# Waterborne disease

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Disease caused by agents transmitted by water

Medical condition

Waterborne diseases Waterborne diseases can be spread via groundwater which is contaminated with fecal pathogens from pit latrines. Specialty Infectious disease

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

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

Therefore, reliable access to clean [drinking water](/source/Drinking_water) and [sanitation](/source/Sanitation) is the main method to prevent waterborne diseases. This includes improving [sanitation systems](/source/Sanitation), chlorination, vaccination, and sustainable technologies, like solar-powered [desalination](/source/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 regions](/source/Developing_country). Each consequence places greater economic strain on affected communities. The consequences of climate change also increases risk because of the increased possibility of [droughts](/source/Drought) and [flooding](/source/Flood), which can spread contaminants and disproportionately affect vulnerable populations. Surveillance systems, such as those maintained in the United States, help monitor and prevent [outbreaks](/source/Disease_outbreak). Historically, advances in [sanitation](/source/Sanitation), [filtration](/source/Filtration), chlorination, and [microbiology](/source/Microbiology) may help to understand and control of these diseases.

## Terminology

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 [polluted water](/source/Water_pollution). 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. [1]

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".[2]: 47 Water-related diseases are grouped according to their transmission mechanism: water borne, water hygiene, water based, water related.[2]: 47 The main transmission mode for waterborne diseases is [ingestion](/source/Ingestion) of contaminated water.[3]

## Causes

Further information: [WASH](/source/WASH)

Lack of clean [water supply, sanitation and hygiene](/source/WASH) (WASH) are major causes for the spread of waterborne diseases in a community. The [fecal–oral route](/source/Fecal%E2%80%93oral_route) is a disease transmission pathway for waterborne diseases.[4] [Poverty](/source/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.[5] 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.[6] Additionally, 1 in 4 people, or 2.1 billion people globally, still do not have access to safe drinking water. [7]

### 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](/source/Middle_East), [South East Asia](/source/Southeast_Asia), and [Sub-Saharan Africa](/source/Sub-Saharan_Africa) are prone to these issues because they lack advanced education.[8] For example, [Morocco](/source/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](/source/United_States) and Morocco along with many other agencies worked together to initiate H2O [Maghreb](/source/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.[8]

Political turmoil and war stimulate the transmission of waterborne disease in addition to lack of education. Countries in the [Eastern Mediterranean Region](/source/WHO_Regional_Office_for_the_Eastern_Mediterranean) deal with this issue especially.[9] The world bank has classified [Yemen](/source/Yemen), along with several other countries in the Eastern Mediterranean Region as "fragile and conflict-affected countries." [Syria](/source/Syria) and [Lebanon](/source/Lebanon) [10] had not seen any out breaks of [cholera](/source/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.[11] 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](/source/Pandemic), but rather an [endemic](/source/Endemic_(epidemiology)).[9]

Other war torn regions such as [Gaza](/source/Gaza_war) 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](/source/Israel); they also have several desalination plants across the region.[12] Workers are constantly working to fix water pipeline systems that have been destroyed by [artillery](/source/Artillery) from the war but are sometimes killed in the process.[12] 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](/source/Acute_diarrhea) and even a 10 month old with [polio](/source/Polio).[12]

Additionally, a study done in 2022 published by Nature Communications measured the associations between [racial](/source/Racial) and [ethnic](/source/Ethnicity) 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](/source/Arsenic) and [uranium](/source/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. [13]

### Influence of climate change

See also: [Climate change and infectious diseases](/source/Climate_change_and_infectious_diseases)

Climate change influences the growth and survival of [bacteria](/source/Bacteria) and other pathogens in food and water systems.[14][15][16] It affects waterborne diseases by influencing water temperature, [water quality](/source/Water_quality), [sanitation](/source/Sanitation), and [microbial ecology](/source/Microbial_ecology).[17]: 1107[18]: 12

[Climate change](/source/Climate_change) plays a major role in the [socioeconomic](/source/Economic_sociology) impact of waterborne disease, especially in [informal settlements](/source/Informal_housing). Over 60% of Africa’s urban population lives in areas with limited water and sanitation infrastructure. Droughts have been linked to [cholera](/source/Cholera) outbreaks in [Nairobi](/source/Nairobi), while flooding can spread pathogens through contaminated water.[19]

