The Turnstone: talking about vaccine #38

Waterborne disease and vaccines, and a question for my readers (7 minute read)

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Before I get started on this month’s resources, I’d like to ask for some feedback from you. I started the talking about vaccines section of The Turnstone in September 2021, when vaccines for Covid-19 were on all our minds. I was motivated to do so because I was seeing some of the conversations about vaccines on social media, and they bothered me. I realised that some of those who were pro-vaccine may have been achieving the opposite of what they wanted, and driving people away from vaccines. I decided that I could do something, by sharing information and resources to help people have better conversations about vaccination.

Initially, I intended only to share information and resources for a short time, but it evolved into a regular topic. I’ve now done 38 sets of resources under the topic talking about vaccines. I’ve looked at different aspects of Covid-19 vaccines. I’ve looked at where to get reliable information about the diseases and vaccines covered on New Zealand’s vaccination schedule. I’ve looked at misinformation and how to respond to it.

My writing has now largely moved away from Covid-19 and onto other issues – especially climate change, but also related topics such as water quality, invasive species and food security. I think I’ve probably reached the end of sharing resources about vaccination.

I’m still mulling over what I might do with that once-a-month space. I am tempted to write more articles of the type I write each fortnight. I’ve got so much work in progress – pine trees, erosion, dairy effluent, as well as some planned topics on the health of marine environments, from coral to toxic shellfish. But these articles are time-consuming, and writing The Turnstone is only one of three jobs I’m doing right now[1].

One other possibility is to do some more reflective writing – a more personal perspective on what I’m learning and feeling from all the research I’m doing. Last year I wrote one such article about how writing The Turnstone made me change how I was living – small changes, maybe, but significant to me. I’m not sure that I would write one such piece a month, but I thought I’d let you know that was on my mind.

However, before I make a change to my writing schedule, I’d like to hear from you. What would you like to see more of in The Turnstone? Do you want me to continue with vaccines? Would you prefer more articles, or more personal reflections? Let me know in the comments, or simply reply to the email.

Now, onto vaccines and waterborne disease…

Since I’ve been writing about water lately, I decided that this month I would share resources about to a few different vaccines which are available against waterborne diseases. But vaccines are not the only tool for preventing these diseases, and for some important diseases there are no vaccines. So I’ve included some other resources about preventing diseases associated with dirty water.

Not exactly dirty water, but I filtered it as it’s downstream from a popular back country hut by Lake Angelus (image credit: Melanie Newfield)

New Zealand’s major waterborne diseases

In New Zealand, the three most common waterborne diseases are caused by Campylobacter, Cryptosporidium and Giardia. The illnesses they cause are known as campylobacteriosis, cryptosporidiosis and giardiasis, but for obvious reasons, the first two are sometimes known as “campy” and “crypto”. As well as being found in water, all three diseases can be spread by unwashed hands, and campy can also contaminate some foods.

There are brochures from New Zealand’s Ministry of Health which give a good overview of these diseases.

Cryptosporidium and Giardia (11 minute read)

Campylobacter, E. coli and Salmonella (11 minute read)

There is more detailed information on the USA Centres for Disease Control website

Campylobacter (5 minute read for the main page, but with more detailed information on other pages)

Cryptosporidium (7 minute read for the main page, but with more detailed information on other pages)

Giardia (5 minute read for the main page, but with more detailed information on other pages)

All three of these diseases are important worldwide as well as in New Zealand, but there are no vaccines available.

Waterborne diseases for which there are vaccines available

There are vaccines available for some waterborne diseases. There are also vaccines in development for other waterborne diseases.

Hepatitis A

I’ve written about vaccines for Hepatitis before – here’s the link which has a range of resources for all the different types of hepatitis viruses, including Hepatitis A, which can be associated with contaminated water.

The Turnstone: talking about vaccines #32 Hepatitis (7 minute read)

Polio

Polio is another disease associated with contaminated water. I’ve also written about the polio vaccines, so here is the link.

