Water and Foodborne Infections in India

by Shatakshi Gupta
water borne

Infections are not rare in India, where more than a billion people live closely and clean water and sanitation is also a challenge. The outbreaks of food-borne diseases and diarrhea are highest during the monsoon seasons when floodwaters bring faecal contaminants and infecting agents such as bacteria, viruses, protozoa, and parasites into homes and the food chain. Unsafe food and dirty water are the most responsible factors for infection in India. Acute diarrhea and food poisoning are still the cause of the third-highest number of deaths by diseases. Though the news always covers the deadly infections like coronavirus spread, Zika, Nipah virus outbreak but the number of deaths due to these outbreaks is much less than the deaths caused by unsafe food and water worldwide. Foodborne diseases are of two types foodborne intoxication and foodborne infections. Food-borne infections are caused by consuming foods or liquids contaminated with bacteria, viruses, or parasites. These pathogens cause infection by invading and multiplying in the lining of the intestines and other tissues, invading and multiplying in the intestinal tract and releasing a toxin. Whereas, Food-borne intoxications are caused by consuming foods or beverages already contaminated with a toxin. Sources of toxins usually are certain bacteria (pre-formed toxins), Poisonous chemicals, Natural toxins found in animals, plants, and fungi. Chemical food poisoning can also occur through adulteration of food by adding prohibited substances to partly or wholly substitute healthy ingredients or to artificially create the impression of freshness in stale food. Also, coloring agents in food are also deteriorating to health. Now if we talk about the waterborne disease, these are caused by the microorganisms that most commonly are transmitted in contaminated fresh water. Infection commonly caused during bathing, washing, drinking, in the preparation of food, or the consumption of food thus infected. Various forms of waterborne diarrheal disease probably are the most prominent examples and affect mainly children in developing countries like India Water-borne diseases spread by contaminating drinking water systems with feces and urine of infected animals or people. The spread of contaminated water is likely to happen where private and public drinking systems get their water such as surface waters – creeks, rivers, lakes, and rain. These sources of water may be contaminated by infected animals or people. Contaminated water consumption often causes cholera, which is a fatal disease. Also clogged water gives birth to mosquitoes which are carriers of diseases like malaria and dengue.

In India, the exact burden of food-borne disease is not known as most food-borne diseases go unreported, only a few are reported, usually, those with high morbidity and/or occurring in urban areas. The Integrated Disease Surveillance Programme (IDSP) network was launched in India in 2004. Aggregate analysis of IDSP data from 2011-15 shows food-borne outbreaks together with acute diarrhoeal diseases constitute nearly half of all reported outbreaks under IDSP for the period. It is the second leading cause of death in children under five years old and is responsible for killing around 5,25,000 children every year. It is also the leading cause of the undernourishment of Children below 5.

Food borne

   Reasons for such outbreak in India are inadequate sanitary infrastructure, high-density area are more prone to such infections, lack of education and awareness among people and failure of disaster mitigation strategies as well as post-disaster relief management. Also, there is a need for change in the behaviour of masses to improve hygiene. The government must take some proactive steps to improve sanitary conditions as well as promoting a hygienic lifestyle. Also, the government should strictly regulate and monitor the standards of vendors selling street food. In this context, we need to see food safety regulations in India. India is a signatory to World Trade Organization on food trade and therefore has to abide by guidelines of Codex Alimentarius, a collection of international food standards, guidelines, and codes of practice covering all the main foods tailored to the Indian context and known as codex India. Prior to 2006 in India, food-related issues were managed by various departments and ministries through a number of central acts. These included the Prevention of Food Adulteration Act 1954, Fruit Products Order 1955, Meat Food Products Order 1973, Vegetable Oil Products (Control) Order 1947, and the Edible Oils Packaging (Regulation) Order 1988, among others. In 2006, these orders were consolidated and brought under one overarching act, the Food Safety and Standards (FSS) Act, 2006. The Food Safety and Standards Authority of India (FSSAI) is an autonomous statutory body created for defining science-based standards for articles of food, and regulating the manufacture, storage, distribution, sale and import of food items to ensure the availability of safe and wholesome food for human consumption. The Ministry of Health & Family Welfare, Government of India is the Administrative Ministry for the implementation of the FSS Act. Enforcement and execution of the act are done at the central level by the Food authority and at the state level by Food Safety Commissioners. At the local level, Food Safety Officers are the licensing authority and municipal corporations and gram panchayats are the registering authority. In order to improve drinking water conditions government is working with WHO, the World Health Organization (WHO) and Population Services International (PSI) have partnered to develop and test a safe drinking water strategy to reduce the incidence of diarrhoeal diseases in India. The Safe Water System (SWS) is a water quality intervention that uses simple, inexpensive, and robust technologies appropriate for the developing world to prevent mortality and morbidity associated with diarrhoeal diseases. Developed by the World Health Organization (WHO), the Pan American Health Organization (PAHO) and the Centres for Disease Control and Prevention (CDC), the SWS reduces the number of diarrhoeal episodes by around 50%. It consists of a bottle of 0.5 to 1% sodium hypochlorite (chlorine) solution to disinfect water at the point-of-use, the household level, along with a home water storage vessel to prevent water recontamination. Volunteers, or change agents, were trained to use the SWS, to raise awareness about hygiene-related issues and to motivate the consumption of safe drinking water in their community. Apart from that awareness is being spread with the help of educating posters and distributing covered dustbins.

We can understand from above-taken efforts that our country is improving but the true change is only possible when there will be the inclusion of whole society as a behavioural change in people is the only possible way to mitigate the menace of these infections.