{{Short description|Disease caused by agents transmitted by water}} {{Infobox medical condition (new) | name = Waterborne diseases | image = Groundwater Contamination Latin America Sm.png | alt = | caption = Waterborne diseases can be spread via groundwater which is contaminated with fecal pathogens from pit latrines. | pronounce = | width = 300px | field = [[Infectious disease (medical specialty)|Infectious disease]] | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }}

'''Waterborne diseases''' are diseases caused by [[pathogenic]] [[Microorganism|micro-organisms]], such as [[bacteria]], [[Virus|viruses]], [[protozoa]], and [[Parasitic worm|parasitic worms]], that are transmitted through contaminated [[water]]. Many of these micro-organisms are intestinal parasites, invading the tissues or [[circulatory system]] through walls of the [[Gastrointestinal tract|digestive tract]]. Various other waterborne diseases are caused by [[Virus|viruses.]] Other important classes of waterborne diseases are caused by [[Animal|metazoan]] parasites. Typical examples include certain [[Nematoda]], or "roundworms," which may result in diseases such as [[Dracunculiasis]] or even [[Dracunculiasis|guinea worm disease]]. Additional classes of waterborne [[Animal|metazoan]] pathogens include [[Schistosomatidae]], a family of blood [[Trematoda|flukes]]. In addition to pathogens, water contamination may also be driven by chemical pollutants such as [[Volatile organic compound|volatile organic compounds]] (VOCs). This includes [[benzene]], [[toluene]], [[ethylbenzene]], and [[Xylene|xylenes]], which can enter water lines through industrial dumping, pipeline leaks, jet fuel spills, or heat-damaged plastic pipes.

These [[Disease|diseases]] can spread through bathing, washing, drinking, or by eating food exposed to [[Water pollution|contaminated water]], especially prevalent in developing countries that lack clean water, sanitation, and hygiene ([[WASH]]). While [[diarrhea]] and [[vomiting]] are the most commonly reported symptoms of waterborne illness, other symptoms can include [[nausea]], [[Cramp|stomach cramps]], [[fever]], and skin, ear, respiratory, or eye problems. Exposure to VOC-contaminated water has been associated with headaches, nausea, tumor formation, and increased [[cancer]] risk, including [[leukemia]].

Therefore, reliable access to clean [[drinking water]] and [[sanitation]] is the main method to prevent waterborne diseases. This includes improving [[Sanitation|sanitation systems]], chlorination, vaccination, and sustainable technologies, like solar-powered [[desalination]]. Infrastructure improvements, such as replacing damaged plastic piping with metal alternatives in wildfire-prone areas, may also reduce contamination risks. Billions of people worldwide lack access to clean water, making it vital for prevention. Waterborne diseases contribute significantly to mortality and disability, especially in [[Developing country|developing regions]]. Each consequence places greater economic strain on affected communities. The consequences of climate change also increases risk because of the increased possibility of [[Drought|droughts]] and [[Flood|flooding]], which can spread contaminants and disproportionately affect vulnerable populations. Surveillance systems, such as those maintained in the United States, help monitor and prevent [[Disease outbreak|outbreaks]]. Historically, advances in [[sanitation]], [[filtration]], chlorination, and [[microbiology]] may help to understand and control of these diseases.

== Terminology == [[File:Red blood cells infected with malaria.jpg|thumb|Red blood cells of an organism which has contracted malaria, a water borne disease ]] The term waterborne disease is reserved largely for infections that predominantly are transmitted through contact with or consumption of microbially [[Water pollution|polluted water]]. Many infections may be transmitted by microbes or parasites that accidentally, possibly as a result of exceptional circumstances, have entered the water. However, the fact that there might be an occasional infection need not mean that it is useful to categorize the resulting disease as "waterborne." Diseases such as malaria are commonly mistaken as "waterborne" because mosquitos, acting as vectors, have aquatic stages in their life cycle. Controlling or treating still water can reduce mosquito populations, suggesting the idea that the disease is transmitted through water and not mosquito bites. <ref>{{Citation |last=Atangana |first=Abdon |title=Groundwater Pollution |date=2018 |work=Fractional Operators with Constant and Variable Order with Application to Geo-Hydrology |pages=49–72 |url=https://linkinghub.elsevier.com/retrieve/pii/B9780128096703000035 |access-date=2026-02-27 |publisher=Elsevier |language=en |doi=10.1016/B978-0-12-809670-3.00003-5 |isbn=978-0-12-809670-3 |pmc=7149999}}</ref>

A related term is "water-related disease" which is defined as "any significant or widespread adverse effects on human health, such as death, disability, illness or disorders, caused directly or indirectly by the condition, or changes in the quantity or quality of any water".<ref name="Marcos">{{Cite journal |last=Von Sperling |first=M. |date=2015 |title=Wastewater Characteristics, Treatment and Disposal |url=https://iwaponline.com/ebooks/book/72/ |journal=Water Intelligence Online |language=en |volume=6 |doi=10.2166/9781780402086 |issn=1476-1777 |url-access=subscription |doi-access=free |article-number=9781780402086}}</ref>{{rp|47}} Water-related diseases are grouped according to their transmission mechanism: water borne, water hygiene, water based, water related.<ref name="Marcos" />{{rp|47}} The main transmission mode for waterborne diseases is [[ingestion]] of contaminated water.<ref>{{Cite web |title=Waterborne illness and disease {{!}} Life Sciences {{!}} Research Starters {{!}} EBSCO Research |url=https://www.ebsco.com/ |access-date=2026-02-27 |website=EBSCO |language=en}}</ref>

== Causes == {{Further|WASH}} Lack of clean [[WASH|water supply, sanitation and hygiene]] (WASH) are major causes for the spread of waterborne diseases in a community. The [[fecal–oral route]] is a disease transmission pathway for waterborne diseases.<ref>{{Cite web |title=The United Nations World Water Development Report 2023: partnerships and cooperation for water; facts, figures and action examples |url=https://unesdoc.unesco.org/ark:/48223/pf0000384659 |access-date=2025-10-02 |website=unesdoc.unesco.org}}</ref> [[Poverty]] also increases the risk of communities to be affected by waterborne diseases. For example, the economic level of a community impacts their ability to have access to clean water.<ref>{{cite journal|display-authors=6|vauthors=Adelodun B, Ajibade FO, Ighalo JO, Odey G, Ibrahim RG, Kareem KY, Bakare HO, Tiamiyu AO, Ajibade TF, Abdulkadir TS, Adeniran KA, Choi KS|date=October 2020|title=Assessment of socioeconomic inequality based on virus-contaminated water usage in developing countries: A review|url= |journal=Environmental Research|volume=192|article-number=110309|doi=10.1016/j.envres.2020.110309|pmc=7546968|pmid=33045227}}</ref> Less developed countries might be more at risk for potential outbreaks of waterborne diseases but more developed regions also are at risk to waterborne disease outbreaks.<ref name=":4">{{cite journal|vauthors=Smith A, Reacher M, Smerdon W, Adak GK, Nichols G, Chalmers RM|date=December 2006|title=Outbreaks of waterborne infectious intestinal disease in England and Wales, 1992-2003|url= |journal=Epidemiology and Infection|volume=134|issue=6|pages=1141–9|doi=10.1017/S0950268806006406|pmc=2870523|pmid=16690002}}</ref> Additionally, 1 in 4 people, or 2.1 billion people globally, still do not have access to safe drinking water. <ref>{{Cite web |title=1 in 4 people globally still lack access to safe drinking water – WHO, UNICEF |url=https://www.who.int/news/item/26-08-2025-1-in-4-people-globally-still-lack-access-to-safe-drinking-water---who--unicef |access-date=2026-02-27 |website=www.who.int |language=en}}</ref>

