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| Sunday, 2 January 2005 |
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Features |  |
| News Business Features Editorial
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Managing bowel and respiratory diseases Following the massive floods caused by the Tsunami, health authorities have warned of an outbreak of several bowel related and respiratory infections. A health spokesman from the Epidemology Unit said that Diarrhoea is usually widespread following floods. The commonest type of diarrhoea is where a person passes copious amounts of watery stools. This is most often due to an infection of the small intestine caused by viruses or bacteria. In children under two years of age, about 50 per cent of the watery diarrhoeas is caused by viruses (in the same way that the common cold is due to an infection with viruses). In both the common cold and diarrhoea, the disease gets cured on its own within three to four days. However the difference between them is that in diarrhoea there is the loss of a large amount of water and salts from the body, which results in dehydration.When the diarrhoea is predominantly associated with frequent small stools with blood and mucus, it is the large intestine that is the site of infection, and the condition is known as dysentery. Dysentery is most often caused by bacteria called Shigella, and rarely by Amoebae and other infective agents. Yet another rare cause of a severe form of watery diarrhoea is cholera; this is due to a bacterial infection. How diarrhoea is caused Infecting organisms (usually viruses and bacteria) get into the intestine from: . contaminated food (whether solids or fluids) - milk, unboiled water, etc. . unwashed fingers, unclean nipples of the mother, unclean bottles and teats (in bottle feeding), unclean clothes, . through flies. Diarrhoea is particularly dangerous in babies. Water constitutes about 70 per cent of a baby's body. Vitally important substances called salts are dissolved in this water. During watery diarrhoea there is an excessive loss of water and salts from the small intestine. This is due to a process called secretion (caused by the germs) whereby excessive amounts of water and salts are transferred from the body to the cavity of the small intestine. These secretions go down the intestines and pass out as watery stools. This causes dehydration (loss of water and salts) and eventually death if no action is taken, in the same way as a plant will shrivel up and die if not watered. Dehydration can be made worse by vomiting, which is often associated with diarrhoea. Dehydration occurs faster in infants and young children than in older persons. Dehydration in watery diarrhoea, the child will usually recover if dehydration is prevented or treated early. The first symptom of dehydration is thirst; but infants are not able to complain of thirst. Thirst may manifest itself as excessive crying, irritability and fretfulness. In addition to thirst (or its manifestations), other features of dehydration include: reduction in urine output, dryness of mouth and tongue, sunken eyes, and reduction of tears on crying. Dehydration may be mild, moderate or severe. If thirst is the only symptom, it is reckoned to be mild; if any of the additional symptoms mentioned above are present, it is moderate. In severe dehydration, they will become drowsy and have a rapid and feeble pulse, low blood pressure, cold and moist extremities, total absence of urine, and rapid and deep breathing. If not treated vigorously at this stage, they will go into a coma and die. Prevention and treatment of dehydration: Dehydration is prevented by the use of home based fluids. As soon as the child starts watery stools or vomiting, fluids such as rice cungee (preferably roasted rice cungee), young coconut water (king coconut water has a similar composition), fruit drinks or jeevani etc. should be given to replace the continuing loss of fluid. * When the child has mild or moderate dehydration a calculated amount of Oral Rehydration Fluid (ORF) is given over a period of four hours to correct the dehydration. The ORF is dissolved in one litre of water (boiled and cooled). Dissolve the packet in 1000ml, 1 litre (1 litre is the amount contained in 1 and 1/3 of a standard bottle (750 ml), or 2 and 1/2 Elephant Brand aerated water bottles) of clean water. Do not add the salts into the water and then boil, as the salts will change their chemical composition. 90 to 95 per cent of children with acute watery diarrhoeas can be treated with either home based fluids or ORF alone. 