Warmer waters, increased [flooding](/source/Flood), [precipitation](/source/Precipitation) and [humidity](/source/Humidity) promote the growth and spread of bacteria such as [Vibrio cholerae](/source/Vibrio_cholerae), which causes [cholera](/source/Cholera), and other pathogens responsible for [gastroenteritis](/source/Gastroenteritis), wound infections and [diarrheal diseases](/source/Diarrhea).[17]: 1107[18]: 12[20] 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.[21]

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](/source/Backflow) that lead to contamination of [groundwater](/source/Groundwater) and other drinking water sources.[20]

## Diseases by type of pathogen

### Protozoa

Disease and transmission[22][23] Microbial agent Sources of agent in water supply General symptoms Acanthamoeba keratitis (cleaning of contact lenses with contaminated water) 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, non-treated drinking water, flies in water supply, saliva transfer(if the other person has the disease) Abdominal discomfort, fatigue, weight loss, diarrhea, bloating, fever Cryptosporidiosis (oral) Protozoan (Cryptosporidium parvum) Collects on water filters and membranes that cannot be disinfected, animal manure, seasonal 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, 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[24] Diarrhea and wasting in immunocompromised individuals. Naegleriasis (primary amebic meningoencephalitis [PAM]) (nasal) Protozoan (Naegleria fowleri) (Cyst-like appearance) Watersports, non-chlorinated water Headache, vomiting, confusion, loss of balance, light sensitivity, hallucinations, fatigue, weight loss, fever, and coma

### Bacteria

Disease and transmission[25][26] 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 and/or 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 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 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. 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;[27] but only causes severe disease when aerosolized.[28] 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, 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 bacterial and 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 typhi Ingestion of water contaminated with feces of an infected person Characterized by sustained fever up to 40 °C (104 °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 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

**Hepatitis A virus**Hepatitis A is one of waterborne diseases and its symptoms are only acute. Symptoms include fatigue, fever, etc.

Disease and transmission[24][29][22][30][31] 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 (no chronic stage to the virus) and include Fatigue, fever, malaise, abdominal pain, nausea, diarrhea, weight loss, itching, jaundice, and depression. Hepatitis E (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; 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 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 transplant patients. JC virus infects the respiratory system, kidneys or can cause progressive multifocal leukoencephalopathy in the brain (which is fatal).

### Algae

Disease and transmission[32] 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

Disease and transmission[33][22] 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.) [34] Schistosoma The worm enters your body through the skin and spreads throughout your body through the blood stream. [34] Rash, itching, flu-like symptoms, stomach pain, muscle aches, loss of appetite, vomiting blood, and neurological symptoms. [34]

### Volatile Organic Compounds (VOC)

Disease and transmission VOC Sources of agent in water supply General symptoms Leukemia Any volatile compounds such as benzene, toluene, ethylbenzene, and xylenes. [35] Water used as dumping grounds of VOCs, causing contamination; pipeline bursts; jet fuel leakage. [36] Headache, fever, nausea, formation of tumors. [35]

## Prevention

Further information: [WASH § Health aspects](/source/WASH#Health_aspects)

Reliable access to clean, uncontaminated [drinking water](/source/Drinking_water) and proper [sanitation](/source/Sanitation) are the main methods to prevent waterborne diseases. Vaccination is another method to prevent the body from getting water-born diseases[37] The aim is to break the [fecal–oral route](/source/Fecal%E2%80%93oral_route) of disease transmission.[37]

[Solar energy](/source/Solar_energy) has been become a clean and efficient means by which water can now be [distilled](/source/Distillation) and [desalinated](/source/Desalination). 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.[38]

Desalination is the process by which salt is removed from water making it potable. Because water is a [scarce resource](/source/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](/source/Potable) water is important.[39] With an abundance of salt water on Earth, the [solar desalination](/source/Solar_desalination) method is innovative and presents potential. It works by using [solar panels](/source/Solar_panel) that capture solar energy from the sun which it then uses to remove the salt from the water through a process called reverse [osmosis](/source/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.[40] 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.[40]

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.[41] 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.[42]

## Epidemiology

Further information: [WASH § Health aspects](/source/WASH#Health_aspects)

According to the [World Health Organization](/source/World_Health_Organization), waterborne diseases account for an estimated 3.6% of the total [DALY](/source/DALY) [(disability- adjusted life year) global burden of disease](/source/Disease_burden), 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](/source/WASH)).[37]

