| Waterborne and Water-Related Diseases - Role of Water Treatment and Sanitation, Syndromes |
| What do we mean by waterborne? |
| Epidemic and Endemic Disease – some definitions |
| Issues of Surveillance |
| Why do we care about waterborne diseases? |
| Worldwide Distribution of Child Deaths |
| Diarrhea and Pneumonia |
| Water and Hygiene |
| Water-related causes of child death |
| Age-related Incidence of Diarrhea |
| UN Millennium Report 2005 |
| UN Millennium Report 2005 |
| UN Millennium Report 2005 |
| “Person, Place, & Time”… |
| Behaviors – Higher Risk Diarrhea |
| Fetching Water |
| Pipe Filters |
| Overview |
| Water Needs (Quantity) and Water Risk |
| Drought |
| Summary of requirement for water service level to promote health |
| Minimal Water Needs |
| Sub-populations Needed Water |
| Need Water…. |
| Historical Information… |
| US was once a developing country |
| It was Cleanliness against Cholera and Yellow Fever |
| Water Tunnels |
| Typhoid rates in Chicago deaths per 10,000 persons |
| ‘Multiple Barriers’ Concept |
| Overview of Waterborne and Water-Related Diseases: Slide 31 |
| Overview of Waterborne and Water-Related Diseases: Slide 32 |
| Overview of Waterborne and Water-Related Diseases: Slide 33 |
| Overview of Waterborne and Water-Related Diseases: Slide 34 |
| Overview of Waterborne and Water-Related Diseases: Slide 35 |
| Sanitation / Cholera |
| Things are better – 1870s on |
| We developed guidelines |
| What did chlorination accomplish 1910-1925? |
| Nutrition/Cognition |
| Water and Sanitation associated with improved child growth |
| Effect of Water and Sanitation |
| Effects of Stunting, Diarrheal Disease, and Parasitic Infection |
| Epidemics… what happens when water treatment lapses |
| Morbidity, Rwandan Refugees, ’94 (UNHCR) |
| Walkerton |
| Walkerton Deaths and Illness |
| Animal Manure to Human Disease |
| Contaminated Wells |
| Socio-Economic Analysis of Walkerton |
| Overview of Waterborne and Water-Related Diseases: Slide 51 |
| Concentrated Animal Feedlot Operations (CAFO) |
| Typhoid in Tajikistan |
| Typhoid Fever |
| Case-control Dushanbe, Tajikistan |
| Overview of Waterborne and Water-Related Diseases: Slide 56 |
| Overview of Waterborne and Water-Related Diseases: Slide 57 |
| Cryptosporidium |
| Geographic Pattern to Diarrhea |
| ‘Multiple Barriers’ Concept |
| The epidemiological iceberg... |
| Las Vegas 1994 |
| Range of syndromes I |
| Range of syndromes II |
| A review of immunology and a few words on clinical syndromes |
| The Gut Surface |
| Lumen |
| Overview of Waterborne and Water-Related Diseases: Slide 68 |
| Idiot’s Guide to Pathogens |
| MALT: the Mucosa-associated Lymphoid Tissues |
| M Cell Internal Topology |
| Some pathogens get inside....Shigella |
| Some pathogens get inside....Shigella |
| Shigella zooming around inside of cell by polymerizing actin |
| Syndromes and a Few Specific Diseases |
| The Big Picture… |
| What is dehydration? How is it classified? |
| Cholera |
| Cholera: In the New World, and a New Serotype |
| Cholera |
| Cholera Cot |
| Extreme Dehydration from Cholera
|
| Cholera in Chad (WHO Website) |
| Cholera in Chad update (WHO website) |
| Cholera in Iraq (WHO website) |
| Invasive Diarrhea = Dysentery = Diarrhea containing blood |
| Invasion of the Colon |
| Death of the Colon due to Dysentery |
| Increasing Antibiotic Resistance |
| Pathogens |
| Persistent Diarrhea |
| Hospital del Nino ‘Francisco Icaza’ with Persistent Diarrhea, 1998 |
| E. Bieneusi and E. Intestinalis sporesi |
| Why new waterborne disease agents? |
| Demographics – Population Density and Aging |
| Overview of Waterborne and Water-Related Diseases: Slide 96 |
| 2000 |
| 2050 |
| 2000 Superimposed on 2050 |
| Modern View of Risk |
| Ill people are living longer |
| A few important waterborne diseases to know about: |
| Salmonella Infections |
| Overview of Waterborne and Water-Related Diseases: Slide 104 |
| Overview of Waterborne and Water-Related Diseases: Slide 105 |
| Overview of Waterborne and Water-Related Diseases: Slide 106 |
| Overview of Waterborne and Water-Related Diseases: Slide 107 |
| Overview of Waterborne and Water-Related Diseases: Slide 108 |
| Rotavirus: Diarrheal Pathogen |
| Rotavirus: Washington DC |
| Rotavirus, cont’d. |
| Global Distribution of Deaths from Rotavirus |
| Polio |
| Poliovirus |
| Polio Outbreaks: How to Stop Them |
| Wild Poliovirus*, 12 Aug 2002 to 11 Aug 2003 |
| Wild Poliovirus, 2003 |
| Wild Poliovirus, 2006-2007 |
| Wild Poliovirus, 2003 |
| Wild Poliovirus, 2003 |
| Overview of Waterborne and Water-Related Diseases: Slide 121 |
| Geographic Distribution of Hepatitis A Virus Infection |
| Overview of Waterborne and Water-Related Diseases: Slide 123 |
| Overview of Waterborne and Water-Related Diseases: Slide 124 |
| Overview of Waterborne and Water-Related Diseases: Slide 125 |
| Hepatitis A Incidence |
| Overview of Waterborne and Water-Related Diseases: Slide 127 |
| Hepatitis E in Chad, Update 3 |
| Hepatitis E – Clinical Features |
| Geographic Distribution of Hepatitis E |
| Hepatitis E Virus Sequences |
| Hepatitis E Virus Epidemiology in Industrialized Countries |
| Xenozoonosis |
| Cryptosporidium |
| Entamoeba histolytica |
| Giardia |
| Schistosomias |
| Schistosomiasis-Endemic Area |
| Schistosomiasis |
| Anning River Valley |
| Dry Months |
| Population Density |
| Seasonality and Temporality |
| Seasonal Characteristics of Ambient Temperature |
| Back to Square One… |
| Handwashing |
| Conclusions |
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