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A review of outbreaks of waterborne disease associated with ships: evidence for risk management.
Public Health Rep. 2004 Jul-Aug; 119(4):435-42.PH

Abstract

OBJECTIVE

The organization of water supply to and on ships differs considerably from that of water supply on land. Risks of contamination can arise from source water at the port or during loading, storage, or distribution on the ship. The purpose of this article is to review documented outbreaks of waterborne diseases associated with passenger, cargo, fishing, and naval ships to identify contributing factors so that similar outbreaks can be prevented in the future.

METHODS

The authors reviewed 21 reported outbreaks of waterborne diseases associated with ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and remedial action are presented.

RESULTS

The findings of this review show that the majority of reported outbreaks were associated with passenger ships and that more than 6,400 people were affected. Waterborne outbreaks due to Enterotoxigenic Escherichia coli, noroviruses, Salmonella spp, Shigella sp, Cryptosporidium sp, and Giardia lamblia occurred on ships. Enterotoxigenic E. coli was the pathogen most frequently associated with outbreaks. One outbreak of chemical water poisoning also occurred on a ship. Risk factors included contaminated port water, inadequate treatment, improper loading techniques, poor design and maintenance of storage tanks, ingress of contamination during repair and maintenance, cross-connections, back siphonage, and insufficient residual disinfectant.

CONCLUSIONS

Waterborne disease outbreaks on ships can be prevented. The factors contributing to outbreaks emphasize the need for hygienic handling of water along the supply chain from source to consumption. A comprehensive approach to water safety on ships is essential. This may be achieved by the adoption of Water Safety Plans that cover design, construction, operation, and routine inspection and maintenance.

Authors+Show Affiliations

Water, Sanitation and Health Programme, Department of Protection of the Human Environment, World Health Organization, Geneva, Switzerland. rooneyr@who.intNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15219801

Citation

Rooney, Roisin M., et al. "A Review of Outbreaks of Waterborne Disease Associated With Ships: Evidence for Risk Management." Public Health Reports (Washington, D.C. : 1974), vol. 119, no. 4, 2004, pp. 435-42.
Rooney RM, Bartram JK, Cramer EH, et al. A review of outbreaks of waterborne disease associated with ships: evidence for risk management. Public Health Rep. 2004;119(4):435-42.
Rooney, R. M., Bartram, J. K., Cramer, E. H., Mantha, S., Nichols, G., Suraj, R., & Todd, E. C. (2004). A review of outbreaks of waterborne disease associated with ships: evidence for risk management. Public Health Reports (Washington, D.C. : 1974), 119(4), 435-42.
Rooney RM, et al. A Review of Outbreaks of Waterborne Disease Associated With Ships: Evidence for Risk Management. Public Health Rep. 2004 Jul-Aug;119(4):435-42. PubMed PMID: 15219801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A review of outbreaks of waterborne disease associated with ships: evidence for risk management. AU - Rooney,Roisin M, AU - Bartram,Jamie K, AU - Cramer,Elaine H, AU - Mantha,Stacey, AU - Nichols,Gordon, AU - Suraj,Rohini, AU - Todd,Ewen C D, PY - 2004/6/29/pubmed PY - 2004/7/31/medline PY - 2004/6/29/entrez SP - 435 EP - 42 JF - Public health reports (Washington, D.C. : 1974) JO - Public Health Rep VL - 119 IS - 4 N2 - OBJECTIVE: The organization of water supply to and on ships differs considerably from that of water supply on land. Risks of contamination can arise from source water at the port or during loading, storage, or distribution on the ship. The purpose of this article is to review documented outbreaks of waterborne diseases associated with passenger, cargo, fishing, and naval ships to identify contributing factors so that similar outbreaks can be prevented in the future. METHODS: The authors reviewed 21 reported outbreaks of waterborne diseases associated with ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and remedial action are presented. RESULTS: The findings of this review show that the majority of reported outbreaks were associated with passenger ships and that more than 6,400 people were affected. Waterborne outbreaks due to Enterotoxigenic Escherichia coli, noroviruses, Salmonella spp, Shigella sp, Cryptosporidium sp, and Giardia lamblia occurred on ships. Enterotoxigenic E. coli was the pathogen most frequently associated with outbreaks. One outbreak of chemical water poisoning also occurred on a ship. Risk factors included contaminated port water, inadequate treatment, improper loading techniques, poor design and maintenance of storage tanks, ingress of contamination during repair and maintenance, cross-connections, back siphonage, and insufficient residual disinfectant. CONCLUSIONS: Waterborne disease outbreaks on ships can be prevented. The factors contributing to outbreaks emphasize the need for hygienic handling of water along the supply chain from source to consumption. A comprehensive approach to water safety on ships is essential. This may be achieved by the adoption of Water Safety Plans that cover design, construction, operation, and routine inspection and maintenance. SN - 0033-3549 UR - https://www.unboundmedicine.com/medline/citation/15219801/A_review_of_outbreaks_of_waterborne_disease_associated_with_ships:_evidence_for_risk_management_ L2 - https://journals.sagepub.com/doi/10.1016/j.phr.2004.05.008?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -