Changing understanding of water and infectious diseases

It has long been recognized that access to potable water and modern wastewater disposal can reduce morbidity and mortality from gastrointestinal illnesses; however, recent data have established the important role of adequate water supplies for preventing respiratory diseases. Having an adequate supply of safe water is important for the prevention of both “water-borne” diseases, where the pathogen can be ingested from contaminated water, and “water-washed” disease, where hygienic practices such as handwashing and bathing play a role. Although improvements in water and wastewater services to rural Alaska villages have been ongoing since 1960, approximately 1/3 of villages still lack in-home water service. Until recently, the health benefits of in-home sanitation services in Alaska have been poorly understood. The presenter will review the current data on the role of water in infectious diseases and discuss recent studies in rural Alaska where the relationship between in-home water and wastewater service and the risks of infectious diseases have been described. These data shed light on the higher rates of respiratory infections of infancy, Staphylococcal skin infections and invasive bacterial infections and the added health care costs experienced by persons living in settings where access to in-home sanitation services is limited. These data point to water as a key component in preventing a much wider range of health problems than was previously appreciated and lend support to efforts aimed at increasing access to adequate amounts of potable water for consumption and hygiene in communities with infectious disease health disparities.