health, from sources like World Health Organization (WHO) and the U.S.Center for Diseases Control (CDC), but that information only gives a general idea of how safe is tap water in an area. If there is no specific notice of your hotel owner or operator, or you don't trust it, better safe than sorry.

 How can I know what is risky to do, if tap water is not safe? See "Frequently Asked Questions" to know if is risky toothbrushing, taking a shower, etc, and how to take care where tap water is not safe. What can I do if I need to use unsafe tap water? Boiling is the most reliable method to make water safe to drink. Bring water to a vigorous boil, and then allow it to cool; do not add ice. At high altitudes, allow water to boil vigorously for a few minutes or use chemical disinfectants. Adding a pinch of salt or pouring water from one container to another will improve the taste.

 Portable boiling coils are very useful for boiling water in hotel rooms. Chemical disinfection can be achieved with either iodine or chlorine, in spite that are often ineffective if the water is visibly cloudy. Iodine provides greater disinfection in a wider set of circumstances (chlorine based are less effective against amoebic cysts than iodine). If the water is cloudy, then strain it through a clean cloth & double disinfectant dose added. If the water is very cold, either warm it or allow increased time for disinfectant to work. For disinfection with iodine, use either tincture of iodine(4 drops of 2% tincture of iodine should be added to each liter of water and left for 15 minutes).

 Or use tetraglycine hydroperiodide tablets (such as Globaline and Potable-Aqua). These disinfectants can be found in sporting goods stores and pharmacies. Read & follow the manufacturers instructions. Prolonged use of iodine should be avoided (longer than 6 weeks). If we have not iodine or we can not use it, use household bleach (2 to 4 drops per litre of clear water) and leave for 15 minutes. This is safe and effective but will taste of chlorine (which can be improved by letting the wa-ter stand exposed to the air for a while). Chlorine tabs (as Sterotabs & Puritabs) could let less bad taste.The water from the hot tap in your hotel is likely to be safer than the water from the cold tap.

 Run it for a minute or so first. It can be used for not swallowing uses, as brushing teeth, in an emergency. How can I test my tap water? If you are going to stay in a place for a long time, could be wise that you test your tap water, if you don't trust the hotel owner or operator. Drinking water, including bottled water, may reasonably be expected to contain at least small amounts of some contaminants. As long as they occur below EPAs or WHO's standards, they dont pose a significant threat to health, although people with severely compromised immune systems & children may have special needs.

 You have to test for specific contaminants that can vary from city to city, or any other contaminant youre concerned about. The most important safety concern is from organisms that cause diseases. These organisms, called pathogens, are difficult to address because there are so many varieties that it would not be feasible to test for all of them individually. Instead, usually are made tests for "indicator organisms", bacteria which typically are not pathogens, but which alert that water is susceptible to contamination. We may click on section "TEST YOUR WATER" to get a list of acceptable laboratories in the country. A trustful and skilled laboratory will give you the instructions to get a representative sample.

 Depending on how many contaminants we test for, a water test can cost from few dollars to hundreds of dollars. What if I have a severely compromised immune system? Some people may be more vulnerable to contaminants in drinking water than the general population. People with severely compromised immune systems, such as people with cancer undergoing chemotherapy, people who have undergone organ transplants, people with HIV/AIDS or other immune system disorders, some elderly, and infants can be particularly at risk from infections. These people should seek advice about drinking water from their health care providers.

 BOTTLED WATER What is bottled water? The U.S.Food and Drug Administration's (FDA) product definition for bottled water is water that is sold for human consumption in sanitary containers and contains no added sweeteners or chemical additives . It must be calorie-free & sugar-free. Flavors, extracts or essences may be added to drinking water, but they must comprise less than one-percent-by-weight of the final product. Some bottled waters contain natural or added carbonation. While the term bottled water is widely used, the term packaged water is perhaps more accurate.

 Water sold in countries for consumption can come in cans, laminated boxes and even plastic bags. However, bottled water is most commonly sold in glass or disposable plastic bottles. Bottled water also comes in various sizes from single servings to large holding can up to 80 liters. Bottled water containing not less than 250 parts per million total dissolved solids may be labeled as mineral water. Mineral water is distinguished from other types of bot-tled water by its constant level and relative proportions of mineral & trace elements at the point of emergence from the source. No minerals can be added to this product.

