SRINAGAR: Jammu Kashmir and Ladakh are confronting a public health challenge that often receives little attention outside emergency situations—water-borne diseases.
Data released in the Rajya Sabha by the Ministry of Health and Family Welfare, compiled from the Integrated Disease Surveillance Programme (IDSP) portal, shows that the Union Territories have seen fluctuating but concerning trends in diseases such as acute diarrhoeal diseases, hepatitis A and E, typhoid, and leptospirosis over the past five years.
In Jammu Kashmir, the total number of reported water-borne disease cases rose steadily from 54,990 in 2021 to 61,862 in 2022, before dipping slightly to 57,184 in 2023, reflecting some short-term improvement, likely linked to targeted public health campaigns. However, 2024 saw a sharp spike, with cases climbing to 81,002, before settling at 78,300 in 2025. The pattern suggests that while routine preventive measures and awareness campaigns have some impact, seasonal factors, floods, and water supply issues continue to contribute to surges in disease incidence.
Acute diarrhoeal diseases (ADD), the most frequently reported, increased from 54,990 cases in 2021 to 61,862 in 2022, slightly receding to 57,184 in 2023, before reaching a peak of 81,002 in 2024. Cholera cases were largely absent or very low until 2024, when 30 cases were reported, signaling localized outbreaks. Leptospirosis remained negligible, with only 20 cases recorded in 2024, while hepatitis E showed a worrying rise from 41 cases in 2021 to 3,760 in 2024, before slightly declining to 3,500 in 2025. Hepatitis A, although historically low, also spiked from 41 cases in 2021 to 182 in 2024, underscoring lapses in water sanitation and hygiene. Typhoid remained a persistent concern, fluctuating from 2,270 cases in 2021 to 15,582 in 2022, then 19,244 in 2023, 16,582 in 2024, and 17,100 in 2025, highlighting chronic contamination of water sources in certain districts.
In Ladakh, the absolute numbers are smaller due to its sparse population and arid terrain, yet trends show gradual increases in certain diseases. Total cases rose from 5,681 in 2021 to 3,923 in 2022, before declining to 2,901 in 2023, and then spiking again to 4,143 in 2024, with 4,000 reported in 2025. Acute diarrhoeal diseases remain the bulk of infections, while typhoid and hepatitis E are rare but emerging concerns. Leptospirosis and hepatitis A remain virtually absent, reflecting both the harsher climate and smaller population density.
Mortality and long-term health burden, measured in Disability-Adjusted Life Years (DALYs), remain significant. Unsafe water and poor sanitation contribute not only to deaths but also to chronic health conditions, particularly among children and vulnerable rural populations. In Jammu & Kashmir, recurring floods, disruption of water supply systems, and inadequately maintained municipal water sources exacerbate the risk of outbreaks.
To address the challenge, the Ministry of Health and Family Welfare has rolled out comprehensive guidelines for flood-related public health risks, emphasizing disease surveillance, hygiene, and safe water practices. Community engagement through Village Water and Sanitation Committees, regular water testing, public awareness campaigns, and training in water purification and handwashing have been central to preventive efforts. In Jammu & Kashmir, these measures have been implemented alongside targeted interventions in flood-prone districts and urban centers with aging water infrastructure.
Experts note that while annual fluctuations in case numbers are influenced by seasonal patterns and environmental factors, the overall trend in Jammu & Kashmir points to a gradual increase in water-borne diseases over the five-year period, particularly in hepatitis E and typhoid. In Ladakh, although absolute numbers are smaller, the pattern underscores the fragility of water and sanitation infrastructure in high-altitude and remote areas.
Public health specialists emphasize the urgent need for improved water treatment facilities, sustainable sanitation systems, and continuous community education, especially in rural and peri-urban areas. Mobile water testing units, local awareness campaigns, and rapid response teams during floods or contamination events could reduce disease transmission and prevent spikes in morbidity.
