From street food to stored water: What causes a spike in water-borne diseases

New Delhi: Each year, especially during the monsoon season, clinics and diagnostic labs across India report a sharp increase in water-borne illnesses—from simple diarrhoea to more serious infections like typhoid and hepatitis. Many of these cases are preventable, yet they persist due to overlooked habits and delayed diagnosis. Dr. Abhilasha Kochhar, Senior Consultant – Microbiology and Molecular Biology, MD (Microbiology), Metropolis Healthcare Limited, explained how the waterborne-disease crisis can wreak havoc in monsoons.

A major contributor is the widespread consumption of street food and use of stored water, both essential yet risky in the absence of proper hygiene. Street food, while serving a vital socio-economic role by offering affordable meals to urban populations, often operates without access to clean water, toilets, or waste disposal. Foods are frequently handled with bare hands, and even a single lapse in hygiene can trigger an outbreak. Research shows that Salmonella Typhi, the agent that causes typhoid fever, for instance, can survive on human hands for over three hours, making transmission alarmingly easy in such environments.

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Contrary to popular belief, unsafe water isn’t always muddy or foul-smelling. Some of the most common sources of infection are deceptively present in our everyday lives in the form of:

⦁ Street Food and Roadside Beverages: Often prepared with contaminated water and handled without adequate hygiene.

⦁ Water Suppliers: Water vendors may supply water of questionable quality, vulnerable to contamination during collection, storage, and transportation.

⦁ Stored Water: Overhead tanks, buckets, and open containers, if not cleaned regularly, become breeding grounds for bacteria.

⦁ Rainwater Contamination: Monsoons overwhelm drainage systems, causing sewage to mix with rainwater and infiltrate household supplies.

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The infections most frequently linked to contaminated water and food include typhoid fever, hepatitis A and E, cholera, amoebiasis, giardiasis, and leptospirosis. Since many of these illnesses show common and overlapping symptoms like fever, vomiting, diarrhoea, abdominal pain, and jaundice, it can be difficult to identify the exact cause without laboratory tests. Thus, accurate diagnosis is crucial—not just to ensure the right treatment, but also to avoid the unnecessary use of antibiotics. Various diagnostic methods are available such as: stool examination and culture to find common germs like Giardia, Entamoeba, Salmonella, and Vibrio cholerae; blood tests to look for infection-specific antigens or antibodies; liver tests to spot damage caused by hepatitis A and E; and advanced molecular tests like PCR to detect the infection more accurately and quickly.

Persistent symptoms should never be ignored, particularly during the monsoon season when the risk of water-borne infections is high. Timely testing can make the critical difference between a mild illness and a serious health emergency. While there is a need to improve sanitation infrastructure and access to safe drinking water, individual awareness and early medical intervention remain key to preventing large-scale outbreaks and ensuring better health outcomes.