 Water that has been produced by distillation, deionization, reverse osmosis or other suitable processes may be labeled as purified bottled water. Which are the hazards regarding bottled water? If bottled-water is not produced under certified methods of quality control, may be contaminated by a range of chemical, microbial and physical hazards that could pose risks to health if they are present at high levels. Examples of chemical hazards include lead, arsenic and benzene. Microbial hazards, include bacteria, viruses and parasites, such as Vibrio cholerae, hepatitis A virus, and Crytosporidium parvum, respectively. Physical hazards include glass chips and metal fragments.

 Are there international standards for bottled water? Because of the large number of possible hazards in bottled-water, the development of standards requires significant resources and expertise, which many countries are unable to afford. Fortunately, guidance is available at the international level. According to the US Centers for Disease Control and Prevention (CDC), bottled water that meets the standards set by the U.S.Food and Drug Administration (FDA) has never been responsible for an out-break of waterborne illness. To ensure that bottled water is as safe as possible the producers must use one or more of the following practices:

 source protection and monitoring, reverse osmosis, distillation, filtration, ozonation and disinfection. The International Bottled Water Association (IBWA), has set standards, contained in the IBWA "Model Code," that exceed the FDA regulations currently in place for bottled water. The intergovernmental body for the development of internationally recognized standards for food is the Codex Alimentarius Commission (CAC). WHO, one of the co-sponsors of the CAC, has advocated the use of the Guidelines for Drinking-water Quality as the basis for derivation of standards for all bottled waters.The CAC has developed a Codex Standard for Natural Mineral Waters and an associated code of practice.

 The Codex Standard describes the product and its labeling, compositional and quality factors, including limits for certain chemicals, hygiene, packaging and labeling. The Codex Code of Practice for Collecting, Processing and Marketing of Natural Mineral Waters provides guidance to the industry on a range of good manufacturing practices matters. While CAC standards & recommendations are not strictly mandatory, Codex health and safety requirements are recognized by the World Trade Organization as representing the international consensus for consumer protection and any deviation from Codex recommendations may require a scientifically-based justification.

 How I know if that bottled water meets the standards? International bottler members of IBWA that sell products with "IBWA label" must submit a certificate of inspection to IBWA.As a condition of membership, bottlers must submit to an annual, unannounced plant inspection administered by an independent, internationally recognized third-party inspection organization. Another well know & trustful certifier of bottled water is the National Sanitation Foundation (NSF). NSF Certification means that a credible, objective, independent third-party, widely recognized by public health officials, has actually tested and verified that bottled water complies with specific standards.

 NSF maintains policies that establish additional requirements that a company must comply with to maintain NSF Certification and authorization to place the NSF Mark on products. These include initial and periodic testing and/or evaluation, and annual unannounced inspections. Bottlers meeting all requirements are authorized to use the NSF Listing Mark and are included in the published Listing Book. All European producers of bottled water must meet strict standards set by the European Union and also, if they export their production to the U.S., they have to meet the federal and state standards. So you can trust that a bottled water with the IBWA or NSF label or a well known European brand is safe for drinking.

 Of course , there are another brands in many countries that are safe, but unfortunately there are also reports of companies bottling unsafe tap water and selling it as bottled water. Consumers may not be able to detect this by taste alone and, if concern is warranted, should examine the closures of bottled waters carefully before purchase and insist on seeing bottles opened in their presence in restaurants and other food and beverage service establishments. So is safer to drink only certified bottled water that is in a container with a tight seal. Where can I found the listing of certified bottled water?

 You can search at: NSF site: www.nsf.org/Certified/BWPI or IBWA site: www.bottledwater.org/public/WhatIsBrand List.htm FOOD & BEVERAGE WATER What is food and beverages water? Is water that is used for food and beverages preparation and dishwashing.If the water is contaminated, the food and beverages will also be unsafe to use. How important is safe kitchen water? In many developing countries tap water is often untreated, or not adequately treated, and is unsafe to drink.

 It is very important to use safe water for washing fruits and vegetables,preparing beverages and meals that will not boil and making ice cubes. Also is important to use safe water to clean the surfaces used for food preparation and for washing the dishes, if dishwahing machines that sterilize the content are not used. What can a hotel or resort do to have safe kitchen water? If tap water is not safe, the following measures can be taken to treat water: 1. Boiling: is the best method of disinfecting.

