Epidemiological Trends of Waterborne Infectious Diseases and the Role of Community Health Nurses, Health Inspectors, and Epidemiology Workers in Prevention

Waterborne infectious diseases (WBD), contracted via contamination in water supplies, are one of the most significant healthcare problems worldwide. More than 7 million people become ill each year in the United States from WBD, and WBD contributes to 1.5 million deaths per year around the world, which is primarily in low- and middle-income countries. This study explores the changing epidemiology of WBD with consideration of the decline in enteric pathogenic WBD (i.e., Cryptosporidium, Giardia, and Norovirus, etc.) compared to the increase in biofilm WBD, such as Legionella pneumophila and Nontuberculous Mycobacteria (NTM) in developed countries. Furthermore, in low-resource areas, a lack of water, sanitation, and hygiene (WASH) contributes to continuing WBD, such as cholera and typhoid, in the communities utilizing these resources. Data is obtained from the World Health Organization, Centers for Disease Control and Prevention, and the wastewater-based epidemiology (WBE) programs initiated in Vancouver (Canada). The study identified the variation in pathogens, outbreak trends, and risk factors (e.g., climate change, aging infrastructure, etc). Finally, the roles of community health nurses, health inspectors, and epidemiology workers for surveillance, education, and enforcement or regulations, and reporting were examined as major elements of WBD prevention. Evidence-based strategies for prevention of WBD based on the overall enhancement of communities, for example, the improvement of the water, sanitation, and hygiene infrastructure, and community engagement and participation, were considered. The outcome of this study may serve as a guide to inform strategies for public health to lessen the burden caused by WBD illnesses throughout the world.