### United States

The [Waterborne Disease and Outbreak Surveillance System (WBDOSS)](/source/Waterborne_Disease_and_Outbreak_Reporting_System) 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.[43] Since 1971, the [Centers for Disease Control and Prevention (CDC)](/source/Centers_for_Disease_Control_and_Prevention), the [Council of State and Territorial Epidemiologists (CSTE)](/source/Council_of_State_and_Territorial_Epidemiologists), and the [US Environmental Protection Agency (EPA)](/source/United_States_Environmental_Protection_Agency) 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."[43][44] "Data from WBDOSS have supported EPA efforts to develop drinking water regulations and have provided guidance for CDC's recreational water activities."[43][44]

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.[43] In 2009, reporting to the WBDOSS transitioned from a paper form to the electronic [National Outbreak Reporting System (NORS)](/source/National_Outbreak_Reporting_System).[43] 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 (MMWR)](/source/Morbidity_and_Mortality_Weekly_Report).[43]

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.[43] They do so by having the public health community investigating the outbreaks and WBDOSS receiving the reports.[43]

## 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.[45]

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.[46] [Sustainable Development Goal 6](/source/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](/source/Sustainable_Development_Goals) pertaining to society and the economy.[47] 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](/source/Water_stress) because farming uses about 72% of the fresh water that the cities need.[48] An example of industries doing their part to help reach Sustainable Development Goal 6 would is the Adopt-a-River Project in [Nairobi](/source/Nairobi), [Kenya](/source/Kenya). The [United Nations Environment Program](/source/United_Nations_Environment_Programme) worked with several other clubs on the project which consists of traps being established along the [Athi River](/source/Athi_River_(town)) to capture large solid waste. Recycling stations will also be constructed and industries that dump their [effluent](/source/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.[48]

## History

Further information: [History of water supply and sanitation § Understanding of health aspects](/source/History_of_water_supply_and_sanitation#Understanding_of_health_aspects)

Waterborne diseases were once wrongly explained by the [miasma theory](/source/Miasma_theory), the theory that bad air causes the spread of diseases.[49][50] However, people started to find a correlation between [water quality](/source/Water_quality) and waterborne diseases, which led to different [water purification](/source/Water_purification) methods, such as [sand filtering](/source/Sand_filter) and [chlorinating](/source/Water_chlorination) their drinking water. Founders of [microscopy](/source/Microscopy), [Antonie van Leeuwenhoek](/source/Antonie_van_Leeuwenhoek) and [Robert Hooke](/source/Robert_Hooke), used the newly invented [microscope](/source/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.[51]

## See also

- [Airborne disease](/source/Airborne_disease)

- [Foodborne disease](/source/Foodborne_illness)

- [List of diseases caused by water pollution](/source/List_of_diseases_caused_by_water_pollution)

- [Neglected tropical diseases](/source/Neglected_tropical_diseases)

- [Public health](/source/Public_health)

- [Vector-borne diseases](/source/Disease_vector)

- [Water quality](/source/Water_quality)

- [Zoonosis](/source/Zoonosis)

## References

1. **[^](#cite_ref-1)** Atangana, Abdon (2018), ["Groundwater Pollution"](https://linkinghub.elsevier.com/retrieve/pii/B9780128096703000035), *Fractional Operators with Constant and Variable Order with Application to Geo-Hydrology*, Elsevier, pp. 49–72, [doi](/source/Doi_(identifier)):[10.1016/B978-0-12-809670-3.00003-5](https://doi.org/10.1016%2FB978-0-12-809670-3.00003-5), [ISBN](/source/ISBN_(identifier)) [978-0-12-809670-3](https://en.wikipedia.org/wiki/Special:BookSources/978-0-12-809670-3), [PMC](/source/PMC_(identifier)) [7149999](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7149999), retrieved 2026-02-27{{[citation](https://en.wikipedia.org/wiki/Template:Citation)}}: CS1 maint: work parameter with ISBN ([link](https://en.wikipedia.org/wiki/Category:CS1_maint:_work_parameter_with_ISBN))

1. ^ [***a***](#cite_ref-Marcos_2-0) [***b***](#cite_ref-Marcos_2-1) Von Sperling, M. (2015). ["Wastewater Characteristics, Treatment and Disposal"](https://iwaponline.com/ebooks/book/72/). *Water Intelligence Online*. **6** 9781780402086. [doi](/source/Doi_(identifier)):[10.2166/9781780402086](https://doi.org/10.2166%2F9781780402086). [ISSN](/source/ISSN_(identifier)) [1476-1777](https://search.worldcat.org/issn/1476-1777).