3 rules for treating diarrhoea at home * Give the patient more fluids than usual to prevent dehydration. * Give the patient food - soups, bread, plantains, beli, after food every 3-4 hours (at least 6 times a day). In the case of young children, after diarrhoea stops, give an extra meal each day for a week till the child regains normal weight. How to prevent diarrhoea * Use only boiled cool water. If the well water has been contaminated by sea water etc. don't drink from it. Contact health authorities and ensure the water is chlorinated before drinking it. * Prepare fresh hygienic food and make sure it's kept covered to prevent flies resting on it. - Don't eat food from street vendors. - Wash hands (before and after using the latrine) is a must. - Wash the latrine and flush it after using it. ############ More on post flood diseases Common colds and coughs They are also likely to occur among people who have been affected by the recent tidal waves. If the cold is not treated in time it can turn to pneumonia. Prevention Cover the nose with a handkerchief when blowing the nose so that the air around will not be polluted with viruses. Take plenty of hot drinks. A hot cup of coriander with ginger and a steam inhalation of spices and coriander or a few leaves of lemon or lime will help in relieving congestion of the nose. If there is fever or headache take paracetamol. Typhoid Symptoms Headache, usually confined to the forehead. The tongue will be dry and furred. There may be abdominal pain. Enlargement of the spleen is common. Diarrhoea is common in the second week. If typhoid is suspected contact the nearest health worker or hospital. Treatment: Bed rest and a nutritious diet of milk, strained soups and rice conjee, yoghurt, jelly. Prevention: Proper disposal of faeces Drink only boiled cool water. Wash hands well after using the toilet and before meals. Hepatitis This is another likely disease following the recent floods. The type of hepatitis common in Sri Lanka is Hepatitis A. It is due to a virus that gets entry into the body through the mouth as in typhoid and causes infection in the liver. The symptoms are; fever, vomiting, abdominal pain, yellowish (tea coloured) discolouration of the urine and yellowish discolouration of the white of the eyes (jaundice). Consult a doctor immediately if these symptoms occur. Prevention: Avoid eating contaminated food Take special care in disposal of the patient's urine and faeces. If there is no water seal latrine, the faeces and urine should be covered with an antiseptic such as lime powder and buried. ############ Warning: outbreak of diseases In the wake of the Tsunami, the Health Ministry has warned of a possible outbreak of the following diseases: Diarrhoea could follow as a result of bodies that have already begun to putrefy and contaminate drinking water. Ministry sources said that chlorine tablets were been distributed to chlorinate drinking water in the Tsunami struck areas. The intrusion of sea water into wells is another health hazard and all wells should be chlorinated before water from wells is drunk. "The debris in the wells will first have to be removed and then the water will have to be chlorinated," a health spokesman said. Other diseases likely to occur include respiratory diseases, hepatitis, conjunctivitis and typhoid. Health Ministry sources also emphasised the importance of drinking only boiled water and food that is freshly cooked or could be preserved for a long time. SOS for drugs, injections, bandages, syringes Due to the fast depletion of essential drugs to treat injured people following Sunday's tsunami, the Health Ministry has appealed to all business establishments, donors and the public in general to provide them with additional drugs. The Sunday Observer Health page learns that a list of urgently needed drugs has been released by the Medical Supplies Division of the Health Ministry. The list includes; Cannula, injections, syringes, surgical gloves, catheters, urine bags, synthetic absorbable surgical sutures, bandages and several essential life saving drugs that are now running short. Medical update on the tsunami The Epidemiology unit has sent over six teams of doctors to the worst affected areas in the Northern, Eastern and Southern provinces. A spokesperson for the Epidemiology unit told the Sunday Observer that a set of guidelines had been prepared on basic rules to be followed to avoid the spread of diseases, which are being distributed in these areas. "We have not yet got any reports of any diseases that have broken out in any area. But we are taking all precautions to prevent their spread," the spokesperson said. She warned of a likely outbreak of diarrhoeal diseases, Hepatitis, and Respiratory diseases and stressed the need for observing personal hygiene. Her advice to the general public is: Don't drink unboiled water or water from wells where the sea water has seeped in. Eat only food cooked in hygienic conditions. Keep the toilet clean and wash with water after use," she said. What the CMC has to say Dr. Pradeep Kariyawasam, Chief Medical Officer, Colombo Municipal office says, "we have set up 12 refugee camps in the Colombo Municipal area. These are being closely supervised to prevent any outbreak of diseases. So far we have not received reports of any diseases, but we're taking all precautions. All the wells in the city are being chlorinated and the toilets are being disinfected twice a day in the morning and afternoon in all the refugee camps in Colombo. We have also provided clean (bottled) water and requested the refugees to drink only boiled water and to observe strict hygienic rules." |
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