Waterborne Diseases in India: Symptoms and Treatment

They are diseases that are transmitted by ingesting contaminated water, food and contact with faeces that contain harmful bacteria, viruses and other disease causing microorganisms.
Most common water borne disease symptoms include:

• Diarrhea
• Abdominal pain
• Fever
• Nausea and vomiting
• Excessive thirst due to dehydration
• Loss of appetite
• Weakness
• Other gastrointestinal problems

Common causes of diseases through water

There are two major causes of the diseases:

(i) Waterborne pathogens such as viruses and bacteria that are ingested through contaminated water

(ii) Contact with waste products such as faeces through contaminated water.

If you ingest water from unclean sources such as public tanks, lakes or tap water (which is often contaminated in India), you might get infected with waterborne disease.

There are different types of diseases caused by water, most of which are caused by chemical pollution of water bodies due to the effect of increased levels of nitrates and heavy metals on the body. Industrial areas in India often have contaminated water
bodies because the waste from factories contains toxic materials that are dumped into nearby lakes and rivers.

Around 37.7 million Indians are affected by consuming contaminated water every year, ranging from simple diarrhoea to more complicated infections. This is mainly due to lack of access to safe drinking water and living in unsanitary conditions.

Rivers such as the Ganges provide water for nearly 500 million people in India. So contamination of even one water source can affect a large part of the population. Access to clean water is extremely important and
making sure that you boil water before drinking and using it for cooking is absolutely essential.

Most of these diseases can be treated at an early stage. The first step to preventing serious complications from diseases stemming from polluted water is to ensure you stay hydrated. Treatment of these diseases mainly includes rehydration, rest, and sometimes medication and antibiotics.

Water borne diseases are extremely common in India and anybody can fall prey to them. Therefore, understanding the nature of these diseases and being able to identify the symptoms in time is crucial for their treatment.

While there are different kinds of diseases that stem from contaminated water, there are a few which are extremely common in India and there is no collective, common disease symptoms.
These diseases typically occur both in rural and urban areas, so it’s important to take strict precautions no matter where you live.

Here are the symptoms and characteristics of some of the most common water-based diseases in India.

1. Typhoid

Typhoid is a common bacterial waterborne disease caused by the Salmonella typhi bacteria. This disease is often seen in places where personal hygiene is low and
handwashing is not practised enough. According to one report, around 494 out of every 1,00,000 children in India suffer from typhoid. A lot of villages and smaller towns in India with poor sanitation face a higher risk of typhoid. However, it can also occur in urban cities during the monsoons.

Typhoid can have very serious consequences and can even be fatal if proper treatment is not administered. On average,
around 1 in every 5 cases of typhoid can be fatal. The bacteria is spread through the urine and faeces of infected people, also known as the faeco-oral transmission route. Salmonella typhi
bacteria is also passed through contaminated food and drinking water. This makes typhoid very contagious and anyone who comes in contact with an infected person can contract the disease.

Once infected, you need to be treated immediately. Any delay in treatment can have serious consequences.

Typhoid Symptoms:

Symptoms of typhoid are usually not immediately apparent. The bacterium enters the body through the mouth and then makes its way to the intestine. After around 1-3 weeks, it passes through the intestinal wall to the bloodstream. Once it enters the bloodstream, it can get passed on to other organs in
the body and it is during this period that the symptoms of typhoid become noticeable.

Some of the common typhoid symptoms include:

• High fever
• Extreme weakness
• Muscle pain
• Diarrhea
• Loss of appetite
• Constipation
• Cough
• Skin rashes with small red spots
• Weight loss
• Chills and abdominal pain

These are the most typical water borne disease symptoms if you’re suffering from typhoid.

Typhoid diagnosis and treatment in India:

Typhoid is usually diagnosed through a blood test or urine samples or stool test to check for the presence of Salmonella typhi.

Once the diagnosis has been made, antibiotics are administered to battle against the infection. The patient will also be given oral fluids or an IV to rehydrate them and prevent dehydration.
If the disease has reached more advanced stages and has affected the bowels, surgical treatment might be required.

Typhoid prevention:

One of the reasons why typhoid is so dangerous is because the body’s immune system cannot fight against it. The bacteria resides within the cells of the host, and so the immune
system cannot attack it. Thus, prevention is the most important step in combating the prevalence of typhoid.

