Waterborne diseases are caused by pathogenic microorganisms which are directly transmitted when contaminated water is used. According to the World Health Organization, diarrheal disease accounts for an estimated 4.1% of the total DALY global burden of disease and is responsible for the deaths of 1.8 million people every year. It was estimated that 88% of that burden is attributable to unsafe water supply, sanitation and hygiene, and is mostly concentrated in children in developing countries.
Waterborne disease can be caused by protozoa, viruses, or bacteria, many of which are intestinal parasites.
|
Disease and Transmission |
Microbial Agent |
Sources of Agent in Water Supply |
General Symptoms |
|
Amoebiasis (hand-to-mouth) |
Protozoan (Entamoeba histolytica) (Cyst-like appearance) |
Sewage, non-treated drinking water, flies in water supply |
Abdominal discomfort, fatigue, weight loss, diarrhea, bloating, fever |
|
Cryptosporidiosis (oral) |
Protozoan (Cryptosporidium parvum) |
Collects on water filters and membranes that cannot be disinfected, animal manure, seasonal runoff of water. |
Flu-like symptoms, watery diarrhea, loss of appetite, substantial loss of weight, bloating, increased gas, nausea |
|
Protozoan parasite (Cyclospora cayetanensis) |
|||
|
Giardiasis (oral-fecal) (hand-to-mouth) |
Protozoan (Giardia lamblia) Most common intestinal parasite |
Untreated water, poor disinfection, pipe breaks, leaks, groundwater contamination, campgrounds where humans and wildlife use same source of water. Beavers and muskrats create ponds that act as reservoirs for Giardia. |
Diarrhea, abdominal discomfort, bloating, and flatulence |
|
Protozoan phylum (Microsporidia), but closely related to fungi |
The genera of Encephalitozoon intestinalis has been detected in groundwater, the origin of drinking water [3] |
Diarrhea and wasting in immunocompromised individuals |
|
Disease and Transmission |
Microbial Agent |
Sources of Agent in Water Supply |
General Symptoms |
|
Schistosomiasis (immersion) |
Members of the genus Schistosoma |
Fresh water contaminated with certain types of snails that carry schistosomes |
Rash or itchy skin. Fever, chills, cough, and muscle aches |
|
Dracunculiasis (Guinea Worm Disease) |
Stagnant water containing larvae |
Allergic reaction, urticaria rash, nausea, vomiting, diarrhea, asthmatic attack. |
|
|
Tapeworms of the genus Taenia |
Drinking water contaminated with eggs |
Intestinal disturbances, neurologic manifestations, loss of weight, cysticercosis |
|
|
Drinking water contaminated with encysted metacercaria |
GIT disturbance, diarrhea, liver enlargement, cholangitis, cholecystitis, obstructive jaundice. |
||
|
Hymenolepiasis (Dwarf Tapeworm Infection) |
Drinking water contaminated with eggs |
Abdominal pain, anorexia, itching around the anus, nervous manifestation |
|
|
Echinococcosis (Hydatid disease) |
Drinking water contaminated with feces (usually canid) containing eggs |
Liver enlargement, hydatid cysts press on bile duct and blood vessels; if cysts rupture they can cause anaphylactic shock |
|
|
multiceps multiceps |
contaminated drinking water with eggs |
increases intacranial tension |
|
|
Drinking water contaminated with feces (usually canid) containing eggs |
Mostly, disease is asymptomatic or accompanied by inflammation, fever, and diarrhea. Severe cases involve Löffler's syndrome in lungs, nausea, vomiting, malnutrition, and underdevelopment. |
||
|
Drinking water contaminated with eggs |
Peri-anal itch, nervous irritability, hyperactivity and insomnia |
|
Disease and Transmission |
Microbial Agent |
Sources of Agent in Water Supply |
General Symptoms |
|
Bacteria can enter a wound from contaminated water sources. Can enter the gastrointestinal tract by consuming contaminated drinking water or (more commonly) food |
Dry mouth, blurred and/or double vision, difficulty swallowing, muscle weakness, difficulty breathing, slurred speech, vomiting and sometimes diarrhea. Death is usually caused by respiratory failure. |
||
|
Most commonly caused by Campylobacter jejuni |
Drinking water contaminated with feces |
Produces dysentery like symptoms along with a high fever. Usually lasts 2–10 days. |
|
|
Spread by the bacterium Vibrio cholerae |
Drinking water contaminated with the bacterium |
In severe forms it is known to be one of the most rapidly fatal illnesses known. Symptoms include very watery diarrhoea, nausea, cramps, nosebleed, rapid pulse, vomiting, and hypovolemic shock (in severe cases), at which point death can occur in 12–18 hours. |
|
|
Certain strains of Escherichia coli (commonly E. coli) |
Water contaminated with the bacteria |
Mostly diarrhea. Can cause death in immunocompromised individuals, the very young, and the elderly due to dehydration from prolonged illness. |
|
|
Naturally occurs in water, most cases from exposure in swimming pools or more frequently aquariums; rare infection since it mostly infects immunocompromised individuals |
Symptoms include lesions typically located on the elbows, knees, and feet (from swimming pools) or lesions on the hands (aquariums). Lesions may be painless or painful. |
||
|
Caused by a number of species in the genera Shigella and Salmonella with the most common being Shigella dysenteriae |
Water contaminated with the bacterium |
Frequent passage of feces with blood and/or mucus and in some cases vomiting of blood. |
|
|
Legionellosis (two distinct forms: Legionnaires’ disease and Pontiac fever) |
Caused by bacteria belonging to genus Legionella (90% of cases caused by Legionella pneumophila) |
Contaminated water: the organism thrives in warm aquatic environments. |
Pontiac fever produces milder symptoms resembling acute influenza without pneumonia. Legionnaires’ disease has severe symptoms such as fever, chills, pneumonia (with cough that sometimes produces sputum), ataxia, anorexia, muscle aches, malaise and occasionally diarrhea and vomiting |
|
Caused by bacterium of genus Leptospira |
Water contaminated by the animal urine carrying the bacteria |
Begins with flu-like symptoms then resolves. The second phase then occurs involving meningitis, liver damage (causes jaundice), and renal failure |
|
|
Otitis Externa (swimmer’s ear) |
Swimming in water contaminated by the responsible pathogens |
Ear canal swells causing pain and tenderness to the touch |
|
|
Caused by many bacteria of genus Salmonella |
Drinking water contaminated with the bacteria. More common as a food borne illness. |
Symptoms include diarrhea, fever, vomiting, and abdominal cramps |
|
|
Ingestion of water contaminated with feces of an infected person |
Characterized by sustained fever up to 40°C (104°F), profuse sweating, diarrhea, less commonly a rash may occur. Symptoms progress to delirium and the spleen and liver enlarge if untreated. In this case it can last up to four weeks and cause death. |
||
|
Vibrio vulnificus, Vibrio alginolyticus, and Vibrio parahaemolyticus |
Can enter wounds from contaminated water. Also got by drinking contaminated water or eating undercooked oysters. |
Symptoms include explosive, watery diarrhea, nausea, vomiting, abdominal cramps, and occasionally fever. |