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What is the Safe Water System (SWS)?
Why was the SWS developed?
Who is the SWS for?
Where has the Safe Water System (SWS) been used?
How is a SWS started?

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Where has the Safe Water System been used?
Guinea Bissau

Project Partners

  • CDC
  • Simão-Mendes National Hospital

Target Populations/Location

  • Cholera ward at a hospital

Project Design

  • Research project to determine whether the SWS could prevent bacterial contamination of bulk oral rehydration solution

Intervention Elements

  • CDC safe water storage vessel
  • Locally available commercial bleach
  • Education for hospital staff on use of the Safe Water System

Project Implementation Date

  • November 1997


Results of Project Evaluations

  • Oral rehydration solution (ORS) is lifesaving therapy for cholera and pediatric diarrhea. During a cholera epidemic in Guinea-Bissau, the microbiologic quality of ORS prepared in buckets at a hospital was evaluated and a simple intervention using special vessels for disinfecting tap water with bleach and for preparing, storing, and dispensing ORS was tested. Few coliform bacteria and Escherichia coli were recovered from tap water; however, pre-intervention ORS contained numerous bacteria including E. coli and toxigenic Vibrio cholerae O1. In contrast, ORS samples from intervention vessels had few or no coliform bacteria, no E. coli, and no V. cholerae. Mean pre-intervention counts of coliform bacteria (3.4 X 107 colony-forming units [cfu]/100 ml) and E. coli (6.2 X 103 cfu) decreased significantly during the intervention period to 3.6 X 102 cfu and 0 cfu, respectively (P<0.001). This simple system using bleach disinfectant and special storage vessels prevents bacterial contamination of ORS and reduces the risk of nosocomial transmission of cholera and other enteric pathogens.

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Centers for Disease Control and Prevention
National Center for Infectious Diseases
Division of Bacterial and Mycotic Diseases
Foodborne and Diarrheal Diseases Branch

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