The rapid spread of infectious disease to a large number of people in a given population within a short period of time, usually two weeks or less. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic.
Epidemics of infectious disease are generally caused by several factors including a change in the ecology of the host population (e.g., increased stress or increase in the density of a vector species), a genetic change in the pathogen reservoir, or the introduction of an emerging pathogen to a host population (by the movement of pathogen or host). Generally, an epidemic occurs when host immunity to either an established pathogen or a newly emerging novel pathogen is suddenly reduced below that found in the endemic equilibrium, and the transmission threshold is exceeded.
An epidemic may be restricted to one location; however, if it spreads to other countries or continents and affects a substantial number of people, it may be termed a pandemic. The declaration of an epidemic usually requires a good understanding of a baseline rate of incidence; epidemics for certain diseases, such as influenza, are defined as reaching some defined increase in incidence above this baseline. A few cases of a very rare disease may be classified as an epidemic, while many cases of a common disease (such as the common cold) would not.
Epidemics of infectious disease are generally caused by several factors including a change in the ecology of the host population (e.g., increased stress or increase in the density of a vector species), a genetic change in the pathogen reservoir, or the introduction of an emerging pathogen to a host population (by the movement of pathogen or host). Generally, an epidemic occurs when host immunity to either an established pathogen or a newly emerging novel pathogen is suddenly reduced below that found in the endemic equilibrium, and the transmission threshold is exceeded.
An epidemic may be restricted to one location; however, if it spreads to other countries or continents and affects a substantial number of people, it may be termed a pandemic. The declaration of an epidemic usually requires a good understanding of a baseline rate of incidence; epidemics for certain diseases, such as influenza, are defined as reaching some defined increase in incidence above this baseline. A few cases of a very rare disease may be classified as an epidemic, while many cases of a common disease (such as the common cold) would not.
There are several changes that may occur in an infectious agent that may trigger an epidemic. These include:
- Increased virulence
- Introduction to a novel setting
- Changes in host susceptibility to the infectious agent
The conditions which govern the outbreak of epidemics include infected food supplies such as contaminated drinking water and the migration of populations of certain animals, such as rats or mosquitoes, which can act as disease vectors. Certain epidemics occur in certain seasons.
For example, whooping cough occurs in spring, whereas measles produces two epidemics, one in winter and one in March. Influenza, the common cold, and other infections of the upper respiratory tract, such as sore throat, occur predominantly in the winter.
For example, whooping cough occurs in spring, whereas measles produces two epidemics, one in winter and one in March. Influenza, the common cold, and other infections of the upper respiratory tract, such as sore throat, occur predominantly in the winter.
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There is another variation, both as regards the number of people affected and the number who die in successive epidemics: the severity of successive epidemics rises and falls over periods of five or ten years.
In a common source outbreak, the affected individuals had exposure to a common agent. If the exposure is singular and all of the affected individuals develop the disease over a single exposure and incubation course, it can be termed a point source outbreak. If the exposure was continuous or variable, it can be termed a continuous outbreak or intermittent outbreak, respectively. In a propagated outbreak, the disease spreads person-to-person. Affected individuals may become independent reservoirs leading to further exposures. |
Many epidemics will have characteristics of both common sources and propagated outbreaks.
For example, secondary person-to-person spread may occur after a common source exposure, or an environmental vector may spread a zoonotic disease agent.
For example, secondary person-to-person spread may occur after a common source exposure, or an environmental vector may spread a zoonotic disease agent.
- Airborne transmission: Airborne transmission is the spread of infection by droplet nuclei or dust in the air. Without the intervention of winds or drafts, the distance over which airborne infection takes place is short, say 10 to 20 feet.
- Arthropod transmission: Arthropod transmission takes place by an insect, either mechanically through a contaminated proboscis or feet or biologically when there is growth or replication of an organism in the arthropod.
- Biological transmission: Involving a biological process, e.g. passing a stage of development of the infecting agent in an intermediate host. Opposite to mechanical transmission.