=== Socioeconomic factors === The lack of education in impoverished regions is a key component to the issue of waterborne disease. The more a society is educated on an issue, the more they can take action and solve the problem domestically rather than relying on foreign counties for aid. Many countries in the [[Middle East]], [[Southeast Asia|South East Asia]], and [[Sub-Saharan Africa]] are prone to these issues because they lack advanced education.<ref name=":3" /> For example, [[Morocco]] has a very insufficient labor supply for the production of food and other work forces that it could very well be maximizing. In response, the [[United States]] and Morocco along with many other agencies worked together to initiate H2O [[Maghreb]]. This program works to educated the people of Morocco on clean water and sanitization through simulations of water treatment. Not only do the virtual reality technologies recreate rare emergency circumstances to practice dealing with, but they also provide jobs for a poorer country to help the economy too.<ref name=":3">{{Cite book |url=https://doi.org/10.18356/9789210026208 |title=The United Nations World Water Development Report 2023 |date=2023-03-22 |publisher=United Nations |isbn=978-92-1-002620-8 |doi=10.18356/9789210026208 }}</ref>

Political turmoil and war stimulate the transmission of waterborne disease in addition to lack of education. Countries in the [[WHO Regional Office for the Eastern Mediterranean|Eastern Mediterranean Region]] deal with this issue especially.<ref name=":7" /> The world bank has classified [[Yemen]], along with several other countries in the Eastern Mediterranean Region as "fragile and conflict-affected countries." [[Syria]] and [[Lebanon]] <ref>{{Cite web |last=emhj |title=WHO EMRO - Resurgence of cholera in Lebanon |url=https://www.emro.who.int/in-press/commentaries/resurgence-of-cholera-in-lebanon.html |access-date=2025-12-09 |website=www.emro.who.int |language=en-gb}}</ref> had not seen any out breaks of [[cholera]] in about three decades, yet they did in 2022. War destroys necessary infrastructure for clean water and sanitization structures: a recipe for disease to spread. Two years ago the world health organization changed the status of cholera to a Grade 3 global public health emergency. Between the years 2016 and 2022 Yemen saw 2.5 million cases of cholera.<ref>{{Cite web |last=ABDEL HAY, Ihab Fouad |title=WHO EMRO - Mitigating the increasing threat of cholera in Yemen and other conflict-affected countries in the Eastern Mediterranean Region |url=https://www.emro.who.int/emhj-volume-31-2025/volume-31-issue-7/mitigating-the-increasing-threat-of-cholera-in-yemen-and-other-conflict-affected-countries-in-the-eastern-mediterranean-region.html |access-date=2025-12-09 |website=www.emro.who.int |language=en-gb}}</ref> These outbreaks are closely tied to the conflicts in the region. War also destroys the necessary medical facilities and hospitals to take care of patients who have contracted the waterborne diseases. In the Eastern Mediterranean Region, countries are no longer grappling with a [[pandemic]], but rather an [[Endemic (epidemiology)|endemic]].<ref name=":7">{{Cite journal |last=Balkhy |first=Hanan H. |date=2025-08-04 |title=Mitigating the increasing threat of cholera in Yemen and other conflict-affected countries in the Eastern Mediterranean Region |journal=Eastern Mediterranean Health Journal |volume=31 |issue=7 |pages=423–425 |doi=10.26719/2025.31.7.423 |issn=1020-3397|doi-access=free |pmid=40832862 }}</ref>

Other war torn regions such as [[Gaza war|Gaza]] must manage complex water systems which present more danger to the quality of water and chance of waterborne disease being present. Gaza gets the majority of their water from underground but also some from [[Israel]]; they also have several desalination plants across the region.<ref name=":8" /> Workers are constantly working to fix water pipeline systems that have been destroyed by [[artillery]] from the war but are sometimes killed in the process.<ref name=":8">{{Cite web |last=Ebeid |first=Claudine |date=2025-03-13 |title=Water Is Not Political |url=https://www.theatlantic.com/politics/archive/2025/03/water-is-not-political/682016/ |access-date=2025-12-09 |website=The Atlantic |language=en}}</ref> For a comparison of a safe country's clean water consumption to a war torn country's water consumption, Americans use about 300 liters per day while in Gaza a person would use about 80 liters per day. With every part of the water system in Gaza suffering harm in some shape or form by 2024, waterborne disease cases shortly thereafter exploded with 600,000 cases of [[acute diarrhea]] and even a 10 month old with [[polio]].<ref name=":8" />

Additionally, a study done in 2022 published by Nature Communications measured the associations between [[racial]] and [[Ethnicity|ethnic]] communities and concentrations of contaminants in drinking water from 2000 to 2011 in the United States. Counties with a greater proportion of Hispanic and American Indian residents contained higher concentrations of [[arsenic]] and [[uranium]] in drinking water. However, non-Hispanic White residents had lower concentrations. The authors concluded that disparities in drinking water quality vary by region and demographic composition, representing the inequalities in exposure to regulated drinking water in the United States. <ref>{{Cite journal |last=Martinez-Morata |first=Irene |last2=Bostick |first2=Benjamin C. |last3=Conroy-Ben |first3=Otakuye |last4=Duncan |first4=Dustin T. |last5=Jones |first5=Miranda R. |last6=Spaur |first6=Maya |last7=Patterson |first7=Kevin P. |last8=Prins |first8=Seth J. |last9=Navas-Acien |first9=Ana |last10=Nigra |first10=Anne E. |date=2022-12-03 |title=Nationwide geospatial analysis of county racial and ethnic composition and public drinking water arsenic and uranium |url=https://www.nature.com/articles/s41467-022-35185-6 |journal=Nature Communications |language=en |volume=13 |issue=1 |pages=7461 |doi=10.1038/s41467-022-35185-6 |issn=2041-1723}}</ref>

