While cholera may be one of the most widely recognized examples of a water-borne disease, the list of illnesses associated with water is extensive. Several of the terms commonly used help clarify the relationships between water and various pathogens follow. Water-borne diseases are those such as cholera which are caused by the ingestion of water contaminated with human or animal feces or urine containing the pathogen. The pathogen may be bacterial or viral. Typhoid, diarrhea, and dysentery, as well as cholera, are examples of water-borne diseases.
Water-washed diseases are those associated with poor hygiene and are often associated with unreliable access to clean water. Water-washed pathogens can cause diseases such as scabies, trachoma, and flea, lice, and tick-borne diseases when contaminated water is brought into contact with human skin and eyes.
Water-based diseases are caused by parasites found in non-human hosts living in water, and are transmitted when humans come into contact with the intermediate organisms while wading, swimming, bathing, washing clothes, or other water-based activities. Schistosomiasis, dracunculiasis, and other helminths are such examples.
Water-related diseases are caused by insect vectors that use water as breeding grounds. Yellow fever, malaria, and dengue fever are some of the best-known examples, but onchocerciasis and trypanosomiasis, while less well known, are also examples.
Human activities such as the building of dams for water and electricity, the creation of irrigation systems, the flooding of land for agriculture, and the construction of human dwellings in pristine forests, savannas, and flood plains each change the balance between hosts and vectors by changing the proximity of common reservoirs. The Aswan Dam in Egypt, for instance, provided water and electricity but also increased rates of schistosomiasis (a water-based disease) (Kloos, 1985). In the Dominican Republic, crowded urban living conditions and an unreliable water supply system created a perfect breeding ground for Aedes egypti mosquitoes and resulted in increased rates of dengue fever (a water-related disease) in the urban areas (Whiteford, 1997). In rural communities in the Andes, labor migration patterns continue to influence the re-introduction of cholera when laborers return home to celebrate holidays with traditional food- and drink-sharing practices (Whiteford, 1998; Whiteford, Laspina, & Torres, 1996). As these examples suggest, central to any in-depth understanding of the distribution of water-borne and water-washed diseases is a social science analysis of the underlying sociopolitical and economic variables that effect changing patterns of human contact with non-human vectors and pathogens.
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