- Colostral transmission: A form of vertical transmission via successive generations.
- Contact transmission: The disease agent is transferred directly by biting, sucking, chewing, or indirectly by inhalation of droplets, drinking contaminated water, or traveling in contaminated vehicles.
- Developmental transmission: The agent undergoes some development in the transmission vehicle.
- Fecal-oral transmission: The infectious agent is shed by the infected host in feces and acquired by the susceptible host through ingestion of contaminated material.
- Horizontal transmission: Lateral spread to others in the same group and at the same time; spread to contemporaries.
- Mechanical transmission: The transmitter is not infected in that tissues are not invaded and the agent does not multiply.
- Propagative transmission: The agent multiplies in the transmission vehicle.
- Vertical transmission: From one generation to the next, perhaps transovarially or by intrauterine infection of the fetus. Some retroviruses are transmitted in the germ line, i.e. their genetic material is integrated into the DNA of either the ovum or sperm.
Microsoft founder and philanthropist Bill Gates wrote an essay published in the New England Journal of Medicine in March 2015. In the essay, Gates states that an epidemic caused by a natural disaster or bioterrorism is the most likely event that could kill 10 million or more people all at the same time.
Gates and other experts suggest that the best way to prepare for an epidemic is to have a disease surveillance system, be able to quickly dispatch emergency workers, especially local-based emergency workers, and have a legitimate way to guarantee the safety and health of health workers.
Effective preparations for a response to a pandemic are multi-layered. The first layer is a disease surveillance system. Tanzania, for example, runs a national lab that runs testing for 200 health sites and tracks the spread of infectious diseases. The next layer is the actual response to an emergency. According to U.S.-based columnist Michael Gerson, only the U.S. military and NATO have the global capability to respond to such an emergency.
Gates proposed that the world responded slowly to the Ebola virus outbreak because of a lack of preparation. Two weeks after the 2013 typhoon hit the Philippines, over 150 foreign medical teams were on the ground helping injured victims. After the 2005 earthquake in Pakistan, a team of aid workers who had been helping Afghan refugees for several decades was able to get to the victims in less than 24 hours. Dr. Bruce Aylward, assistant director general for emergencies at the World Health Organization, says that in the case of the Ebola outbreak, "there was no way anyone could guarantee the right of medical evacuation for people affected by Ebola.” Aylward said that for future emergency health workforces, it is critical to offer a "duty of care", meaning the ability to ensure that aid workers will be taken care of in terms of health and safety.
Gates and other experts suggest that the best way to prepare for an epidemic is to have a disease surveillance system, be able to quickly dispatch emergency workers, especially local-based emergency workers, and have a legitimate way to guarantee the safety and health of health workers.
Effective preparations for a response to a pandemic are multi-layered. The first layer is a disease surveillance system. Tanzania, for example, runs a national lab that runs testing for 200 health sites and tracks the spread of infectious diseases. The next layer is the actual response to an emergency. According to U.S.-based columnist Michael Gerson, only the U.S. military and NATO have the global capability to respond to such an emergency.
Gates proposed that the world responded slowly to the Ebola virus outbreak because of a lack of preparation. Two weeks after the 2013 typhoon hit the Philippines, over 150 foreign medical teams were on the ground helping injured victims. After the 2005 earthquake in Pakistan, a team of aid workers who had been helping Afghan refugees for several decades was able to get to the victims in less than 24 hours. Dr. Bruce Aylward, assistant director general for emergencies at the World Health Organization, says that in the case of the Ebola outbreak, "there was no way anyone could guarantee the right of medical evacuation for people affected by Ebola.” Aylward said that for future emergency health workforces, it is critical to offer a "duty of care", meaning the ability to ensure that aid workers will be taken care of in terms of health and safety.
