Monsoon & Spread of Typhoid and Diarrhea

Nowadays lot of rain is observed mostly in the South Asian region especially in Indo-Pakistan and Bangladesh. The monsoon season normally starts from the end of June and last till mid of September every year. During rain fall in monsoon weather, the craving for fried food items increases and its nice smell or aroma also tempted to eat.

Severe Mosoon rain

In monsoon season persist damp and hot weather, due to these condition chances of the outbreak of water borne disease is more likely. The disease is spread among masses because of consumption of unhygienic and contaminated food, beverages and water available through street vendors and dhabas (ڈھابا) which mean food or beverages stall along the road side. This source is quite commonly used in our region by the public. The water borne diseases are also spread due to lack of proper sewerage system as well as poor hygienic condition.

Waterborne diseases are of many types. Here we will mostly cover three diseases that is Typhoid, Cholera, and Diarrhea. These diseases are likely to appear as the outbreak in monsoon weather in our region that is India, Pakistan and Bangladesh.  In these three referred countries, approximately 25% of world population lives and out of which nearly 45% people live in abject poverty and in unhygienic condition.

These dhabas are the major source of contaminated food which spreads Typhoid, cholera, diarrhea and vomiting.

Typhoid/Enteric fever

The patient will have a high-grade fever in typhoid, the main reason is taking contaminated or unhygienic food, water or beverages.  Bacteria which causes typhoid is Salmonella typhi. which will harbor in the Gastrointestinal tracts. These available contaminated sources of food and beverages contain theses bacteria i.e. Salmonella typhi, which is the causative agent of typhoid fever. Typhoid is severe in nature and may be fatal in its intensity. It needs proper and full treatment of (14-21days of antibiotic as prescribed by the physician, eat semi solid and freshly cooked food, drink clean water and advise rest) and recommended to follow physician advice.  Typhoid fever is caused by bacteria known as Salmonella typhi or also refer as enterica.

Symptoms of Typhoid

  • High-grade fever, thermometer reading 104degree Fahrenheit or 40degree Celsius.
  • Patient has a headache, abdominal pain and body aches.
  • Poor appetite, sluggish feeling or lethargy.
  • May be suffering from diarrhea (mainly in young children) or constipation in adults.
  • Excessive sweating.
  • Feeling of weakness.
  • Allergic spot or rose spot appear on the chest and abdomen

Typhoid to be taken very seriously if it is left untreated this will lead to intestinal hemorrhage (bleeding) and bacterial infection may spread to the gall bladder, heart, brain and bone.  This may even lead to death of the patient.

As per WHO conservative estimate, the annual reported cases of typhoid fever worldwide are 22 million, out of these reported cases 1-4% of the patient die. WHO further states 90% of the death are reported from Asia. This is mostly observed in children up to the age of 5 years. In children’s it is difficult to diagnose because of confusing symptoms, due to this state it is difficult to adjudge the disease and treat it correctly.

Secondly, if diagnose than compliance will be also an issue due to the length of treatment with the antibiotic for 14-21days along with rest.

The third issue is the emergence of antibiotic or multi drug resistance and physician needs to identify and prescribe the antibiotic which is sensitive to typhoid causing bacteria that is Salmonella strains. In South Asia region, the real challenge is correct diagnosis of typhoid, if it is delayed this may result in shape hospitalization. This add further cost and botheration to patient and family members.

“Prevention is a better choice than treatment in case of typhoid.”

There are two identified paths to reduce the incidence of typhoid in South Asian Region where nearly 90% cases of typhoid are reported:

  • Improve overall hygiene and living conditions in the respective area.
  • Second option is to reduce the incidence of typhoid by vaccination, especially among young children’s to be done as a routine vaccination. This will provide a longer and safe immunity to the children.

Monsoon season rain

Recommended precautions

The best way is to protect yourselves we have listened to very common proverb “prevention is better than cure”.  In this case, it is quite appropriate.

  • Drink clean water that is to drink filtered water or properly boiled water.
  • Refrain and hold back yourself by buying food and beverages from the street vendors.
  • Prevent typhoid by having Vaccination that is Vi conjugate vaccine. The typhoid available vaccine can be safely given to children above the age of six months, routine vaccination of children to be continued as per schedule.

Cholera

Now below we will briefly discuss Cholera. This disease is usually spread via taking food, beverages, and water, which is contaminated by feces. The second source is carried away by flies where poor sanitation condition persists. Cholera can be easily treated but if undiagnosed or not treated properly then it is deadly and will become an epidemic.

Symptoms of Cholera

  • Intense or severe diarrhea and vomiting,
  • Body dehydrates (loss of water and salt)
  • Low blood pressure
  • Dryness of mouth, throat, and nose.
  • Muscular cramp
  • Rapid weight loss.

Protection and prevention

  • Drink clean water
  • Regular and proper hand washing or regular use of sanitizer
  • Always cover or store the food properly.
  • Flush the toilet after every use.
  • Keep bathroom clean and dry.

Diarrhea and its management

During monsoon season which is the hot and damp weather. In this weather diarrhea is a serious health issue and this needs immediate attention. Excessive diarrhea leads to dehydration which means rapid loss of water and salts from the body.

This condition arises in shape of bowel disturbance. This condition prevails because of using unhygienic food and water.

The treatment or cure is to use /consume Oral rehydrate salt (ORS) in boiled or filtered water.

This normally comes with greater intensity for a couple of days called acute diarrhea. Another form of diarrhea is chronic form and this persists for more than a week. Both forms of diarrhea which are mentioned above can be prevented and if occur can be treated. For this need to follow personal cleanness and hygiene guidelines.

Article written by Mahmood Hussain for Baby First Pakistan

About Mahmood Hussain

Professional Experience More than 36 years work experience in Healthcare & Pharmaceutical sectorDirector & General Manager Baby First (Pvt.) Ltd Pakistan March 2011 – till to date I have been associated with Baby First (Pvt) Ltd for more than 5 years. It is advisory, community and social interaction medium for parents 16-38 years and babies 0-6 years.General Manager Aga Khan Health Service Pakistasn December 2005 – December 2007 (2 years 1 month)Based at Karachi Pakistan Worked as General Manager managing Karachi & Baluchistan Health care services of AKHSP which includes primary and secondary health care centers and diagnostic centers on all areas nearly 102 centers which include three leading hospitals in Karachi.General Manager Janssen Cilag (Johnson & Johnson) February 1998 – January 2005 (7 years)Education MBA, Marketing 1995 – 1996, Preston University MSc, Biochemistry 1970 – 1974, Karachi University

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