===Influence of climate change=== {{See also|Climate change and infectious diseases}} Climate change influences the growth and survival of [[bacteria]] and other pathogens in food and water systems.<ref name=":022">{{cite journal |last1=Van de Vuurst |first1=Paige |last2=Escobar |first2=Luis E. |date=2023 |title=Climate change and infectious disease: a review of evidence and research trends |journal=Infectious Diseases of Poverty |volume=12 |issue=1 |page=51 |doi=10.1186/s40249-023-01102-2 |hdl=10919/115131 |pmc=10186327 |pmid=37194092 |doi-access=free |hdl-access=free}}</ref><ref name=":12">IPCC, 2022: [https://www.ipcc.ch/report/ar6/wg2/downloads/report/IPCC_AR6_WGII_SummaryForPolicymakers.pdf Summary for Policymakers] [H.-O. Pörtner, D.C. Roberts, E.S. Poloczanska, K. Mintenbeck, M. Tignor, A. Alegría, M. Craig, S. Langsdorf, S. Löschke, V. Möller, A. Okem (eds.)]. In: [https://www.ipcc.ch/report/ar6/wg2/ Climate Change 2022: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change] [H.-O. Pörtner, D.C. Roberts, M. Tignor, E.S. Poloczanska, K. Mintenbeck, A. Alegría, M. Craig, S. Langsdorf, S. Löschke, V. Möller, A. Okem, B. Rama (eds.)]. Cambridge University Press, Cambridge, UK and New York, NY, USA, pp. 3–33, doi:10.1017/9781009325844.001.</ref><ref name="Romanello20212">{{cite journal |last1=Romanello |first1=Marina |last2=McGushin |first2=Alice |last3=Di Napoli |first3=Claudia |last4=Drummond |first4=Paul |last5=Hughes |first5=Nick |last6=Jamart |first6=Louis |last7=Kennard |first7=Harry |last8=Lampard |first8=Pete |last9=Solano Rodriguez |first9=Baltazar |last10=Arnell |first10=Nigel |last11=Ayeb-Karlsson |first11=Sonja |last12=Belesova |first12=Kristine |last13=Cai |first13=Wenjia |last14=Campbell-Lendrum |first14=Diarmid |last15=Capstick |first15=Stuart |display-authors=40 |date=October 2021 |title=The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future |url=http://sro.sussex.ac.uk/id/eprint/102413/1/2021%20Report%20of%20the%20Lancet%20Countdown%20revised%20_no%20refs%20ES_clean.pdf |journal=The Lancet |volume=398 |issue=10311 |pages=1619–1662 |doi=10.1016/S0140-6736(21)01787-6 |hdl=10278/3746207 |pmc=7616807 |pmid=34687662 |s2cid=239046862 |hdl-access=free |last16=Chambers |first16=Jonathan |last17=Chu |first17=Lingzhi |last18=Ciampi |first18=Luisa |last19=Dalin |first19=Carole |last20=Dasandi |first20=Niheer |last21=Dasgupta |first21=Shouro |last22=Davies |first22=Michael |last23=Dominguez-Salas |first23=Paula |last24=Dubrow |first24=Robert |last25=Ebi |first25=Kristie L |last26=Eckelman |first26=Matthew |last27=Ekins |first27=Paul |last28=Escobar |first28=Luis E |last29=Georgeson |first29=Lucien |last30=Grace |first30=Delia |last31=Graham |first31=Hilary |last32=Gunther |first32=Samuel H |last33=Hartinger |first33=Stella |last34=He |first34=Kehan |last35=Heaviside |first35=Clare |last36=Hess |first36=Jeremy |last37=Hsu |first37=Shih-Che |last38=Jankin |first38=Slava |last39=Jimenez |first39=Marcia P |last40=Kelman |first40=Ilan |last41=Kiesewetter |first41=Gregor |last42=Kinney |first42=Patrick L |last43=Kjellstrom |first43=Tord |last44=Kniveton |first44=Dominic |last45=Lee |first45=Jason K W |last46=Lemke |first46=Bruno |last47=Liu |first47=Yang |last48=Liu |first48=Zhao |last49=Lott |first49=Melissa |last50=Lowe |first50=Rachel |last51=Martinez-Urtaza |first51=Jaime |last52=Maslin |first52=Mark |last53=McAllister |first53=Lucy |last54=McMichael |first54=Celia |last55=Mi |first55=Zhifu |last56=Milner |first56=James |last57=Minor |first57=Kelton |last58=Mohajeri |first58=Nahid |last59=Moradi-Lakeh |first59=Maziar |last60=Morrissey |first60=Karyn |last61=Munzert |first61=Simon |last62=Murray |first62=Kris A |last63=Neville |first63=Tara |last64=Nilsson |first64=Maria |last65=Obradovich |first65=Nick |last66=Sewe |first66=Maquins Odhiambo |last67=Oreszczyn |first67=Tadj |last68=Otto |first68=Matthias |last69=Owfi |first69=Fereidoon |last70=Pearman |first70=Olivia |last71=Pencheon |first71=David |last72=Rabbaniha |first72=Mahnaz |last73=Robinson |first73=Elizabeth |last74=Rocklöv |first74=Joacim |last75=Salas |first75=Renee N |last76=Semenza |first76=Jan C |last77=Sherman |first77=Jodi |last78=Shi |first78=Liuhua |last79=Springmann |first79=Marco |last80=Tabatabaei |first80=Meisam |last81=Taylor |first81=Jonathon |last82=Trinanes |first82=Joaquin |last83=Shumake-Guillemot |first83=Joy |last84=Vu |first84=Bryan |last85=Wagner |first85=Fabian |last86=Wilkinson |first86=Paul |last87=Winning |first87=Matthew |last88=Yglesias |first88=Marisol |last89=Zhang |first89=Shihui |last90=Gong |first90=Peng |last91=Montgomery |first91=Hugh |last92=Costello |first92=Anthony |last93=Hamilton |first93=Ian}}</ref> It affects waterborne diseases by influencing water temperature, [[water quality]], [[sanitation]], and [[microbial ecology]].<ref name=":162">Cissé, G., R. McLeman, H. Adams, P. Aldunce, K. Bowen, D. Campbell-Lendrum, S. Clayton, K.L. Ebi, J. Hess, C. Huang, Q. Liu, G. McGregor, J. Semenza, and M.C. Tirado, 2022: [https://www.ipcc.ch/report/ar6/wg2/downloads/report/IPCC_AR6_WGII_Chapter07.pdf Chapter 7: Health, Wellbeing, and the Changing Structure of Communities]. In: [https://www.ipcc.ch/report/ar6/wg2/ Climate Change 2022: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change] [H.-O. Pörtner, D.C. Roberts, M. Tignor, E.S. Poloczanska, K. Mintenbeck, A. Alegría, M. Craig, S. Langsdorf, S. Löschke, V. Möller, A. Okem, B. Rama (eds.)]. Cambridge University Press, Cambridge, UK and New York, NY, USA, pp. 1041–1170, doi:10.1017/9781009325844.009.</ref>{{rp|1107}}<ref name="Romanello202122">{{cite journal |last1=Romanello |first1=Marina |last2=McGushin |first2=Alice |last3=Di Napoli |first3=Claudia |last4=Drummond |first4=Paul |last5=Hughes |first5=Nick |last6=Jamart |first6=Louis |last7=Kennard |first7=Harry |last8=Lampard |first8=Pete |last9=Solano Rodriguez |first9=Baltazar |last10=Arnell |first10=Nigel |last11=Ayeb-Karlsson |first11=Sonja |last12=Belesova |first12=Kristine |last13=Cai |first13=Wenjia |last14=Campbell-Lendrum |first14=Diarmid |last15=Capstick |first15=Stuart |display-authors=40 |date=October 2021 |title=The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future |url=http://sro.sussex.ac.uk/id/eprint/102413/1/2021%20Report%20of%20the%20Lancet%20Countdown%20revised%20_no%20refs%20ES_clean.pdf |journal=The Lancet |volume=398 |issue=10311 |pages=1619–1662 |doi=10.1016/S0140-6736(21)01787-6 |hdl=10278/3746207 |pmc=7616807 |pmid=34687662 |s2cid=239046862 |hdl-access=free |last16=Chambers |first16=Jonathan |last17=Chu |first17=Lingzhi |last18=Ciampi |first18=Luisa |last19=Dalin |first19=Carole |last20=Dasandi |first20=Niheer |last21=Dasgupta |first21=Shouro |last22=Davies |first22=Michael |last23=Dominguez-Salas |first23=Paula |last24=Dubrow |first24=Robert |last25=Ebi |first25=Kristie L |last26=Eckelman |first26=Matthew |last27=Ekins |first27=Paul |last28=Escobar |first28=Luis E |last29=Georgeson |first29=Lucien |last30=Grace |first30=Delia |last31=Graham |first31=Hilary |last32=Gunther |first32=Samuel H |last33=Hartinger |first33=Stella |last34=He |first34=Kehan |last35=Heaviside |first35=Clare |last36=Hess |first36=Jeremy |last37=Hsu |first37=Shih-Che |last38=Jankin |first38=Slava |last39=Jimenez |first39=Marcia P |last40=Kelman |first40=Ilan |last41=Kiesewetter |first41=Gregor |last42=Kinney |first42=Patrick L |last43=Kjellstrom |first43=Tord |last44=Kniveton |first44=Dominic |last45=Lee |first45=Jason K W |last46=Lemke |first46=Bruno |last47=Liu |first47=Yang |last48=Liu |first48=Zhao |last49=Lott |first49=Melissa |last50=Lowe |first50=Rachel |last51=Martinez-Urtaza |first51=Jaime |last52=Maslin |first52=Mark |last53=McAllister |first53=Lucy |last54=McMichael |first54=Celia |last55=Mi |first55=Zhifu |last56=Milner |first56=James |last57=Minor |first57=Kelton |last58=Mohajeri |first58=Nahid |last59=Moradi-Lakeh |first59=Maziar |last60=Morrissey |first60=Karyn |last61=Munzert |first61=Simon |last62=Murray |first62=Kris A |last63=Neville |first63=Tara |last64=Nilsson |first64=Maria |last65=Obradovich |first65=Nick |last66=Sewe |first66=Maquins Odhiambo |last67=Oreszczyn |first67=Tadj |last68=Otto |first68=Matthias |last69=Owfi |first69=Fereidoon |last70=Pearman |first70=Olivia |last71=Pencheon |first71=David |last72=Rabbaniha |first72=Mahnaz |last73=Robinson |first73=Elizabeth |last74=Rocklöv |first74=Joacim |last75=Salas |first75=Renee N |last76=Semenza |first76=Jan C |last77=Sherman |first77=Jodi |last78=Shi |first78=Liuhua |last79=Springmann |first79=Marco |last80=Tabatabaei |first80=Meisam |last81=Taylor |first81=Jonathon |last82=Trinanes |first82=Joaquin |last83=Shumake-Guillemot |first83=Joy |last84=Vu |first84=Bryan |last85=Wagner |first85=Fabian |last86=Wilkinson |first86=Paul |last87=Winning |first87=Matthew |last88=Yglesias |first88=Marisol |last89=Zhang |first89=Shihui |last90=Gong |first90=Peng |last91=Montgomery |first91=Hugh |last92=Costello |first92=Anthony |last93=Hamilton |first93=Ian}}</ref>{{rp|12}}