The term epidemic derives from a word form attributed to Homer's Odyssey, which later took its medical meaning from the Epidemics, a treatise by Hippocrates. Before Hippocrates, epidemios, epidemeo, epidamos, and other variants had meanings similar to the current definitions of "indigenous" or "endemic."
Thucydides' description of the Plague of Athens is considered one of the earliest accounts of a disease epidemic. By the early 17th century, the terms endemic and epidemic referred to contrasting conditions of population-level disease, with the endemic condition at low rates of occurrence and the epidemic condition widespread.
Following the recent outbreak of one of the deadliest virus/diseases ever known to mankind in the West Africa called EBOLA VIRUS; thousands have lost their life’s including children, adult, and family’s.
Thucydides' description of the Plague of Athens is considered one of the earliest accounts of a disease epidemic. By the early 17th century, the terms endemic and epidemic referred to contrasting conditions of population-level disease, with the endemic condition at low rates of occurrence and the epidemic condition widespread.
Following the recent outbreak of one of the deadliest virus/diseases ever known to mankind in the West Africa called EBOLA VIRUS; thousands have lost their life’s including children, adult, and family’s.
Please take your time to read this information carefully. Before 2014, Ebola was a disease relegated to remote villages in Africa. Even public health officials didn't worry about it spreading very far. Until recently, they would probably tell you that the virus typically burned out after ravaging only a handful of people.
But then came 2014. It has, in many ways, rewritten the Ebola rule book. We're in the middle of an unprecedented, nightmarish epidemic that has spread from a rural rainforest region in West Africa to large urban centers. The World Health Organization's director has called it "the greatest peacetime challenge" the world has ever faced, with the number of cases doubling each week. Now, healthcare officials are starting to talk about a worst-case scenario for Ebola. The World Health Organization projects that 20,000 people will be infected in November the Centers for Disease Control and Prevention, (CDC) meanwhile, projects up to 1.4 million people could be infected by January, assuming that Ebola cases continue to increase exponentially (as they have) and are currently under-reported.
The 2014 Ebola outbreak is the largest Ebola outbreak in history and the first Ebola outbreak in West Africa. This outbreak is the first Ebola epidemic the world has ever known —affecting multiple countries in West Africa. A small number of cases in the United States and Spain have been associated with a man from Liberia who traveled to the US and died from Ebola.
But then came 2014. It has, in many ways, rewritten the Ebola rule book. We're in the middle of an unprecedented, nightmarish epidemic that has spread from a rural rainforest region in West Africa to large urban centers. The World Health Organization's director has called it "the greatest peacetime challenge" the world has ever faced, with the number of cases doubling each week. Now, healthcare officials are starting to talk about a worst-case scenario for Ebola. The World Health Organization projects that 20,000 people will be infected in November the Centers for Disease Control and Prevention, (CDC) meanwhile, projects up to 1.4 million people could be infected by January, assuming that Ebola cases continue to increase exponentially (as they have) and are currently under-reported.
The 2014 Ebola outbreak is the largest Ebola outbreak in history and the first Ebola outbreak in West Africa. This outbreak is the first Ebola epidemic the world has ever known —affecting multiple countries in West Africa. A small number of cases in the United States and Spain have been associated with a man from Liberia who traveled to the US and died from Ebola.
The Geneva-based W.H.O said in its report, which it dubbed a road map for responding to Ebola, strengthening laboratory facilities and adding staff with more expertise to help contain the outbreak of the virus. Public health infrastructure needed to be improved to cope with future treatments. The road map called for the establishment of Ebola isolation centers and burials of victims which are supervised by health care experts among other specific responses to the disease.
The W.H.O. said getting health experts to regions affected by the Ebola virus outbreak was an urgent priority. That has been made difficult because of international airlines, including Air France, British Airways, Emirates Airline, and K.L.M airline. Have suspended flights to the four affected countries. The W.H.O. program will likely cost around $490 million and require contributions from national governments, some U.N. and non-governmental agencies, and individuals as well as humanitarian organizations, as a result of the assistance which part of the public has been financially, materially, and morally donated.
Although the risk of an Ebola outbreak in the United States and other parts of the world is low, CDC and its partners are taking precautions to prevent this from happening. CDC is working with other U.S. government agencies, the World Health Organization (WHO), and other domestic and international partners and has activated its Emergency Operations Center to help coordinate technical assistance and control activities with partners.
The W.H.O. said getting health experts to regions affected by the Ebola virus outbreak was an urgent priority. That has been made difficult because of international airlines, including Air France, British Airways, Emirates Airline, and K.L.M airline. Have suspended flights to the four affected countries. The W.H.O. program will likely cost around $490 million and require contributions from national governments, some U.N. and non-governmental agencies, and individuals as well as humanitarian organizations, as a result of the assistance which part of the public has been financially, materially, and morally donated.
Although the risk of an Ebola outbreak in the United States and other parts of the world is low, CDC and its partners are taking precautions to prevent this from happening. CDC is working with other U.S. government agencies, the World Health Organization (WHO), and other domestic and international partners and has activated its Emergency Operations Center to help coordinate technical assistance and control activities with partners.
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CDC has also deployed teams of public health experts to West Africa and will continue to send experts to the affected countries.
A new coronavirus was first identified in Wuhan, Hubei, China, in late December 2019, as causing a cluster of cases of an acute respiratory disease, now referred to as coronavirus disease 2019 (COVID-19), which had been identified in December 2019. According to the media report, more than 116 countries and territories have been affected, with major outbreaks in central China, Italy, South Korea, and Iran. On March 11, 2020, the World Health Organization characterized the spread of COVID-19 as a pandemic. There have been a number of significant epidemics and pandemics recorded in human history, generally zoonoses that came about with the domestication of animals, such as influenza and tuberculosis. There have been a number of particularly significant epidemics that deserve mention above the "mere" destruction of cities: |
Plague of Athens, from 430 to 426 BC. During the Peloponnesian War, typhoid fever killed a quarter of the Athenian troops and a quarter of the population over four years. This disease fatally weakened the dominance of Athens, but the sheer virulence of the disease prevented its wider spread, i.e., it killed off its hosts at a rate faster than they could spread it. The exact cause of the plague was unknown for many years. In January 2006, researchers from the University of Athens analyzed teeth recovered from a mass grave underneath the city and confirmed the presence of bacteria responsible for typhoid.
- Antonine Plague, from 165 to 180 AD. Possibly smallpox was brought to the Italian peninsula by soldiers returning from the Near East; it killed a quarter of those infected, and up to five million in all. At the height of a second outbreak, the Plague of Cyprian (251–266), which may have been the same disease, 5,000 people a day were said to be dying in Rome.
- Plague of Justinian, from 541 to 750, was the first recorded outbreak of the bubonic plague. It started in Egypt and reached Constantinople the following spring, killing (according to the Byzantine chronicler Procopius) 10,000 a day at its height, and perhaps 40% of the city's inhabitants. The plague went on to eliminate a quarter to a half of the human population that it struck throughout the known world. It caused Europe's population to drop by around 50% between 550 AD and 700 AD.
- Black Death, from 1331 to 1353. The total number of deaths worldwide is estimated at 75 million people. Eight hundred years after the last outbreak, the plague returned to Europe. Starting in Asia, the disease reached the Mediterranean and western Europe in 1348 (possibly from Italian merchants fleeing fighting in Crimea) and killed an estimated 20 to 30 million Europeans in six years; a third of the total population, and up to a half in the worst-affected urban areas. It was the first of a cycle of European plague epidemics that continued until the 18th century. There were more than 100 plague epidemics in Europe in this period. The disease recurred in England every two to five years from 1361 to 1480. By the 1370s, England's population was reduced by 50%. The Great Plague of London of 1665–66 was the last major outbreak of the plague in England. The disease killed approximately 100,000 people, 20% of London's population.