2. Chemical treatment with chlorine or iodine: 3. chlorine may not kill giardia ( a parasite found all over the world) and its disinfectant activity depends on several factors, such as water temperature, organic content and length of contact time. 4. iodine could be more effective, but water is safe if a slight taste of iodine is present, so it could be unpleasant. Pregnant women and persons with thyroid problems should not use iodine. Long term use of iodine is not recommended 5. Filtering: most filters remove bacteria, parasites and visible material from water.There is a wide range of filters and the effectiveness of the units depends

Disinfectant UK Free chlorine Bromine

EC

USA

USA Germany Italy (Michigan) 0.30.6 0.71. 0.71

12 1.03.0 0.41.0 1.53.5

FAQ What is a water-borne disease? What does it mean safe water? How safe is water worldwide? What does it mean access to safe water and sanitation? What is travelers' diarrhea? Who gets travelers' diarrhea? What causes travelers' diarrhea? What treatment measures are effective for travelers' diarrhea? Can I find out if tap water is safe to drink by tasting or smelling it? How does a traveler know if tap water is safe to drink? What is a drinking water standard? Are all the contaminants equally harmful for travelers? Who sets international drinking water standards? What about edible ice cubes? Can I disinfect ice cubes? What is bottled water? How I know if that bottled water is safe? Where can I found the listing of certified bottled water? What can I do if I need to use unsafe tap water? How can I know what is risky to do, if tap water is not safe? How can I prevent to get diseases in swimming pools and spas? What about people with severely compromised immune system? Are waterborne diseases the same in people with HIV/AIDS as in other people? Which substances have to be identified when testing drinking water? What is a water-borne disease? Is a disease which arises from the contamination of water by human or animal faeces or urine infected by pathogenic viruses or bacteria, and which is directly transmitted when the water is drunk or swallowed or used in the preparation of food. On average, a person needs about 20 liters of safe water each day to meet his or her metabolic, hygienic, and domestic needs What does it mean safe water? Safe water means water that will not harm you if you come in contact with it. The most common use of this term applies to drinking water, but it could also apply to water for swimming or other uses. Safe water includes treated surface water, as well as untreated but uncontaminated water from sources such as natural springs and sanitary wells. To be safe, the water must have sufficiently low concentrations of harmful contaminants to avoid sickening people who use it. The list of harmful contaminants includes disease-causing microbes such as bacteria, viruses, and protozoans; cancer-causing chemicals such as many pesticides, organic solvents, petroleum products, and some metals and metalloids; nitrates and nutrients, endocrine-disrupting compounds, strong acids, strong bases, radionuclides, and any other acutely toxic substance. Defining safe water becomes a matter of risk assessment. Without safe water, people cannot lead healthy, productive lives. How safe is water worldwide? While the occurrence of waterborne diseases in developed countries is generally low due to a generally good system of water treatment, distribution and monitoring, waterborne diseases are among the leading causes of morbidity and mortality in in low- and middle-income countries, frequently called developing countries. For example, an estimated 900 million people suffer (and approximately 2 million die) from water-related diarrhoeal illnesses each year. At least 10 percent of the total burden of human diseases in many developing countries can be attributed to diarrhea and infestations by intestinal worms. Under no circumstances is it advisable to drink unsafe water, use it for oral hygiene or use ice made from unsafe water in drinks. However, you should not become hysterical about avoiding all water whilst traveling abroad. Is not the same Santiago (Chile), where water is as safe as the water of a developed country's city, than Freetown (Sierra Leone), where could be very dangerous to drink tap water, if you can get it. Just get the best information you can about water safety. In the section" Can I drink water in[ Choose a country}?", SWIT provides the best public available information of water quality regarding health, from sources like World Health Organization (WHO) and the UNICEF, for every country around the world. What does it mean access to safe water and sanitation? As a countrys economy becomes stronger (as its GNP per capita or PPP rise) a larger percentage of its people tend to have ac cess to safe water and sanitation. Access to safe water is measured by the number of people who have a reasonable means of getting an adequate amount of water that is safe for drinking, washing, and essential household activities, expressed as a percentage of the total population. It reflects the health of a countrys people and the countrys capacity to collect, clean, and distribute water to consumers. According to the World Health Organization (WHO) more than one billion people in low and middle-income countries lack access to safe water for drinking, personal hygiene and domestic use. These numbers represent more than 20 percent of the worlds people. In addition, close to 2 billion people did not have access to adequate sanitation facilities. What is travelers' diarrhea?