[[Climate change]] plays a major role in the [[Economic sociology|socioeconomic]] impact of waterborne disease, especially in [[Informal housing|informal settlements]]. Over 60% of Africa’s urban population lives in areas with limited water and sanitation infrastructure. Droughts have been linked to [[cholera]] outbreaks in [[Nairobi]], while flooding can spread pathogens through contaminated water.<ref>{{Cite web |title=Informal settlements and climate change in the ‘last mile of urbanization’ |url=https://www.brookings.edu/articles/informal-settlements-and-climate-change-in-the-last-mile-of-urbanization/ |access-date=2026-02-26 |website=Brookings |language=en-US}}</ref>

Warmer waters, increased [[Flood|flooding]], [[precipitation]] and [[humidity]] promote the growth and spread of bacteria such as [[Vibrio cholerae]], which causes [[cholera]], and other pathogens responsible for [[gastroenteritis]], wound infections and [[Diarrhea|diarrheal diseases]].<ref name=":162" />{{rp|1107}}<ref name="Romanello202122" />{{rp|12}}<sup><ref name="(Levy et al., 2016)2">{{cite journal |vauthors=Levy K, Woster AP, Goldstein RS, Carlton EJ |date=May 2016 |title=Untangling the Impacts of Climate Change on Waterborne Diseases: a Systematic Review of Relationships between Diarrheal Diseases and Temperature, Rainfall, Flooding, and Drought |journal=Environmental Science & Technology |volume=50 |issue=10 |pages=4905–4922 |bibcode=2016EnST...50.4905L |doi=10.1021/acs.est.5b06186 |pmc=5468171 |pmid=27058059}}</ref></sup> Higher water temperatures can also increase the yield of bacteria from drinking water delivery systems and during periods of warmer temperatures water consumption rates are also typically higher. Together these increase the probability of pathogen ingestion and infection.<ref name="(Levy et al., 2016)">{{cite journal |vauthors=Levy K, Woster AP, Goldstein RS, Carlton EJ |date=May 2016 |title=Untangling the Impacts of Climate Change on Waterborne Diseases: a Systematic Review of Relationships between Diarrheal Diseases and Temperature, Rainfall, Flooding, and Drought |journal=Environmental Science & Technology |volume=50 |issue=10 |pages=4905–4922 |bibcode=2016EnST...50.4905L |doi=10.1021/acs.est.5b06186 |pmc=5468171 |pmid=27058059}}</ref>

Heavy rainfall and flooding caused by climate change can also affect pathogen transmission via impacts on sanitation and/or drinking water treatment infrastructure, contaminating drinking water sources or food products. Floods can overwhelm water systems, causing [[backflow]] that lead to contamination of [[groundwater]] and other drinking water sources.<sup><ref name="(Levy et al., 2016)2" /></sup>

==Diseases by type of pathogen==

===Protozoa=== {| class="wikitable" |- ! Disease and transmission<ref name=":0">{{Cite book|title=Guidelines for drinking-water quality.|others=World Health Organization|year=2017|isbn=978-92-4-154995-0|edition=Fourth edition incorporating the first addendum|location=Geneva|oclc=975491910}}</ref><ref>{{cite journal|vauthors=Baldursson S, Karanis P|date=December 2011|title=Waterborne transmission of protozoan parasites: review of worldwide outbreaks - an update 2004-2010|journal=Water Research|volume=45|issue=20|pages=6603–14|doi=10.1016/j.watres.2011.10.013|pmid=22048017|bibcode=2011WatRe..45.6603B }}</ref> ! Microbial agent ! Sources of agent in water supply ! General symptoms |- |[[Acanthamoeba keratitis]] (cleaning of contact lenses with contaminated water) |[[Acanthamoeba|''Acanthamoeba'' spp.]] (''A. castellanii'' and ''A. polyphaga'') |widely distributed free-living amoebae found in many types of aquatic environments, including surface water, tap water, swimming pools, and contact lens solutions |Eye pain, eye redness, blurred vision, sensitivity to light, sensation of something in the eye, and excessive tearing |- | [[Amoebiasis]] (hand-to-mouth) | Protozoan (''[[Entamoeba histolytica]]'') (Cyst-like appearance) | [[Sewage]], [[water treatment|non-treated drinking water]], [[flies]] in water supply, saliva transfer(if the other person has the disease) | Abdominal discomfort, [[fatigue (medical)|fatigue]], weight loss, [[diarrhea]], [[bloating]], [[fever]] |- | [[Cryptosporidiosis]] (oral) | Protozoan (''[[Cryptosporidium parvum]]'') | Collects on water filters and membranes that cannot be [[disinfected]], [[manure|animal manure]], seasonal [[Surface runoff|runoff]] of water. | [[Flu-like symptoms]], watery diarrhea, loss of appetite, substantial loss of weight, [[bloating]], increased gas, [[nausea]] |- | [[Cyclosporiasis]] | Protozoan parasite (''[[Cyclospora cayetanensis]]'') | [[Sewage]], [[water treatment|non-treated drinking water]] | [[cramps]], nausea, [[vomiting]], muscle aches, fever, and fatigue |- | [[Giardiasis]] (fecal-oral) (hand-to-mouth) | Protozoan (''[[Giardia lamblia]]'') Most common intestinal parasite | Untreated water, poor disinfection, pipe breaks, leaks, [[groundwater]] contamination, [[campgrounds]] where humans and wildlife use same source of water. [[Beavers]] and [[muskrats]] create [[ponds]] that act as [[reservoirs]] for Giardia. | Diarrhea, abdominal discomfort, [[bloating]], and [[flatulence]] |- | [[Microsporidiosis]] | Protozoan phylum (''[[Microsporidia]]''), but closely related to [[fungi]] | ''[[Encephalitozoon intestinalis]]'' has been detected in [[groundwater]], the origin of drinking water<ref name="ewpcw">{{cite journal|vauthors=Nwachcuku N, Gerba CP|date=June 2004|title=Emerging waterborne pathogens: can we kill them all?|url=http://env1.gist.ac.kr/~aeml/paper/papers(pdf)/27-waterborne_pathogens.pdf|journal=Current Opinion in Biotechnology|volume=15|issue=3|pages=175–80|doi=10.1016/j.copbio.2004.04.010|pmc=7134665|pmid=15193323|bibcode=2004COBt...15..175N |archive-url=https://web.archive.org/web/20080307190853/http://env1.gist.ac.kr/~aeml/paper/papers(pdf)/27-waterborne_pathogens.pdf|archive-date=2008-03-07|access-date=2007-08-09}}</ref> | Diarrhea and [[wasting]] in [[immunocompromised]] individuals. |- | [[Primary amoebic meningoencephalitis|Naegleriasis]] ([[primary amebic meningoencephalitis]] [PAM]) (nasal) | Protozoan (''[[Naegleria fowleri]]'') (Cyst-like appearance) | [[Watersport]]s, [[Water chlorination|non-chlorinated water]] | Headache, vomiting, confusion, loss of balance, light sensitivity, [[hallucination]]s, [[fatigue (medical)|fatigue]], weight loss, [[fever]], and coma |}

