Water Borne Diseases

Typhoid

Typhoid fever, also known as enteric fever or commonly just typhoid is an illness caused by the bacterium Salmonella typhi. Common worldwide, it is transmitted by the ingestion of food or water contaminated with faeces from an infected person.

Typhoid fever is characterized by a sustained fever as high as 40°C (104°F), profuse sweating, gastroenteritis, weakness or stomach pains, headache or loss of appetite and non-bloody diarrhea. Less commonly a rash of flat, rose-colored spots may appear.

You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding S.Typhi or if sewage contaminated with S.Typhi bacteria gets into the water you use for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where hand washing is less frequent and water is likely to be contaminated with sewage. Once S.Typhi bacteria are consumed through water or food, they multiply and spread into the intestine. The body reacts with the toxin generated by this bacteria present in the blood causing fever and other symptoms.

Sanitation and hygiene are the most important measures that can be taken to prevent typhoid. Typhoid does not affect animals and therefore transmission is only from human to human. Typhoid can only spread in environments where human faeces or urine can come into contact with food or drinking water. It is preferred to drink water only when you are sure that the water it is pure and safe. Careful food preparation and washing of hands are also crucial to prevent typhoid.

If Typhoid is suspected, doctor should be contacted immediately. Usually Antibiotic treatment is recommended. Persons given antibiotics usually begin to feel better within 2 to 3 days, and deaths rarely occur. However, persons who do not get treatment may continue to have fever for weeks or months, and as many as 20 per cent may die from complications of the infection.

Note: This information is not meant to be medical advice. Please consult your doctor for details.

Jaundice

Jaundice, also referred to as icterus, is the yellow staining of the skin and sclerae (the whites of the eyes) by abnormally high blood levels of the bile pigment, bilirubin. The yellowing extends to other tissues and body fluids and also may turn the urine dark.

Bilirubin is a yellowish pigment that is produced from the breakdown of heme, primarily from haemoglobin and red blood cells (RBCs). Bilirubin is transported by the blood to the liver, where the liver processes it, allowing it to be excreted in bile. Bile is a thick, yellow-green-brown fluid that is secreted into the upper small intestine (duodenum) to get rid of waste products (such as bilirubin and excess cholesterol) and to aid in the digestion of fats. Jaundice may arise from increased breakdown of red blood cells, inherited changes in bilirubin metabolism, liver disease or damage, and whenever there is interference with bile excretion.

Hepatitis A Alcoholic liver disease
Hepatitis B Inflammation of the liver
Hepatitis C Haemolytic anemia
Hepatitis D Typhoid
Liver cirrhosis Malaria
Hepatitis E Yellow fever
Obstruction of bile ducts Tuberculosis
Gallstones Certain medication
Pancreatic cancer Pregnancy
Extreme weakness Nausea
Headache Yellow discoloration of the eyes, tongue, skin, and urine
Fever Dull pain in the liver region
Loss of appetite Intense itching
Severe constipation  

The cause of jaundice must be determined before treatment can be given. Follow doctor prescribed therapy to treat the underlying cause. Always call your doctor if symptoms of jaundice are present.

Note: This information is not meant to be medical advice. Please consult your doctor for details.

Cholera

  • Cholera is an acute diarrhoeal disease that can kill within hours if left untreated.
  • There are an estimated 3–5 million cholera cases and 100,000–120,000 deaths due to cholera every year globally.
  • Up to 80% of cases can be successfully treated with oral rehydration salts.
  • Effective control measures rely on prevention, preparedness and response.
  • Provision of safe water and sanitation is critical in reducing the impact of cholera and other waterborne diseases.
  • Oral cholera vaccines are considered an additional means to control cholera, but should not replace conventional control measures.
  • Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Every year, there are an estimated 3–5 million cholera cases and 100 000–120 000 deaths due to cholera. The short incubation period of two hours to five days, enhances the potentially explosive pattern of outbreaks.

The incubation period, from infection until the disease breaks out, is generally less than two days, although it can be as long as five days. The infection is often a mild illness with ordinary diarrhea, and it can even evolve without any symptoms at all. But the individual is still able to pass on the disease.

Typically, cholera begins over quite a short period of time with stomach pains without feeling sick. There may also be a mild fever. Then vomiting and diarrhea begins, and may continue for several hours.

This is followed by very copious, watery diarrhea, which is pale and flaky and looks like rice water. The fluid loss may be as high as 1 litre every hour which can lead to death if untreate.

Cholera is an easily treatable disease. The prompt administration of oral rehydration salts to replace lost fluids nearly always results in cure. In especially severe cases, intravenous administration of fluids may be required to save the patient's life.

Note: This information is not meant to be medical advice. Please consult your doctor for details.

Diarrhea

Diarrhea is the passage of 3 or more loose or liquid stools per day, or more frequently than is normal for the individual. 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 diarrhoea leads to fluid loss, and may be life-threatening, particularly in young children and people who are malnourished or have impaired immunity.