1. **[^](#cite_ref-3)** ["Waterborne illness and disease | Life Sciences | Research Starters | EBSCO Research"](https://www.ebsco.com/). *EBSCO*. Retrieved 2026-02-27.

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## External links

Classification D MeSH: D000069578

Wikimedia Commons has media related to [Waterborne diseases](https://commons.wikimedia.org/wiki/Category:Waterborne_diseases).

- [Water-related Diseases, Contaminants, and Injuries](https://www.cdc.gov/healthywater/disease/) 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)

- [World Health Organization (WHO) "Water-Related Diseases"](https://www.who.int/water_sanitation_health/diseases-risks/diseases/diarrhoea/en/)

v t e Concepts in infectious disease (Outline) Determinants Agent Biofilm Germ theory of disease Infectivity Infectious dose Pathogenesis Pathogenicity Attack rate Quorum sensing Virulence Endotoxin Exotoxin Case fatality rate factors Antimicrobial resistance Drug resistance Horizontal gene transfer Multidrug-resistant bacteria Host tropism Host Burn Comorbidity Diabetes Host–pathogen interaction Immune response Immunodeficiency Immunosuppression Immunopathology Cytokine storm Microbiome health Opportunistic infection Risk of infection Susceptible individual Age Gender Nutrition status Vaccination status Genetic predisposition Behavioral/lifestyle factors Smoking Pregnancy Stress levels Environment Access to water, sanitation, and hygiene Air quality Biodiversity loss Climate change Climate zones El Niño Tropical diseases Commerce Deforestation Ecology Humidity Injection drug use Natural disaster Flood Poultry and livestock Poverty Travel Urbanization Vector control War and conflict Transmission Basic concepts Asymptomatic carrier Chain of infection Focus of infection Fomite Host Incubation period Index case Infectious period Latent period Natural reservoir Opportunistic infection Silent/Subclinical infection Superinfection Transmission heterogeneity Super-spreader Viral load Window period Modes Endogenous Endogenous overgrowth Normal flora overgrowth Endogenous reactivation Endogenization Microbial translocation Endogenous seeding Biofilm formation Exogenous Cross-species Spillover infection Vector Zoonosis Reverse zoonosis Human-to-human /Cross-infection Contagious disease Source Nosocomial/Hospital Iatrogenic/Medical care Generational difference Vertical/Congenital Prenatal Perinatal Neonatal Horizontal Breakthrough infection Environment- to-human Sapronosis Routes Respiratory Air Bioaerosol Aerosol-generating procedure Dental aerosol Respiratory droplet Linked to Vascular system Blood-borne disease Percutaneous inoculation Injection site Intravenous line Insect bite Animal bite Surgical intervention Postoperative wound Surgical site infection Vector-borne Mosquito Tick Gastrointestinal Food Contamination Breastmilk Water Feces Cutaneous Burn Fomite Soil Open wound Genitourinary Sex Trans-placental Prenatal Cervico-vaginal Perinatal Other Ocular (Eye) mucosal membrane Modelling Agent-based model Animal disease model Attack rate Basic reproduction number Compartmental models in epidemiology Critical community size Force of infection Generation time Herd immunity Infection rate Machine learning Multiplicity of infection Secondary attack rate Serial interval WAIFW matrix Occurrence in population Cluster Endemic Epidemic Curve Farr's laws Geographic distribution Holoendemic Hyperendemic Incidence Inequality Mesoendemic Outbreak Pandemic Prevalence Seasonality Social factors Sporadic Syndemic Twindemic Anatomical location Respiratory Ear-Nose-Throat/Upper respiratory tract Chest/Lower respiratory tract Gastrointestinal Intestinal Genitourinary Nervous system Skin Soft tissue Bone Joint Cardiovascular Systemic/Generalized Blood Tooth Mouth Fetus Eye Outcome Carrier state Chronic infection Convalescence Disability-adjusted life years Late effect Post-acute infection syndrome Post-viral fatigue syndrome Recovery Sequela Prevention and Control measures Pharmaceutical Antibiotic prophylactic Antifungal Anthelmintic Ascaricide Antimicrobial Antimicrobial stewardship Antiseptic Antiviral Asepsis Combination Drug safety Immunization Immunotherapy Monoclonal antibody therapy Inoculation Phage therapy Pre-exposure prophylaxis Post-exposure prophylaxis Repurposed drugs Vaccination efficacy/effectiveness booster hesitancy resistance Vaccine-preventable disease Ring vaccination Non- pharmaceutical Contact tracing Cordon sanitaire Disease surveillance Disinfection Flattening the curve Hygiene Food hygiene Hand washing Gloves Isolation Barrier nursing Lockdown Notification list Protective sequestration Public health Community health services Health communication Health education Outbreak response Quarantine Respiratory source control N95 respirator Surgical mask PPE Safe sex Sanitation Screening Social distancing Sterilization Transmission-based precautions Travel restrictions Universal precautions Vector control Wastewater surveillance Zoning Emerging infections Antigenic drift Antigenic shift Antimicrobial resistance surveillance EARS-Net Biosecurity CRISPR Disease X Emergent virus Evolutionary epidemiology Genetic epidemiology Global Health Initiatives Microbial phylogenetics One Health Model Genomic reassortment Re-emerging disease Reverse zoonosis Selection pressure Synthetic biology Viral phylodynamics Other Discovery Disease ecology Eradication Economics of Infectious Diseases Infectious disease (medical specialty) Infectious disease informatics Microbial bioterrorism Pandemic prevention Tropical disease Tropical medicine