===Bacteria=== {| class="wikitable" |- ! Disease and transmission<ref name="swdo">{{cite journal|display-authors=6|vauthors=Dziuban EJ, Liang JL, Craun GF, Hill V, Yu PA, Painter J, Moore MR, Calderon RL, Roy SL, Beach MJ|date=December 2006|title=Surveillance for waterborne disease and outbreaks associated with recreational water--United States, 2003-2004|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5512a1.htm|url-status=live|journal=Morbidity and Mortality Weekly Report. Surveillance Summaries|volume=55|issue=12|pages=1–30|pmid=17183230|archive-url=https://web.archive.org/web/20171029121311/https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5512a1.htm|archive-date=29 October 2017}}</ref><ref name="mmuawg">{{cite journal|vauthors=Petrini B|date=October 2006|title=Mycobacterium marinum: ubiquitous agent of waterborne granulomatous skin infections|journal=European Journal of Clinical Microbiology & Infectious Diseases|volume=25|issue=10|pages=609–13|doi=10.1007/s10096-006-0201-4|pmid=17047903|s2cid=7485002}}</ref> ! Microbial agent ! Sources of agent in water supply ! General symptoms |- | [[Botulism]] | ''[[Clostridium botulinum]]'' | Bacteria can enter an open wound from contaminated water sources. Can enter the gastrointestinal tract through consumption of contaminated [[drinking water]] or (more commonly) food | Dry mouth, [[blurred vision|blurred]] and/or [[Diplopia|double vision]], difficulty swallowing, muscle weakness, difficulty breathing, slurred speech, [[vomiting]] and sometimes [[diarrhea]]. Death is usually caused by [[respiratory failure]]. |- | [[Campylobacteriosis]] | Most commonly caused by ''[[Campylobacter jejuni]]'' | Drinking water contaminated with [[feces]] | Produces [[dysentery]]-like symptoms along with a [[fever|high fever]]. Usually lasts 2–10 days. |- | [[Cholera]] | Spread by the bacterium ''[[Vibrio cholerae]]'' | Drinking water contaminated with the bacterium | In severe forms it is known to be one of the most rapidly fatal illnesses known. Symptoms include very watery diarrhea, [[nausea]], [[cramps]], [[nosebleed]], rapid [[pulse]], vomiting, and [[hypovolemic shock]] (in severe cases), at which point death can occur in 12–18 hours. |- | [[E. coli|''E. coli'' Infection]] | Certain strains of ''[[Escherichia coli]]'' (commonly ''E. coli'') | Water contaminated with the bacteria | Mostly diarrhea. Can cause death in [[immunocompromised]] individuals, the very young, and the elderly due to [[dehydration]] from prolonged illness. |- | [[Mycobacterium marinum|''M. marinum'' infection]] | ''[[Mycobacterium marinum]]'' | Naturally occurs in water, most cases from exposure in [[swimming pools]] or more frequently [[aquariums]]; rare infection since it mostly infects [[immunocompromised]] individuals | Symptoms include [[lesions]] typically located on the elbows, knees, and feet (from [[swimming pools]]) or lesions on the hands ([[aquariums]]). Lesions may be painless or painful. |- | [[Dysentery]] | Caused by a number of species in the genera ''[[Shigella]]'' and ''[[Salmonella]]'' with the most common being ''[[Shigella dysenteriae]]'' | Water contaminated with the bacterium | Frequent passage of [[feces]] with [[blood]] and/or [[mucus]] and in some cases vomiting of blood. |- | [[Legionellosis]] (two distinct forms: Legionnaires' disease and Pontiac fever) | Caused by bacteria belonging to genus ''[[Legionella]]'' (90% of cases caused by ''[[Legionella pneumophila]]'') | Legionella is a very common organism that reproduces to high numbers in warm water;<ref>{{cite web|url=https://www.osha.gov/dts/osta/otm/legionnaires/faq.html|title=Legionnaires' Disease eTool: Facts and FAQs|website=www.osha.gov|access-date=29 April 2018|url-status=live|archive-url=https://web.archive.org/web/20171115083526/https://www.osha.gov/dts/osta/otm/legionnaires/faq.html|archive-date=15 November 2017}}</ref> but only causes severe disease when aerosolized.<ref>{{cite web|url=https://www.cdc.gov/legionella/about/causes-transmission.html|title=Legionella - Causes and Transmission - Legionnaires - CDC|date=8 December 2017|website=www.cdc.gov|access-date=29 April 2018|url-status=live|archive-url=https://web.archive.org/web/20160325023304/http://www.cdc.gov/legionella/about/causes-transmission.html|archive-date=25 March 2016}}</ref> | Pontiac fever produces milder symptoms resembling acute [[influenza]] without [[pneumonia]]. Legionnaires' disease has severe symptoms such as [[fever]], [[chills]], pneumonia (with cough that sometimes produces [[sputum]]), [[ataxia]], [[Anorexia (symptom)|anorexia]], muscle aches, [[malaise]] and occasionally diarrhea and vomiting |- | [[Leptospirosis]] | Caused by bacterium of genus ''[[Leptospira]]'' | Water contaminated by the animal urine carrying the bacteria | Begins with [[flu-like symptoms]] then resolves. The second phase then occurs involving [[meningitis]], [[liver]] damage (causes [[jaundice]]), and [[kidney failure]] |- | [[Otitis Externa]] (swimmer's ear) | Caused by a number of [[bacteria]]l and [[fungus|fungal]] species. | Swimming in water contaminated by the responsible pathogens | [[Ear canal]] swells, causing pain and tenderness to the touch |- | [[Salmonellosis]] | Caused by many bacteria of genus ''[[Salmonella]]'' | Drinking water contaminated with the bacteria. More common as a [[food borne illness]]. | Symptoms include [[diarrhea]], [[fever]], vomiting, and abdominal cramps |- | [[Typhoid fever]] | [[Salmonella enterica|''Salmonella typhi'']] | Ingestion of water contaminated with [[feces]] of an infected person | Characterized by sustained fever up to 40&nbsp;°C (104&nbsp;°F), profuse [[sweating]]; diarrhea, muscle aches, fatigue, and constipation may occur. Symptoms progress to [[delirium]], and the [[spleen]] and [[liver]] enlarge 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. |- | [[Vibrio|Vibrio Illness]] | ''[[Vibrio vulnificus]]'', ''[[Vibrio alginolyticus]]'', and ''[[Vibrio parahaemolyticus]]'' | Can enter [[wounds]] from contaminated water. Also acquired by drinking contaminated water or eating undercooked [[oysters]]. | Symptoms include abdominal tenderness, agitation, bloody stools, chills, confusion, difficulty paying attention (attention deficit), delirium, fluctuating mood, hallucination, nosebleeds, severe fatigue, slow, sluggish, lethargic feeling, weakness. |}

===Viruses=== [[File:Hepatitis A virus 01.jpg|alt=Hepatitis A is one of waterborne diseases and its symptoms are only acute. Symptoms include fatigue, fever, etc.|thumb|197x197px|'''Hepatitis A virus'''Hepatitis A is one of waterborne diseases and its symptoms are only acute. Symptoms include fatigue, fever, etc.]] {| class="wikitable" |- ! Disease and transmission<ref name="ewpcw" /><ref name="ciasuv">{{cite journal|vauthors=Nwachuku N, Gerba CP, Oswald A, Mashadi FD|date=September 2005|title=Comparative inactivation of adenovirus serotypes by UV light disinfection|url= http://aem.asm.org/cgi/reprint/71/9/5633.pdf|url-status=live|journal=Applied and Environmental Microbiology|volume=71|issue=9|pages=5633–6|doi=10.1128/AEM.71.9.5633-5636.2005|pmc=1214670|pmid=16151167|bibcode=2005ApEnM..71.5633N|archive-url=https://web.archive.org/web/20070926101329/http://aem.asm.org/cgi/reprint/71/9/5633.pdf|archive-date=2007-09-26}}</ref><ref name=":0" /><ref>{{cite journal|vauthors=Gall AM, Mariñas BJ, Lu Y, Shisler JL|date=June 2015|title=Waterborne Viruses: A Barrier to Safe Drinking Water|journal=PLOS Pathogens|volume=11|issue=6|article-number=e1004867|doi=10.1371/journal.ppat.1004867|pmc=4482390|pmid=26110535 |doi-access=free }}</ref><ref>{{Cite web|title=Hepatitis A|url=https://www.who.int/news-room/fact-sheets/detail/hepatitis-a|access-date=2020-11-19|website=www.who.int|language=en}}</ref> ! Viral agent ! Sources of agent in water supply ! General symptoms |- | [[Hepatitis A]] | Hepatitis A virus (HAV) | Can manifest itself in water (and food) | Symptoms are only [[acute (medicine)|acute]] (no [[chronic (medicine)|chronic]] stage to the virus) and include [[Fatigue (medical)|Fatigue]], fever, [[malaise]], abdominal pain, nausea, diarrhea, weight loss, itching, [[jaundice]], and [[depression (mood)|depression]]. |- |Hepatitis E ([[Fecal–oral route|fecal-oral]]) |[[Hepatitis E virus]] (HEV) |Enters water through the [[feces]] of infected individuals |Symptoms of acute [[hepatitis]] (liver disease), including [[fever]], [[fatigue]], loss of appetite, [[nausea]], vomiting, abdominal pain, [[jaundice]], dark urine, clay-colored stool, and joint pain |- |Acute gastrointestinal illness [AGI] ([[Fecal–oral route|fecal-oral]]; spread by food, water, person-to-person, and fomites) |[[Norovirus]] |Enters water through the [[feces]] of infected individuals |[[Diarrhea]], vomiting, [[nausea]], stomach pain |- | [[Poliomyelitis]] (Polio) | [[Poliovirus]] | Enters water through the [[feces]] of infected individuals | 90–95% of patients show no symptoms, 4–8% have minor symptoms (comparatively) with [[delirium]], [[headache]], [[fever]], and occasional [[seizures]], and [[spastic paralysis]], 1% have symptoms of non-paralytic [[aseptic meningitis]]. The rest have serious symptoms resulting in [[paralysis]] or death |- | [[Polyomavirus|Polyomavirus infection]] | Two of [[Polyomavirus]]: [[JC virus]] and [[BK virus]] | Very widespread, can manifest itself in water, ~80% of the population has [[antibodies]] to Polyomavirus | BK virus produces a mild [[respiratory infection]] and can infect the [[kidneys]] of [[immunosuppressed]] [[Organ transplant|transplant]] patients. JC virus infects the [[respiratory system]], kidneys or can cause [[progressive multifocal leukoencephalopathy]] in the [[brain]] (which is fatal). |}

===Algae=== {| class="wikitable" !Disease and transmission<ref>{{cite journal|vauthors=Westblade LF, Ranganath S, Dunne WM, Burnham CA, Fader R, Ford BA|date=March 2015|title=Infection with a chlorophyllic eukaryote after a traumatic freshwater injury|journal=The New England Journal of Medicine|volume=372|issue=10|pages=982–4|doi=10.1056/NEJMc1401816|pmid=25738686|doi-access=free}}</ref> !Microbial agent !Sources of agent in water supply !General symptoms |- |[[Desmodesmus]] infection |[[desmodesmus]] armatus |Naturally occurs in water. Can enter open wounds. |Similar to fungal infection. |}

=== Parasitic worms === {| class="wikitable" !Disease and transmission<ref name="isbn0-697-26071-2">{{cite book | vauthors = Janovy J, Schmidt GD, Roberts LS |title=Gerald D. Schmidt & Larry S. Roberts' Foundations of parasitology |publisher=Wm. C. Brown |location=Dubuque, Iowa |year=1996 |isbn=978-0-697-26071-0 }}</ref><ref name=":0" /> !Agent !Sources of agent in water supply !General symptoms |- |[[Dracunculiasis]] [Guinea worm disease] (ingestion of contaminated water.) |''[[Dracunculus medinensis]]'' |Female worm emerges from host skin and releases larvae in water. |Slight [[fever]], itchy [[rash]], [[nausea]], [[vomiting]], [[diarrhea]], dizziness, followed by formation of painful blister (typically on lower body parts) |- |Schistosomiasis [an infection with the parasitic worm [[Schistosoma]]](ingestion or swimming in contaminated water.) <ref name=":10">{{Cite web |last=Cleveland Clinic |title=Schistosomiasis |url=https://my.clevelandclinic.org/health/diseases/22631-schistosomiasis}}</ref> |''[[Schistosoma]]'' |The worm enters your body through the skin and spreads throughout your body through the blood stream. <ref name=":10" /> |Rash, itching, flu-like symptoms, stomach pain, muscle aches, loss of appetite, [[Hematemesis|vomiting blood]], and [[Neurological disorder|neurological symptoms]]. <ref name=":10" /> |}

=== Volatile Organic Compounds (VOC) === {| class="wikitable" !Disease and transmission !VOC !Sources of agent in water supply !General symptoms |- |Leukemia |Any volatile compounds such as benzene, toluene, ethylbenzene, and xylenes. <ref name=":6">{{Cite web |title=AJPH |url=http://ajph.aphapublications.org/ |access-date=2026-02-26 |website=American Journal of Public Health |language=en |doi=10.2105/AJPH.80.10.1209}}</ref> |Water used as dumping grounds of VOCs, causing contamination; pipeline bursts; jet fuel leakage. <ref>{{Cite web |last=Crane-Murdoch |first=Sierra |date=2014-04-05 |title=Looking for Answers in a Town Known for Leukemia |url=https://www.theatlantic.com/health/archive/2014/04/looking-for-answers-in-a-town-known-for-leukemia/284385/ |access-date=2026-02-26 |website=The Atlantic |language=en}}</ref> |Headache, fever, nausea, formation of tumors. <ref name=":6" /> |}

== Prevention == {{Further|WASH#Health aspects}} Reliable access to clean, uncontaminated [[drinking water]] and proper [[sanitation]] are the main methods to prevent waterborne diseases. Vaccination is another method to prevent the body from getting water-born diseases<ref name="WHO">{{cite web|title=Burden of disease and cost-effectiveness estimates|url=https://www.who.int/water_sanitation_health/diseases/burden/en/index.html|archive-url=https://web.archive.org/web/20140213190013/http://www.who.int/water_sanitation_health/diseases/burden/en/index.html|archive-date=February 13, 2014|access-date=April 5, 2014|publisher=[[World Health Organization]]}}</ref> The aim is to break the [[fecal–oral route]] of disease transmission.<ref name="WHO" />

[[Solar energy]] has been become a clean and efficient means by which water can now be [[Distillation|distilled]] and [[Desalination|desalinated]]. This method is environmentally safe because it does not produce mass amounts of carbon dioxide that could damage the planet. In fact, the carbon dioxide emissions are virtually zero from using solar energy to distill or desalinate water.<ref>{{Cite web |last=Manimaran |first=Renganathan |title=A comprehensive review of solar-assisted technologies in India for clean water and clean energy |url=https://academic.oup.com/ce/article/9/2/12/7950472#507002734}}</ref>

Desalination is the process by which salt is removed from water making it potable. Because water is a [[scarce resource]], meaning that there is a finite amount of it for all of humanity to share, research into sustainability methods for increasing the amount of [[potable]] water is important.<ref>{{Cite journal |last1=Patel |first1=Suresh G. |last2=Bhatnagar |first2=Shilpi |last3=Vardia |first3=Jitendra |last4=Ameta |first4=Suresh C. |date=2006-03-01 |title=Use of photocatalysts in solar desalination |url=https://www.sciencedirect.com/science/article/pii/S0011916406001007 |journal=Desalination |series=Selected paper from the 10th Aachen Membrane Colloquium |volume=189 |issue=1 |pages=287–291 |doi=10.1016/j.desal.2005.07.010 |bibcode=2006Desal.189..287P |issn=0011-9164|url-access=subscription }}</ref> With an abundance of salt water on Earth, the [[solar desalination]] method is innovative and presents potential. It works by using [[Solar panel|solar panels]] that capture solar energy from the sun which it then uses to remove the salt from the water through a process called reverse [[osmosis]]. The solar energy is converted into electricity via the solar panels. This electricity is then used to push the water at high pressures through filters that block the salt from passing through but do allow the water to pass.<ref name=":02">{{Cite web |title=How does solar desalination work? |url=https://www.elementalwatermakers.com/knowledge-base/solar-desalination/how-does-solar-desalination-work/ |access-date=2025-12-09 |website=Elemental Water Makers |language=en-US}}</ref> This method of desalination is also beneficial to society because it can be used in remote locations. It does not require a connection to a large pipeline system traditionally used that also produce large amounts of carbon dioxide. Specifically, this method is most productive were there is ready access to salt water, an abundance of sunshine, and a lack of fresh drinkable water.<ref name=":02" />

Other policies and precautions can be taken too in order to prevent the spread of disease through contaminated water. For example, appropriate amounts of chlorine can be added to the potable water pipes to remove viruses. Typical household precautions including the use of disinfection wipes and sanitization sprays also are important to use around areas where clean water consumption is very important such as in bathrooms and kitchens.<ref>{{Cite journal |last1=Adelodun |first1=Bashir |last2=Ajibade |first2=Fidelis Odedishemi |last3=Ighalo |first3=Joshua O. |last4=Odey |first4=Golden |last5=Ibrahim |first5=Rahmat Gbemisola |last6=Kareem |first6=Kola Yusuff |last7=Bakare |first7=Hashim Olalekan |last8=Tiamiyu |first8=AbdulGafar Olatunji |last9=Ajibade |first9=Temitope F. |last10=Abdulkadir |first10=Taofeeq Sholagberu |last11=Adeniran |first11=Kamoru Akanni |last12=Choi |first12=Kyung Sook |date=January 2021 |title=Assessment of socioeconomic inequality based on virus-contaminated water usage in developing countries: A review |journal=Environmental Research |volume=192 |article-number=110309 |doi=10.1016/j.envres.2020.110309 |issn=1096-0953 |pmc=7546968 |pmid=33045227 |bibcode=2021ER....19210309A }}</ref> Additionally, it is noted that plastic pipes can release benzene and other VOCs into drinking water when heat-damage occurs from wildfires. The installation of metal piping in high-risk areas may reduce future contamination risks.<ref>{{Cite web |last=Shah |first=Amisha |last2=Whelton |first2=Andrew J. |last3=Isaacson |first3=Kristofer P. |date=2020-12-14 |title=Plastic pipes are polluting drinking water systems after wildfires – it’s a risk in urban fires, too |url=http://theconversation.com/plastic-pipes-are-polluting-drinking-water-systems-after-wildfires-its-a-risk-in-urban-fires-too-150923 |access-date=2026-02-26 |website=The Conversation |language=en-US}}</ref>

== Epidemiology == {{Further|WASH#Health aspects}}

According to the [[World Health Organization]], waterborne diseases account for an estimated 3.6% of the total [[DALY]] [[Disease burden|(disability- adjusted life year) global burden of disease]], and cause about 1.5 million human deaths annually. The World Health Organization estimates that 58% of that burden, or 842,000 deaths per year, is attributable to a lack of safe drinking water supply, sanitation and hygiene (summarized as [[WASH]]).<ref name="WHO" />

=== United States === The [[Waterborne Disease and Outbreak Reporting System|Waterborne Disease and Outbreak Surveillance System (WBDOSS)]] is the principal database used to identify the causative agents, deficiencies, water systems, and sources associated with waterborne disease and outbreaks in the United States.<ref name=":1">{{Cite web|date=2017-10-16|title=Waterborne Disease & Outbreak Surveillance Reporting {{!}} Water-related Topics {{!}} Healthy Water {{!}} CDC|url=https://www.cdc.gov/healthywater/surveillance/index.html|access-date=2018-12-07|website=www.cdc.gov|language=en-us}} {{PD-notice}}</ref> Since 1971, the [[Centers for Disease Control and Prevention|Centers for Disease Control and Prevention (CDC)]], the [[Council of State and Territorial Epidemiologists|Council of State and Territorial Epidemiologists (CSTE)]], and the [[United States Environmental Protection Agency|US Environmental Protection Agency (EPA)]] have maintained this surveillance system for collecting and reporting data on "waterborne disease and outbreaks associated with recreational water, drinking water, environmental, and undetermined exposures to water."<ref name=":1" /><ref name=":2">{{Cite book|title=Methods for the investigation and prevention of waterborne disease outbreaks; EPA/600/1-90/005A|vauthors=Craun GF|date=2004|publisher=Health Effects Research Laboratory, U.S. Environmental Protection Agency|oclc=41657130}}</ref> "Data from WBDOSS have supported EPA efforts to develop drinking water regulations and have provided guidance for CDC's recreational water activities."<ref name=":1" /><ref name=":2" />

