How to prevent water-related diseases

It’s World Plumbing Day soon, so celebrate by becoming educated about water-related diseases.

Plenty of communities all over South Africa still rely on untreated water for their daily supply, and often, they have very limited access to adequate sanitation facilities. As a result, these communities are threatened by waterborne and water-washed diseases every day. While access to clean drinking water, proper personal hygiene and adequate sanitation infrastructure are the best ways to prevent these diseases, there are other ways to avoid them.

Waterborne diseases

Waterborne diseases are transmitted through untreated drinking water.


19Cholera is contracted by ingesting water or food that has been contaminated by a strain of the bacterium, Vibrio cholera. Water becomes contaminated when it comes into contact with the excrement of infected individuals. The disease is characterised by a sudden and substantial loss of body fluids through diarrhoea and vomiting, causing dehydration. When cholera goes untreated, it can be fatal within six hours, depending on the level of dehydration. In order to treat cholera, the patient must be rehydrated, orally or intravenously, as soon as possible.


20Campylobacteriosis is caused by the bacterium Campylobactor jejuni and is transmitted predominantly via the faecal-oral route. However, animals, such as cows and chickens, are often reservoirs of the bacterium, and therefore, proper hygiene is essential when preparing meals with poultry and beef. The disease is characterised by diarrhoea (which may be bloody), abdominal pains, fever and, in severe cases, vomiting and convulsions. Patients should be treated with fluid and salt replacements.

Prevention of waterborne diseases

• Disinfect untreated water by adding one teaspoon of domestic bleach to every 20 litres of water. Let the water sit for at least three minutes before ingesting it. If the untreated water is cloudy, add two or three extra teaspoons of domestic bleach.
• Always use clean drinking containers.


Water-washed diseases

Water-washed diseases occur as a result of poor hygiene.


Gastroenteritis is contracted by ingesting contaminated food or water and is spread via the faecal-oral route as a result of poor hygiene practices. It is characterised by sudden vomiting and diarrhoea, often accompanied by fever and stomach cramps. Healthy adults generally recover within a few days if they replace the water and salts they have lost. However, the disease can be fatal as a result of rapid dehydration, especially for infants, the elderly and for those infected with HIV.


Typhoid is caused by Salmonella typhi, transmitted via the faecal-oral route, and is characterised by an initial headache, followed by fever and abdominal pain, and finally, by bronchitis. Weight loss and a loss of appetite can also occur. Antibiotics are necessary soon after infection in order to prevent life-threatening complications, and bed rest is crucial.

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 Salmonella typhi  Vegetables irrigated with contaminated water is a common cause of Amoebic Dysentry.

Amoebic Dysentery

Amoebic Dysentery is caused by the parasite Entamoeba histolytica when it is transmitted via the faecal-oral route. A common source of infection is raw fruit or vegetables that have been irrigated with contaminated water. Most often, the infection presents without symptoms. However, when symptoms are present, they include diarrhoea (which is often bloody), a tender abdomen, nausea and weight loss. If intestinal perforation occurs, it can be life threatening. The disease should be treated with antiparasitic medication, and when complications occur, surgery.

Prevention of water-washed diseases

25• Follow the prevention methods for waterborne diseases, described above. However, after adding bleach to untreated water, leave it to stand for at least an hour before drinking.
• Practice regular washing of hands, especially after using the toilet; proper hygiene during food preparation; cleaning of soiled clothes with hot water; adequate waste disposal; and fly control.
• Wash and peel fruit and vegetables before eating them.


Waterborne and water-washed diseases

These diseases can be transmitted either through drinking untreated water, or as a result of poor hygiene.


Cryptosporidiosis is an infection caused by ingesting the parasite Cryptosporidium parvum. However, person-to-person contact and animals serving as reservoirs may also spread the disease. It is characterised by diarrhoea, stomach pains, and sometimes, vomiting and fever. Healthy individuals generally recover within two weeks, but the infection can be life threatening for those infected with HIV. Treatment is largely symptomatic, and therefore includes antidiarrhoeal drugs and rehydration therapy.


Giardiasis is an infection caused by the parasite Giardia lamblia and is characterised by diarrhoea and stomach cramps. Infection occurs through contaminated drinking water as a result of poor sanitation and hygiene, or via person-to-person contact. The disease is easily treated with prescription medicines that destroy the parasite.


Shigellosis is caused by Shigella dysentery and other Shigella species. It is characterised by abdominal pain and diarrhoea (stools are often accompanied by mucous and blood). In severe cases, dehydration, as a result of the diarrhoea in conjunction with decreased urine production, can cause kidney failure. The disease is spread via close person-to-person contact, by contaminated food or water, as well as via the faecal-oral route. In order to treat it, rehydration is necessary. Hospitalisation is required in rare cases when kidney failure or severe rectal bleeding occurs.

 Giardiasis parasite                         Legionnaires Disease bacteria  

Prevention of waterborne and waster-washed diseases

• Boil the water for at least five minutes, and filter it with a very fine filter (0.1 to 1.0 micrometres).
• Practice regular washing of hands, especially after using the toilet; proper hygiene during food preparation; cleaning of soiled clothes with hot water; adequate waste disposal; and fly control.
• Always use clean drinking containers.

Other water-related diseases

Legionnaires Disease

Legionnaires Disease is most often contracted by inhaling water droplets that contain a bacteria called Legionella Pneumophila. Once these bacteria reach the lungs and settle there, their hosts begin to suffer energy-loss, headaches, nausea, muscle aches, fever and chest pains. Most healthy people will easily fight off the infection. However, the disease can be fatal for the elderly and those that have compromised immune systems.

The bacteria responsible for Legionnaires Disease is most common in the workplace, in industrial cooling water systems, central air conditioning systems and water heating systems. The only permanent solution for preventing the contraction of this disease is by installing equipment that treats the water in these systems with chlorine, chlorine dioxide or copper silver ion.

Learn more about World Plumbing Day, or find a reputable plumber close to you!

Sources: Water Wise, The Department of Water Affairs and Legionella.