Josephine Tsakok, MBBS, MSc, Environmental Health Sciences, Mailman School of Public Health, Columbia University, 60 Haven Avenue, New York, NY 10032, 212 9287357, jt349@columbia.edu

China has an impending water shortage crisis, exacerbated by water mismanagement. Water-related infectious disease is an immediate threat intimately linked to water resource management. This is illustrated by schistosomiasis, perpetuated by a lack of water for cleaning after defecation, inadequate separation of human and animal excrement from water that they come into contact with, and the ecology of the parasite’s aquatic snail hosts. In China, the predominant species is Schistosoma japonicum. Because of its complex life cycle in water, its impact on health and the presence of a zoonotic host, the buffalo, which is widely used in agriculture, schistosomiasis control remains a challenge. In the last 50 years, great improvements in reducing prevalence, transmission and morbidity have been made, but additional approaches are now needed. Firstly, the original strategy, mass drug therapy with praziquantel for infected humans and animals, reduces morbidity but does not break the cycle of transmission, and is vulnerable to drug resistance. Secondly, China’s water and sanitation infrastructure remains inadequate, increasing the country’s vulnerability to a resurgence of schistosomiasis. Thirdly, the Three Gorges Dam will link Hunan Province and Sichuan Province, two regions endemic for schistosomiasis. Strategies to break the cycle of transmission include sanitation, water treatment, waterway management, irrigation modifications, biological methods to reduce snail numbers, and reduced exposure to infected water. These measures have the added benefit that other diseases, such as mosquito borne diseases, and fecal-oral diseases, may also be reduced.

Learning Objectives:

• (1)Appreciation of scale and complexity of water-related disease and other problems caused by mismanagement of water resources.
• (2)Multidisciplinary effort between local population, soil scientists, water scientists, biologists, engineers, health providers, and policy makers needed to address water mismanagement and its effects.
• (3)Schistosomiasis in China is as an case study of a serious problem which requires drastic infrastructure changes to solve.

Keywords: Infectious Diseases, Water Quality

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.