To prevent typhoid, you should practice the following steps:

• Drink purified mineral water
• Wash hands regularly with disinfectant
• Carry sanitiser at all times in case running water is not available
• Avoiding eating in unclean places.

There are also two vaccines available for typhoid – oral vaccine and injectable vaccine. Oral vaccine is given to kids below 6 years of age. Injectable vaccine is given to children under 2 years of age and 2 weeks before to people travelling to high-risk areas.

2. Cholera

Cholera is a waterborne disease caused by the bacterium Vibrio cholerae. It is commonly transmitted through contaminated food and faeces. According to a report by WHO, there are around 4 million cases of cholera each year. India has experienced cholera outbreaks in the past and there are still
active cases of cholera in the country. One study of an at-risk locality in Kolkata found that there were around 2.2 cases out of every 1000 people. It’s extremely important that we maintain good hygiene and sanitation to contain the spread of cholera and protect ourselves from it.

Some of the ways in which a person might contract cholera include:

• Ice made from contaminated water,
• Roadside food prepared in unhygienic conditions
• Vegetables grown in unhygienic water
• Raw/uncooked fish found in dirty water

Person-to-person transmission of cholera is very rare so it is unlikely that you might contract cholera from coming into contact with someone suffering from it.

Cholera Symptoms:

Cholera is a waterborne disease that is extremely virulent and in some cases can even be life-threatening. Once a person ingests the bacteria, it reaches the intestine and starts producing toxins that cause diarrhoea.

Some of the common symptoms of cholera include

• Frequent, rice water coloured loose stools
• Nausea and vomiting
• Muscle cramps
• Feeling thirsty
• Abdominal pain

These are the most typical symptoms of cholera, a waterborne disease. You must meet a doctor immediately if you’re experiencing a combination of these symptoms.

Cholera Diagnosis and Treatment in India:

If you are experiencing symptoms of cholera, your doctor will first look at your history to check if you have travelled to any areas where cholera can spread. They will also check for other signs of cholera like reduced skin elasticity and dry mucous membranes in the nose, eyelids and mouth. If your doctor suspects a case of cholera, you will be asked to provide a stool sample.
The sample will then be examined to identify the presence of the bacteria Vibrio cholerae

Common treatment methods for cholera in India include:

• Rehydration – Drinking lots of water and ORS solution will compensate for fluids lost from the body. ORS is available at any medical store
• Intravenous Fluids – IV drip may be needed for people who are severely dehydrated
• Antibiotics and Zinc supplements to counter infections and build resistance
• Feeling thirsty
• Abdominal pain

3. Malaria

Malaria fever is caused by plasmodium parasites and is transmitted by the female Anopheles mosquito that breeds on stagnant, unclean water such as lakes and sewage drains. When a carrier mosquito bites you, the parasite enters your bloodstream and goes straight to the liver, the site of RBC production. There, the parasite attacks your
RBCs and infected RBCs burst open, resulting in malaria symptoms and the onset of the disease. According to the WHO, India reports around 15 million cases of malaria each year. Sewage systems and public waterbodies, if maintained well will significantly reduce Malaria cases.

Malaria Symptoms:

Some of the common symptoms of malaria include:

• Shaking and chills – can be mild or severe
• High fever
• Continuous sweating
• Nausea and vomiting
• Headaches
• Diarrhea
• Abdominal pain
• Muscle pain and weakness
• Convulsions and bloody stools in more severe cases

Malaria diagnosis and treatment in India:

A doctor will be able to diagnose malaria fever through a medical examination and a blood test, such as a peripheral smear to visualize the parasite and serological tests to determine the stage of the disease.
A blood test will tell you what type of malaria you have, if it’s a drug-resistant parasite, if it has resulted in anaemia and if any vital organs have been affected. A peripheral smear test is the most common method to detect malaria in the blood. A drop of the patient’s blood is smeared on a microscopic slide and is stained to identify malarial parasites. Serological tests are also done to detect antibodies against malaria.

Malaria and dengue may have similar symptoms, so you should get a test.

Malaria is treated through a series of drugs and medications as prescribed by a doctor.
To prevent contracting malaria, always practice safe hygiene protocol, install blinds in your house to prevent mosquitoes from entering and stay clear of unhygienic water sources such as sewage drains and stagnant water.

4. Giardiasis:

Giardiasis is a parasitic infection caused by Giardia lamblia, a water-based pathogen, that mainly spreads through a faeco-oral contamination route and affects the small intestine. You may contact Giardia by eating contaminated food or drinking contaminated water. It is quite common in India and countries with cramped spaces and poor sanitation in communities.

