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The cost of infectious waterborne disease in the United States

  • The cost of infectious waterborne disease in the United States

The Centers for Disease Control and Prevention (CDC) has estimated the healthcare costs of waterborne infectious diseases in the United States to be $3.3 billion per year, informs Circle of Blue.

Diseases transmitted by water common in the early 20th century such as cholera and typhoid are no longer a threat in the U.S., thanks to the reliable provision of safe drinking water. Despite this achievement, infectious diseases are still transmitted via drinking water systems, but also through recreational water use. More than 7 million illnesses occur annually, resulting in 118,000 hospitalizations and more than 6,600 deaths. That is the waterborne disease burden estimated by an analysis published in Emerging Infectious Diseases. Estimates were based on the 2014 population, the most recent year for which data were available.

The study takes into account from minor illnesses such as swimmer’s ear (otitis externa), to intestinal and respiratory illnesses from all water sources (drinking, recreational, environmental) and exposure pathways (through mouth, nose and skin).

The authors highlight that although the risk of illness from intestinal pathogens, usually controlled by water treatment processes, still exits nowadays, the results point to a new waterborne disease scenario with an increasing role of environmental pathogens that grow in drinking water distribution systems, plumbing in buildings, recreational waters, and industrial water systems.

Emerging threats are pathogens like Legionella – responsible for the deadliest waterborne illness in the United States –, Pseudomonas and nontuberculous mycobacteria that grow in biofilms. Exposure occurs through contact, ingestion or inhalation of aerosols, such as through showerheads, cooling towers or decorative fountains. They cause primarily respiratory diseases, responsible for the largest number of deaths attributed to waterborne transmission in the U.S., and 72% ($2.4 billion) of the direct healthcare costs estimated by the study.

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