WBDOSS relies on complete and accurate data from public health departments in individual states, territories, and other U.S. jurisdictions regarding waterborne disease and outbreak activity.<ref name=":1" /> In 2009, reporting to the WBDOSS transitioned from a paper form to the electronic [[National Outbreak Reporting System|National Outbreak Reporting System (NORS)]].<ref name=":1" /> Annual or biennial surveillance reports of the data collected by the WBDOSS have been published in CDC reports from 1971 to 1984; since 1985, surveillance data have been published in the [[Morbidity and Mortality Weekly Report|Morbidity and Mortality Weekly Report (MMWR)]].<ref name=":1" />

WBDOSS and the public health community work together to look into the causes of contaminated water leading to waterborne disease outbreaks and maintaining those outbreaks.<ref name=":1" /> They do so by having the public health community investigating the outbreaks and WBDOSS receiving the reports.<ref name=":1" />

== Society and culture ==

===Socioeconomic impact===

Waterborne diseases can have a significant impact on the economy. People who are infected by a waterborne disease are usually confronted with related healthcare costs. This is especially the case in developing countries. On average, a family spends about 10% of the monthly households income per person infected.<ref>{{cite web|last=Schnabel|first=Bastian|title=Drastic consequences of diarrhoeal disease|date=30 March 2009 |url=http://www.dandc.eu/en/article/drastic-consequences-diarrhoeal-disease|url-status=live|archive-url=https://web.archive.org/web/20150923213627/http://www.dandc.eu/en/article/drastic-consequences-diarrhoeal-disease|archive-date=2015-09-23|name-list-style=vanc}}</ref>

Socioeconomic impact refers to the effects that waterborne disease has on society such as the quality of life, medical care, the economy, and education sustainable.<ref>{{Cite journal |last1=Adelodun |first1=Bashir |last2=Ajibade |first2=Fidelis Odedishemi |last3=Ighalo |first3=Joshua O. |last4=Odey |first4=Golden |last5=Ibrahim |first5=Rahmat Gbemisola |last6=Kareem |first6=Kola Yusuff |last7=Bakare |first7=Hashim Olalekan |last8=Tiamiyu |first8=AbdulGafar Olatunji |last9=Ajibade |first9=Temitope F. |last10=Abdulkadir |first10=Taofeeq Sholagberu |last11=Adeniran |first11=Kamoru Akanni |last12=Choi |first12=Kyung Sook |date=January 2021 |title=Assessment of socioeconomic inequality based on virus-contaminated water usage in developing countries: A review |journal=Environmental Research |volume=192 |article-number=110309 |doi=10.1016/j.envres.2020.110309 |issn=1096-0953 |pmc=7546968 |pmid=33045227 |bibcode=2021ER....19210309A }}</ref> [[Sustainable Development Goal 6]], access to clean water and sanitization for all by the year 2030, is at the roots of many of the other [[Sustainable Development Goals|sustainable development goals]] pertaining to society and the economy.<ref>{{Cite journal |last=Tortajada |first=Cecilia |date=2020-04-30 |title=Contributions of recycled wastewater to clean water and sanitation Sustainable Development Goals |url=https://www.nature.com/articles/s41545-020-0069-3 |journal=npj Clean Water |language=en |volume=3 |issue=1 |article-number=22 |doi=10.1038/s41545-020-0069-3 |bibcode=2020npjCW...3...22T |issn=2059-7037}}</ref> Agricultural industries in particular are most severely effected and the increasing stress comes from the booming city populations taking away water from farming. The need for clean water and sanitation is vital because without clean water there is no sustainable food source. Clean water is necessary to produce healthy crops for people to consume. If the water used for crop irrigation is contaminated, the produce could bring a ravaging disease to the people who consume it.

About one third of all of the cities in the world rely on the necessary freshwater that the agriculture industry needs. There is this constant tension on the freshwater supply because as populations in urban areas boom they demand more and more water. This demand for freshwater is estimated to increase 80% in the next 25 years which adds to [[water stress]] because farming uses about 72% of the fresh water that the cities need.<ref name=":9" /> An example of industries doing their part to help reach Sustainable Development Goal 6 would is the Adopt-a-River Project in [[Nairobi]], [[Kenya]]. The [[United Nations Environment Programme|United Nations Environment Program]] worked with several other clubs on the project which consists of traps being established along the [[Athi River (town)|Athi River]] to capture large solid waste. Recycling stations will also be constructed and industries that dump their [[effluent]] into water sources will also join the effort. This is a step to remove extra waste from water reducing chances of contamination of water that would eventually be used for irrigation of crops.<ref name=":9">{{Cite web |title=The United Nations World Water Development Report 2023 |url=https://unesdoc.unesco.org/ark:/48223/pf0000384659/PDF/384659eng.pdf.multi |access-date=2025-10-12 |website=unesdoc.unesco.org}}</ref>

== History == {{Further|History of water supply and sanitation#Understanding of health aspects}}Waterborne diseases were once wrongly explained by the [[miasma theory]], the theory that bad air causes the spread of diseases.<ref name="Juuti_20072">{{cite book|url=https://books.google.com/books?id=pZDbCwAAQBAJ&pg=PA103|title=Environmental History of Water|vauthors=Juuti PS, Katko T, Vuorinen H|date=2007-02-01|publisher=IWA Publishing|isbn=978-1-84339-110-4|language=en}}</ref><ref name=":5">{{Cite web|title=ESSAI {{!}} College Publications {{!}} College of DuPage|url=https://dc.cod.edu/essai/|access-date=2020-11-24|website=dc.cod.edu}}</ref> However, people started to find a correlation between [[water quality]] and waterborne diseases, which led to different [[water purification]] methods, such as [[sand filter]]ing and [[Water chlorination|chlorinating]] their drinking water. Founders of [[microscopy]], [[Antonie van Leeuwenhoek]] and [[Robert Hooke]], used the newly invented [[microscope]] to observe for the first time small material particles that were suspended in the water, laying the groundwork for the future understanding of waterborne pathogens and waterborne diseases.<ref>{{Cite web|title=The Use of the Microscope in Water Filter History|url=http://www.historyofwaterfilters.com/microscope-in-water.html|access-date=2012-12-17}}</ref>

== See also == * [[Airborne disease]] * [[Foodborne illness|Foodborne disease]] * [[List of diseases caused by water pollution]] * [[Neglected tropical diseases]] * [[Public health]] * [[Disease vector|Vector-borne diseases]] * [[Water quality]] * [[Zoonosis]]

== References == {{Reflist}}

== External links == {{Medical resources | DiseasesDB = | ICD10 = <!-- {{ICD10|Xxx.x}} --> | ICD9 = <!-- {{ICD9|xxx}} --> | ICDO = | OMIM = | MedlinePlus = | MeSH = | GeneReviewsNBK = | GeneReviewsName = }} {{Commons category}} * [https://www.cdc.gov/healthywater/disease/ Water-related Diseases, Contaminants, and Injuries] Listing of water-related diseases, contaminants and injuries with alphabetical index, listing by type of disease (bacterial, parasitic, etc.) and listing by symptoms caused (diarrhea, skin rash, and many more ) including links to other resources (CDC's Healthy Water site) * [https://www.who.int/water_sanitation_health/diseases-risks/diseases/diarrhoea/en/ World Health Organization (WHO) "Water-Related Diseases"]

{{-}} {{Concepts in infectious disease}} {{Public health}} {{Plumbing}}

{{DEFAULTSORT:Waterborne Diseases}} [[Category:Waterborne diseases| ]] [[Category:Drinking water]] [[Category:Sanitation]] [[Category:Environmental health]]