Waterborne Diseases Are Everywhere Now. Here's What to Know

Sipping a cold drink and taking a dip at the beach or pool is the ultimate way to cool off on a hot day. But it comes with a very real – and often unrealized – risk of developing waterborne diseases. This group of diseases can cause symptoms like diarrhea, nausea, vomiting, fever, and more. In some rare cases, these illnesses can be fatal.

Even though the US has one of the safest drinking water supplies in the world, about 7.2 million Americans get sick every year from diseases spread through water, according to the Centers for Disease Control and Prevention (CDC). But what exactly are waterborne diseases and how can you protect yourself and your family? Infectious disease experts break it down.

What Are Waterborne Diseases?

Waterborne diseases, aka water-related illnesses, are a group of diseases that are caused by ingesting, inhaling, or having direct contact with contaminants in water, according to the National Institute of Environmental Health Sciences (NIEHS). “‘Waterborne diseases’ is an umbrella term for these illnesses, which can range in severity,” says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. Symptoms of waterborne illnesses include diarrhoea, nausea, stomach cramps, vomiting, and fever, along with skin, ear, respiratory, and eye problems.

What Causes Waterborne Diseases?

There is a wide range of waterborne diseases, but they’re generally caused by bacteria, viruses, protozoa, and toxins that thrive in water, the CDC says. “The planet teems with microorganisms and water is no different,” says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security.

Climate change and global warming may play a role in the spread of some waterborne diseases, Dr Adalja says. “Some diseases may increase because of favoured growth conditions, while others may decrease,” he says. “Also, people’s behaviour could change and hotter weather could, for example, increase recreational water activities.” Natural disasters like flooding, hurricanes, and tornadoes that disrupt sanitation systems “increase the risk of waterborne disease,” he adds.

One particularly lethal pathogen, Naegleria fowleri (aka a brain-eating amoeba) “has been able to move further north because it’s able to multiply in still-warm bodies of water impacted by climate change,” Dr Russo says.

What Are Common Waterborne Diseases

There are actually quite a few. CDC data show that, in 2014 in the United States, 17 waterborne pathogens caused an estimated 7.15 million illnesses, 601,000 ER visits, 118,000 hospitalisations, and 6,300 deaths. The CDC also has a breakdown of the most common waterborne diseases, along with how many estimated cases they cause each year:

• Otitis externa (swimmer’s ear): 4.67 million
• Norovirus (a virus that causes vomiting and diarrhoea): 1.3 million
• Giardiasis (an infection that causes stomach cramps and diarrhoea): 415,000
• Cryptosporidiosis (a parasitic infection that causes diarrhoea): 322,000
• Campylobacteriosis (the most common cause of bacterial diarrhoea in the U.S.): 171,000

How Do You Prevent Waterborne Diseases?

You can pick up waterborne diseases by coming into contact with contaminated water, this includes ingesting it, getting it up your nose, or breathing in aerosols, Dr Russo says. To lower your risk of getting a waterborne disease, experts recommend taking these steps:

• Stick to well-managed pools. That means taking a pass on pools with cloudy water or those that don’t seem to be well maintained.
• Try to avoid aerosolized water. Breathing in contaminated droplets can increase your risk of waterborne diseases like Legionnaires’ disease.
• Don’t drink recreational water (e.g. water in lakes and rivers, swimming pools, hot tubs, and water parks) – and don’t put water into your mouth and spit it out, if you can help it.
• Try to stick to cleaner bodies of water. Dr Adalja specifically recommends that you “be wary of any water where large amounts of faecal contamination may be present.”
• Try to avoid getting water up your nose. Some waterborne pathogens, like Naegleria fowleri, infect people this way.

If you do contract a waterborne disease, most people tend to recover on their own. But treatment options depend on the type of disease. “Some are treated with supportive care, such as norovirus, while others may be treated with antibiotics, and others with antiparasitic agents,” Dr Adalja says. The American Family Physician journal recommends you talk to a doctor if “you have bloody diarrhoea, diarrhoea that lasts more than a week, or a cough with fever.” Other serious symptoms, like a fever, stiff neck after swimming in a freshwater pond, or a bad skin infection with fever, are also red flags that you should see a physician.