Waterborne Diseases

 

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There have recently been waterborne disease outbreaks across Michigan potentially caused by problems with our water and sewer system, and/or connected to water shutoffs.  The history of and reason why we have public water and sewer systems is to prevent these kinds of diseases.  There have been numerous studies over the years showing that waterborne diseases are more prevalent in areas that lack access to clean water, and in 2017 a study by We the People of Detroit Community Research Collective and Henry Ford Health System in Detroit narrowed this prevalence of increased waterborne diseases down to the neighborhood block level.  The problems with mass water shutoffs in Detroit began in 2014 connected to Detroit's bankruptcy.  Local Detroit activists have connected these mass shutoffs to neighborhoods also affected by austerity policies and gentrification.  In August of 2016, 25% of residential customers in the City of Detroit were scheduled for shutoffs with an additional 18% who were on payment plans.  Both the cities of Detroit and Flint have been faced with exponentially increasing water rates while both also have had increasing poverty rates.  In 2016, the contract afforded to the contractor shutting off residents (Homrich) was $6 million, compared to the $4.5 million that was budgeted for public assistance with water rates.  That same year, businesses in Detroit owed $41 million in overdue water bills while residents owed $26 million and the State of Michigan owed $1 million.  In the three years between 2013 and 2016, Detroit Water and Sewerage Department (DWSD) shut off access to water to over 100,000 residents, over 50% of their 175,000 residential customers in the city as of 2016.  While just over half of the overdue bills were residential, and many businesses had much larger overdue bills, 97% of the shutoffs in Detroit just in 2016 alone were to residents, and in some instances entire neighborhoods had their access to water shut off by the city.  The United Nations visited Detroit, toured these affected neighborhoods, declared the City to be in violation of their Declaration of Human Rights, and that these shutoffs were creating more homelessness due to the connection to tax foreclosures.  The State of Michigan received $188 million from the federal Hardest Hit Fund, yet used some to tear down homes rather than use them towards prevention of foreclosures (what it was intended to be for).  Despite this, Detroit has already slated 17,000 residences to be shut off from access to water in the coming months of 2018.  For more history on Detroit's water shutoffs click here.  In Flint, residents still do not have access to clean, safe drinking water after the state alongside local officials switched residents over to the Flint River in order to build the KWA pipeline and sell $220 million worth of bonds.  Over the same timeframe as Detroit, residents of Flint have also been threatened with water shutoffs.  Many residents have not been paying their water bills as a form of civil disobedience, have yet to be made whole, and are already suffering from health problems due to drinking raw water from the Flint River that has contaminates such as Mercury and PCBs and lead that was leached from their pipes due to this corrosive water that already caused a Legionnaire's outbreak during the crisis.  Due to this crisis not being fixed, and a majority of residents with a higher proportion of health problems from their exposure during the crisis, citizens of Flint are at a higher risk for waterborne disease outbreaks.  Waterborne diseases include Hepatitis A, Legionnaire's Disease, and MRSA (methicillin-resistant staphylococcus aureus).  Every community in Michigan is at risk due to our aging water and sewer infrastructure, and many communities across the state have reported main breaks and boil water advisories.  Some boil water advisories may also be related to sewage overflows.

 

Hepatitis A*

Recent health issues include over 527 cases of Hepatitis A across Michigan in 2017 causing at least 20 deaths.  This disease is found in feces, and can be spread by eating contaminated food, contaminated water, and through sexual contact.  It is highly contagious and that risk is increased with shared living space with an infected person.  There is potential for this outbreak to also be connected to the opioid epidemic.  There was a marked increase in Hepatitis A cases for people who work in the food service industry.  *It is important to note that there is a vaccine for Hepatitis A which may be available at your county health department.  In March of 2018, there has been a confirmed case of Hepatitis A in Flint's City Lockup.

