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