1. SUBJECT :- Environmental engineering Topic :- Water Borne Diseases Guided by:- Dr. Reshma L. Patel Prepared By :-  130070106098 Jay Rachchh  130070106099 Chirag Radiya

2. WATER BORNE DISEASES  Diseases caused by ingestion of water, contaminated by, human or animal excrement, containing various pathogenic micro-organisms.

3. WATER BORNE DISEASES  Diseases caused by ingestion of water, contaminated by, human or animal excrement, containing various pathogenic micro-organisms.  Includes : Cholera Typhoid Dysenteries

4. cholera An acute diarrheal disease, caused by Vibrio Cholerae. In the severe form, Painless watery diarrhea and copious effortless vomiting occurs, leading to hypovolemic shock and death within 24 hours. If treated early, then the disease lasts for around 4-6 days, during which the patient loses huge amounts of liquids and electrolytes from his body.

5. Clinical Features : Stool is typically, a colorless watery fluid with flecks of mucus, called rice water stools. Has a characteristic inoffensive sweetish odor, with bicarbonate-rich isotonic electrolyte solution and little protein. It leads to diminution of ECF volume, hemoconcentration, hypokalemia, base- deficit acidosis and shock. Muscular cramps, Renal failure, pulmonary edema, cardiac arrhythmias, and paralytic ileus. Clinical illness begins slowly with mild diarrhea and vomiting within 1-3 days OR abruptly with sudden massive diarrhea.

6. Organism : Vibrios are Gram –ve, rigid, curved rods. They are actively motile by means of a polar flagellum. The movement is vibratory motility, hence the name Vibrio. They are asporogenous and noncapsulated. Most important member of this genus is Vibrio cholerae, causative agent of cholera. MORPHOLOGY : It is a short, curved, cylindrical rod with rounded/pointed ends. Size : 1.5µm * 0.2-0.4 µm

7. Contd. Koch described these organisms as ‘ fish in stream’ appearance –as seen in thin films of mucous flakes from acute cholera cases. Strongly aerobic. In anaerobic conditions, growth is scanty. Temperature range that supports their growth is 16 – 40ºC, with optimum temperature being 37ºC. Ph that supports their growth is 6.4 – 9.6 ; optimum being 8.2. Distinguishing feature : Oxidase test : +ve

8. Lab tests: No direct microscopic examination is done. Motility of vibrio is seen under dark- field/phase contrast microscope. Non-specific fluorescence is common yet complicated technique. Slide-agglutination tests may also be done, followed by chick red cell agglutination. The strains are sent to NICED : National Institute of Cholera & Enteric Diseases, Kolkata ; for further tests.

9. TREATMENT:  Up to 80% of cases can be treated through oral rehydration salts  Severe cases require intravenous fluids  Parenteral Vaccine : 2 doses administered 2 weeks apart 50% efficiency provides 6 months protection  Killed Vaccine : Killed whole-cell + recom. B-subunit of CT Safe even during pregnancy & breastfeeding Efficiency is 75-80%,decreases to 50% - 3yrs

10. Prevention & Control Hygiene education Good nutrition Good sanitation Water related issues should be addressed immediately Public health infrastructure is of utmost importance to control outbreaks Avoid contacting soils that may be contaminated with feces Do not defecate outdoors ~ rural areas Wash /Sanitize our hands before eating While travelling to places with poor sanitation, avoiding contaminated water

11. World Distribution of Cholera

12. TYPHOID Also Known As :  Enteric Fever  Bilious Fever  Yellow Jack

13. TYPHOID Typhoid fever is caused by Salmonella typhi. The term ‘Enteric fever’ consists of both typhoid and paratyphoid fever. Typhoid was once not demarcated from normal fevers, but a detailed study of the diseases was given by Bretonneau, 1826 – identified the intestinal lesions. Louis gave the name ‘Typhoid’ in 1829

14. Salmonella: Belongs to Enterobactericieae family Gram –ve rods causing intestinal infections Facultative anaerobes & Aerobes Size :1-3µm * 0.5µm Motile with peritrichate flagella CULTURAL CHARACTERISTICS : Grows readily on simple media PH range : 6-8 Temperature : 15-41ºC Large colonies,2-3mm in diameter- circular, low convex translucent and smooth

15. Modes of transmission : Ingestion of contaminated food or water Rarely, from person to person – fecal-oral route. Food handlers/ Carriers... ‘Typhoid Mary’, is a classic example of carrier transmission of the diseases. Mary Mallon, a cook in New York City in early 1900s was affected by Typhoid fever; She was responsible for infecting at least 78 people and killing 5 people. She was later put in prison, to avoid passing of the infection further.

16. Clinical Features : ENTERIC FEVER SEPTICEMIA- with(out) local suppurative lesions GASTROENTERITIS / FOOD POISONING Typhoid fever is a septicemia characterized by fever, bradycardia, splenomagaly, abdominal symptoms, and ‘rose spots’- which are clusters of pink mauls on the skin. Complications viz., intestinal haemorrhage or perforations develop in untreated patients or when there is a delayed treatment.

17. Pathogenecity: The organisms penetrate ileal mucosa reach mesenteric lymph nodes via lymphatics, multiply, invade blood stream via thoracic duct. In 7-10 days, they infect Liver, Gall-Bladder, Spleen, Kidney, Bone-Marrow. After multiplication, bacilli pass into blood causing secondary and heavy Bacteremia. Mechanism: From gall bladder, invasion occurs in intestines. Involvement of peyer’s patches, gut lymphoid tissues leads to inflammatory reaction. Finally leading to necrosis and formation of characteristic typhoid ulcers.

18. Symptoms: Diarrhea Severe headache Abdominal pain Anorexia Fever Ulcers on intestinal wall Shock Rose spots intestinal hemorrhage + perforations

19. Control & Prevention : Simple hand hygiene and washing can reduce several cases of typhoid. Choose processed foods for safety All milk and dairy products should be pasteurized. Control fly populations Any bleeding from rectum, bloody stools, sudden acute abdominal pains should be reported at once to the physician.

21. References.., https://en.wikipedia.org/wiki/Waterborne_diseaseshttps://en.wikipedia.org/wiki/Waterborne_diseases www.azdhs.gov/phs/oids/epi/waterborne/list.htmwww.azdhs.gov/phs/oids/epi/waterborne/list.htm www.pulitzercenter.org/‎ www.lenntech.com/library/diseases/diseases/waterborne- diseases.htmwww.lenntech.com/library/diseases/diseases/waterborne- diseases.htm https://www.google.co.in/search?q=water+borne+d iseases&biw=1024&bih=643&espv=2&source=lnms& tbm=isch&sa=X&ved=0CAYQ_AUoAWoVChMI1Zaf0Y OyyAIVgXCOCh1vJArG&dpr=1#imgrc=q5grVegApqnP ZM%3Ahttps://www.google.co.in/search?q=water+borne+d iseases&biw=1024&bih=643&espv=2&source=lnms& tbm=isch&sa=X&ved=0CAYQ_AUoAWoVChMI1Zaf0Y OyyAIVgXCOCh1vJArG&dpr=1#imgrc=q5grVegApqnP ZM%3A https://www.google.co.in/search?q=water+borne+d iseases&biw=r=1#imgrc=BApeUlIeTORFoM%3A.jpg