title: Drinking cholera: salinity levels and palatability of drinking water in coastal Bangladesh.
abstract: OBJECTIVE
  To measure the salinity levels of common water sources in coastal Bangladesh and explore perceptions of water palatability among the local population to investigate the plausibility of linking cholera outbreaks in Bangladesh with ingestion of saline-rich cholera-infected river water.
  
  
  METHODS
  Hundred participants took part in a taste-testing experiment of water with varying levels of salinity. Salinity measurements were taken of both drinking and non-drinking water sources. Informal group discussions were conducted to gain an in-depth understanding of water sources and water uses.
  
  
  RESULTS
  Salinity levels of non-drinking water sources suggest that the conditions for Vibrio cholerae survival exist 7-8 days within the local aquatic environment. However, 96% of participants in the taste-testing experiment reported that they would never drink water with salinity levels that would be conducive to V. cholerae survival. Furthermore, salinity levels of participant's drinking water sources were all well below the levels required for optimal survival of V. cholerae. Respondents explained that they preferred less salty and more aesthetically pleasing drinking water.
  
  
  CONCLUSIONS
  Theoretically, V. cholerae can survive in the river systems in Bangladesh; however, water sources which have been contaminated with river water are avoided as potential drinking water sources. Furthermore, there are no physical connecting points between the river system and drinking water sources among the study population, indicating that the primary driver for cholera cases in Bangladesh is likely not through the contamination of saline-rich river water into drinking water sources.
authors.affiliation: Department of Public Health, Copenhagen Center for Disaster Research COPE, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Stephen Lawrence
authors.initials: SL
authors.lastname: Grant
authors.forename: Charlotte Crim
authors.initials: CC
authors.lastname: Tamason
authors.forename: Bilqis Amin
authors.initials: BA
authors.lastname: Hoque
authors.forename: Peter Kjaer Mackie
authors.initials: PK
authors.lastname: Jensen
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D002771:Cholera / Q000382:microbiology*; D060766:Drinking Water / Q000737:chemistry / Q000382:microbiology*; D005260:Female; D005618:Fresh Water; D006801:Humans; D008297:Male; D008875:Middle Aged; D045483:Rivers / Q000737:chemistry / Q000382:microbiology; D054712:Salinity; D012623:Seawater; D012965:Sodium Chloride; D013649:Taste; D014734:Vibrio cholerae; D014871:Water Microbiology; D014881:Water Supply; D055815:Young Adult
chemical_list: D060766:Drinking Water; D012965:Sodium Chloride
keywords: Agua Potable; Bangladesh; Cólera; Fuentes de agua; Salinidad; cholera; choléra; eau potable; potable water; salinity; salinité; sources d'eau; water sources