- The third plague pandemic started in China in 1855 and spread to India, where 10 million people died. During this pandemic, the United States saw its first outbreak: the San Francisco plague of 1900–1904. Today, isolated cases of plague are still found in the western United States.
- Spanish flu, from 1918 to 1920. It infected 500 million people around the world, including people on remote Pacific islands and in the Arctic, and resulted in the deaths of 50 to 100 million people. Most influenza outbreaks disproportionately kill the very young and the very old, with a higher survival rate for those in between, but the Spanish flu had an unusually high mortality rate for young adults. Spanish flu killed more people than World War I did, and it killed more people in 25 weeks than AIDS did in its first 25 years. Mass troop movements and close quarters during World War I caused it to spread and mutate faster; the susceptibility of soldiers to Spanish flu might have been increased due to stress, malnourishment, and chemical attacks. Improved transportation systems made it easier for soldiers, sailors, and civilian travelers to spread the disease.
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Encounters between European explorers and populations in the rest of the world often introduced local epidemics of extraordinary virulence. The disease killed part of the native population of the Canary Islands in the 16th century (Guanches). Half the native population of Hispaniola in 1518 was killed by smallpox. Smallpox also ravaged Mexico in the 1520s, killing 150,000 in Tenochtitlán alone, including the emperor, and Peru in the 1530s, aiding the European conquerors. Measles killed a further two million Mexican natives in the 17th century. In 1618–1619, smallpox wiped out 90% of the Massachusetts Bay Native Americans. During the 1770s, smallpox killed at least 30% of the Pacific Northwest Native Americans. Smallpox epidemics in 1780–1782 and 1837–1838 brought devastation and drastic depopulation among the Plains Indians. Some believe that the death of up to 95% of the Native American population of the New World was caused by Old World diseases such as smallpox, measles, and influenza. Over the centuries, the Europeans had developed high degrees of immunity to these diseases, while the indigenous peoples had no such immunity.
Smallpox devastated the native population of Australia, killing around 50% of Indigenous Australians in the early years of British colonization. It also killed many New Zealand Māori. As late as 1848–49, as many as 40,000 out of 150,000 Hawaiians are estimated to have died of measles, whooping cough, and influenza. Introduced diseases, notably smallpox, nearly wiped out the native population of Easter Island. Measles killed over 40,000 Fijians, approximately one-third of the population, in 1875, and in the early 21st century devastated the Andamanese population. The Ainu population decreased drastically in the 19th century, due in large part to infectious diseases brought by Japanese settlers pouring into Hokkaido.
Researchers concluded that syphilis was carried from the New World to Europe after Columbus' voyages. The findings suggested Europeans could have carried the nonvenereal tropical bacteria home, where the organisms may have mutated into a more deadly form in the different conditions of Europe. The disease was more frequently fatal than it is today. Syphilis was a major killer in Europe during the Renaissance. Between 1602 and 1796, the Dutch East India Company sent almost a million Europeans to work in Asia. Ultimately, only less than one-third made their way back to Europe. The majority died of diseases. The disease killed more British soldiers in India and South Africa than in war.
As early as 1803, the Spanish Crown organized a mission (the Balmas expedition) to transport the smallpox vaccine to the Spanish colonies and establish mass vaccination programs there. By 1832, the federal government of the United States established a smallpox vaccination program for Native Americans. From the beginning of the 20th century onwards, the elimination or control of disease in tropical countries became a driving force for all colonial powers. The sleeping sickness epidemic in Africa was arrested due to mobile teams systematically screening millions of people at risk. In the 20th century, the world saw the biggest increase in its population in human history due to the lessening of the mortality rate in many countries due to medical advances. The world population has grown from 1.6 billion in 1900 to an estimated 7.8 billion today.
