Common Vehicle Spread

Unfortunately, the the term "common vehicle spread" is defined in several very different ways by different authors. We will use the expression to refer to transmission of disease via

These "common vehicles" potentially expose many people and can be responsible for widespread transmission. Some authors include airborne transmission in this category.

Water-related Illnesses

The World Health Organization takes a broad view of the potential for water-related illnesses.

Water-related Diseases (from WHO)

"Water, sanitation and hygiene have important impacts on both health and disease.

Water-related diseases include:

  • those due to micro-organisms and chemicals in water people drink;
  • diseases like schistosomiasis which have part of their lifecycle in water;
  • diseases like malaria with water-related vectors;
  • drowning and some injuries;
  • and others such as legionellosis carried by aerosols containing certain micro-organisms.

Water also contributes to health, for example through hygiene."

Water is essential to life, but it is also a potential "common vehicle" for disease. Naturally occurring water has impurities, but as human populations grew and began to establish towns and cities, increasingly contaminated water became a major source of illness and premature death. All public drinking water sources in the United States are regulated by the FDA to ensure quality, although there are cases of contamination occasionally. In many parts of the world, clean water is by no means assured.

The five major classes of disease-causing agents that can be found in water are:

  1. Parasites (e.g., Giardia, Cryptosporidia)
  2. Bacteria (e.g., Cholera, Shigella, E. coli)
  3. Viruses (e.g., Norwalk virus, hepatitis A)
  4. Chemical contaminants (e.g., pesticides, heavy metals, organic solvents)
  5. Neurotoxins from "algal blooms" (see report of contamination of Toledo, Ohio's water supply in August 2014)

The first three groups of agents often enter water supplies as a result of contamination with human or animal feces. Chemical contaminants are most commonly from man-made pollution, but it can also be naturally-occurring, e.g., arsenic.

Fecal-Oral Transmission

Fecal-oral transmission can occur when bacteria or viruses in the stool of one person are swallowed by another. This can occur whenever there is


The fecal-oral route can transmit diseases caused by bacteria, viruses, or protozoa.


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Prevention of Fecal-Oral Transmission

Contaminated Drugs, Blood, Blood Products, or Medical Devices

Drugs, transfusions of blood or blood products (e.g., clotting factors for hemophiliacs), and medical devices are all considered "common vehicles," and contamination of these medical products can cause small or large disease outbreaks. In September 2012, the Centers for Disease Control and Prevention (CDC), in collaboration with state and local health departments and the Food and Drug Administration (FDA) , began investigating a multistate outbreak of fungal meningitis and other infections among patients who received contaminated methylprednisolone (an anti-inflammatory steroid) injections. The investigation began when Vanderbilt University contacted the Tennessee Department of Health to report a patient with fungal meningitis after receiving an injection of methylprednisolone. The methlyprednisolone had been prepared at the New England Compounding Center, and three lots of the drug were believed to have been contaminated. The contaminated drugs had been shipped to 75 medical facilities in 23 states, and doses had been administered to approximately 14,000 patients. The contaminated lots were recalled, and hospitals were notified, but as of March 10, 2013, 48 people had died, and 720 were being treated for persistent fungal infections.