Mon­soon WOES

Society - - SOCIETY SAYS SO -

DR PRASANNA S SHAH,

MD, DNB, an in­ter­ven­tional gas­troen­terol­o­gist at Breach Candy Hospi­tal and Jaslok Hospi­tal and Re­search Cen­tre, briefly dis­cusses some com­mon wa­ter-re­lated dis­eases that can be cur­tailed if we choose to be more pre­ven­tive in our ap­proach, es­pe­cially in the mon­soon.

Diar­rhoeal Dis­ease

Di­ar­rhoea is a symp­tom of in­fec­tion caused by either bac­te­rial, vi­ral or par­a­sitic or­gan­isms, most of which can be spread by con­tam­i­nated wa­ter—wa­ter con­tam­i­nated with hu­man fae­ces, for ex­am­ple, from mu­nic­i­pal sewage and la­trines. It may be sur­pris­ing to many that 1 gm of fae­ces can con­tain 10,000,000 viruses, 1,000,000 bac­te­ria, 1,000 par­a­site cysts and 100 par­a­site eggs. This shows how highly in­fec­tive fae­ces can be. De­pend­ing on the type of in­fec­tion, the di­ar­rhoea may be rice wa­tery (for ex­am­ple in cholera) or passed with blood (in dysen­tery, for ex­am­ple). Poor per­sonal hy­giene and un­hy­gienic food han­dlers are another sources of in­fec­tion.

Key in­ter­ven­tions

- im­proved san­i­ta­tion, the use of boiled drink­ing wa­ter and of course, ab­so­lute stress on per­sonal hy­giene and clean food han­dling.

As­cari­a­sis (Round­worm

Dis­ease) As­cari­a­sis is the most com­mon in­testi­nal worm in­fec­tion and is caused by con­sum­ing food or drinks con­tam­i­nated with round­worm eggs. The first sign may be the pas­sage of a live worm, usu­ally in the fae­ces. In se­vere in­fec­tion, in­testi­nal ob­struc­tion may oc­cur, es­pe­cially in chil­dren. Other symp­toms may in­clude low-grade fever, breath­less­ness, wheez­ing and ab­dom­i­nal pain. Im­proved san­i­ta­tion and hy­giene in de­vel­op­ing coun­tries re­duce the risk in those ar­eas. Pre­ven­tive treat­ment with de­worm­ing med­i­ca­tions may be ad­vised in en­demic ar­eas. Key In­ter­ven­tions -Wash­ing, peel­ing or cook­ing all raw veg­eta­bles and fruits. Per­sonal hy­giene be­fore han­dling food can­not be over­stressed.

Hep­ati­tis A and E

These are liver dis­eases caused by the hep­ati­tis A and E virus re­spec­tively. The virus is trans­mit­ted mainly through the fae­cal-oral route due to fae­cal con­tam­i­na­tion of drink­ing wa­ter and food­borne trans­mis­sion from in­ges­tion of prod­ucts de­rived from in­fected an­i­mals. Symp­toms in­clude fever, ab­dom­i­nal pain and jaun­dice. On a per­sonal level, in­fec­tion can be min­imised by main­tain­ing hy­gienic prac­tices such as hand wash­ing with safe wa­ter, par­tic­u­larly be­fore han­dling food; avoid­ing drink­ing wa­ter and/or ice of un­known pu­rity; avoid­ing eat­ing un­cooked shell­fish, and un­cooked fruits or veg­eta­bles that are not peeled or well-cooked.

Typhoid and Paraty­phoid In­fec­tion

These are caused by the bac­te­ria Sal­monella ty­phi and Sal­monella paraty­phi re­spec­tively. These micro­organ­isms are passed in the fae­ces and urine of in­fected peo­ple. Peo­ple be­come in­fected af­ter eat­ing food that has been han­dled by a per­son who is in­fected or by drink­ing wa­ter that has been con­tam­i­nated by sewage con­tain­ing the bac­te­ria. In­ter­ven­tions in­clude hy­giene, es­pe­cially re­gard­ing hand-wash­ing af­ter toi­let use and be­fore food prepa­ra­tion, safe wa­ter sup­ply, proper san­i­ta­tion sys­tems, ex­clud­ing dis­ease car­ri­ers from food han­dling. Surely, one re­alises the ne­ces­sity of per­sonal hy­giene and proper food han­dling to prevent these dis­eases. More than mon­soon re­lated, most of these are kitchen re­lated, in my opin­ion, and the home-mak­ers and food han­dlers at home and out­side should cer­tainly be more strin­gent. As dif­fi­cult as it may sound, avoid­ing out­side food is the hall­mark of the pre­ven­tive in­ter­ven­tion of these wa­ter re­lated dis­eases. The list of such dis­eases is very ex­haus­tive and surely can­not be cov­ered in this space. Malaria, dengue, lep­tospiro­sis are cer­tainly other mon­soon dis­eases which have for­tu­nately re­ceived enough at­ten­tion and aware­ness.

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