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 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
• 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.
 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
 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
 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.

•Arsenicosis(high levels of arsenic) •Cholera

•Fluorosis(high levels of flourine) •Dysentery

•Metheglobinemia(high levels of •Typhoid

 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
 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
 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.

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
 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
 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
 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
Transmission can be prevented by:
• Elimination of insect breeding sites e.g stagnant
• 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
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
 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.
 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
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.