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Water Related Diseases Water… • 1 billion people do not have access to safe drinking water • 2.9 billion people do not have adequate sanitation facilities • 11,000 children die each day of water-related diseases Out-Break • Two or more persons experiencing a similar illness after ingestion of a common food or liquid • Epidemiologic analysis implicates the food/beverage as the source of illness 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 Disease Causing Agents • Giardiasis (Protozoan) • Shigellosis (Bacteria) • Viral Gastroenteritis (Virus) • Escherichia coli (Bacteria) • Vibrio cholera (Bacteria) • Salmonella typhi (Bacteria) • Hepatitis A virus • Poliovirus Other Agents • In addition, water-borne disease can be caused by the pollution of water with chemicals that have an adverse effect on health • Arsenic • Fluoride • Nitrates from fertilizers • Carcinogenic pesticides (DDT) • Lead (from pipes) • Heavy Metals E.coli • Mostly diarrhea • Fecal-oral and person-to-person transmission • Can cause death in immunocompromised individuals, the very young, and the elderly due to dehydration from prolonged illness Shigella • Bacterial Dysentery • Profuse diarrhea and dehydration • Humans are the reservoir • Fecal-oral and person-to-person transmission • A disease of crowded conditions and poor hygiene • Lack of sufficient clean water for adequate hygiene • Handwashing is a crucial control measure Vibrio cholerae • Cholera • There are other species that are causes of foodborne disease • Cause of epidemic diarrheal disease • Crowding, poor sanitation, lack of water treatment • Fecal-oral and person-to-person transmission • There are asymptomatic carriers who can transmit disease • Bacteria produces a toxin that causes severe fluid and electrolyte loss from the intestine Salmonella typhi • Typhoid fever • Typhoid can be food or water borne • Mostly in developing world • Fecal-oral and person-to-person transmission • Humans are the reservoir • Asymptomatic people in a chronic carrier state can spread disease • Vaccination is only done for travelers • Inadequate water treatment and sanitation is a cause Hepatitis A virus • Symptoms are only acute and include Fatigue, fever, abdominal pain, nausea, diarrhea, weight loss, itching, jaundice and depression • Almost everyone recovers fully from hepatitis A with a lifelong immunity. However, a very small proportion of people infected with hepatitis A could die • The risk of hepatitis A infection is associated with a lack of safe water, and poor sanitation and hygiene (such as dirty hands) • Safe water supply, food safety, improved sanitation, hand washing and the hepatitis A vaccine are the most effective ways to combat the disease Poliovirus • Enters water through the feces of infected individuals • Poliovirus is usually spread from person to person through infected fecal matter entering the mouth • It may also be spread by food or water containing human feces • The disease is preventable with the polio vaccine 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 tickborne diseases. Water Based Diseases • Diseases caused by parasites found in intermediate organisms living in contaminated water • Includes Schistosomiasis and Dracunculiasis 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, trypanosomiasis and yellow fever Food Borne Diseases Causes of Food-Borne Outbreaks Foods Associated with Agents Continue Control and Prevention Global Governments Communities Individual Education & Awareness General Preventions Global Strategy • • • • • • • • Track waterborne disease nationally Investigate the causes and sources of waterborne disease and outbreaks Identify the risk factors for infection Develop improved laboratory detection and sampling methods Develop new ways to remove or inactivate pathogens Assess new prevention ideas Promote improved public health through communication and education Develop WASH-related guidance and policy (CDC) Continue… • Build a strong team • Deliver the best administrative and mission support • Use a multidisciplinary approach to yield the best science • Develop strategic internal and external partnerships • Maximize effectiveness and productivity from taxpayer investment • Provide superior technical support and capacity building expertise to partners • Train and educate new waterborne disease prevention experts • Translate science into prevention