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What treatment measures are effective for travelers' diarrhea? |
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Can I find out if tap water is safe to drink by tasting or smelling it? |
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How can I know what is risky to do, if tap water is not safe? |
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What is a water-borne disease? |
Is a disease which arises from the contamination of water by human or animal faeces or urine infected by pathogenic viruses or bacteria, and which is directly transmitted when the water is drunk or swallowed or used in the preparation of food. On average, a person needs about 20 liters of safe water each day to meet his or her metabolic, hygienic, and domestic needs
Safe water means water that will not harm you if you come in contact with it. The most common use of this term applies to drinking water, but it could also apply to water for swimming or other uses. Safe water includes treated surface water, as well as untreated but uncontaminated water from sources such as natural springs and sanitary wells.
To be safe, the water must have sufficiently low concentrations of harmful contaminants to avoid sickening people who use it. The list of harmful contaminants includes disease-causing microbes such as bacteria, viruses, and protozoans; cancer-causing chemicals such as many pesticides, organic solvents, petroleum products, and some metals and metalloids; nitrates and nutrients, endocrine-disrupting compounds, strong acids, strong bases, radionuclides, and any other acutely toxic substance. Defining safe water becomes a matter of risk assessment.
Without safe water, people cannot lead healthy, productive lives.
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How safe is water worldwide? |
While the occurrence of waterborne diseases in developed countries is generally low due to a generally good system of water treatment, distribution and monitoring, waterborne diseases are among the leading causes of morbidity and mortality in in low- and middle-income countries, frequently called developing
countries. For example, an estimated 900 million people
suffer (and approximately 2 million die) from water-related
diarrhoeal illnesses each
year. At least 10 percent of the total burden of human diseases in many developing countries can be attributed to
diarrhea and infestations by intestinal worms.
Under no circumstances is it advisable to drink unsafe water, use it for oral hygiene or use ice made from unsafe water in drinks. However, you should not become hysterical about avoiding all water whilst
traveling abroad. Is not the same Santiago (Chile), where water is as safe as the water of a developed country's city, than Freetown (Sierra Leone), where could be very dangerous to drink tap water, if you can get it. Just get the best information you can about water
safety.
In the section" Can I drink water in[
Choose a country}?", SWIT
provides the best public available information of water quality regarding health, from sources like World Health
Organization (WHO) and the UNICEF, for every
country around the world.
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What does it mean access to safe water and sanitation? |
As a country’s economy becomes stronger (as its GNP per capita or PPP
rise) a larger percentage of its people tend to have access to safe water and sanitation.
Access to safe water is measured by the number of people who have a reasonable means of getting an adequate amount of water that is safe for drinking, washing, and essential household activities, expressed as a percentage of the total population.
It reflects the health of a country’s people and the country’s capacity to collect, clean, and distribute water to consumers.
According to the World Health Organization (WHO) more than one billion people in low and middle-income countries lack access to safe water for drinking, personal hygiene and domestic use. These numbers represent more than 20 percent of the world’s people. In addition, close to 2 billion people did not have access to adequate sanitation facilities.
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What is travelers' diarrhea? |
Travelers' diarrhea (TD) is the most common illness affecting travelers. Traveler's diarrhea is defined as three or more unformed stools in 24 hours, commonly accompanied by abdominal cramps, nausea, and bloating.
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Who gets travelers' diarrhea? |
Each year approximately one third (20 to 50 percent) of international travelers from an industrialized nation traveling in a less developed country (an estimated 10 million persons) develop diarrhea from ingestion of fecally contaminated water or food. The most important determinant of risk is the traveler's destination. High-risk destinations are the developing countries of Latin America, Africa, the Middle East, and Asia.
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What causes travelers' diarrhea? |
There are many causes of diarrhea and it is important to recognize which ones are serious and which are not. Infectious agents are the primary cause of TD. Bacterial enteropathogens cause approximately 80% of Traveler's Diarrhea cases.
