Waterborne infection

Waterborne diseases are caused by pathogenic microorganisms that most commonly are

transmitted in contaminated fresh water. Infection commonly results during bathing, washing,
drinking, in the preparation of food, or the consumption of food that is infected. Various
forms of waterborne diarrheal disease probably are the most prominent examples, and affect
mainly children in developing countries; according to the World Health Organization, such
diseases account for an estimated 3.6% of the total DALY global burden of disease, and
cause about 1.5 million human deaths annually
INTRODUCTION:
The term "waterborne disease" is reserved largely for infections that predominantly are
transmitted through contact with or consumption of infected water.
Microorganisms causing diseases that characteristically are waterborne prominently
include protozoa and bacteria, many of which are intestinal parasites, or invade the tissues or
circulatory system through walls of the digestive tract. Various other waterborne diseases are
caused by viruses. (In spite of philosophical difficulties associated with defining viruses as
"organisms", it is practical and convenient to regard them as microorganisms in this
connection.)
Yet other important classes of water-borne diseases are caused by metazoan parasites.
Typical examples include certain Nematoda, that is to say "roundworms". As an example of
water-borne Nematode infections, one important waterborne nematodal disease
is Dracunculiasis. It is acquired by swallowing water in which certain copepoda occur that act
as vectors for the Nematoda. Anyone swallowing a copepod that happens to be infected with
Nematode larvae in the genus Dracunculus, becomes liable to infection. The larvae
cause guinea worm disease.
Another class of waterborne metazoan pathogens are certain members of
the Schistosomatidae, a family of blood flukes. They usually infect victims that make skin
contact with the water.[2] Blood flukes are pathogens that cause Schistosomiasis of various
forms, more or less seriously affecting hundreds of millions of people world-wide.

Infections by type of pathogen

Protozoan

Disease and
Microbial Sources of Agent in Water
Transmissio General Symptoms
Agent Supply
n

Protozoan
(Entamoe
ba
Amoebiasis(h Abdominal
histolytica Sewage, non-treated drinking
and-to- discomfort, fatigue, weight
) (Cyst- water, flies in water supply
mouth) loss,diarrhea, bloating, fever
like
appearanc
e)
 Flu-like symptoms, watery
Protozoan Collects on water filters and
diarrhea, loss of appetite,
Cryptosporidi (Cryptosp membranes that cannot
substantial loss of
osis(oral) oridium be disinfected, animal manure,
weight,bloating, increased
parvum) seasonal runoff of water.
gas, nausea

Protozoan
parasite
cramps, nausea, vomiting,
Cyclosporiasi (Cyclospo Sewage, non-treated drinking
muscle aches, fever, and
s ra water
fatigue
cayetanen
sis)

Untreated water, poor

Protozoan
disinfection, pipe breaks,
(Giardia
Giardiasis (fe leaks, groundwater contaminatio
lamblia) Diarrhea, abdominal
cal-oral) n,campgrounds where humans
Most discomfort, bloating,
(hand-to- and wildlife use same source of
common and flatulence
mouth) water. Beavers andmuskrats crea
intestinal
te ponds that act as reservoirs for
parasite
Giardia.

Protozoan
phylum
(Microspo Encephalitozoon intestinalis has Diarrhea
Microsporidi
ridia), but been detected in groundwater, and wasting inimmunocompr
osis
closely the origin of drinking water [6] omised individuals.
related
to fungi

Bacterial

Disease and
Sources of Agent in
Transmissio Microbial Agent General Symptoms
Water Supply
n

Botulism Clostridium botulinum Bacteria can enter an open Dry

wound from contaminated mouth, blurred and/or d
water sources. Can enter ouble vision, difficulty
the gastrointestinal tract swallowing, muscle
through consumption of weakness, difficulty
contaminated drinking breathing, slurred
water or (more speech, vomiting and
commonly) food sometimes diarrhea.
 Death is usually caused
by respiratory failure.

