Table 1.
Pathogens in drinking water systems and their related diseases a.
| Pathogen | Associated disease b | Health significance c | Persistence in drinking water supplies d |
|---|---|---|---|
| Bacteria | |||
| Campylobacter spp., C. jejuni | Diarrhea, gastroenteritis | High | Moderate |
| Yersinia enterocolitica | Diarrhea, reactive arthritis | High | Long |
| Escherichia coli, particularly enterohemorragic E. coli (EHEC), and other such as enteropathogenic (EPEC), enterotoxigenic (ETEC), and enteroinvasive (EIEC) | Acute diarrhea, bloody diarrhea and gastroenteritis | High | Moderate |
| Burkholderia pseudomallei | Meliodosis | High | May multiply |
| Legionella pneumophila and related bacteria | Acute respiratory illness, pneumonia (legionellosis) | High | May multiply |
| Non-tuberculous mycobacteria | Pulmonary disease, skin infection | Low | May multiply |
| Pseudomonas aeruginosa | Infections on lungs, urinary tract, and kidney Can cause inflammation and sepsis | Moderate | May multiply |
| Salmonella enterica serotype Typhi | Typhoid fever, paratyphoid fever and other serious salmonellosis | High | Moderate |
| Other salmonellae | Gastroenteritis, reactive arthritis | High | May multiply |
| Shigella spp. | Bacillary dysentery or shigellosis | High | Short |
| Vibrio cholerae | Gastroenteritis, cholera | High | Short to long |
| Helicobacter pylori | Chronic gastritis, ulcer disease and gastric cancer | Low | Moderate |
| Virus | |||
| Adenovirus | Gastroenteritis | High | Long |
| Enteroviruses | Gastroenteritis | High | Long |
| Hepatitis A virus | Hepatitis | High | Long |
| Hepatitis E virus | Infectious hepatitis; miscarriage and death | High | Long |
| Rotavirus | Gastroenteritis | High | Long |
| Sapoviruses | Acute viral gastroenteritis | High | Long |
| Astroviruses | Diarrhea | High | Long |
| Norovirus | Gastroenteritis | High | Long |
| Protozoa | |||
| Acanthamoeba spp. | Amoebic meningoencephalitis, keratitis, encephalitis | High | May multiply |
| Cryptosporidium parvum | Cryptosporidiosis, diarrhea | High | Long |
| Cryptosporidium cayetanensis | Diarrhea | High | Long |
| Entamoeba histolytica | Amoeba dysentery | High | Moderate |
| Giardia intestinalis | Diarrhea | High | Moderate |
| Naegleria fowleri | Infection of the brain called primary amebic meningoencephalitis (PAM) | High | May multiply in warm water |
| Toxoplasma gondii | Toxoplasmosis, miscarriage, birth defects | High | Long |
| Helminths | |||
| Dracunculus medinensis | Dracunculiasis (Guinea worm disease, ulcerating skin infection). | High | Moderate |
| Schistosoma spp. | Schistosomiasis, , liver and kidney damage, itchy skin, fever, chills, cough and muscle aches. | High | Short |
a Adapted from Table 7.1 in WHO Guidelines for drinking water quality [24]; b Data obtained from WHO [24], Cabral et al. [29], Straub and Chandler [25], and Nygård [30]; c Health significance relates to the severity of impact, including association with outbreaks; d Detection period for infective stage in water at 20 °C: short, up to 1 week; moderate, 1 week to 1 month; long, over 1 month.