v t e Public health General Auxology Biological hazard Chief medical officer Climate change Cultural competence Deviance Environmental health Eugenics History of Liberal Euthenics Genomics Globalization and disease Harm reduction Health economics Health literacy Health policy Health system Health care reform Housing First Human right to water and sanitation Management of depression Public health law National public health institute Health politics Labor rights Maternal health Medical anthropology Medical sociology Mental health (Ministers) Occupational safety and health Pharmaceutical policy Pollution Air Water Soil Radiation Light Prisoners' rights Public health intervention Public health laboratory Right to food Right to health Right to a healthy environment Right to housing Right to rest and leisure Right to sit Security of person Sexual and reproductive health Social psychology Sociology of health and illness Unisex changing rooms Unisex public toilets Workers' right to access the toilet Preventive healthcare Behavior change Theories Drug checking Family planning Harm reduction Health promotion Human nutrition Healthy diet Preventive nutrition Hygiene Food safety Hand washing Infection control Oral hygiene Needle and syringe programmes Occupational safety and health Human factors and ergonomics Hygiene Controlled Drugs Injury prevention Medicine Nursing Patient safety Organization Pharmacovigilance Reagent testing Safe sex Sanitation Emergency Fecal–oral transmission Open defecation Sanitary sewer Waterborne diseases Worker School hygiene Smoking cessation Supervised injection site Vaccination Vector control Population health Adult mortality Biostatistics Child mortality Community health Epidemiology Global health Health impact assessment Health system Infant mortality Open-source healthcare software Multimorbidity Public health informatics Social determinants of health Commercial determinants of health Health equity Race and health Social medicine Biological and epidemiological statistics Case–control study Randomized controlled trial Relative risk Statistical hypothesis testing Analysis of variance (ANOVA) Regression analysis ROC curve Student's t-test Z-test Statistical software Infectious and epidemic disease prevention Asymptomatic carrier Epidemics List Notifiable diseases List Public health surveillance Disease surveillance Quarantine Sexually transmitted infection Social distancing Tropical disease Vaccine trial WASH Food hygiene and safety management Food Additive Chemistry Engineering Microbiology Processing Safety Safety scandals Good agricultural practice Good manufacturing practice HACCP ISO 22000 Health behavioral sciences Diffusion of innovations Health belief model Health communication Health psychology Positive deviance PRECEDE–PROCEED model Social cognitive theory Social norms approach Theory of planned behavior Transtheoretical model Organizations, education and history Organizations Caribbean Caribbean Public Health Agency China Center for Disease Control and Prevention Europe Centre for Disease Prevention and Control Committee on the Environment, Public Health and Food Safety Russia Rospotrebnadzor India Ministry of Health and Family Welfare Canada Health Canada Public Health Agency U.S. Centers for Disease Control and Prevention Health departments in the United States Council on Education for Public Health Public Health Service World Health Organization World Toilet Organization (Full list) Education Health education Higher education Bachelor of Science in Public Health Doctor of Public Health Professional degrees of public health Schools of public health History History of public health in the United Kingdom History of public health in the United States History of public health in Australia Sara Josephine Baker Samuel Jay Crumbine Carl Rogers Darnall Joseph Lister Margaret Sanger John Snow Typhoid Mary Radium Girls Germ theory of disease Social hygiene movement Category Commons WikiProject