Documented side effects of Hepatitis A include, but are not limited to:

Abdominal pain

Chills

Clay-colored stool

Dark urine

Diarrhea

Fever

Jaundice (yellowing of the skin and eyes)

Liver failure

Nausea

Vomiting

 

Counties that have been affected by this outbreak include:

Michigan_Map_Green_favicon.png  Clare County

Michigan_Map_Green_favicon.png  Genesee County

Michigan_Map_Green_favicon.png  Isabella County

Michigan_Map_Green_favicon.png  Lapeer County

Michigan_Map_Green_favicon.png  Macomb County

Michigan_Map_Green_favicon.png  Monroe County

Michigan_Map_Green_favicon.png  Oakland County

Michigan_Map_Green_favicon.png  Sanilac County

Michigan_Map_Green_favicon.png  St. Clair County

Michigan_Map_Green_favicon.png  Washtenaw County

Michigan_Map_Green_favicon.png  Wayne County

 

Legionnaire's Disease (Legionella)^

Risk for Legionnaire's Disease can spike during warm months and the average number of cases during warm summer months are 30.  This disease made national headlines in 2015 after news broke of the Flint Water Crisis and a Legionnaire's outbreak in Genesee County that went unreported to the public resulting in at least 12 deaths and nearly 100 cases.  In June and July of 2017 there were 73 confirmed cases of Legionnaire's Disease in the Metro Detroit area.  The legionella bacteria is found naturally in freshwater lakes and streams, but is also found in man-made water systems.  This disease is transmitted via the inhalation of water vapor or mist, not through personal contact and can be treated with antibiotics.  ^Symptoms appear between 2 days and 2 weeks after exposure and after antibiotic treatment full recovery can happen in 2-4 months.  Outbreaks of the disease are generally associated with complex water systems in buildings or structures like hotels, health-care facilities, cruise ships, and public water systems and likely sources for infection include in water used for showering, hot tubs, decorative fountains, and central air-conditioning cooling towers.  Different causes can create conditions that support the growth of this bacteria including warm water, stagnant water, low levels of disinfectants, and water areas that are not cleaned or maintained properly.  A major factor that can cause outbreaks in public water systems is that chlorine may react with heavy metals like lead and iron alongside other organic materials from raw water, which may then decrease the amount of chlorine available in water systems to kill the bacteria.  There are no federal laws that currently protect consumers from Legionella.  

People who are at a higher risk of getting ill or dying from the disease include seniors, current and former smokers, those who have weakened immune systems, chronic lung disease, or who take immunosuppressant drugs.  1 out of every 10 people with this disease will die form complications, but 1 out of 4 will die if the disease was caught at a healthcare facility.  Legionnaire's is also a likely under-diagnosed disease according to the CDC.

Pontiac Fever is a milder form of Legionella caused by the same bacteria, and there were further cases of this disease in 2017 in the Metro Detroit Area.  This disease also manifests with flu-like symptoms that generally resolve on their own and is diagnosed most often when known cases of legionnaire's disease are diagnosed in the same area.  Symptoms and side-effects of this disease include fever and muscle aches, appear 1-2 days after exposure, and go away without treatment after a few days.  The origins of this disease were from an outbreak in Pontiac, Michigan in 1968.

Documented side effects of Legionnaire's Disease include, but are not limited to:

Chest pain

Chills

Confusion

Cough

Death

Diarrhea

Fever

Headaches

Lung failure

Muscle aches

Nausea

Pneumonia

Shortness of breath

Stomach pain

 

Counties that have been affected by a recent Legionnaire's outbreak include:

Michigan_Map_Green_favicon.png  Genesee County

Michigan_Map_Green_favicon.png  Macomb County

Michigan_Map_Green_favicon.png  Oakland County

Michigan_Map_Green_favicon.png  Wayne County

 

Flint and the Flint Water Crisis obviously fall under these issues of water contamination and other water issues.  To find out more information follow the Flint link to the subsite on Jennifer's plan to fix Flint and to find out more information on the Flint Water Crisis.

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Sources

https://www.freep.com/story/news/local/michigan/detroit/2017/12/11/hepatitis-outbreak-southeast-michigan/931420001/

https://www.clickondetroit.com/health/hepatitis-a-infection-confirmed-in-westland-lounge-worker

http://michiganradio.org/post/gov-picks-flint-water-defendant-lead-new-panel-looking-public-health-threats

https://www.freep.com/story/news/2017/08/04/legionnaires-disease-michigan/539902001/

https://www.npr.org/sections/health-shots/2018/02/05/582482024/lethal-pneumonia-outbreak-caused-by-low-chlorine-in-flint-water

http://www.mlive.com/news/detroit/index.ssf/2017/08/73_new_cases_of_legionnaires_d.html

https://www.cdc.gov/legionella/

http://www.michigan.gov/mdhhs/0,5885,7-339-73970_71692_71696-428027--,00.html

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http://oakland.mi.networkofcare.org/ph/library/article.aspx?hwid=ug2994

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http://michiganradio.org/post/over-17000-households-could-face-water-shutoffs-detroit

 

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