Oral

Worldwide diarrheal disease is a primary cause of morbidity and mortality. In the US it is estimated that 76 million cases of illness and 5,000 deaths are caused by food and waterborne gastrointestinal (GI) infections and young children and the elderly are both vulnerable populations. The incidence of waterborne disease (WBD) is shown to be sensitive to climate and weather; WDB typically demonstrates seasonal fluctuations suggesting strong effects of environmental drivers for these diseases. However, the seasonal patterns and their link to environmental exposures, climate characteristics, water source and water quality parameters are not fully understood. This session uses an interdisciplinary approach to discuss the seasonality and environmental drivers for waterborne diseases. The session will illustrate current seasonal patterns in waterborne diseases and suggest environmental drivers such as meteorological and hydrological parameters. The session will also discuss novel epidemiological and statistical methods for assessing and properly controlling for seasonality. Inadequate control for seasonality may result in residual confounding in epidemiological studies. Despite well-established seasonal trends in health outcome (e.g., infectious disease and reproductive effects) and exposure data, few studies have adequately controlled for seasonality. Exposure to waterborne contaminants can be influenced by seasonal fluctuations in pathogen or chemical concentration data, as well as behavioral factors such as water intake and recreational activities. The session will draw on the field of environmental engineering to provide a description of how the progression and control of a waterborne epidemic involves understanding and predicting the transport and fate of pathogens through two systems: the water distribution network (rivers, groundwater, wells, pipes, sewers, etc.) and the human population. The session will also provide an assessment of the change in disease patterns in association with hydrological parameters. Overall, this session will provide a forum for those from different disciplines, including environmental epidemiology, civil and environmental engineering, and biostatistics, to address seasonality in WBD and environmental associations. The findings presented in this invited session will emphasize the relevance and importance of such associations for public health policy, control and prevention of waterborne diseases.

Session Objectives: 1. Identify that waterborne diseases demonstrate a seasonal pattern which may be driven by climatic characteristics. 2. Describe that these seasonal patterns may also be driven by hydrological parameters and water quality. 3. Assess the relevance and importance of associations between rates of waterborne disease and environmental parameters for control and prevention of these infections and implications for public health policy.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)