Researchers concluded that syphilis was carried from the New World to Europe after Columbus' voyages. The findings suggested Europeans could have carried the nonvenereal tropical bacteria home, where the organisms may have mutated into a more deadly form in the different conditions of Europe. The disease was more frequently fatal than it is today. Syphilis was a major killer in Europe during the Renaissance. Between 1602 and 1796, the Dutch East India Company sent almost a million Europeans to work in Asia. Ultimately, only less than one-third made their way back to Europe. The majority died of diseases. The disease killed more British soldiers in India and South Africa than in war.
As early as 1803, the Spanish Crown organized a mission (the Balmas expedition) to transport the smallpox vaccine to the Spanish colonies and establish mass vaccination programs there. By 1832, the federal government of the United States established a smallpox vaccination program for Native Americans. From the beginning of the 20th century onwards, the elimination or control of disease in tropical countries became a driving force for all colonial powers. The sleeping sickness epidemic in Africa was arrested due to mobile teams systematically screening millions of people at risk. In the 20th century, the world saw the biggest increase in its population in human history due to the lessening of the mortality rate in many countries due to medical advances. The world population has grown from 1.6 billion in 1900 to an estimated 7.8 billion today.
Public health conditions related to clean drinking water and treatment and disposal of human excreta and sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap. Sanitation systems aim to protect human health by providing a clean environment that will stop the transmission of disease, especially through the fecal–oral route. For example, diarrhea, a main cause of malnutrition and stunted growth in children can be reduced through adequate sanitation. There are many other diseases that are easily transmitted in communities that have low levels of sanitation, such as ascariasis (a type of intestinal worm infection or helminthiasis), cholera, hepatitis, polio, schistosomiasis, and trachoma, to name just a few.
A range of sanitation technologies and approaches exists. Some examples are community-led total sanitation, container-based sanitation, ecological sanitation, emergency sanitation, environmental sanitation, onsite sanitation, and sustainable sanitation. A sanitation system includes the capture, storage, transport, treatment, and disposal or reuse of human excreta and wastewater. Reuse activities within the sanitation system may focus on the nutrients, water, energy, or organic matter contained in excreta and wastewater. This is referred to as the "sanitation value chain" or "sanitation economy". The people responsible for cleaning, maintaining, operating, or emptying a sanitation technology at any step of the sanitation chain are called "sanitation workers": 2
Several sanitation "levels" are being used to compare sanitation service levels within countries or across countries. The sanitation ladder defined by the Joint Monitoring Program in 2016 starts at open defecation and moves upwards using the terms "unimproved", "limited", and "basic", with the highest level being "safely managed". This is particularly applicable to developing countries.
The Human Right to Water and Sanitation was recognized by the United Nations (UN) General Assembly in 2010. Sanitation is a global development priority and the subject of Sustainable Development Goal 6. The estimate is 2017 by JMP states that 4.5 billion people currently do not have safely managed sanitation. Lack of access to sanitation has an impact not only on public health but also on human dignity and personal safety.
A range of sanitation technologies and approaches exists. Some examples are community-led total sanitation, container-based sanitation, ecological sanitation, emergency sanitation, environmental sanitation, onsite sanitation, and sustainable sanitation. A sanitation system includes the capture, storage, transport, treatment, and disposal or reuse of human excreta and wastewater. Reuse activities within the sanitation system may focus on the nutrients, water, energy, or organic matter contained in excreta and wastewater. This is referred to as the "sanitation value chain" or "sanitation economy". The people responsible for cleaning, maintaining, operating, or emptying a sanitation technology at any step of the sanitation chain are called "sanitation workers": 2
Several sanitation "levels" are being used to compare sanitation service levels within countries or across countries. The sanitation ladder defined by the Joint Monitoring Program in 2016 starts at open defecation and moves upwards using the terms "unimproved", "limited", and "basic", with the highest level being "safely managed". This is particularly applicable to developing countries.
The Human Right to Water and Sanitation was recognized by the United Nations (UN) General Assembly in 2010. Sanitation is a global development priority and the subject of Sustainable Development Goal 6. The estimate is 2017 by JMP states that 4.5 billion people currently do not have safely managed sanitation. Lack of access to sanitation has an impact not only on public health but also on human dignity and personal safety.