Giardia lamblia is most commonly found in human and animal faeces. Swimming pools, lakes and public water bodies are the most common infection points of this water based disease. It mostly spreads when people come into contact with infected faeces.

Giardiasis Symptoms:

• Nausea and vomiting
• Diarrhoea
• Loss of appetite
• Abdominal pain and discomfort
• Headache
• Weight loss
• Extreme tiredness and fatigue

These are the most common water borne disease symptoms of Giardiasis.

Giardiasis diagnosis and treatment in India:

You will have to provide a stool sample to check for Giardia. If required, your
doctor may also do an enteroscopy to get a tissue sample from your intestine.

Your doctor will prescribe anti-parasitic drugs to speed up the treatment process.

5. Amoebic Dysentery:

Amoebic dysentery is a waterborne disease that mainly spreads through contaminated food, water and contact with faecal matter. It is an intestinal infection which leads to
inflammation of the intestine as well as severe abdominal cramps and diarrhoea. Blood and mucous in the stools is common too.
Amoebic dysentery usually lasts for 3-7 days.

Amoebic Dysentery symptoms:

• Abdominal cramps/pain
• Fever and chills
• Painful passing of stools
• Intermittent constipation
• Nausea and vomiting
• Bloody stools
• High fever
• Excessive thirst due to Dehydration
• Fatigue

Amoebic Dysentery Diagnosis and Treatment in India:

Amoebic dysentery is diagnosed through a stool sample under a microscope.

A blood test and a stool test is enough to confirm dysentery. Your doctor will suggest rehydration methods to make up for all the lost fluids
from your body and will also recommend OTC medications and antibiotics if necessary.

6. Hepatitis A

Another common viral waterborne disease, Hepatitis A, occurs by exposure to contaminated food and water. Hepatitis A infection leads to the
inflammation of the liver and temporarily affects liver function. Fortunately, Hepatitis A is not very serious or fatal and
generally goes away on its own in a few days. However, if symptoms persist your doctor will recommend medications and antibiotics to combat the disease.

Waterborne diseases such as Hepatitis A spread when you come in contact with uncooked vegetables, contaminated food and water in unclean food joints and roadside vendors.

Hepatitis A symptoms:

• Yellowish skin due to jaundice
• Fever
• Fatigue
• Body pain and weakness
• Abdominal pain
• Light colored stools
• Loss of appetite
• Darker urine
• Weight loss

Symptoms take some time to appear, usually 15-50 days after you contract the virus.

Hepatitis A diagnosis and treatment in India:

Your doctor will conduct a blood test and look for physical signs such as jaundice for Hepatitis A. There’s no hard and fast treatment for Hepatitis A. Since it goes away on its own in most cases, taking rest for a few weeks will help you recover
fully. Drink plenty of water, eat hot home-cooked meals and avoid alcohol and outside junk foods.

7. Shigellosis

Shigellosis is caused by the Shigella bacterium strain and it affects the intestine, resulting in diarrhoea and vomiting. It is a common disease that spreads through the faeco-oral route. Shigella bacteria is present in contaminated water, food and faeces.

Shigellosis commonly occurs in toddlers and school-going children, because they tend to touch dirty surfaces and put their fingers in their mouths.

Shigellosis Symptoms:

• Frequent diarrhea
• Fever
• Stomach pain

More serious symptoms include:

• High fever
• Blood in stools
• Severe abdominal pain and cramps
• Excessive thirst due to dehydration
• Severe nausea and vomiting

Symptoms appear 1-3 days after exposure to the bacteria.

Shigellosis diagnosis and treatment in India:

Dehydration is the biggest issue associated with Shigellosis. It’s important to replenish
your body with fluids to ensure that you don’t lose more water. Your doctor may recommend medications and antibiotics if it’s more severe.

8. Amoebiasis

Amoebiasis is a water-based disease caused by the protozoan Entamoeba histolytica. It affects the intestines and causes loose stools, water
loss and stomach cramps. It usually goes away on its own with rest and rehydration.

It is waterborne and enters the body through contaminated food, drinks and faeces. When you ingest small cysts containing E.Histolytica, you will get
infected. If infected, a person can spread the disease through faecal contamination.

