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Sarah E. Henrickson,¹ Thomas Wong,² Paul Allen,³ Tim Ford,⁴ and Paul R. Epstein⁵

¹Harvard University, Boston, Massachusetts, USA
²Division of Infectious Disease, University of Ottawa, Ottawa, Ontario, Canada
³The Cambridge Hospital, Harvard Medical School, Boston, Massachusetts, USA
⁴Harvard School of Public Health, Boston, Massachusetts, USA
⁵Center for Health and the Global Environment, Harvard Medical School, Boston, Massachusetts, USA

Abstract

There is increasing evidence that environmental degradation may be contributing to an increase in marine-related diseases across a wide range of taxonomic groups. This includes a growing number of reports of both recreational and occupational users of marine waters developing gastrointestinal, respiratory, dermatologic, and ear, nose, and throat infections. The duration and type of exposure, concentration of pathogens, and host immunity determine the risk of infection. Public health authorities may not be able to accurately predict the risk of waterborne disease from marine waters due to the limitations of conventional monitoring, as well as erroneous perceptions of pathogen life span in marine systems. Pathogens undetectable by conventional methods may remain viable in marine waters, and both plankton and marine sediments may serve as reservoirs for pathogenic organisms, which can emerge to become infective when conditions are favorable. In this paper we address the environmental factors that may contribute to illness, the types of associated economic costs, the issues of water quality monitoring and the policy implications raised by the apparent rise in incidence of marine water-related illnesses. Key words: disease surveillance, marine ecosystems, waterborne disease. Environ Health Perspect 109:645-650 (2001) . [Online 19 June 2001]

http://ehpnet1.niehs.nih.gov/docs/2001/109p645-650henrickson/ abstract.html

Address correspondence to P.R. Epstein, Associate Director, Center for Health and the Global Environment, Harvard Medical School, Oliver Wendell Holmes Society, 260 Longwood Avenue, Boston, MA 02115 USA. Telephone: (617) 432-0493. Fax: (617) 432-2595. E-mail: paul_epstein@hms.harvard.edu

T. Ford is partially supported by grant P42ES-05947 from the National Institute of Environmental Health Sciences (NIEHS) , with funding provided by the U.S. Environmental Protection Agency (U.S. EPA) . The manuscript contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIEHS, National Institutes of Health, or U.S. EPA.

Received 6 April 2000 ; accepted 17 January 2001.