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Correction to This Article
This article misstated the publication date of a study, commissioned by the Environmental Protection Agency, that correlated heavy rainfall with more than half of the nation's outbreaks of waterborne illness. The study was published in 2001, not 1991.

Risk of Disease Rises With Water Temperatures

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Washington Post Staff Writer
Monday, October 20, 2008; Page A08

When a 1991 cholera outbreak that killed thousands in Peru was traced to plankton blooms fueled by warmer-than-usual coastal waters, linking disease outbreaks to epidemics was a new idea.

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Now, scientists say, it is a near-certainty that global warming will drive significant increases in waterborne diseases around the world.

Rainfalls will be heavier, triggering sewage overflows, contaminating drinking water and endangering beachgoers. Higher lake and ocean temperatures will cause bacteria, parasites and algal blooms to flourish. Warmer weather and heavier rains also will mean more mosquitoes, which can carry the West Nile virus, malaria and dengue fever. Fresh produce and shellfish are more likely to become contaminated.

Heavier rainfalls are one of the most agreed-upon effects of climate change. The frequency of intense rainfalls has increased notably in the Midwest, the Northeast and Alaska, and the trend will accelerate, said the 2007 report of the United Nations' Intergovernmental Panel on Climate Change.

The consequences will be particularly severe in the 950 U.S. cities and towns -- including New York, the District, Milwaukee and Philadelphia -- that have "combined sewer systems," archaic designs that carry storm water and sewage in the same pipes. During heavy rains, the systems often cannot handle the volume, and raw sewage spills into lakes or waterways, including drinking-water supplies.

On Sept. 13, during an unrelenting downpour, Chicago chose to prevent urban flooding by opening and releasing runoff containing raw sewage into Lake Michigan. About a month later, a University of Wisconsin study published in the American Journal of Preventive Medicine predicted an increase of 50 to 120 percent in such releases into the lake by the end of the century.

"One of the strongest indicators from climate models is more intense rains," said co-author Stephen Vavrus, director of the university's Center for Climatic Research. "They don't agree on everything, but they do agree on that. A warmer atmosphere holds more moisture, so as we get more moisture in the air, when we do have a storm situation, you get more total rainfall."

From 1948 to 1994, heavy rainfall was correlated with more than half of the nation's outbreaks of waterborne illness, according to a 1991 study commissioned by the Environmental Protection Agency. In one of the worst, torrential rains in Milwaukee in 1993 triggered a sewage release that exposed 403,000 people to cryptosporidium, a protozoan parasite transmitted in fecal matter. Fifty-four people died.

"Raw sewage got sucked back into the clean water supplies," said Paul Epstein, associate director of the Center for Health and the Global Environment at Harvard Medical School. "Cryptosporidium is a parasite that chlorine doesn't kill, so it escaped water treatment."

On Ohio's South Bass Island in Lake Erie in the summer of 2004, at least 1,450 residents and tourists suffered gastrointestinal illnesses linked to several months of above-average rains that contaminated the town's drinking water.

More than 100 pathogens can cause illness if you drink or swim in water contaminated by sewage, including norovirus Norwalk and hepatitis A viruses and bacteria such as E. coli and campylobacter.

"If someone gets something swimming, they could bring it into work or day care. This is what's happened with cryptosporidium before," said Joan Rose, a Michigan State University professor and water researcher. "So we have all these rippling effects that occur in our community."


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