The Turnstone: talking about vaccines #28 Polio (5 minute read)

Rotavirus

Rotavirus is most commonly spread by dirty hands and contact with contaminated surfaces, and spreads very easily in homes and places such as childcare centres. However, it can also be spread by contaminated water, so I’m including it here. It is a very common cause of diarrhoea, especially in young children – or rather it was a very common cause. Until 2016, nearly every pre-schooler in New Zealand caught it, and it put hundreds in hospital every year. In the USA, hospitalisations were in the tens of thousands, with 20-60 deaths. However, a vaccine is now routinely given to young babies and there has been a major drop in cases.

Rotavirus - Immunisation Advisory Centre (immune.org.nz) (3 minute read and 1 minute video)

Rotavirus | CDC (information over multiple pages, each less than a 1 minute read)

Rotavirus vaccine

A rotavirus vaccine is on the schedules for a number of countries, including New Zealand, the USA and India. This vaccine differs from other vaccines on the schedule – it is only given to babies under a certain age. The best resource I’ve found explaining this is on the Healthify website[2]. There is no rotavirus vaccine for other age groups.

Rotavirus vaccine | Healthify (5 minute read)

There is further information available from New Zealand’s Immunisation Advisory Centre and the UK National Health Service.

Rotarix - Immunisation Advisory Centre (immune.org.nz) (4 minute read, also has a link to a more detailed datasheet)

Rotavirus vaccine common questions - NHS (www.nhs.uk) (6 minute read)

Typhoid

Typhoid caused regular outbreaks in New Zealand in the 19^th century and is still a problem in many countries. It is associated with contaminated water but can also be caught from contaminated food. Worldwide, there were more than 9 million cases in 2019, with around 110,000 deaths.

Typhoid | Healthify (3 minute read)

Typhoid Fever | Disease Directory | Travelers' Health | CDC (3 minute read)

Typhoid vaccine

Typhoid is not on the vaccination schedule for New Zealand, but two different vaccines are available as an option for travellers. However, I have not found New-Zealand based resources about the vaccines. I’ve linked to some overseas information.

Typhoid - Fit for Travel - UK NHS (3 minute read)

Typhoid Vaccine Information Statement | CDC (4 minute read)

The typhoid vaccine is on the vaccination schedule for India and is recommended for children older than 9 months.

Typhoid Vaccines – Immunize India

Cholera

Cholera can be caught from contaminated water as well as contaminated food. Although some cases are mild, it can be severe and can kill people within hours. Estimates for how many people are affected each year vary widely. Figures from the World Health Organisation suggest that there are 1.3 million to 4 million cases per year and 21,000-143,000 deaths.

General Information | Cholera | CDC (7 minute read)

Cholera vaccines

There are vaccines available against cholera, but they are not recommended for routine vaccination, either on vaccine schedules for children, or for travellers. Instead, they are recommended for use among those who are most vulnerable, such as refugees and aid workers, or for use in outbreaks.

The World Health Organisation page on cholera includes information about the vaccines and the situations where they are recommended.

Cholera (who.int) (11 minute read)

Avoiding waterborne disease in the environment

There are a number of different ways to prevent diseases associated with contaminated water. The US Centres for Disease Control has information aimed at travellers.

Avoid Contaminated Water During Travel | Travelers' Health | CDC (4 minute read)

The following website gives a thorough explanation on treating water in the back country. I admit that in remote parts of New Zealand I haven’t always been quite this careful, but the article contains some good advice.

Two Ways to Purify Water (U.S. National Park Service) (nps.gov) (6 minute read)

Swimming in contaminated water can also be a risk. For New Zealand, especially northern parts of New Zealand, there are two website which have information on which beaches, rivers and streams are contaminated and which are safe.

Land, Air, Water Aotearoa (LAWA) - Can I swim here?

Safeswim

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[1] One of the others is helping with the Wellington Glean Report which lists science events that are on in Wellington, as well as some online. If you are in Wellington and interested in science check it out.

[2] Healthify used to be known as “Health Navigator” and is a reliable, New Zealand-based source for health information.

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