Most commonly Produces dysentery like

Campylobac caused Drinking water symptoms along with
teriosis byCampylobacter contaminated with feces a high fever. Usually
jejuni lasts 2–10 days.

In severe forms it is
known to be one of the
most rapidly fatal
illnesses known.
Symptoms include very
Spread by the Drinking water watery
Cholera bacteriumVibrio contaminated with the diarrhea, nausea, cramps
cholerae bacterium , nosebleed, rapidpulse,
vomiting,
and hypovolemic
shock (in severe cases),
at which point death can
occur in 12–18 hours.

Mostly diarrhea. Can

cause death
E. Certain strains in immunocompromised 
Water contaminated with
coli Infectio ofEscherichia individuals, the very
the bacteria
n coli (commonlyE. coli) young, and the elderly
due to dehydration from
prolonged illness.

Symptoms
Naturally occurs in water,
include lesions typically
most cases from exposure
located on the elbows,
in swimming pools or
M. knees, and feet
Mycobacterium more
marinuminfe (fromswimming pools)
marinum frequently aquariums; rare
ction or lesions on the hands
infection since it mostly
(aquariums). Lesions
infects immunocompromi
may be painless or
sedindividuals
painful.

Dysentery Caused by a number of Water contaminated with Frequent passage

species in the the bacterium of feces with blood and/
generaShigella and Sal or mucus and in some
 monellawith the most
common
cases vomiting of blood.
being Shigella
dysenteriae

Pontiac fever produces

milder symptoms
resembling
acute influenza withoutp
Legionellosi
neumonia. Legionnaires'
s (two Caused by bacteria
disease has severe
distinct belonging to
Contaminated water: the symptoms such
forms: genusLegionella (90%
organism thrives in warm as fever, chills,
Legionnaires of cases caused
aquatic environments. pneumonia (with cough
' disease and by Legionella
that sometimes
Pontiac pneumophila)
produces sputum), ataxi
fever)
a, anorexia, muscle
aches, malaise and
occasionally diarrhea
and vomiting

Begins with flu-like
symptoms then resolves.
The second phase then
Water contaminated by
Leptospirosi Caused by bacterium occurs
the animal urine carrying
s of genus Leptospira involving meningitis, liv
the bacteria
er damage
(causes jaundice),
and renal failure

Otitis Caused by a number Swimming in water Ear canal swells,

Externa(swi ofbacterial and fungals contaminated by the causing pain and
mmer's ear) pecies. responsible pathogens tenderness to the touch

Drinking water Symptoms

Caused by many
Salmonellosi contaminated with the include diarrhea, fever,
bacteria of
s bacteria. More common vomiting, and
genus Salmonella
as a food borne illness. abdominal cramps

Typhoid Salmonella typhi Ingestion of water Characterized by

fever contaminated with fecesof sustained fever up to
an infected person 40 °C (104 °F),
profuse sweating;
 diarrhea may occur.
Symptoms progress
to delirium, and
the spleen and liverenlar
ge if untreated. In this
case it can last up to
four weeks and cause
death. Some people with
typhoid fever develop a
rash called "rose spots",
small red spots on the
abdomen and chest.

Symptoms include
abdominal tenderness,
agitation, bloody stools,
chills, confusion,
Can enter wounds from
Vibrio difficulty paying
contaminated water. Also
vulnificus, Vibrio attention (attention
Vibrio acquired by drinking
alginolyticus, deficit), delirium,
Illness contaminated water or
and Vibrio fluctuating mood,
eating
parahaemolyticus hallucination,
undercookedoysters.
nosebleeds, severe
fatigue, slow, sluggish,
lethargic feeling,
weakness.