Diarrhoea is a symptom of infection caused by a host of bacterial, viral and parasitic organisms most of which can be spread by contaminated water. It is more common when there is a shortage of clean water for drinking, cooking and cleaning and basic hygiene is important in prevention.

Water contaminated with human faeces for example from municipal sewage, septic tanks and latrines is of special concern. Animal faeces also contain microorganisms that can cause diarrhoea.

Diarrhoea can also spread from person to person, aggravated by poor personal hygiene. Food is another major cause of diarrhoea when it is prepared or stored in unhygienic conditions. Water can contaminate food during irrigation, and fish and seafood from polluted water may also contribute to the disease.

Diarrhoea may be accompanied by cramping abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a fever or bloody stools.

Diarrhoea can be either acute (short-term) or chronic (long-term). The acute form, which lasts less than 4 weeks, is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhoea lasts more than 4 weeks and is usually related to functional disorders like irritable bowel syndrome or inflammatory bowel diseases like coeliac disease.

Key measures to reduce the number of cases of diarrhoea include:

  • Access to safe drinking water.
  • Improved sanitation.
  • Good personal and food hygiene.
  • Health education about how infections spread.

Key measures to treat diarrhoea include:

  • Giving more fluids than usual, including oral rehydration salts solution, to prevent dehydration.
  • Continue feeding.
  • Consulting a health worker if there are signs of dehydration or other problems.
  • Diarrhoea is a common problem that usually resolves on its own.
  • Diarrhoea is dangerous if a person becomes dehydrated.
  • Causes include viral, bacterial, or parasitic infections; food intolerance; reactions to medicine; intestinal diseases; and functional bowel disorders.
  • Treatment involves replacing lost fluids and electrolytes. Depending on the cause of the problem, a person might also need medication to stop the diarrhoea or treat an infection. Children may need an oral rehydration solution to replace lost fluids and electrolytes.
  • Call the doctor if a person with diarrhoea has severe pain in the abdomen or rectum, a fever of 102 degrees Fahrenheit or higher, blood in the stool, signs of dehydration, or diarrhoea for more than 3 days.
  • Note: This information is not meant to be medical advice. Please consult your doctor for details.

  • 1.8 million people die every year from diarrhoeal diseases (including cholera); 90% are children under 5, mostly in developing countries.
  • 88% of diarrhoeal disease is attributed to unsafe water supply, inadequate sanitation and hygiene.
  • Improved water supply reduces diarrhoea morbidity by between 6% to 25%, if severe outcomes are included.
  • Improved sanitation reduces diarrhoea morbidity by 32%.
  • Hygiene interventions including hygiene education and promotion of hand washing can lead to a reduction of diarrhoeal cases by up to 45%.
  • Improvements in drinking-water quality through household water treatment, such as chlorination at point of use, can lead to a reduction of diarrhoea episodes by between 35% and 39%.
  • Diarrhoeal Disease: The health hazards from poor water, sanitation and hygiene behaviour

    A recent report* notes that around 4 billion cases of diarrhoea are recorded each year, leading to 2.2 million deaths, mostly among children under the age of five (15% of all child deaths). Water, sanitation and hygiene interventions reduce diarrhoeal disease on average by between one-quarter and one-third.

Gastroenteritis

Gastroenteritis is the inflammation of the stomach and the intestine caused by viruses or bacteria or their toxins. It is also called as “stomach flu”.

The viral gastroenteritis is caused due to infection by Rotavirus or Norovirus. These infections are mainly prevalent in children and are generally caused as outbreaks. Adults, too are affected by gastroenteritis. The viruses are found to be present in drinking water and food.

Bacterial gastroenteritis may be caused due to infection by E coli, Closteridium, Salmonella, Shigella, Campylobacter jejuni, Staphylococcus aureus, Yersinia and many others.

Consumption of improperly prepared food or contaminated water , Inadequate hygiene practices of handling, preparation and storage of food, inadequate cooking and sharing things with the infected person may cause gastroenteritis. Young children and immuno-compromised people are at greater risk of getting the infection.

Symptoms of viral gastritis appear after 4 to 48 hours after the infection. The symptoms are nausea, vomiting, diarrhoea, abdominal pain and cramps. Other symptoms may be headaches, fatigue, weight loss, fever, chills, cold clammy skin, joint stiffness and muscle pain, excessive sweating, blood in stool and rarely blood in the vomit.

The treatment is aimed to prevent dehydration. Normally lots of fluids and electrolyte solutions are given. Low fibre diet or liquid diet is preferred till the diarrhoea subsides. If it is not possible to give fluids orally then fluids are given intravenously. Sugary drinks, soft drinks and juices should be avoided in children as they make the condition worse. Probiotics, zinc supplement, drugs to prevent vomiting and yogurt are also given.

Antibiotics are given for gastroenteritis of bacterial origin, generally, if other body parts are affected but antibiotics are not useful in viral gastroenteritis.

Diuretics should be used with caution and any such treatment is already going on it should be discussed with the doctor.

The infection gets cured on its own but dehydration caused due to it can cause severe illness. Fluid replacement and restoration of electrolyte imbalance improves the condition within a week.

If treatment is not given, severe dehydration may lead to death. There may be systemic infection, anemia, arthritis, kidney failure or new onset of irritable bowel syndrome in case of gastroenteritis of bacterial origin.

If there is dizziness, dry mouth, fever, faintness, sunken eyes, less urine output, confusion or blood in stool then it is better to call the health care provider.

Washing hands properly and frequently and hygienic handling, preparation and storage of food can prevent gastritis. Special care about food and drinking water is needed especially while travelling.

Note: This information is not meant to be medical advice. Please consult your doctor for details

Water Facts and Figures

  • 1.1 billion people in the world do not have access to safe water, roughly one-sixth of the world’s population. At NGBS we take a social responsibility to support NGO’s as we are associated with www.water.org to help fellow humans globally.
  • 2.4 billion people in the world do not have access to adequate sanitation, about two-fifths of the world’s population.
  • 1.35 million people in developing countries, most of them children, die every year from diseases associated with lack of access to safe drinking water, inadequate sanitation and poor hygiene.
  • Some 3,300 children die every day from diseases associated with lack of access to safe drinking water, inadequate sanitation and poor hygiene – equivalent to 10 jumbo jets crashing every day.
  • At any one time it is estimated that half of the world’s hospital beds are occupied by patients suffering from water-borne diseases.
  • 200 million people in the world are infected with schistosomiasis, of whom 20 million suffer severe consequences. The disease is still found in 74 countries of the world. Scientific studies show that a 77% reduction of incidence from the disease was achieved through well designed water and sanitation interventions.
  • The average distance that women in Africa and Asia walk to collect water is 6 km.
  • The weight of water that women in Africa and Asia carry on their heads is the equivalent of your airport luggage allowance (20kg).
  • The average person in the developing world uses 10 litres of water a day.
  • The average person in the United Kingdom uses 135 litres of water every day.
  • One flush of your toilet uses as much water as the average person in the developing world uses for a whole day’s washing, cleaning, cooking and drinking.
  • Comparative costs: In Europe $11 billion is spent each year on ice cream; in USA and Europe, $17 billion is spent on pet food; in Europe $105 billion is spent annually on alcoholic drinks, ten times the amount required to ensure water, sanitation and hygiene for all.
  • In the past 10 years diarrhoea has killed more children than all the people lost to armed conflict since World War II.
  • In China, India and Indonesia twice as many people are dying from diarrhoeal diseases as from HIV/AIDS.
  • In 1998, 308,000 people died from war in Africa, but more than two million (six times as many) died of diarrhoeal disease.
  • The population of the Kibeira slum in Nairobi, Kenya pay up to five times the price for a litre of water than the average American citizen.
  • An estimated 25% of people in developing country cities use water vendors purchasing their water at significantly higher prices than piped water.
  • Projections for 2025 indicate that the number of people living in water-stressed countries will increase to 3 billion – a six-fold increase. Today, 470 million people live in regions where severe shortages exist.
  • The simple act of washing hands with soap and water can reduce diarrhoeal disease by one-third.
  • Following the introduction of the Guatemalan Handwashing Initiative in 1998, there were 322,000 fewer cases of diarrhoea each year amongst the 1.5 million children under 5 nationwide in the country's lowest income groups.
  • In Zambia, one in five children die before their fifth birthday. In contrast in the UK fewer than 1% of children die before they reach the age of five.
  • A study in Karachi found that people living in areas without adequate sanitation who had no hygiene education spend six times more on medical treatments than those with sanitation facilities.
  • Waterborne diseases (the consequence of a combination of lack of clean water supply and inadequate sanitation) cost the Indian economy 73 million working days a year. And a cholera outbreak in Peru in the early 1990s cost the economy US$1 billion in lost tourism and agricultural exports in just 10 weeks.
  • Improved water quality reduces childhood diarrhoea by 15-20% BUT better hygiene through handwashing and safe food handling reduces it by 35% AND safe disposal of children’s faeces leads to a reduction of nearly 40%.
  • At any time, 1.5 billion people suffer from parasitic worm infections stemming from human excreta and solid wastes in the environment. Intestinal worms can be controlled through better sanitation, hygiene and water. These parasites can lead to malnutrition, anaemia and retarded growth, depending upon the severity of the infection.
  • It is estimated that pneumonia, diarrhoea, tuberculosis and malaria, which account for 20% of global disease burden, receive less than 1% of total public and private funds devoted to health research.
  • Ecological sanitation is one option being practised in some communities in China, Mexico, Vietnam, etc. Excreta contains valuable nutrients. We produce 4.56 kg nitrogen, 0.55 kg phosphorous, and 1.28 kg potassium per person per year from faeces and urine. This is enough to produce wheat and maize for one person every year.
  • One gramme of faeces can contains:10,000,000 Viruses, 1,000,000 bacteria, 1,000 parasite cysts, 100 parasite eggs.
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