Yellow Track (C-33): Infectious Disease and Water Quality

- Session Description (click to collapse)

This session will focus on the effects of enhanced climate change on water supplies.  Throughout the world increased climatic variability has exacerbated floods and droughts.

All regions of the world show an overall net negative impact of climate change on water resources and freshwater ecosystems. Areas in which runoff is projected to decline are likely to face a reduction in the value of the services provided by water resources. The beneficial impacts of increased annual runoff in other areas are likely to be tempered in some areas by negative effects of increased precipitation variability and seasonal runoff shifts on water supply, water quality and flood risks (IPCC, 2007).

The years 2004 and 2007 marked two of the earliest spring melts on record in the western US, and 2007 was one of the driest years on record in California. Glaciers are disappearing across the West, and Glacier National Park in Montana may have no glaciers by 2030. Warming temperatures and corresponding shifts from solid to liquid precipitation have profound implications for water supplies and management.

Recommended Resources

- Moderator (click to collapse)

Kellogg Schwab

Kellogg Schwab is a Professor in the Bloomberg School of Public Health’s Department of Environmental Health Sciences as well as Director of both The Johns Hopkins University (JHU) Global Water Program (GWP) and the JHU Center for Water and Health. The GWP integrates Hopkins researchers from public health, engineering, behavior, policy, and economic disciplines to address the critical triangle of water, food, and energy with the goal of achieving sustainable, scalable solutions for disparate water needs both internationally and domestically.

Dr. Schwab’s research focuses on environmental microbiology and engineering with an emphasis on the fate and transport of pathogenic microorganisms in water, food, and the environment. His current research projects involve improving environmental detection methods for noroviruses. He is also investigating how important human pathogens are transported through environmental media (water, air, and food).


Dr. Schwab has developed and participated in multiple research projects designed to evaluate the public health impacts of improving water access and potable water quality and the effectiveness of point-of-use water treatment. Recent international work has focused on developing field-portable microbial and chemical laboratories that facilitate evidence-based assessments of the point-of-use and community-level water treatment systems providing potable water to individuals in low-income countries.


Ph.D., Public Health, University of North Carolina, 1995
M.S., Public Health, University of North Carolina, 1991
B.S., Biology, University of North Carolina, 1987

- Notes (click to collapse)

Infectious Disease and Water Quality (Kellogg Schwab, JHSPH)

*Refer to Power Point Slides for more information


---Kellogg Schwab lecture accompanied by Power Point---

Question of Morbidity and Mortality of Common Infections*

-Respiratory infections have a higher occurrence than diarrhea

-Other types of high morbidty and high mortality: Malaria

4 main types of transmission cycle for infectious disease: Direct vs. Indirect Transmission (Human to Human, Animal to Animal)

Classic example: In the1960s and 1970s millions of people dying from Cholera in Bangladesh

-Dug wells instead for groundwater

-Problem of Arsenic levels in groundwater affecting the public health of Bangladesh

-Now taking wells off-line, wells that are contaminated by Arsenic


    -Strains of Bacteria in particular: Animals to Animals - West NIle Virus

    -Refer to power point for "Criteria for Zoonotic Water-related Disease"

Drivers of emergence and re-emergence of pathogens in water (Connection to Climate Change)*

    -Improved water does not indicate potable water

    -Human behavior and technology: UN example

    -Microorganisms such as Legionella emerging

Examples of how environmental changes affect the occurrence of various infectious diseases in humans (refer to power point)*

---Interactive Survey---



Question: How should we bring people up to speed? Where do we gain information from?

Question: Domestic or International drivers? Drivers for infectious disease is worldwide where people are suffering from infectious disease.

Question: How will we pull all of this together? [Challenge we face]

Question: How do we validate the information/data?

Comment 1 - Google answers, check authors and locations (majority of discussion group agreed)

Comment 2 - Pubmed - significant number of published journals (half journals do not show up as Engineer)

                 - Missing information from Google

Comment 3 - Wikipedia as a source

                 - Dangerous source of information, not always correct as various individuals can post information


-Do not have the technology to only put the valid information forward

-Example: Water for People (organization), received a grant for 5 million dollars to address the following question

Question: How do they acquire information for their systems?

