Water related diseases are all diseases which result from contact,
consumption of contaminated water , inadequate use of water and
transmission of pathogens by vectors. These micro organisms or their eggs are invisible so that water
may look clean yet it is infected. These diseases are classified
into 4 categories depending on how the pathogen
is transmitted as follows
Water borne diseases
Water based diseases
Water washed diseases
Water related insect vector
“All people, whatever their stage of development and social and economic condition, have the right to have access to drinking water in quantities and of a quality equal to their basic needs.” (UN Conference at Mar del Plata, 1977) Definition: water-washed diseases are diseases caused by inadequate use of water for domestic and personal hygiene. Contaminated clothing: scabies, lice, louse borne diseases e.g typhus, Unwashed cooking utensils: enteritides Unwashed bodies, skin rashes, degenerate life conditions…. To date, WHO has not provided guidance on the quantity of domestic water that is required to promote good health.
Minimum requirements for all hygiene needs
Basic access: Average is unlikely to exceed 20 l/c/d. Not all requirements may be met.
Intermediate access: Medium, likely to be
around 50 l/c/d. Most basic hygiene and consumption needs met. Water-washed diseases(caused by lack of water) Scabies; Skin sepsis,yaws and leprosy Lice and thypus; Trachoma; Dysenteries; Ascariasis; Parathphoid Scabies is a pimple-like skin disease caused by the microscopic mite Sarcoptes scabei and characterized by intense itching. This is due to inadequate use of water for bathing. Scabies spreads rapidly, and causes an estimated 300 million cases each year. Epidemic or lice-born typhus is an acute and often fatal fever caused by Rickettsia prowazekii. It is prevalent in children due to them being naturally not hygienic. The types of prevention measures applied to curb any water- related disease depend on the transmission mechanisms associated with the disease. There are 4 primary routes of transmission of water related diseases and each route has a set of proven diseases prevention measures.
- The main types of control methods are those directed to the
pathogen and / or its vector or at humans themselves. These methods can be classified as:
• Chemical e.g spraying insecticides or use of preventive or
curative pharmaceuticals • Biological e.g introducing a harmless predator for disease vectors. • Environmental e.g modification or manipulation of the environment, including changes in human behavior or habitat Prevention water-washed Diseases.
These can be prevented by increasing the quantity of
water available to populations and effectively promoting improved hygiene. Community awareness of preventive measures. Monitoring of children to ensure that they are using water adequately. INTRODUCTION: Waterborne diseases are caused by pathogenic microorganisms and chemical wastes that most commonly are transmitted in contaminated fresh water ( ie Where the pathogen is present in the drinking water) The term “waterborne disease” is reserved largely for infections that predominantly are transmitted through contact with (i.e on hands, clothes ,food) or consumption of infected water ( eating and drinking implements). Water borne diseases can be non-infectious chemical based or infectious (pathogenic).
Non-Infectious Waterborne Diseases:
Non infectious diseases are a result of , the presence or insufficient
quantities of certain minerals , or inorganic matter.
Where inorganic matter is found in concentrations above
prescribed limits, health threats are posed. In certain instances, diseases are caused by the presence in minute quantities or complete absence of these minerals. N0N-INFECTIOUS INFECTIOUS
•Arsenicosis(high levels of arsenic) •Cholera
•Fluorosis(high levels of flourine) •Dysentery
•Metheglobinemia(high levels of •Typhoid
nitrates) Some minerals ,however, such as arsenic and lead are toxic even in small quantities.
Fluorides are beneficial for young teeth at concentrations between
0.3mg/l and 2 mg/l. At concentrations less than the lower limit tooth decay occurs such that concentrations in drinking water have to be augmented (increase) artificially. At concentrations greater than 2mg/l skeletal damage and mottling of teeth occurs.
