April 2008 Issue

WHO Report Assesses Cost Effectiveness of Water Interventions

A new study published by the World Health Organization (WHO) assesses the cost-effectiveness of various types of water initiatives to reduce waterborne illnesses. Each year, an estimated 1.8 million people are killed from diarrheal disease in developing countries , with 17 percent of those deaths affecting children under the age of five. WHO estimates that 94 percent of diarrheal disease is attributable to the environment, including risks associated with unsafe water, lack of sanitation and poor hygiene.

While programs to improve water quality at the source (point of distribution) have well-recognized benefits, more recent reviews have shown household-based (point-of-use) interventions to be significantly more effective in preventing diarrheal disease . As a result, there is increasing interest in such household-based interventions.

The new WHO study evaluates the cost effectiveness of conventional improvements of water quality at the source (well, borehole, communal stand post) and four interventions to improve water quality at the household level (chlorination, filtration, solar disinfection and combined flocculation/disinfection). The WHO report stated that among all water quality interventions, household-based chlorination is the most cost-effective source in combating diarrheal disease. Both solar disinfection and chlorination were found to be “highly cost effective” in all 10 geographic regions included in the study.

This analysis reports only on the cost-effectiveness related to preventing diarrhea, and does not address diseases such as typhoid, hepatitis A and E and polio that may be transmitted by the ingestion of unsafe water. Therefore, the authors note, the study understates the true impact of such interventions.

While piped-in water supplies remain an important long-term goal, the WHO report stated that it is unlikely that the UN Millennium Development Goal target of halving the proportion of the people without sustainable access to safe drinking water and basic sanitation by 2015 will be met.

To read the complete report, please go to:
Water Quality Interventions to Prevent Diarrhea: Cost and Cost-Effectiveness

Myanmar Facing Waterborne Crisis in wake of Cyclone Nargis

An estimated 1.5 million Myanmarese are on the brink of a “massive public health catastrophe,” according to health officials who have descended upon the beleaguered nation in the wake of Cyclone Nargis. The cyclone and tidal sea surge ripped across the low-lying delta a week ago, with winds topping 120 miles per hour. Earlier this week, the country’s ruling junta yesterday raised its official tally of the dead to more than 28,000, though humanitarian specialists say the toll could be much higher. Thousands are still thought to remain missing.

According to media reports, ponds are full of dead bodies, wells have been laced with saline water, and basic supplies are scarce. The International Federation of Red Cross and Red Crescent Societies has successfully shipped shelter kits, made up of tarps, ropes and hammers, and jerry cans for storing clean water to the Myanmar Red Cross.

With conditions in the delta increasingly desperate, many survivors began besieging small towns, searching for help. In the town of Laputta, which lost 85 percent of its buildings, about 28 makeshift camps have sprung up. UN agencies and international charities that were operating in Myanmar before the disaster have been slowly setting up operations. Emergency supplies are gradually arriving in the country and just beginning to reach the low-lying Irrawaddy Delta, but is far short of what is needed. Cyclone Nargis is the worst storm to hit Asia since 1991 when 143,000 people died in Bangladesh, the Red Cross said.

To read more about the Red Cross’ efforts in Myanmar, please go to
Red Cross Effort in Myanmar

Recreational Water Illness Prevention Week, May 19-25, 2008

The third annual National Recreational Water Illness Prevention Week will take place May 19-25 at the onset of swimming season, to raise awareness regarding the potential for spread of infectious diseases at swimming venues and the need to improve prevention measures.Each year, U.S. residents make an estimated 360 million visits to recreational water venues swimming the second most common physical activity (after walking) in the country and the most common among children.

An estimated 8.1 million swimming pools are available for private or public use in the United States, while the number of waterparks has increased to approximately 1,000 in North America and another 600 across the world. Recreational water illnesses (RWIs) are spread by swallowing, breathing, or having contact with contaminated water from swimming pools, spas, lakes, rivers, or oceans . The most commonly reported RWI is diarrhea caused by pathogens such as Cryptosporidium , Giardia , Shigella , and Escherichia coli O157:H7.

Chlorine in properly disinfected pools kills most germs that cause RWIs within minutes. However, it takes longer to kill some germs such as Cryptosporidium that can survive for days in even a properly disinfected pool. Also, many things can reduce chlorine levels in pool water. Swimming pool operators should vigilantly monitor chlorine levels and pH, and make adjustments accordingly. In addition, healthy swimming behaviors and good hygiene are needed to protect you and your family from RWIs and will help stop germs from getting in the pool.

In connection with RWI Prevention Week, the Water Quality and Health Council has again issued the following tips to help swimmers and parents recognize the difference between a healthy pool and a risky one:

Practice ” Sense “-able Swimming

Sight : Look for water that’s clean, clear and blue.
Touch : Check for tiles that feel smooth and clean.
Smell : Make sure there are no strong odors.
Sound : Listen for pool cleaning equipment. o Taste: Never drink or swallow pool water.
Common Sense : Do your part to protect yourself and others.

For more information about healthy pools and swimming tips, please go to:
WQ&HC’s Healthy Pools Website

CDC’s RWI Prevention Week Website

CDC and the NSPF ® establish a Crypto Outbreak Alert System

The Centers for Disease Control and Prevention (CDC) and the National Swimming Pool Foundation ® (NSPF ® ) have established a Cryptosporidium (Crypto) Outbreak Alert System to help aquatic facilities protect against recreational water illness. During the past two decades, Crypto has become recognized as one of the most common causes of waterborne disease in the United States.

The CDC and NSPF encourage other organizations to disseminate the Outbreak Alert by broadcasting a regional email when they learn of an outbreak. NSPF will also send Alerts to national and regional organizations who request they be notified of any outbreak. Previous outbreak investigations have shown that when a pool is contaminated and the pool is closed, patrons will go to other facilities and also unknowingly contaminate them. According to the CDC, in 2007, there were at least 18 documented Cryptosporidiosis outbreaks related to treated aquatics venues, the largest one in Utah affecting more than 1,900 people.

Cryptosporidiosis is a gastrointestinal illness which causes diarrhea, stomach aches, vomiting, dehydration and other symptoms. It is spread from diarrhea of ill people. Most people who have healthy immune systems will recover without treatment. Symptoms can be particularly severe with young children, the elderly, and people who are immune-compromised.

To read more about Crypto, please go to:
Crypto Toolkit