Amoebiasis Symptoms:

• Loose stools
• Stomach cramps
• Fatigue
• Excessive flatulence
• Unintentional weight loss
• Blood in stools

Amoebiasis Diagnosis and Treatment in India:

A stool test taken continuously over a few days will confirm the presence of cysts. You may also have to take a liver function test to check for any liver damage. In serious cases, a colonoscopy may be prescribed too.

As you’re now aware, you can contact water borne diseases by drinking contaminated water, eating contaminated food or coming in contact with unclean
water such as swimming pools and lakes. While most conditions are treatable, it’s best if you try and prevent them altogether by practising some simple habits.

Here are some ways you can ensure you are protected from contaminated water diseases:

1. Practice Environmental Hygiene:

Whenever you use a toilet, whether at home or in public, make sure you flush it well or use a bucket of water to flush it down. At home, regularly clean the toilet with
hot water and anti-bacterial detergent, preferably a chlorine-based one to keep your toilet clean and disease-free.

If possible, avoid using public bathrooms altogether. If you must, try using an Indian-style bathroom to completely avoid any contact with contaminated surfaces.

2. Practice personal hygiene:

• Wash your hands regularly, especially after using the toilet, changing diapers or touching public surfaces in public bathrooms which may be contaminated.
• Wash your hands thoroughly with soap after dealing with animals and especially while discarding animal faeces.
• Always cook meals with clean hands and wash your hands while serving as well.
• Carry a hand sanitizer with you when you step out of the house and some tissues as well.

3. Practice food safety precautions:

• Wash all fruits and vegetables thoroughly before consuming since you don’t know where they came from
• Consume pasteurized dairy products only. Avoid drinking juices from places you don’t know.
• Avoid consuming ice in food joints which seem unclean. If you want to be a little more cautious, avoid ice outside the home altogether.
• There’s nothing healthier than a hot meal. Consume home-cooked hot meals as much as possible.
• Wash your hands thoroughly after handling non-veg products and raw meat
• Clean utensils regularly with detergents. Don’t leave your dishes unattended for long periods of time. Use hot water to do the dishes.
• Avoid roadside foods such as paani puri, chaat, juices and ice golas as these are sure shot contributors to tummy upsets.

4. Practice good water hygiene:

• Make sure your source of water at home is clean – whether it be a septic tank or an Aquaguard for drinking water. Get it tested for quality regularly.
• Swim in clean swimming pools that are chlorinated and well maintained
• Do not swallow water while swimming in pools, lakes, ponds or even the ocean.
• Completely avoid drinking tap water at all costs. In India, it is certainly not recommended.

The above is the most common water borne diseases list that can be avoidable by following simple hygiene standards. However, if you do contact a water-based disease, the first step you need to take is to
to get your symptoms evaluated and treated. Putting off treatment can worsen your condition and lead to severe consequences like extreme dehydration.

Q1. What are the common water borne diseases in India?

There are several diseases that spread through contaminated water in India, the most common being Typhoid, Cholera, Shigella, Dysentery, Malaria, Amoebiasis, Giardia and Hepatitis A. The common symptom among all of them is diarrhoea.

Q2. What are the effects of waterborne diseases?

The most common effects include food poisoning, abdominal cramps, diarrhea, muscle weakness, fatigue. The first step to take if you are experiencing these symptoms is to rehydrate with water and/or electrolytes.

Q3. What are the main causes of water-based diseases?

There are two main causes of water borne diseases – pollution and contamination through waterborne pathogens. Pollution of water by chemicals such as nitrates and heavy metals when ingested can cause trouble for the body. Contamination of water and food, which is far more common, is the major cause of water borne diseases.

Q4. How do diseases spread through water?

Bacteria mainly grow and reside in stagnant water and water that is contaminated with human and animal faeces. When this water is used for drinking, bathing, washing clothes and cooking, it spreads from water to humans, resulting in diarrhea and other symptoms.

Q5. What are the major symptoms of water borne diseases?

Major symptoms of water borne diseases include:

• Diarrhea
• Abdominal pain
• Fever
• Nausea and vomiting
• Feeling very thirsty
• Loss of appetite
• Weakness
• Other gastrointestinal problems

Q6. What are the methods of prevention of water-based diseases in India?

Major methods of prevention of water-based diseases include washing your hands regularly, drinking clean water, cleaning toilets with detergents, avoiding public restrooms, consuming hot meals, eating in clean restaurants and avoiding ingesting water in swimming pools and lakes.