The presence of sulphates of magnesium has a laxative effect(
loosening of bowels) as a result of disorders in the alimentary tract Infectious Waterborne diseases Waterborne diseases are usually acute (ie rapid onset and generally lasting a short time in healthy people) and most often characterised by gastrointestinal symptoms (eg fatigue, diarrhoea, abdominal cramps). Various forms of waterborne diarrheal diseases affect mainly children in developing countries ,according to WHO, such diseases account for an estimated 4.1% of the daily global burden of diseases and cause about 1.8million human deaths annually. Microorganisms are responsible for a wide spectrum of diseases. Agents found in excreta are obvious candidates for waterborne transmission , particularly because water is used as a carriage vehicle for wastes. Most of pathogenic agents have to be orally ingested to cause the disease . Therefore hand to mouth ,water and food are the most common routes for disease transmission. Disease causing organisms are called PATHOGENS. Pathogens that have been implicated in waterborne diseases include: Bacteria,viruses and protozoa Bacteria are single-celled microorganisms that possess no well defined nucleus and reproduce by binary fission. Many of the bacterial agents are associated with diarrhoea or dysentery (gastroenteritis) which is a more severe upset of the digestive system involving inflammation of the stomach and intestinal linings. The most common disease is cholera, in this disease the microbial agent , Vibrio Cholerae produces a substance that upsets the isotomic balance in the fluids in the digestive system causing excessive fluid loss. Death can occur in 3-12 hrs It is most commonly caused by one of two different organisms: a bacteria called shigella and amoeba. Amoebic dysentery is prevalent in regions where human excrement is used as fertiliser.The amoebas that cause dysentery can form cysts which are like bacterial spores that can become inactive and highly resistant to environmental conditions (in other words they can live a long time outside the body and then reactivate and cause disease when conditions become favourable). Symptoms:fever , abnominal cramps and blood stools. AGENT DISEASE HOST
1.Campylobacter spp Diarrhoea Animals
2.Escherichia Coli Diarrhoea Humans
3.Legionella Pneumonia Aquatic habitats
4.Leptospira Leptospirosis Humans and animals
5.Mycobacterium spp Tubercolosis Humans and cattle
6.Salmonella Food poisoning,Salmonellosis Humans and animals
7.Salmonella typhi Typhoid fever Humans
8.Shigella Bacterial dysentery Humans
9.Vibrio Cholerae Cholera Humans
These are a large group of tiny infectious agents ranging in size from 0.02 to 0.3 micrometers. Viruses are characterized by a total dependence on living cells for reproduction and by no independent metabolism. Viruses infect the gastrointestinal tract of humans and animals and are excreted in their faeces. Most of them are found in ground and surface waters Types: Hepatitis A & E ,Hepatitis A virus causes infectious hepatitis , an illness characterised by inflammation of the liver. Symptoms:fever,weakness,nausea,vomiting, diarrhoea and Jaundice These are single celled organisms that lack a cell wall. They are common in fresh water Recognised human pathogens are: giardic lamblia (resistant to chlorine) and entenamoeba histolytica. When ingested entamoeba can cause amoebic dysentry with symptons ranging from acute bloody diarrhoea and fever to mild gastrointestinal illnesses and ulcers. Unlike other waterborne pathogens, algae use photosynthesis as their primary mode of nutrition and all produce chlorophyll. Algae does not pose health concern, however certain species may produce neurotoxins (substances that affect the nervous system) Prevention measures for water borne diseases Transmission of water-borne diseases can be prevented by assuring access to a sufficient quantity of disinfected water and proper disposal of human waste. These are caused by pathogens being carried by an insect that breeds, feeds or bites near water and they fall under water related infections or diseases Water plays an important role in the spread of insect- borne diseases because many insects breed around water. An increase in water, especially from flooding ,can directly impact the number of mosquitoes and other insects that breed around water ,potentially creating high-risk environments for disease. Infected insects can transmit deadly diseases to humans through their bite such as malaria, dengue fever,filariasis,yellow fever and river blindness. Malaria is the most infamous of these diseases. It is caused by a minute parasites called plasmodium parasites, which are spread by mosquitoes. The insects breed in fresh or brackish water. In humans, the plasmodium parasite grows inside red blood cells and destroy them-a process that causes the fevers associated with malaria. other symptoms are chills, head & muscle aches,fatigue,nausea,diarrhea and jaundice and in severe cases convulsions Prevention of water-related vector diseases. Transmission can be prevented by: • Elimination of insect breeding sites e.g stagnant waters. • Use of insecticides and treated bednets. • Introduction of natural predators e.g the use of predatory fish that feed on mosquitoe larvae. In the water-based scenario the pathogens must spend their life cycle in an aquatic intermediate host. They are caused by skin contact with pathogen- infected water or with chemical-contaminated water , these include Schistosomiasis (bilharzia). Schistosomiasis (also known as bilharzia, bilharziosis or snail fever) is a collective name of parasitic diseases caused by several species of trematodes belonging to the genus Schistosoma. 1.SNAILS The life cycles of all five human schistosomes are broadly similar: parasite eggs are released into the environment from infected individuals, hatching on contact with fresh water to release the free- swimming miracidium. Miracidia infect freshwater snails by penetrating the snail's foot. After infection, close to the site of penetration, the miracidium transforms into a primary (mother) sporocyst. Germ cells within the primary sporocyst will then begin dividing to produce secondary (daughter) sporocysts, which migrate to the snail's hepatopancreas.
Once at the hepatopancreas, germ cells within the
secondary sporocyst begin to divide again, this time producing thousands of new parasites, known as cercariae, which are the larvae capable of infecting mammals. Cercariae emerge daily from the snail host in a circadian rhythm, dependent on ambient temperature and light. Young cercariae are highly mobile, alternating between vigorous upward movement and sinking to maintain their position in the water. Cercarial activity is particularly stimulated by water turbulence, by shadows and by chemicals found on human skin. 2.HUMANS Penetration of the human skin occurs after the cercaria have attached to and explored the skin. The parasite secretes enzymes that break down the skin's protein to enable penetration of the cercarial head through the skin. As the cercaria penetrates the skin it transforms into a migrating schistosomulum stage. The newly transformed schistosomulum may remain in the skin for two days before locating a post-capillary venule; from here the schistosomulum travels to the lungs where it undergoes further developmental changes necessary for subsequent migration to the liver. Prevention of water-based Diseases. Transmission can be prevented by: • eliminating contact with infested water • controlling the population of intermediate hosts in water for example schistosomiasis causing snails can be reduced in number by building channels in fast flowing streams to make it difficult for them to survive since they thrive in stagnant waters. • reducing faecal contamination of surface waters by human wastes.