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