A Gut Reaction To Water
Like many people in New Hampshire, I’ve been concerned by the wide variety of extreme weather events this past summer. I get my water from a well so the spring drought scared me as water use restrictions spread throughout our communities. The extreme heat in July and August made enjoying the outdoors difficult. Finally, heavy rains in the mid to late summer caused flooding. Yikes, that’s a lot of change to handle! Extreme weather isn’t new to New England, yet these conditions may be worsening in recent years.
I’m a primary care physician with 36 years of experience. As a doctor, I am trained to diagnose and treat individual patients, yet it’s not easy to associate environmental exposures to counts and rates of illness in a population. For that, we depend on public health and environmental experts to connect the dots and take action.
When several of my patients presented with GI illnesses after eating raw shellfish I started to wonder if these events could be related to contamination of shellfish habitat by waterborne bacteria or viruses. Indeed evaluation of my patients revealed that one had contracted a GI infection with Vibrio, and the other an infection with Hepatitis A.
Vibrio is a naturally occurring bacteria in saltwater coastal environments, which increases in concentration when the water warms. It tends to cause acute diarrheal illness, which resolves in a few days, but can be much more serious too.
Hepatitis A causes acute liver inflammation and is caused by a virus commonly found in human waste water. When torrential rains overwhelm a wastewater treatment facility’s ability to process waste it overflows into our rivers. Shellfish filter the contaminated water and become carriers of the hepatitis A virus. When we eat infected shellfish….well, you know.
Fortunately, the patient with Hepatitis A recovered as well, but had a severe, protracted form of the illness.
So, indeed I have learned that the increasingly common extreme weather events, leading to heavy rains/flooding, along with slowly rising temperatures do impact water-related infections. In addition to the Vibrio and Hepatitis infections already discussed, harmful algal blooms are also encouraged when rising water temperatures combine with increased atmospheric CO2 dissolving in the water. Algal blooms, (think “Red Tide” and others), produce toxins harmful to fish and shellfish, as well as serving as a respiratory irritant to humans.
Fortunately, people in our state are working to monitor and solve the problem of shellfish contamination in the Great Bay area. A group of UNH and State agencies have been measuring vibrio bacteria in shellfish under various conditions, and have improved the ability of harvesters to shade, cool, and protect the food from spoiling and reduce the risk of making people ill.
What can we do about all of this? How can you take action today?
We can protect ourselves and our patients by signing up for advisories and alerts concerning health warnings about drinking, surface, and coastal waters via the NH Dept of Environmental Services website. The NHDES also monitors seacoast shellfish beds and issues alerts when shellfish consumption is potentially dangerous.
We can protect our shellfish with inspecting and training via the NH Division of Public Health. DPHS also tracks infectious disease in order to identify outbreaks of illness. Clinicians can sign up for the Health Alert Network to get advisories, and you can email your request to: DHHS.Health.Alert@dhhs.nh.gov
Join NH Health Care Workers for Climate Action and discuss the changing climate with your friends and peers. I believe that the more informed the public is, the more likely we are to support personal, business, and government efforts to address climate change and mitigate the worst important health impacts.
Consult the websites and references noted in this article to learn more about these topics.
Charles Carrier, MD