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What treatment measures are effective for travelers' diarrhea? |
TD usually is a self-limited disorder and often resolves without specific treatment; however, oral rehydration is often beneficial to replace lost fluids and electrolytes. Clear liquids are routinely recommended for
adults. Water that is purified is best, along with oral rehydration salts to replenish lost electrolytes. Sodas which have been left out so that the carbonation fizz is gone are useful in a pinch.
Travelers who develop three or more loose stools in an 24-hour
period (especially if associated with nausea, vomiting, abdominal cramps, fever, or blood in
stools) should be treated by a doctor.
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Can I find out if tap water is safe to drink by tasting or smelling it? |
You cannot see, smell or taste the germs and other contaminants. Because of water’s different sources and the different ways in which water is treated, the taste and quality of drinking water varies from place to place. Even in areas where the tap water is safe to drink the level of chemical treatment may be sufficient to render it unpalatable to travelers from developed countries. Common complaints about water aesthetics include temporary cloudiness (typically caused by air bubbles) or chlorine taste.
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How does a traveler know if tap water is safe to drink? |
In the section" How Safe is water in?", SWIT brings public available information of water quality regarding
health, from sources like World Health Organization (WHO) and the U.S.Center for Diseases
Control (CDC), but that information only gives an orientation about how safe is tap water in an area.
The hotel or resort owner, or operator, must notify you if tap water meets internationally
accepted drinking water standards (such WHO or EPA standards) or if there is a waterborne disease
emergency. If there is no specific notice of your hotel owner or operator, or you don't trust
it, better safe than sorry.
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What is a drinking water standard? |
All water from natural sources contains dissolved substances. These substances are often called contaminants, especially when the amounts present are at possibly harmful or problematic levels. The substances present in water can result from either natural processes or human activities. At low concentrations, many do not cause known harmful effects and may, in fact, be beneficial. Research has shown some substances may be harmful only when present at high enough concentrations. Drinking water, including bottled water, may reasonably be expected to contain at least small amounts of some contaminants. A drinking water standard is a limit, that establish a maximum contaminant level. As long as water meets these standards, doesn’t pose a significant threat to health to general population, and is safe to drink. People with severely compromised immune systems and children may have special needs.
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Are all the contaminants equally harmful for travelers? |
Infectious diseases caused by pathogenic bacteria, viruses, and protozoa or by parasites are the most common and widespread health risk associated with drinking-water, specially in many developing
countries. Infectious diseases are transmitted primarily through human and animal excreta, particularly faeces. If there are active cases or carriers in the community, then faecal contamination of water sources will result in the causative organisms being present in the
water. If treatment and disinfection are not appropriate, the use of such water for drinking or for preparing food, contact during washing or bathing, and even inhalation of water
vapor or aerosols may then result in infection.
Chemicals might have a detrimental effect to your health over a long term. Usually travelers don't stay enough time at a
location, to suffer consequences from tap water not meeting chemical standards.
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Who sets international drinking water standards? |
There are no international mandatory drinking water
standards.The World Health Organization (WHO) publishes Guidelines for Drinking-water Quality which many countries use as the basis to establish their own national standards. The Guidelines represent a scientific assessment of the risks to health from biological and chemical constituents of drinking-water and of the effectiveness of associated control measures. As the WHO Guidelines for Drinking-water Quality are meant to be the scientific point of departure for standards development, including bottled water, actual national standards will sometimes vary from the Guidelines.
In the U.S. the Environmental Protection Agency (EPA) sets Maximum Contaminant Levels (MCLs) for many harmful contaminants, based on health-effects research, contaminant occurrence data, economic analysis, and risk analysis. The MCLs for currently regulated drinking-water contaminants are listed on EPA's Office of Ground Water and Drinking Water Web page under "Drinking water standards program."
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What about edible ice cubes? |
Ice cubes can cause infection. Don't use ice cubes prepared with unsafe water: freezing doesn't kill offending microbes. Don't drink any drinks with ice cubes if you are not sure that they are made with safe water. Water used for making edible ice should be subject to the same drinking-water standard and include specific sanitary requirements for equipment for making and storing ice.
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Can I disinfect ice cubes? |
No, if they content microorganisms inside, they are not destroyed by disinfectants as chlorine. Also remember that: alcoholic beverages do not purify ice!