Disease and Transmission Amebiasis (hand-to-mouth)

Microbial Agent Protozoan (Entamoeba histolytic) (Cystlike appearance)

Sources of Agent in Water Supply Sewage, non-treated drinking water, flies in water supply

General Symptoms Abdominal discomfort, fatigue, weight loss, diarrhea, gas pains Fever, abdominal pain, diarrhea Watery diarrhea, vomiting, occasional muscle cramps Diarrhea, abdominal discomfort Flu-like symptoms, watery diarrhea , loss of appetite, substantial loss of weight, bloating, increased gas, stomach cramps, nausea, vomiting, muscle aches, low-grade fever, and fatigue Diarrhea, abdominal discomfort, bloating, gas and gas pains

Campylobacteri osis (oral-fecal) Cholera (oralfecal) Cryptosporidiosi s (oral) Bacterium (Vibrio cholerae) Protozoan (Cryptosporidium parvum)

Untreated water, sewage, poor hygiene, crowded living conditions with inadequate sewage facilities Untreated water, sewage, poor hygiene, crowded living conditions with inadequate sewage facilities. Collects on water filters and membranes that cannot be disinfected, animal manure, seasonal runoff of water. Sewage, non-treated drinking water

Cyclosporiasis

Protozoan parasite (Cyclospora cayetanensis) Protozoan (Giardia lamblia) Most common intestinal parasite

Giardiasis (oralfecal) (hand-tomouth)

Untreated water, poor disinfection, pipe breaks, leaks, groundwater contamination, campgrounds where humans and wildlife use same source of water. Beavers and muskrats act as a reservoir for Giardia. Raw sewage, untreated drinking water, poor hygiene, ingestion of shellfish from sewage-flooded beds Contaminated water, shellfish, turtles, fish Sludge, untreated wastewater, groundwater contamination, poorly disinfected drinking water. Contaminated fresh water with certain types of snails that carry schistosomes Raw sewage (carried and excreted

Hepatitis A (oral-fecal) Salmonellosis (oral transmission) Shigellosis (oral-fecal) Schistosomiasis (immersion) Typhoid fever

Virus (Hepatitis A) Bacterium (Salmonella species) Bacterium (Shigella species) Schistosoma

Fever, chills, abdominal discomfort, jaundice, urine dark Gastroenteritis, fever and rapid bloodpoisoning. Fever, diarrhea, bloody stools Rash or itchy skin. Fever, chills, cough, and muscle aches Fever, headache,

Bacterium

Estimates of Global Morbidity and Mortality of Water-Related Diseases (early 1990s)

Disease Diarrheal Diseases Intestinal Helminths Schistosomiasis Dracunculiasis Trachoma Malaria Dengue Fever Poliomyelitis Trypanosomiasis Bancroftian Filariasis Onchocerciasis Morbidity (episodes/year or people infected) 1,000,000,000 1,500,000,000 (people infected) 200,000,000 (people infected) 150,000 (in 1996) 150,000,000 (active cases) 400,000,000 1,750,000 114,000 275,000 72,800,000 (people infected) 17,700,000 (people infected; 270,000 blind) Mortality (deaths/year) 3,300,000 100,000 200,000 1,500,000 20,000 130,000 40,000 (mortality caused by blindness)

 WATER QUALITY STANDARD Water Quality Standards There are no international mandatory drinking water standards.The World Health Organization (WHO) publishes Guidelines for Drinking-water Quality which many countries use as the basis to establish their own national standards. The Guidelines represent a scientific assessment of the risks to health from biological and chemical constituents of drinking-water and of the effectiveness of associated control measures. As the WHO Guidelines for Drinkingwater Quality are meant to be the scientific point of departure for standards development, including bottled water, actual national standards will sometimes vary from the Guidelines. Microbiological Quality Guidelines Chemical Quality Guidelines Safe Water for International Travelers Safe Water for International Travelers is an independent organization that provides the most reliable information about water safety around the world.