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There are some variations in the use of the term "sanitation" between countries and organizations. The World Health Organization defines the term "sanitation" as follows:
"Sanitation generally refers to the provision of facilities and services for the safe disposal of human urine and feces. The word 'sanitation' also refers to the maintenance of hygienic conditions, through services such as garbage collection and wastewater disposal."
Sanitation includes all four of these technical and non-technical systems: Excreta management systems, wastewater management systems (included here are wastewater treatment plants), solid waste management systems as well as drainage systems for rainwater, also called stormwater drainage. However, many in the WASH sector only include excreta management in their definition of sanitation.
Another example of what is included in sanitation is found in the handbook by Sphere on "Humanitarian Charter and Minimum Standards in Humanitarian Response" which describes minimum standards in four "key response sectors" in humanitarian response situations. One of them is "Water Supply, Sanitation, and Hygiene Promotion" (WASH) and it includes the following areas: Hygiene promotion, water supply, excreta management, vector control, solid waste management, and WASH in disease outbreaks and healthcare settings: 91.
Hygiene promotion is seen by many as an integral part of sanitation. The Water Supply and Sanitation Collaborative Council defines sanitation as "The collection, transport, treatment and disposal or reuse of human excreta, domestic wastewater and solid waste, and associated hygiene promotion."
Despite the fact that sanitation includes wastewater treatment, the two terms are often used side by side as "sanitation and wastewater management".
Another definition is in the DFID guidance manual on water supply and sanitation programs from 1998:
"For the purposes of this manual, the word ‘sanitation’ alone is taken to mean the safe management of human excreta. It, therefore, includes both the ‘hardware’ (e.g., latrines and sewers) and the ‘software’ (regulation, hygiene promotion) needed to reduce fecal-oral disease transmission. It encompasses too the re-use and ultimate disposal of human excreta. The term environmental sanitation is used to cover the wider concept of controlling all the factors in the physical environment which may have deleterious impacts on human health and well-being. In developing countries, it normally includes drainage, solid waste management, and vector control, in addition to the activities covered by the definition of sanitation."
Sanitation can include personal sanitation and public hygiene. Personal sanitation work can include handling menstrual waste, cleaning household toilets, and managing household garbage. Public sanitation work can involve garbage collection, transfer and treatment (municipal solid waste management), cleaning drains, streets, schools, trains, public spaces, community toilets and public toilets, sewers, operating sewage treatment plants, etc.: 4 Workers who provide these services for other people are called sanitation workers.
The overall purposes of sanitation are to provide a healthy living environment for everyone, to protect natural resources (such as surface water, groundwater, soil), and to provide safety, security and dignity for people when they defecate or urinate.
The Human Right to Water and Sanitation was recognized by the United Nations (UN) General Assembly in 2010. It has been recognized in international law through human rights treaties, declarations and other standards. It is derived from the human right to an adequate standard of living.
Effective sanitation systems provide barriers between excreta and humans in such a way as to break the disease transmission cycle (for example in the case of fecal-borne diseases). This aspect is visualized with the F-diagram where all major routes of fecal-oral disease transmission begin with the letter F: feces, fingers, flies, fields, fluids, food.
Sanitation infrastructure has to be adapted to several specific contexts including consumers' expectations and local resources available.
Sanitation technologies may involve centralized civil engineering structures like sewer systems, sewage treatment, surface runoff treatment and solid waste landfills. These structures are designed to treat wastewater and municipal solid waste. Sanitation technologies may also take the form of relatively simple onsite sanitation systems. This can in some cases consist of a simple pit latrine or other type of non-flush toilet for the excreta management part.
Providing sanitation to people requires attention to the entire system, not just focusing on technical aspects such as the toilet, fecal sludge management or the wastewater treatment plant. The "sanitation chain" involves the experience of the user, excreta and wastewater collection methods, transporting and treatment of waste, and reuse or disposal. All need to be thoroughly considered.
