Waterborne Diseases in the USA

Disease-free water is one thing that many Americans can enjoy unconditionally due to stringent control and implementation of advanced water purification technology. However things can still go wrong; sudden or gradual geological changes may affect ground water and E-coli outbreaks may still occur due to accidental contamination. Although Americans can feel confident about their clean water system, many still feel insecure with water that comes out from the tap.

In many parts of the world, people suffer a wide variety of waterborne disease. Even in the US the water system can’t withstand the wear and exposure to the elements, pumps, pipes and purification facilities will fail eventually. Contamination through the water distribution system may spread quickly.

Waterborne diseases in the United States:


In 1993, an outbreak of intestinal disorders and diarrhea occurred in Milwaukee and lab tests discovered the presence of cryptosporidium in the water system. About 400,000 people were infected by the protozoa and it caused the most serious waterborne disease outbreak in the history of the US. Unfortunately, cryptosporidium cysts are difficult to detect, even in a well-equipped lab. Cryptosporidium cysts are also resistant to common disinfection methods used in the water treatment facility. During an outbreak it is advisable to boil the water obtained from the tap before using it for drinking.


This is caused by two different organisms, an amoeba and Shigella, a bacterium. Shigella can destroy the cells of the intestinal lining which causes mucosal ulcers and eventually bloody diarrhea. A person may get dysentery after ingesting as few as 10 bacteria. Amoebic dysentery is less common in the US because it spreads mostly from human excrement which is used for fertilizer. Unlike bacterial spores, amoeba cysts are more resistant to common water treatment methods. They may stay outside the human body for a long time and then become activated when the conditions are favorable. In the United States, there are less than 30,000 cases of waterborne dysentery each year, while across the rest of the world, 140 million people are affected by the disease each year and approximately 600,000 die.


Cholera is a bacterial disease that spreads through contaminated water. Severe diarrhea and the resulting dehydration are two common symptoms of cholera. Cholera can cause immediate death when untreated. Fortunately, cholera can be treated easily using modern methods and drugs. For example, dehydration is most common cause of death in cholera patients and it can be prevented using an inexpensive and simple rehydration method. Vibrio cholerae is the main culprit of cholera and the deadly effect is caused by CTX, a potent toxin produced by the bacteria. CTX binds to the cells of the intestinal lining and disrupt the electrolyte cycle inside the body. Although the last waterborne outbreak of cholera in the US occurred in 1911, the risk of future outbreak is still present as some neighboring countries still have inadequate sanitation condition. At the end of 2010, a woman in Florida was diagnosed with cholera after visiting her relatives in Haiti.


Giardia is among the most common parasites that infect human intestines. You can be infected by giardiasis almost anywhere in the world and it is a common cause of diarrheas for travelers. Giardia is also a common cause of waterborne disease outbreak in the United States, because it is found in many places throughout the country. Because giardia parasites are usually found in animal droppings, water taken from streams, ponds and lakes should be boiled before being used for human consumption. Giardiasis may occur when people use water from nature directly without performing basic water treatment methods. For example, the water should be boiled and treated with iodine. In the nature, giardia parasites are usually found as cysts which can withstand unfavorable environmental factors. People can be infected by giardia parasites if they drink water or eat food that has been contaminated by animal droppings. Common symptoms of giardiasis are nausea, abdominal cramps and diarrhea. In severe cases, dehydrations and weight loss may occur.

Legionnaires’ Disease

There are nearly fifty thousands cases of Legionnaires’ disease in the United States each year. The disease is caused by bacteria called Legionella pneumophila. The disease is often associated with contaminated potable water systems and poorly maintained water towers. Common symptoms of Legionnaires’ disease are coughing, chills and fever. Patients may also experience ataxia (loss of coordination), loss of appetite, tiredness, headache and muscle ache. If the disease progresses, the liver and renal functions can be affected, causing electrolytes imbalances and hyponatremia. Sometimes, Legionnaires’ disease can be misdiagnosed as pneumonia as they share a number of similar symptoms when examined with a chest X-ray. The disease requires between 2 to 10 days to exhibit symptoms since the first exposure depending on the amount of bacteria ingested and the state of the immune system. Older people are more vulnerable to this disease and the symptoms can be more severe. In April 2011, Legionella pneumophila was detected in the hot tub of the Playboy Mansion and 123 people were found to have fever after attending the fundraising event.

Hepatitis A

A number of minor waterborne hepatitis A outbreaks occurred in the United States. One common source of hepatitis A is from swimming pools, which may be a problem if someone with poor hygiene enters the pool. The hepatitis A virus spreads through fecal matter and in a crowded swimming pool, contamination may happen. Fortunately, hepatitis A is treatable and an effective vaccine is available.

Chemical Exposure

Waterborne disease in the United States is not only biological in nature. Somehow, chemicals may find their way into the water system and cause illnesses in people. The most common metal contaminants in the water system are copper and lead. Other chemical outbreaks are fluoride, liquid soap and sodium hydroxide.

When the water pipe near your neighborhood breaks, you should boil the water before using it. Also, if you swim regularly at a swimming pool, it is necessary to make sure that the pool is hyperchlorinated regularly and you shouldn’t swim during the weekend or holidays when the pool is crowded to limit exposure to harmful organisms.

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