DREAD AND DISEASE
By Esther Williams
Have you caught the bug yet? At least one member in every Colombo
household seems to have been afflicted with viral fever or flu,
diarrhoea, cold and cough or the dreaded Dengue itself in the past
few weeks. What is the cause of this spate of illnesses that has
hospitals full and the Out-Patient Department (OPD) in every hospital
and clinic overflowing?
Lady Ridgeway Children's Hospital (LRCH) last week registered 3200
patients on a single day in their OPD and their recent records show
an average of 300 children being admitted on most days for various
illnesses - a marked increase in the average number of patients
compared to normal.
parents try everything from mosquito coils to repellents to protect
children from Dengue, what can be done about the other illnesses
that seem so common?
While acknowledging that several diseases have emerged during the
present monsoon rains, Director of LRCH, Dr. R. Wimal Jayantha points
out that Dengue is no longer an epidemic but an endemic disease
that we can expect not only during the monsoon but also the whole
year round. There is clear evidence of the disease having become
endemic as seen from the number of patients who sought treatment
at the LRCH's Dengue Management Centre throughout the last year.
Dengue control programme should therefore be a continuous, year-long
programme and not just during the rains," Dr. Jayantha states.
Formerly, the occurrence was seen more commonly in the peak periods
of June-July and November-December when rain left puddles in tins,
plastic bags, tyres etc., creating rich breeding grounds for mosquitoes
as they still do today.
is now considered an urban disease with the most number of cases
registered from Colombo, Kandy and Kurunegala. Dr. Jayantha attributes
this to the high-rise buildings that allow water to stagnate in
blocked gutters. "These areas are beyond our control.”
Residents have to be stricter about eliminating mosquito-breeding
sites around their homes, he says.
more, when an uninfected Aedes mosquito (black with white spots)
bites a person with Dengue and then bites a healthy individual,
the disease quickly spreads from person to person. Dengue fever
may be confused with other infectious diseases such as influenza
or malaria. It can be confirmed by doing a blood count. Doctors
look for two factors: if the platelet count drops dramatically and
if pack cell volume increases, it proves beyond doubt that the patient
types of Dengue that can be fatal if not treated properly are:
Dengue Haemorrhagic Fever: A patient suffering from this will have
fever, headache, severe muscle and joint pain, pain around the eyes,
vomiting and abdominal pain. He/she will need to be hospitalised
to avoid risk of fatal complications.
condition will also give rise to red patches on the skin, bleeding
from the gums, nose, and internal bleeding. The condition should
be closely monitored and treated properly.
Shock Synd-rome: Although there is no bleeding in this condition
there is leakage of fluid from vessels. The blood platelet count
can drop and a patient can go into shock. Further, body temperature
can drop and the person can become unresponsive. He then has to
be hospitalised and given intravenous fluid and plasma.
show that when compared to those of 10 years ago the disease load
has increased fivefold. From 200 cases a year, there are now 5000-6000
cases a year. However the good news is that because people have
become aware of the management, the number of deaths has come down.
of Dengue has most certainly improved even if cases have gone up,"
reiterates Dr. Jayantha adding that most people know that they need
to have their blood platelet count done and fluid replacement to
On our part, he thinks it is imperative that we keep our premises
clean; identify, isolate and treat a patient properly and follow
the Dengue control programme strictly.
Another condition that is increasingly being reported is Diarrhoea.
When patients pass blood and mucous with stools they are said to
have bacillary dysentery that is caused by a bacteria called Shigella.
The LRCH has seen a few patients each day and today there are 30
inpatients undergoing treatment in the wards.
Dysentery, a water-borne disease occurs in people living in poor
sanitary conditions. With rain, the tendency for the disease to
spread is high. Water invariably gets contaminated and this is compounded
by food prepared unhygienically. The Director urges parents to be
alert and watch out for the signs.
Diarrhoea can be prevented by good personal hygiene. At the LRCH's
Diarrhoea Treatment Unit they see around 50 patients each day. On
June 7, 183 patients registered with the problem. When it is diagnosed,
patients are given a specific antibiotic to prevent complications.
However it is mandatory to seek proper treatment.
can we prevent diarrhoea?
Children should carry boiled and cooled water.
should be properly covered to protect it from dust and flies.
homemade food rather than that which is bought on the road.
from buying ice cream from vendors.
fruits and vegetables should be washed properly.
hands with soap before meals
who prepare food should cleanse hands properly before they start.
disposal of faeces.
type of diarrhoea is the watery type that can most often be treated
at home. Caused by a virus, the infection can be accompanied with
fever, vomiting, and abdominal pain. Patients can be given fluids
(king coconut, conjee water), oral re-hydration salts and good nutrition
to treat the symptoms
This is a condition that has symptoms very much like Dengue - fever,
headache, aches and pains, vomiting, loose motions. The disease
spreads easily through droplets (when infected people cough and
sneeze) that are contagious. Others in the home can catch it from
cough and runny nose that comes along with viral fever stays on
long after the fever subsides. "It is natural for it to take
time to settle," Dr. Jayantha states advising patients to take
antihistamines and cough syrups. But if the cough is accompanied
with wheezing and yellow coloured sputum, it could have developed
into a bacterial infection that needs antibiotics.
Since both Dengue and viral fever have similar symptoms, Dr. Jayantha
suggests some simple steps we can follow while at home:
Patients are advised complete bed rest. Children should not be
allowed to play.
Sufficient fluids - oral re-hydration powders and other fluids
(King coconut, conjee water) should be given.
Good nutrition is essential, as immunity drops if you do not eat
Treat symptoms: fever and cold with panadol, cough syrup etc.
T emperature and general conditions should be carefully monitored.
Severity and length of illness depends on each person's immunity.
If fever persists for more than 2-3 days after treating symptoms,
seek medical attention.
alert to conditions as other complications can develop.