The Sewage System and Disease




During the 1800's, the inefficient sewage system led to the outspread of infectious diseases such as
cholera, typhoid, yellow fever, malaria and various other mosquito diseases. 


Cholera

                       

Cholera is a bacterial infection that spreads primarily through water contaminated by human feces.  Symptoms include high fever and a rice-like diarrhea in which the "rice" is actually pieces of the victim's colon flaking away.  It has a short incubation period, from less than one day to five days, and can quickly lead to severe dehydration and death if treatment is not promptly given.  During an epidemic, 80-90% of diarrhoea patients can be treated by oral rehydration alone, but patients who become severely dehydrated must be given intravenous fluids.  Cholera is often found in the aquatic environment and is often associated with algal blooms (plankton), which are influenced by the temperature of the water.

In 1832, 1.75% of the New York population was killed as a result of the cholera epidemic in a period of six weeks. This is the equivalent of 140,000 New Yorkers today.  The World Health Organization (WHO) estimates that more than 25,000 people throughout the world die every day from waterborne diseases. Every year, nearly 1.5 billion people (mostly children under five) suffer from preventable waterborne diseases such as cholera.


   
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Typhoid Fever


Typhoid fever is transmitted by food and water contaminated by the feces and urine of patients and carriers. Polluted water is the most common source of typhoid At present, there are 107 different strains of the bacteria. Typhoid fever is characterized by the sudden onset of sustained fever, severe headache, nausea, severe loss of appetite, constipation or sometimes diarrhea. Severe forms have been described with mental dullness and meningitis.
Typhoid fever affects 17 million people worldwide every year, with approximately 600,000 deaths. With the advent of proper sanitary facilities, it has been virtually eliminated in many areas. Most cases in developed countries are imported from endemic countries.


Yellow Fever

Yellow fever is a viral disease that has caused large epidemics in Africa and the Americas. The infection causes a wide spectrum of disease, from mild symptoms to severe illness and death. The "yellow" in the name is explained by the jaundice that affects some patients. The number of people infected over the last two decades has increased and yellow fever is now a serious public health issue.
There are 200,000 estimated cases of yellow fever and 30,000 deaths per year. However, due to underreporting, only a small percentage of these cases are identified. Small numbers of imported cases also occur in countries free of yellow fever. Although yellow fever has never been reported from Asia, this region is at risk because the appropriate primates and mosquitoes are present.


Malaria

Approximately 300 million people worldwide are affected by malaria and between 1 and 1.5 million people die from it every year. Previously extremely widespread, the malaria is now mainly confined to Africa, Asia and Latin America. The problems of controlling malaria in these countries are aggravated by inadequate health structures and poor socioeconomic conditions. The situation has become even more complex over the last few years with the increase in resistance to the drugs normally used to combat the parasite that causes the disease.
People have been using protective measures against the mosquito as early as 450 B.C.
More than 120 million clinical cases and over 1 million deaths occur in the world each year.
Eighty per cent of the cases occur in tropical Africa, where malaria accounts for 10% to 30% of all hospital admissions and is responsible for 15% to 25% of all deaths of children under the age of five. Around 800,000 children under the age of five die from malaria every year, making this disease one of the major causes of infant and juvenile mortality. Pregnant women are also at risk since the disease is responsible for a substantial number of miscarriages and low birth weight babies.


Our Current Sewage Disposal System

Our sewage system has made a great deal of progress through the years.  While a vast majority of households lacked the luxury of complete plumbing during the 1800's and early 1900's, this resource became much more available to residents during the late 20th Century.  The greatest decrease in the percentage of households lacking complete plumbing was seen between the years of 1940 and 2000.  This great advancement for New York City residents can be seen in the chart below.



The success of plumbing availability may lead some people to ask the question, "Where  does my wastewater go?"  What happens to your toilet water and waste products after you flush the toilet?  Some people will say that it is dumped from their toilet straight into the environment.  The process is actually more complicated that it may seem.

Wastewater passes through bar screens to remove large pieces of garbage, like rags and sticks.  It is then pumped to settling tanks where solids sink to the bottom and are removed.  The rest of the water goes to aeration tanks, where microorganisms eat the products we call waste, and is then pumped to secondary settling tanks where the water is allowed to sit and final bits of solid sink to the bottom of the tanks and are removed.  Finally, chlorine is added to kill remaining harmful bacteria to finally be emptied into the river.

Chlorine

Since it was first used on a large scale to disinfect water in America in 1908, chlorine has helped defeat some of the deadliest diseases of the past 100 years.  Cholera, typhoid fever, dysentery and other waterborne diseases were serious health issues at the start of the 20th century, but the chlorination of water has virtually eliminated these threats and helped increase life expectancy in America by more than 50 percent.  Right now, chlorine is helping to control new outbreaks of cholera and Legionnaire’s Disease.  Chlorinated water from tankers is being provided to stem a cholera epidemic that has infected more than 12,000 people and killed 52 in South Africa since mid-August.

Deadly illnesses, such as malaria, have also been all but eradicated in many areas, thanks in part to the use of chlorine-based pesticides, one of the most effective and inexpensive ways to deal with mosquitoes and other insects that spread disease.  A recent example of the continuing public health threat from waterborne disease outbreaks occurred in Peru in 1991, where a major causative factor was the absence of disinfecting water with chlorine.  This resulted in a five-year epidemic of cholera.  The epidemic spread to 19 Latin American countries and has been only partially abated through public health interventions and technical assistance. More than a million cases and 12,000 deaths have been reported.




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