- Individual for self-reporting, generates too much information, but technology can help pull it together, sort out information


Question: Where do you think the data gaps are? *See group comment

- We assume we know the issue



[On Water Quality]

Comment: Of the cells that we have, we are about 100 million cells as humans, there are ten times the number of bacteria surrounding each individual

Maybe there are some bacteria are keeping us healthy. Furthermore, what is "High Quality Water" technically?

(Kellogg - Would not think about what is happening chronically, now bringing in issues of diabetes; might reduce burden of acute and chronic illness)

Comment: Eradication of certain pathogens/bacteria (since we are trying to eradicate all of them) are leading to more illness; Our culture of extreme hygeneity may not be beneficial to all communities

Comment: Is the premise correct? Every where else in the world, we are co-habitating with bugs and insects. Only in the U.S., everyone is worried about insects in houses or even in food.

(Kellogg - [On Water Quality] Would behoove us to make smart choices on the water quality we want)


[On Marketing, Economics, Climate Change, and Pathogenic/Non Pathogenic Interrelationships]

Comment: American marketing affecting public health (promoting numerous disinfecting ideologies)

Comment: We live in an environment where a product has to be sold; Maybe we should try and eliminate every type of germ there possibly is, but may not be the right thing to do

(Kellogg - Market demand, doing this for the good of humanity? Integrate this into climate change, is there a market for changes in climates that will allow public health to move forward?)

Comment: We don't consider the interrelationship between pathogenic and non-pathogenic bacteria. We are changing the environmental cycles so we are seeing more malaria in areas, not controlling them.

(Kellogg - Key points; grossly apply DDT you get resistance; putting in bed nets AND apply DDT; Chemical approach is a challenge; integrate it in we can start moving in different ways; Problem is money)

Comment: Natural habitats for fauna and flora with landscapes (Europe) Vs. applying DDT in Africa, causing death of mosquitoes and diminishing/altering the landscape, thus changing the ecosystem for all animals and insects, not just malara carrying mosquitoes

Comment: We lack a framework to ask questions that are not rooted in specific interest of a research (with data gaps).

(Kellogg - Data gap brings different disciplines together)

Comment: Scale is a problem; not explicitely addressed. We are all thinking on a different scale. Climate change forces you to integrate scales, looking at it explicitely.

Comment: Climate change is the first example of global scale of problems. The scale challenge is that we are so far that we have an enormous task ahead of us. What are possible sustainable systems and actions?

(Kellogg - The idea of "baby steps")

Comment: Also the "Wedge Concept" - try to break it up; get small reductions, but economical world is completely misunderstanding what is at stake here.

(Kellogg - What is the "Wedge" here? What is the first step in a driver for success and change? Personally one wedge is an individual step (drinking tap water vs. bottled water)

Comment: We are going to burn every drop of petroleum until we can - CRISIS, we are only fueling the crisis.

(Kellogg - Water reuse. Example: Golfers want their children's children to play golf. They want to be proactive in using proactive mechanisms to be able to have their kids play later therefore looking into Water Reuse as a strategy.)

Comment: Value issues. People want their children to play golf (their values).

Comment: Broad climate change lingo - "Adaptation and mitigation" Mitigation not of the health issue, but of the CLIMATE. Thinking of health and climate change, immediately think of adaptation.

Question: When we look as the world as whole, is there more information/data on infectious data in developing countries? Is there any concern in the US?

Comment: Obama signed on an Antibiotic Task Force. Only now beginning to see the causes emerging bacteria in the US.

(Kellogg -  Can we reconnect as a society back to the core principles or values? Values have skewed as a whole society.)

Comment - Disconnect. Scale, viewing the baby as the individual scale. Parents in their twenties are turning down vaccinations where they do not understand a cause or symptom of the diease (example of Polio)-- information gaps.


End Comments on: Risk perception and risk assessment - everything goes back to risk. Am I going to accept this risk? Orders of magnitude of difference between risks such as dying on the road versus a baby dying from polio.











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