America’s new water safety challenge is biofilm, CDC study says

Robust bioflims can provide a safe haven for microbes and protect them from disinfectants in the water, Hill said. That’s how potentially deadly waterborne pathogens such as Legionella bacteria (which cause Legionnaires’ disease) grow and escape into the air, sickening and killing thousands every year.

In fact, the report found that more than 90% of all deaths and most hospitalizations from waterborne illness are caused by just three airborne pathogens that thrive in biofilms.

“It’s kind of a paradigm shift for us: ‘Oh my god, things are growing in these pipes,’ whether in the water supply system or in your house,” Hill said.

“So that’s kind of a new frontier that we recognize,” Collier added. “And we think this is an area where we can help prevent disease.”

More than 3 billion in healthcare costs

The CDC team estimated the total number of illnesses, emergency room visits, hospital admissions, deaths, and direct health care costs for 17 water-borne infectious diseases found in sanitary and industrial pipes, hot tubs, recreational pools, and water parks.

It was the first report to examine disease from all water sources (drinking, recreational and environmental) and all exposure routes (ingestion, contact and inhalation), Hill said.

The analysis found that more than 7 million water-borne illnesses occur each year, resulting in more than 600,000 annual emergency room visits, 118,000 hospitalizations, and 6,630 deaths – a total of $ 3.33 billion in direct health care costs.

Otitis externa, more commonly known as swimmer’s ear, was the most common condition, accounting for 4.7 million or 65% of annual water-borne illnesses and 20% of hospital admissions. Norovirus infections, which cause vomiting and diarrhea, were the second most common, with 1.3 million cases, followed by the diarrheal disease Giardiasis with just over 400,000 annual cases.

Although much less frequent, biofilm-associated pathogens were responsible for the highest number of hospitalizations and deaths, costing the U.S. healthcare system $ 2.39 billion annually.

Legionella bacteria, responsible for outbreaks of the pneumonia-like illness called Legionnaires’ disease and a mild flu-like illness called Pontiac fever, cause 995 deaths (15%) each year, the report said.

Pseudomonas pneumonia was responsible for 15,500 hospitalizations and 730 deaths per year, costing US $ 453 million per year.

People would come into contact with these airborne illnesses through showerheads, building cooling towers, and decorative outdoor fountains, among other things, the report said.

Because cryptosporidium is “extremely chlorine resistant” and highly contagious at low doses, it has emerged as the leading cause of outbreaks related to treated water sites, the report said.

An infrastructure challenge

Efforts in the United States To improve water safety are “recognized as some of the greatest public health achievements of the 20th century,” the report said. Outbreaks of disease caused by faecal-contaminated drinking water, including cholera and typhus, were common in the 19th and early 20th centuries, but have long since disappeared.

“Over the past 40 years, we have seen a significant decrease in waterborne illness, but complexity has increased with more problems with building plumbing and more problems with recreational water,” said J. Alan Roberson, Executive Director of the Association of State Drinking Water Administrators, who was not involved in the investigation.

At the same time, funding has been flat or dwindling for research, infrastructure, regulation and the ability to improve compliance with existing regulations, both at the federal and state levels, Roberson said.

Then there is the issue of outdated plumbing and the challenges of private wells or unregulated water systems serving an estimated 43 million people.

“Drinking water from the treatment plant to your water meter is very tightly regulated and a lot of work is done to make sure it is safe,” said Collier. “Once it’s in your home or building, it’s up to the individual homeowner or building owner to make sure it’s safe.”

Consumers can do their part, Roberson said, by understanding their home’s plumbing system, starting with where the water enters their home, the materials that make up the plumbing, and how the water is distributed throughout the home.

“Although not part of this report, the land has approximately 6 million lead service lines and ownership of those service lines is typically split between the water system and the property owner,” said Roberson. “So getting rid of all those lines is another public health initiative that requires a concerted effort from a large number of communities.”

Steps to take

If you set your water heater to a higher temperature of 130 to 140 degrees Fahrenheit, you can kill a lot of harmful germs, the CDC says, “ but it also increases the risk of burning. If you set the water heater above 120 ° F, make sure to take extra precautions to mix cold and hot water (using thermostatic taps) at the faucet or shower to avoid scalding. “

Flushing your water heater regularly can also extend its life, the CDC says.

Even heavily treated tap water is “not sterile or completely devoid of microbes,” Hill said. “So if you are using it for medicinal purposes or for your personal care, such as C-paps or humidifiers or nasal rinse, then you should either disinfect the water or use distilled water.”

Humidifiers should be drained of all water every day and properly cleaned regularly. “Consider using distilled or previously boiled (and chilled) water or water disinfected with chlorine bleach in portable humidifiers,” suggests the CDC.

Use only distilled, previously boiled, or filtered water to rinse sinuses with neti pots, the CDC says, but be careful to choose a filter that can trap tiny microorganisms.