"Sanitation generally refers to the provision of facilities and services for the safe disposal of human urine and feces. The word 'sanitation' also refers to the maintenance of hygienic conditions, through services such as garbage collection and wastewater disposal."
Sanitation includes all four of these technical and non-technical systems: Excreta management systems, wastewater management systems (included here are wastewater treatment plants), solid waste management systems as well as drainage systems for rainwater, also called stormwater drainage. However, many in the WASH sector only include excreta management in their definition of sanitation.
Another example of what is included in sanitation is found in the handbook by Sphere on "Humanitarian Charter and Minimum Standards in Humanitarian Response" which describes minimum standards in four "key response sectors" in humanitarian response situations. One of them is "Water Supply, Sanitation, and Hygiene Promotion" (WASH) and it includes the following areas: Hygiene promotion, water supply, excreta management, vector control, solid waste management, and WASH in disease outbreaks and healthcare settings: 91.
Hygiene promotion is seen by many as an integral part of sanitation. The Water Supply and Sanitation Collaborative Council defines sanitation as "The collection, transport, treatment and disposal or reuse of human excreta, domestic wastewater and solid waste, and associated hygiene promotion."
Despite the fact that sanitation includes wastewater treatment, the two terms are often used side by side as "sanitation and wastewater management".
Another definition is in the DFID guidance manual on water supply and sanitation programs from 1998:
"For the purposes of this manual, the word ‘sanitation’ alone is taken to mean the safe management of human excreta. It, therefore, includes both the ‘hardware’ (e.g., latrines and sewers) and the ‘software’ (regulation, hygiene promotion) needed to reduce fecal-oral disease transmission. It encompasses too the re-use and ultimate disposal of human excreta. The term environmental sanitation is used to cover the wider concept of controlling all the factors in the physical environment which may have deleterious impacts on human health and well-being. In developing countries, it normally includes drainage, solid waste management, and vector control, in addition to the activities covered by the definition of sanitation."
Sanitation can include personal sanitation and public hygiene. Personal sanitation work can include handling menstrual waste, cleaning household toilets, and managing household garbage. Public sanitation work can involve garbage collection, transfer and treatment (municipal solid waste management), cleaning drains, streets, schools, trains, public spaces, community toilets and public toilets, sewers, operating sewage treatment plants, etc.: 4 Workers who provide these services for other people are called sanitation workers.
The overall purposes of sanitation are to provide a healthy living environment for everyone, to protect natural resources (such as surface water, groundwater, soil), and to provide safety, security and dignity for people when they defecate or urinate.
The Human Right to Water and Sanitation was recognized by the United Nations (UN) General Assembly in 2010. It has been recognized in international law through human rights treaties, declarations and other standards. It is derived from the human right to an adequate standard of living.
Effective sanitation systems provide barriers between excreta and humans in such a way as to break the disease transmission cycle (for example in the case of fecal-borne diseases). This aspect is visualized with the F-diagram where all major routes of fecal-oral disease transmission begin with the letter F: feces, fingers, flies, fields, fluids, food.
Sanitation infrastructure has to be adapted to several specific contexts including consumers' expectations and local resources available.
Sanitation technologies may involve centralized civil engineering structures like sewer systems, sewage treatment, surface runoff treatment and solid waste landfills. These structures are designed to treat wastewater and municipal solid waste. Sanitation technologies may also take the form of relatively simple onsite sanitation systems. This can in some cases consist of a simple pit latrine or other type of non-flush toilet for the excreta management part.
Providing sanitation to people requires attention to the entire system, not just focusing on technical aspects such as the toilet, fecal sludge management or the wastewater treatment plant. The "sanitation chain" involves the experience of the user, excreta and wastewater collection methods, transporting and treatment of waste, and reuse or disposal. All need to be thoroughly considered.