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Care of the Elderly Policy and Practice.

Microbiological drinking-water quality and human health The microbiological quality of drinking-water has been implicated in the spread of important infectious and parasitic diseases such as cholera, typhoid, dysentery, hepatitis, giardiasis, guinea worm and schistosomiasis. Many other diseases are associated with water in other ways. Water may act positively in the control of some through its use in hygiene, and may act as a source or vector for others where contact with water is required for disease transmission or where agents of disease or insect vectors require water in which to complete their life cycle. The various relationships between water and disease are summarized in Table 1. Water-related disease incidence worldwide Water-related disease places an excessive burden on the population and health services of many countries worldwide and in particular those in developing countries. Table 2 shows estimates of the morbidity and mortality rates of some major water-related diseases worldwide, figures which are likely to be conservative estimates. WHO SEMINAR PACK FOR DRINKING-WATER QUALITY 2 Table 1: Diseases related to water and sanitation Group Disease Route leaving Route of host infection Diseases which are Cholera faeces oral often water-borne Typhoid faeces/urine oral Infectious hepatitis faeces oral Giardiasis faeces oral Amoebiasis faeces oral Dracunculiasis cutaneous percutaneous Diseases which are Bacillary dysentery faeces oral often associated with Enteroviral diarrhoea faeces oral poor hygiene Paratyphoid fever faeces oral Pinworm (Enterobius) faeces oral Amoebaisis faeces oral Scabies cutaneous cutaneous Skin sepsis cutaneous cutaneous Lice and typhus bite bite Trachoma cutaneous cutaneous Conjunctivitis cutaneous cutaneous Diseases which are Ascariasis faecal oral often related to Trichuriasis faecal oral inadequate sanitation Hookworm faecal oral/ (Ancylostoma/Necator) percutaneous Diseases with part Schistosomiasis urine/faeces percutaneous of life cycle of parasite in water Diseases with vectors Dracunculiasis cutaneous percutaneous passing part of their life cycle in water adapted from Bradley, D J, London School of Hygiene and Tropical Medicine, various