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NC Department of Health and Human Services
NC Division of Public Health
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Diseases & Topics

Water-Borne Illnesses

The term "water-borne illness" can apply to a wide range of diseases and a wide range of water sources — from municipal drinking water supplies and non-potable supplies for agricultural or industrial use, to lakes, swimming pools and decorative fish ponds — and many diseases that can be transmitted via water can be transmitted by food, animals or other methods. As with food-borne illnesses, water-borne illnesses can be caused by bacteria, parasites, environmental contaminants or viruses. Symptoms can include gastrointestinal, skin, ear, respiratory, eye, neurologic, and wound infections.

In North Carolina, the water-borne illnesses of the greatest public health significance are those transmitted in recreational water, drinking water, and flood waters.

  • Recreational water illnesses (RWIs) - Illnesses that are spread by swallowing, breathing mist from or having skin contact with contaminated water from swimming pools, water parks, spas and hot tubs, lakes, rivers or oceans, and even interactive or decorative water fountains.
  • Vibrio infections - The Vibrio species of bacteria live in brackish and salt water and may enter the body through injuries such as a puncture wound from fin fish or shellfish, exposure of open wounds to coastal waters, or by eating raw or improperly cooked shellfish, especially oysters.
  • Infections transmitted by food or drinking water - Bacteria, parasites and viruses which can contaminate water used for drinking and food preparation include: V. cholerae, cryptosporidium, cyclospora, giardia, shigella, norovirus, S. Typhi and E. coli.
  • Legionellosis - Legionella bacteria are found naturally in the environment, usually in wet places like natural bodies of water and moist soil, as well as in man-made water handling systems such as produce misters, air conditioners, spas, car washes, and medical ventilator machines.
  • Hurricane Health & Safety

For information regarding North Carolina's natural resources, including water and fish, and known contaminants, like mercury and dioxin, see:

For information on occupational and industrial health risks related to water, seafood, and water-borne contaminants, see:

  • N.C. Occupational and Environmental Epidemiology - The branch of Public Health which identifies and quantifies exposures to environmental and occupational contaminants; conducts risk assessments and risk communication; provides medical evaluation and surveillance for adverse health effects; and provides health-based guidance on levels of exposure to such contaminants.

For Additional Information