Avoiding Bacterial Waterborne Illnesses

Cholera is a disease characterized by severe diarrhea and rapid death. It is caused by the bacterium Vibrio cholerae. Discovery of it as a water-borne disease led to the development of modern water systems.

Cholera is spread by ingesting food, water, or other material contaminated with the feces of a cholera victim. It can result from contact with the soiled clothing or bedding of a cholera victim. Before the days of separate water systems for drinking water and sewage disposal, contamination was common. Since people were unaware of how the disease spread, adequate sanitation measures were not followed.

The cholera bacterium enters the body by way of the digestive system. Once in the intestines, the bacteria multiplies releasing toxins. The onset of symptoms is very sudden, with massive diarrhea, muscle cramps, vomiting, and fever. More than 50% of those who contract the disease die from it. Death often occurrs in only 12-48 hours.

The first major outbreak occurred in India in 1817. India's great Kumbh festival was held at Hardwar on the Upper Ganges River. People came from all over India for the festival, which lasted for three months. The large numbers of people and the resulting sewage contaminated the river. People left the festival, taking the bacteria with them to many parts of India. The resulting outbreak took the lives of 10,000 British soldiers stationed there, and likely hundreds of thousands of Indians.

Cholera followed trade routes from there into the Middle East, Russia, and Europe. Contaminated kegs of water on ships infected sailors, who spread it to others at various ports. Cholera came to the United States in the 1830's.

In England in the 1830's, Dr. John Snow identified cholera as a water-borne poison, but because he could not actually identify the bacteria, people paid little attention to his work, and no action was taken. During a second outbreak in 1854, Snow was able to show through careful recordkeeping the origin of the contaminated water to be a single public drinking water pump contaminated by a faulty sewer pipe. The actual discovery of the cholera bacillus was not made until 1876 by a German named Dr. Robert Koch.

In the late 19th century, municipal water and sewer systems began to be built in the US as people began to understand the real sources of cholera and other diseases. A vaccine was developed in 1893, but it provided only temporary protection. The cholera vaccine is generally recommended today only for individuals traveling to remote areas where cholera outbreaks are known.

Poorer areas of developing countries still see outbreaks of cholera today due to inadequate sanitation. A major outbreak occurred in 1991 in Lima, Peru. A ship from India released cholera contaminated ballast water into the harbor. The bacteria contaminated fish that the local people ate, resulting in an outbreak that affected much of Latin America.

Mary Abigail Fillmore, daughter of U.S. president Millard Fillmore
Elizabeth Jackson, mother of U.S. president Andrew Jackson
U.S. President James K. Polk
Elliott Frost, son of American poet Robert Frost
Daniel Morgan Boone, founder of Kansas City, Missouri, son of Daniel Boone
Ando Hiroshige, Japanese ukiyo-e woodblock print artist.
Inessa Armand, mistress of Lenin and the mother of his son, Andre

Alexandre Dumas, père, French author of The Three Musketeers and The Count of Monte Cristo contracted cholera but survived.

Dysentery is a disease sometimes called flux or bloody flux. It is characterized by fever, cramping, and frequent small passes of diarrhea with blood in the feces. It can be caused by many things, but is usually the result of a bacterial infection or ingestion of an amoeba.

Amoebic dysentery is contracted through ingesting water that has been contaminated with the amoeba Entamoeba histolytica. It is prevalent in developing countries where water supplies are less likely to be treated.

The amoeba can be found in water, or on foods that have been washed in amoeba contaminated water. Once the amoeba is injested, it moves through the digestive tract to the intestines. There they form infective cysts which can be found in the stools. It can also infect the liver, where it can form abscesses.

Treatment for amoebic dysentery includes an amoebicide to kill the parasites, an antibiotic to combat the infection, and drugs to combat infection of the liver or other organs.

Travelers need to be cautious when traveling to developing countries. Risk of infection can be reduced by not drinking water local tap water.

Typhoid fever is caused by the bacterium Salmonella typhi. It is transmitted by eating food or drinking water that has been contaminated by the feces of an infected person, or by eating food prepared by someone who is a carrier of the disease. Common in the undeveloped countries, it affects 21.5 million persons per year worldwide.

Typhoid fever is a serious disease, taking approximately one month to run its course without treatment. Death occurs in 10-30% of untreated cases, but is much less when promptly treated with antibiotics. The disease is characterized by a sustained high fever of 103° to 104° F. Weakness, diarrhea, headache, and loss of appetite follow. Some people develop a rash of flat, rose colored spots.

Once the symptoms go away, the danger of passing on typhoid fever has not passed. A small number of persons retain the bacterium in their body, even though they have no symptoms. They can pass the disease along simply in preparing food for others. One famous incident of a carrier was a woman named Mary Mallon. She was nicknamed Typhoid Mary.

Abigail Adams, wife of US President John Adams
Herbert Hoover's father and mother
General Stonewall Jackson's father, mother, and daughter
General Robert E. Lee's daughter Annie
Abraham Lincoln's third son, William
William McKinley's daughter, Katherine
Louis Pasteur's daughters Cecile and Jeanne
William T. Sherman's father and oldest son
Wilber Wright of the Wright Brothers

Bottled water is safer than tap water. Tap water should be boiled for at least one minute before drinking. When buying bottled water, carbonated water is safer than uncarbonated water.

When preparing local water, bring it to a rolling boil for at least one minute, then allow to cool before using.

Avoid drinks with ice cubes, popsicles, or flavored ices.

Eat foods that have been thoroughly cooked and are hot.

Avoid vegetables and salads that are raw, and any fruit that cannot be peeled. If possible, peel the fruits yourself after washing your hands with soap and water.

Be wary of street vendor foods, as they have had multiple opportunities to become contaminated.

Coffee, tea. canned sodas and juice, beer, wine, and liquor are generally safe to drink. Remember not to have these drinks with ice.

Be careful with other forms of contamination, such as brushing teeth and cleaning contact lenses. Always use boiled or bottled water for these activities as well.

Iodine and chlorine water purification tablets are available for travelers. Of the two, iodine is more effective, but should not be used long term. These may not be effective against some protozoa.

There are devices such as the SteriPEN Classic Handheld Water Purifier [pictured above]
that use ultraviolet light to kill contaminant organisms. They are not inexpensive, but they are very effective and easy to carry. Weighed against the cost of getting sick, they are comparatively cheap. You can read a review of the SteriPEN at here.

Check the CDC Website for travel and vaccination information before traveling abroad.

Human urine is liquid waste products filtered by the kidneys from the blood. It is generally transparent and clear to amber in color. Other colors frequently indicate disease in the body.

Human urine is virtually sterile unless a urinary tract infection is present. In times of war, it has been used to clean wounds when no other sterile agents existed, such as on the battlefield. It is also used by some people to treat jellyfish stings and injuries from sea urchins.

In ancient Rome, human urine was used for bleaching clothes. The Koryak people of Siberia drank urine in order to communicate with spirits. The Aztecs used urine to clean wounds, and drank it to relieve stomach and intestinal difficulties.

Urine makes an excellent fertilizer. Used full strength, it can burn the roots of plants. However, when diluted with water to be 10-20% urine, it makes an excellent fertilizer. Undiluted urine can be added to compost. Its high nitrogen content makes it an excellent compost additive to speed up the decomposition process.

Untreated human sewage has long been used as a fertilizer for crops in developing countries, although urine application is rare.

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