News
How to keep infections in wake of calamity at bay
View(s):By Kumudini Hettiarachchi
Cyclone Ditwah has abated, leaving in its destructive trail floodwaters, landslides, homes and factories that have collapsed or been damaged and thousands of men, women and children displaced.
Now will come the huge health dangers, both physical and mental, warn doctors.
Among the numerous doctors that the Sunday Times spoke to is Consultant Physician Dr Wimalasiri Uluwattage, who says that the Ceylon College of Physicians (CCP) is actively attempting to preempt a health disaster.
“The risk of various infections is heightened following floods and landslides,” says Dr Uluwattage, the Convener of the CCP’s Infectious Diseases Forum.
He turns his focus on leptospirosis (rat fever); melioidosis; dengue; food- and water-related infections, including diarrhoea and hepatitis A; respiratory tract infections; conjunctivitis; skin infections, including scabies; chickenpox; and rarely tetanus. (See graphic.)
Firstly, Dr Uluwattage raises the ‘red flags’ that should be heeded promptly with regard to some of these infections and medical treatment sought at the nearest hospital immediately.
- Leptospirosis – acute febrile illness (sudden high fever) with severe muscle pain. The danger signs are reduced urine output, coughing blood, being short of breath and yellow-tinged eyes.
- Dengue – acute febrile illness, with severe muscle pain and headache. The danger signs are feeling faintish, upper abdominal pain, reduced urine output and becoming drowsy and agitated.
- Diarrhoeal infections – loose stools and abdominal pain. The danger signs are passing blood and mucus with stools, reduced urine output and dehydration. In children, watch for dehydration, which will be indicated by a dry mouth, sunken eyes, reduced urine output for more than six hours and excessive thirst.
Ensure a fluid intake, such as Jeevani (oral rehydration salts), through small and frequent doses.
Don’t delay – take the child or adult to the hospital.
- Respiratory infections – cold, cough and fever. The danger signs are breathing fast (tachypnoea) and being short of breath. In the elderly, there could be confusion and agitation.
- Tetanus – now though rare, may arise through mud contamination of injuries.
- Skin infections – need to be watched closely, as there could be resultant cellulitis.
Referring to leptospirosis, Dr Uluwattage says that even with floodwaters receding, the danger will last awhile, for weeks, as the contaminated muddy environment in homes and temporary shelters will remain. The bacterium can remain in mud and wet soil for weeks.
He said that those at risk are anyone who walks or works in floodwater, muddy fields or stagnant pools; those cleaning wells, drains, toilets, flooded homes and shops; those handling debris, garbage, sandbags or blocked drains; those working barefoot or with exposed cuts on legs and feet; those living in crowded temporary shelters with rodent activity; those in farming, construction, waste removal and rescue/recovery work.
They can seek prophylactic medication from the Public Health Inspectors (PHIs) and Medical Officers of Health (MOHs) of their areas to prevent falling victim to Leptospirosis.
For protection, he suggests:
- Wear boots or covered footwear when walking in wet or muddy areas
- Cover all cuts and wounds with waterproof dressings
- Use gloves and boots for cleaning and handling debris
- Reduce unnecessary contact with muddy water and wet soil
- Keep homes and shelters clean, control rats and store food safely
- Drink only boiled or properly treated water
It is also the same with Melioidosis, as the bacterium which causes this infection remains in dust and drying-up areas for several months, says Dr Uluwattage, adding that even though in the acute stage it is mud-related, people can be prone to inhalation of this bacterium through dust.
Many other physicians who have served in the state sector for long years clearly analysed the short-term, medium-term and long-term health issues that could hit the beleaguered men, women and children.
Malnutrition and lack of nutritious and balanced meals are the first aspects they looked at, as people would be very short of cash. Vegetables and meats/fish would also be scarce in the affected areas. Due to lack of transport, meanwhile, they would also not be able to get about.
A veteran pointed out that roads caving in or being buried under landslides and rail tracks being torn up and laid bare would also hinder people from seeking essential healthcare initially, as their closest hospitals would be hit. They would have no means of accessing higher healthcare facilities too.
The medium-term issues will be the spread of leptospirosis, dengue and diarrhoea, he said, explaining that viral respiratory infections such as influenza would spread in crowded centres for the displaced.
Other things to watch out for would be head-lice infestations (pediculosis), said this physician, also looking at the chances of severe dampness causing candida fungal infections in people’s feet and unhygienic conditions leading to hookworm infections.
He said people have left their homes in a rush with nothing in hand. Those taking long-term medications for conditions such as diabetes, high blood pressure and psychiatric conditions should be considered, as they would not have their medications with them.
Another would be serious surgical emergencies as people engage in home cleaning, roof repairs, etc., he said, adding there is also a need to focus on unwanted pregnancies.
| Prevention suggestions Here are some simple strategies suggested by Dr Wimalasiri Uluwattage to keep diseases at bay:
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| Vulnerable groups Following the floods and landslides, the vulnerable groups include:
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