v t e Plumbing Fundamental concepts Air gap (plumbing) Backflow Compatibility (chemical) Corrosion Drain (plumbing) Drinking water Fuel gas Friction loss Grade (slope) Greywater Heat trap Hydrostatic loop Leak Neutral axis Onsite sewage facility Pressure Sanitary sewer Sewer gas Sewage Sewerage Siphon Storm sewer Stormwater Surface tension Tap water Thermal expansion Thermal insulation Thermosiphon Trap (plumbing) Venturi effect Wastewater Water hammer Water supply network Water table Well Technology Brazing British Standard Pipe (BSP) Cast iron pipe Chemical drain cleaners Compression fitting Copper tubing Crimp (joining) Drain-waste-vent system Ductile iron pipe Flare fitting Garden Hose Thread (GHT) Gasket Hydronics Leak detection National pipe thread (NPT) Nominal Pipe Size (NPS) O-ring Oakum Pipe (fluid conveyance) Pipe dope Pipe support Plastic pipework Push-to-pull compression fittings Putty Sealant Sewage pumping Soldering Solvent welding Swaging Thread seal tape Threaded pipe Tube bending Water heat recycling Components Atmospheric vacuum breaker Automatic bleeding valve Automatic faucet Backflow prevention device Ball valve Bleed screw Booster pump Butterfly valve Check valve Chemigation valve Chopper pump Circulator pump Cistern Closet flange Concentric reducer Condensate pump Coupling (piping) Diaphragm valve Dielectric union Double check valve Eccentric reducer Expansion tank Faucet aerator Float switch Float valve Floor drain Flow limiter Flushing trough Flushometer Gate valve Globe valve Grease trap Grinder pump Hose coupling Manifold Needle valve Nipple (plumbing) Pinch valve Piping and plumbing fitting Plug (sanitation) Pressure regulator Pressure vacuum breaker Pressure-balanced valve Pump Radiator (heating) Reduced pressure zone device Reducer Relief valve Riser clamp Rooftop water tower Safety valve sewage pumping Street elbow Submersible pump Tap (valve) Thermostatic mixing valve Trench drain Vacuum breaker Vacuum ejector Valve Water tank Zone valve Plumbing fixtures Accessible bathtub Bathtub Bidet Dehumidifier Dishwasher Drinking fountain Electric water boiler Evaporative cooler Flush toilet Garbage disposal unit Hot water storage tank Humidifier Icemaker Instant hot water dispenser Laundry tub Shower water recycling shower Sink Storage water heater Sump pump Tankless water heating Urinal Washing machine Washlet Water dispenser Water filter Water heating Water softening Specialized tools Basin wrench Blowtorch Borescope Core drill Drain cleaner Driving cap Flare-nut wrench Pipecutter Pipe wrench Plumber's snake Plumber wrench Plunger Strap wrench Tap and die Measurement and control Control valve Flow sensor Pressure sensor Water detector Water metering Professions, trades, and services Hydronic balancing Hydrostatic testing Leak detection Mechanical, electrical, and plumbing Pipe marking Pipefitter Pipelayer Plumber Industry organizations and standards International Association of Plumbing and Mechanical Officials (IAPMO) NSF International Plumbing & Drainage Institute (PDI) Uniform Plumbing Code (UPC) World Plumbing Council (WPC) Health and safety Plumbing code Scalding Waterborne disease See also Fire sprinkler system Piping Template:HVAC Template:Public health Template:Sewerage Template:Human waste elimination Template:Wastewater

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Adapted from the Wikipedia article [Waterborne disease](https://en.wikipedia.org/wiki/Waterborne_disease) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Waterborne_disease?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.