Viral

Sources of
Disease and Agent in
Viral Agent General Symptoms
Transmission Water
Supply

SARS (Severe Manifests
Symptoms
Acute itself in
Coronavirus include fever, myalgia, lethargy, gastroint
Respiratory improperly
estinal symptoms, cough, and sore throat
Syndrome) treated water

Can Symptoms are

manifest only acute (no chronic stage to the virus)
Hepatitis A
Hepatitis A itself in and include Fatigue, fever, abdominal
virus (HAV)
water (and pain, nausea, diarrhea, weight loss,
food) itching, jaundice and depression.
 90-95% of patients show no symptoms, 4-
8% have minor symptoms (comparatively)
Enters water
with delirium,headache, fever, and
through
Poliomyelitis(P occasional seizures, and spastic paralysis,
Poliovirus the feces of
olio) 1% have symptoms of non-
infected
paralyticaseptic meningitis. The rest have
individuals
serious symptoms resulting in paralysis or
death

Very
widespread,
can manifest BK virus produces a mild respiratory
Two itself in infection and can infect
ofPolyomaviru water, ~80% the kidneys of immunosuppressedtranspla
Polyomavirus
s:JC of the nt patients. JC virus infects the respiratory
infection
virus andBK population system, kidneys or can cause progressive
virus hasantibodie multifocal leukoencephalopathy in
s to the brain (which is fatal).
Polyomaviru
s

Algal

Disease and Sources of Agent in General

Microbial Agent
Transmission Water Supply Symptoms

Naturally occurs in
Similar to
Desmodesmus infection desmodesmus armatus water. Can enter open
fungal infection.
wounds.

Foodborne infection:
Infection:
Foodborne illness (also foodborne disease and colloquially referred to as food poisoning)[
is any illness resulting from the food spoilage of contaminated
food, pathogenic bacteria, viruses, or parasites that contaminate food, as well as chemical or
natural toxins such as poisonous mushrooms and various species of beans that have not been
boiled for at least 10 minutes.
Symptoms vary depending on the cause, and are described below in this article. A few broad
generalizations can be made, e.g.: The incubation period ranges from hours to days,
depending on the cause and on how much was consumed.

Causes
Foodborne infection usually arises from improper handling, preparation, or food storage.
Good hygiene practices before, during, and after food preparation can reduce the chances of
contracting an illness. There is a consensus in the public health community that regular hand-
washing is one of the most effective defenses against the spread of foodborne illness. The
action of monitoring food to ensure that it will not cause foodborne illness is known as food
safety. Foodborne disease can also be caused by a large variety of toxins that affect the
environment.

Foodborne illness can also be caused by pesticides or medicines in food and naturally toxic
substances such as poisonous mushrooms .
Bacteria:
Bacteria are a common cause of foodborne illness.
Toxins from bacterial infections are delayed because the bacteria need time to multiply. As a
result, symptoms associated with intoxication are usually not seen until 12–72 hours or more
after eating contaminated food. However, in some cases, such as Staphylococcal food
poisoning, the onset of illness can be as soon as 30 minutes after ingesting contaminated
food.[5]
Most common bacterial foodborne pathogens are:

 Campylobacter jejuni 
 Clostridium perfringens, the "cafeteria germ"[7]
 Salmonella spp. – its S. typhimurium infection is caused by consumption of eggs or
poultry that are not adequately cooked or by other interactive human-animal pathogens
 Escherichia coli O157:H7 enterohemorrhagic (EHEC) which can cause hemolytic-
uremic syndrome
Other common bacterial foodborne pathogens are:

 Bacillus cereus
 Vibrio cholerae, including O1 and non-O1
 Vibrio parahaemolyticus
 Vibrio vulnificus
 Yersinia enterocolitica and Yersinia pseudotuberculosis
Less common bacterial agents:

 Brucella spp.
 Corynebacterium ulcerans
 Coxiella burnetii or Q fever
 Plesiomonas shigelloides
Enterotoxins
In addition to disease caused by direct bacterial infection, some foodborne illnesses are
caused by enterotoxins (exotoxins targeting the intestines). Enterotoxins can produce illness
even when the microbes that produced them have been killed. Symptom appearance varies
with the toxin but may be rapid in onset, as in the case of enterotoxins ofStaphylococcus
aureus in which symptoms appear in one to six hours.]
This causes intense vomiting including or not including diarrhea (resulting in staphylococcal
enteritis),
  Clostridium botulinum
 Clostridium perfringens
 Bacillus cereus
The rare but potentially deadly disease botulism occurs when
the anaerobic bacterium Clostridium botulinum grows in improperly canned low-acid foods
and produces botulin, a powerful paralytic toxin.
Preventing bacterial food poisoning
Prevention is mainly the role of the state, through the definition of strict rules of hygiene and
a public services of veterinary surveying of animal products in the food chain,
from farming to the transformation industry and delivery (shops and restaurants). This
regulation includes:

 The final product should be properly stored,

 enforcement of hygiene procedures such as  "cold chain";
 power of control and of law enforcement of veterinarians.
Mycotoxins and alimentary mycotoxicoses[edit]
The term alimentary mycotoxicoses refers to the effect of poisoning by Mycotoxins (The
term 'mycotoxin' is usually reserved for the toxic chemical products produced by fungi that
readily colonize crops) through food consumption. 
Mycotoxins sometimes have important effects on human and animal health.
Viruses
Viral infections make up perhaps one third of cases of food poisoning in developed countries
 Enterovirus
 Hepatitis A is distinguished from other viral causes by its prolonged (2–6
week) incubation period and its ability to spread beyond the stomach and intestines
into the liver. It often results in jaundice, or yellowing of the skin, but rarely leads to
chronic liver dysfunction. The virus has been found to cause infection due to the
consumption of fresh-cut produce which has fecal contamination.[42][43]
 Hepatitis E
 Norovirus
 Rotavirus

Parasites

 Platyhelminthes:
 Taenia solium
 Fasciola hepatica

 Nematode:
 Ascaris lumbricoides

Protozoa:
  Cyclospora cayetanensis
 Entamoeba histolytica
 Giardia lamblia
Natural toxins
Several foods can naturally contain toxins, many of which are not produced by bacteria.
Plants in particular may be toxic; animals which are naturally poisonous to eat are rare. In
evolutionary terms, animals can escape being eaten by fleeing; plants can use only
passive defenses such as poisons and distasteful substances, for
example capsaicin in chili peppers and pungent sulfur compounds in garlic and onions.
Most animal poisons are not synthesised by the animal, but acquired by eating poisonous
plants to which the animal is immune, or by bacterial action.

 Alkaloids
 Mushroom toxins

Mechanism
Incubation period
The delay between consumption of a contaminated food and appearance of the
first symptoms of illness is called the incubation period. This ranges from hours to days
(and rarely months or even years, such as in the case of listeriosis or bovine spongiform
encephalopathy), depending on the agent, and on how much was consumed. If symptoms
occur within one to six hours after eating the food, it suggests that it is caused by a
bacterial toxin or a chemical rather than live bacteria.
The long incubation period of many foodborne illnesses tends to cause sufferers to
attribute their symptoms to gastroenteritis.
During the incubation period, microbes pass through the stomach into the intestine, attach
to the cells lining the intestinal walls, and begin to multiply there. Some types of
microbes stay in the intestine, some produce a toxin that is absorbed into the bloodstream,
and some can directly invade the deeper body tissues. The symptoms produced depend on
the type of microbe.
Infectious dose
The infectious dose is the amount of agent that must be consumed to give rise to
symptoms of foodborne illness, and varies according to the agent and the consumer's age
and overall health. Pathogens vary in minimum infectious dose; for example, Shigella
sonnei has a low estimated minimum dose of < 500 colony-forming units (CFU)
whileStaphylococcus aureus has a relatively high estimate.
International Food Safety Authorities Network (INFOSAN):
The International Food Safety Authorities Network (INFOSAN) is a joint program of the
WHO and FAO. INFOSAN has been connecting national authorities from around the
globe since 2004, with the goal of preventing the international spread of contaminated
food and foodborne disease and strengthening food safety systems globally. This is done
by:

1. Promoting the rapid exchange of information during food safety events;

2. Sharing information on important food safety issues of global interest;
3. Promoting partnership and collaboration between countries; and
4. Helping countries strengthen their capacity to manage food safety risks.