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What is bottled water? |
Bottled water is water that is sold for human consumption in sanitary containers and contains no added sweeteners or chemical additives . It must be calorie-free and sugar-free. Flavors, extracts or essences may be added to drinking water, but they must comprise less than one-percent-by-weight of the final product. Some bottled waters contain natural or added carbonation.
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How I know if that bottled water is safe? |
International bottler members of IBWA that sell products with "IBWA label" must submit a certificate of inspection to
IBWA . As a condition of membership, bottlers must submit to an annual, unannounced plant inspection administered by an independent, internationally recognized third-party inspection organization.
Another well know and trustful certifier of bottled water is the National Sanitation
Foundation (NSF). NSF Certification means that a credible, objective, independent third-party, widely recognized by public health officials, has actually tested and verified that bottled water complies with specific standards.
You can trust that a bottled water with the IBWA or NSF label or a well known European brand is safe for drinking.
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Where can I found the listing of certified bottled water? |
You can search at:
NSF site: www.nsf.org/Certified/BWPI
or
IBWA site: www.bottledwater.org/public/WhatIsBrandList.htm
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What can I do if I need to use unsafe tap water? |
Boiling is the most reliable method to make water safe to drink. Bring water to a vigorous boil, and then allow it to cool; do not add ice. At high altitudes, allow water to boil vigorously for a few
minutes. Portable boiling coils are very useful for boiling water in hotel rooms.
Chemical disinfection can be achieved with either iodine or
chlorine, in spite that are often ineffective if the water is visibly
cloudy. See more details in "Tap Water"
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How can I know what is risky to do, if tap water is not safe? |
Use only safe water (safe bottled water or disinfected
water) for toothbrushing. Have always disinfected water for washing your hands and face.
If you are not sure that water is safe, you can take a quick
shower, but avoid swallowing it or contact with eyes. If
you need to take a bath in the tub, disinfect the water with iodine.
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How can I prevent to get diseases in swimming pools and spas? |
Disease prevention should be a part of every water quality management program for pool operators, just like the prevention of drowning, injuries, and
sunburn. Only pools and spas that contain filtrated and
disinfectant water can be considered safe places to swim. Poor maintenance of the pool may lead to low chlorine or bromine levels and clogged filters that may place swimmers at risk for diseases and
infections. Don't swim in locations where the pool water is not continuously disinfected, or do not use or have a defective filtration system.
You are less likely to be exposed to polluted water at swimming pools and spas that are monitored regularly and audited for health hazards. The pool water has to be continuously disinfected by chlorine or bromine so that the concentrations set by standards are maintained throughout the pool water, and also the pH, the clarity and the total alkalinity of the water has to be maintained in accordance with the requirements set by standards.
A rule of thumb is that the water shall be sufficiently clear to permit the main drain to be clearly visible from the pool deck at all distances up to ten meters (eleven yards) in a horizontal direction from the projection of the drain on the pool surface.
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What about people with severely compromised immune system? |
Some people may be more vulnerable to contaminants in drinking water than the general population. People with severely compromised immune systems, such as people with cancer undergoing chemotherapy, people who have undergone organ transplants, people with HIV/AIDS or other immune system disorders, some elderly, and infants can be particularly at risk from infections. These people should seek advice about drinking water from their health care providers
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Are Waterborne Diseases the same in people with HIV/AIDS as in other people? |
No. The diarrhea and nausea are often much worse and more difficult to treat in people with HIV. These illnesses are also more likely to cause serious problems in people with HIV, such as bloodstream infections and meningitis. People with HIV also have a harder time recovering fully from these illnesses.
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Which substances have to be identified in testing drinking water? |
There is no single test to determine the safety of drinking water. Many contaminants can present a health risk if present in sufficient concentrations. These include biological contaminants such as bacteria or viruses; inorganic chemicals such as lead, nitrate or sulfate; and organic chemicals such as insecticides, herbicides, fuel and solvents. Other contaminants, while not a health risk, can make water less desirable for domestic use. These are referred to as nuisance contaminants and include calcium, magnesium, iron, manganese and hydrogen sulfide.