Flood borne diseases

Image credit: www.lankapage.com

This post is going to be little special as there's a special reason to write this. Colombo received highest rainfall in 18 years and many roads in Colombo and its suburbs have also been inundated as a result of the heavy rains. Nearly 186,900 people, the majority of them in Colombo, have been affected as of 11 November, according to the National Disaster Management Centre (DMC).
However I'm not going to give you a report of the rain. But as you know, there is a possibility of epidemic diseases spreading in the country due to the recent floods in various parts of the island. The Epidemiology Unit of the Ministry of Health announced the risk of the spreading of dysentery diseases, skin diseases and respiratory diseases and especially they pointed out that their could be an increase in the spread of the Influenza A (H1N1) virus.

According to WHO, floods can potentially increase the transmission of the following communicable diseases:

• Water-borne diseases, such as typhoid fever, cholera, leptospirosis and hepatitis A

• Vector-borne diseases, such as malaria, dengue and dengue haemorrhagic fever, yellow fever. 

And also various skin and soft tissue infections such as;
Impetigo, Cellulitis, Furuncles (staphylococcal), Scabies, Lice, Athlete’s foot, Eczema, Fungi and other skin allergies.

Typhoid fever - 

• High fever
• Malaise
• Headache
• Constipation or diarrhoea
• Rose-coloured spots on the chest
• Enlarged spleen and liver.

         Image via Wikipedia

Cholera -
Symptoms usually start suddenly, one to five days after ingestion of the bacteria.

• Profuse painless diarrhoea which is "rice water" in nature and may have a fishy odor.
• Vomiting of clear fluid.

Leptospirosis - It is transmitted to humans by exposure of abraded skin or mucous membranes [nasal, oral or eye] to water or wet soil or food and water that has been contaminated by urine from asymptomatic chronically infected animals, especially rodents.

• Initial symptoms - Abrupt onset of fever, Chills, Muscle pain esp. in calf muscles and back, Headache, Cough, Nausea, Vomiting, Diarrhoea and Red eyes.
• Second phase of disease occurs after a short period of relative well being. They can present with; Aseptic meningitis, Myocarditis, Pneumonia, Nephritis and Hepatitis with jaundice.

Hepatitis A -

• Prodrome
  
  • Patients may have mild flu like symptoms of anorexia, nausea and vomiting, fatigue, malaise, low-grade fever (usually <39.5°C), myalgia, and mild headache.
• Icteric phase
  
  • Dark urine appears first (bilirubinuria).
  • Pale stool.
  • Jaundice occurs in most (70-85%) adults with acute hepatitis A virus infection
  • Abdominal pain occurs in approximately 40% of patients.
  • Itch (pruritus) is generally accompanied by jaundice.
  • Arthralgias and skin rash. Rash more often occurs on the lower limbs and may have a vasculitic appearance.

Malaria -
Caused by single-cell parasitic protozoa Plasmodium; transmitted to humans via the bite of the female Anopheles mosquito. Parasites multiply in the liver attacking red blood cells resulting;

• Cycles of fever
• Chills
• Sweats
• Anemia

Dengue and Dengue hemorrhagic fever - 

                            Image via Wikipedia

The clinical features of dengue fever vary according to the age of the patient.

• Infants and young children may have a fever with rash.
• Older children and adults may have either a mild fever or the classical incapacitating disease with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash.

Dengue hemorrhagic fever (DHF) is a potentially deadly complication that is characterized by high fever, often with enlargement of the liver, and in severe cases circulatory failure. The illness often begins with a sudden rise in temperature accompanied by facial flush and other flu-like symptoms. The fever usually continues for two to seven days and can be as high as 41°C, possibly with convulsions and other complications.

Yellow fever -
Infection can occur in one or two phases.
The first, "acute", phase usually causes;

• Fever
• Muscle pain with prominent backache
• Headache
• Shivers
• Loss of appetite
• Nausea or vomiting.

However, 15% of patients enter a second, more toxic phase within 24 hours of the initial remission. High fever returns and several body systems are affected. The patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Once this happens, blood appears in the vomit and faeces. Kidney function deteriorates. Half of the patients who enter the toxic phase die within 10 to 14 days, the rest recover without significant organ damage.

Swine flu -
It affects the upper respiratory tract and its symptoms are similar to that of the Human Influenza Virus.

• Sore throat
• Headaches
• Fever with chills
• Aching limbs
• Fatigue
• Running nose
• Diarrhoea
• Vomiting
• Pneumonia and respiratory failure [signs of a more serious swine flu infection]

How to avoid Flood borne diseases:
1. Hygiene and clean water:
Cleanliness is the most important aspect of protection against diseases. Clean food, air and surroundings are all essential aspects.
-Drink boiled water only.
-Wash vegetables with clean water and steam them well to kill germs.
-Avoid eating uncooked foods and salads.
-Drink plenty of water and keep your body well hydrated.
-Do not allow kids to play in stagnant polluted water filled puddles.
-Always wear dry and clean clothes.
-Lime juice, Cloves will help to prevent GIT infections like Cholera, Dysentery etc.
2. Vector control:
Insect repellants may be used.
-Fumigating the house with smoke of dried Neem leaves in evenings for 1-2 minutes is an excellent ayurvedic method to keep mosquitoes away.
-Tulsi is also used as a mosquito repellant.
3. Control of Skin diseases:
Walking in dirty water during rainy season leads to numerous fungal infections which affect toes and nails. Diabetic patients have to take a special care about their feet.
-Always keep your feet dry and clean.
-Avoid walking in dirty water.
-Keep your shoes, socks and raincoats dry and clean.
-Drying clothes with fumes of Loban and dry Neem leaves is recommended in ayurvedic texts.
-Apply castor oil or sesame oil for cracked feet and skin.
-A freshly prepared paste of turmeric, neem and sesame seeds is recommended in Ayurveda for fungal infection between toes.
4. Control of respiratory diseases:
Precautions have to be taken to prevent dampness and growth of fungus (mold) on and around the house especially where asthmatic patients live.
-Spray the walls with cinnamon to prevent mold growth.
-A pinch each of long pepper powder and rock salt mixed in warm water reduces cough.
-Ginger tea is good in boosting immunity as well as digesting toxins.

Herbs and drugs that can be used in epidemics:

• Cumin, Fennel, Coriander, Turmeric, Ginger and Asafoetida are good immune boosters in any condition.
• Nawarathna Kalka - Diarrhea, Abdominal pain and vomiting
• Buddaraja Kalka - Cough, Breathlessness and Bronchial Asthma
• Seetharama Vati, Sudardhana powder- Fever 
• Sarvavishadi Thailaya- Boils abscesses, Ulcers, Skin ailments

Ayurveda Sri Lanka invites you to gather to help displaced people to return back their homes.
Finally I would like to thank my dear friend who reinforced me to share this post with you.

Dr. Indunil Weerarathne