Beware of water borne diseases

By Rosanne Koelmeyer Anderson

Subsequent to the recent floods which caused havoc in several areas around the country, the outbreak of food and water borne diseases too have been on the increase. The reported cases of diarrhoea, dysentery, viral hepatitis, typhoid and leptospirosis have shown a significant rise especially in the flood affected areas.

Experts of the Epidemiological Unit of the Ministry of Healthcare and Nutrition have stipulated that the only way of overcoming this situation is by following instructions given by the health authorities and taking the necessary precautionary measures. Negligence would lead to unwarranted circumstances, the public is warned.

Speaking to the Sunday Observer, Dr. Jagath Amerasekera, Medical Officer of the Epidemiology Unit Colombo said the repercussions of the recent flood which affected many districts had been manageable as the health infrastructure and the media had played a vital role in curbing the spread of water borne diseases.

The public should be educated on the precautionary measures they should take before and after a flood and especially while the water is receding. Strengthening the surveillance system of communicable diseases in flood affected areas is the function of the Epidemiology Unit, he explained.

Serious issue

During torrential rain and floods the dirt, garbage and faecal

matter gets deposited especially in the wells contaminating the water source of many households which invariably leads to contracting a water borne disease. The incubation period of diseases vary from 3-30 days.

The incubation period of dysentery would be about 3 days while in the case of Hepatitis A the incubation period would extend to 28-30 days. Hence, the predominance of some of the water borne diseases are at high risk, Dr. Amerasekera explained.

Flooding of toilets into the front and back yards where raw leaves and leafy vegetables are grown is yet another contributory factor. Contaminated water sources and food is best avoided in these circumstances. Consumption of boiled and cooled drinking water is a must.

After a flood it is best that all well are cleared, cleaned and chlorinated well removing all garbage debris using proper methods before re using. Experiencing vector borne diseases such as dengue and chickungunya a week or two after a flood is also common.

The flood affected areas were Ratnapura, Kalutara, some parts of Colombo, Galle, Matara and Kegalle in particular where there were a number of cases of skin disease reported too. The availability of active surveillance and mobile clinics were beneficial aspects in these areas.

Meanwhile, Dr. Risintha Premaratne, Consultant, Epidemiology Unit of the Ministry of Healthcare and Nutrition speaking on the prevalence of hepatitis stated that the disease can be caused by several factors including viruses, drugs, chemicals and alcohol.

Alcohol was one of the most significant contributory factors denoting inflammation of the liver. Five viruses have been identified with Hepatitis. The commonest being Hepatitis A and Hepatitis E which are transmitted through food and water borne diseases while Hepatitis B, Hepatitis C and Hepatitis D are transmitted through the blood and body fluid.

Vulnerable

In 2007, 5885 cases of viral hepatitis were reported (on suspicion)Â from the Gampola and surrounding areas. The outbreak of viral Hepatitis has been constant in the Kegalle district over the years. Notably, every five years there has been an outbreak of Hepatitis A due to susceptibility.

At present, Hepatitis A has been spreading in outbreak proportions  in the Sabaragamuwa Province in Mawanella and Aranayake. Hepatitis A causes a high risk as the incubation period is around 28-30 days and could extend to even 45 days before it is diagnosed.

The danger is that Hepatitis A is infectious. It is an infection of the liver which can easily spread from person to person and children are more vulnerable. Stools cause the spread of the Hepatitis virus by the faecal-oral route.

Always drinking boiled and cooled water is a must. Keep cooked food covered and consume home cooked food. Wash fruits thoroughly before eating and leafy vegetables should be well cooked.

Dispose garbage properly to prevent flies from breeding. Using something contaminated or failure on the part of an infected person to wash himself thoroughly after toilet use could cause the spread of Hepatitis A. A vaccine is available for the prevention of Hepatitis A.

The symptoms of Hepatitis A could vary in clinical severity from a mild illness lasting 1-2 weeks to a severely disabling disease lasting several months. Fever, fatigue, loss of appetite, stomach pain, diarrhoea, nausea and jaundice are common symptoms of Hepatitis A which could be diagnosed by a blood test. The test could also differentiate between a current infection and a past one while there are other blood test which could find the extent of damage caused to the liver.

Meanwhile, Dr. Navaratnasingam Janakan also a Consultant Epidemiologist of the Epidemiology Unit, Ministry of Healthcare and Nutrition speaking on the incidence of leptospirosis which was rapidly spreading as a result of the recent floods states that during the past two weeks reports show that leptospirosis is on the decrease although during the latter part of May there was a significant number of cases reported from the Matale district. In 2007, 2195 cases were reported to the Epidemiology Unit.

Up to May 16, of a total of 1700 reported cases 51 deaths have been reported from  Anuradhapura, Ratnapura, Hambantota and Moneragala. There is a direct correlation between the amount of rainfall and the incidence of leptospirosis. The necessity of strengthening prevention activities at primary, secondary and tertiary level is vital.

Exposure to contaminated water and soil should be avoided.

However for  those engaged in agriculture, gemming sewage work and work which involves direct contact with waterways it is inevitable. The risk is very high in such instances. Such persons are advised to wear protective footwear and clothing and cover all abrasions with waterproof dressing.

MOH officers should be notified of all high risk groups. Doxycycline on a regular basis during the period of exposure is recommended. However, children below 12 years of age, pregnant and lactating mothers should not be given Doxycycline, Dr. Janakan states.

De-stress in 5 minutes or less

Lighten up: When the body absorbs sunlight, it enhances the effect of mood-stabilizing chemicals like serotonin. Catch some rays, whether by moving playdates outside or parking your car a little farther from a store so you have to walk a ways to get where you’re going. In the winter, throw open the curtains during the day.

Take a (virtual) vacation: “I close my eyes and visualize being on a luxury ocean liner,” says Alisha Bush, a mom of one in Madisonville, Tennessee. “I feel the rhythm of the waves and inhale the smell of the ocean.”

Jump rope: It’s not just for third-grade recess anymore. Jumping rope for 20 minutes triggers your body to release feel-good endorphins, and its repetitive motion makes you relaxed and focused, says Patricia Arcari, Ph.D., director of the Calm Mother, Happy Child program at Massachusetts General Hospital. Grab your kid and see who can go the longest.

Crank up some tunes: Play music that brings up good memories. “Many people find they have a visceral reaction to something they heard in their youth,” says Suzanne Hanser, chair of the Music Therapy Department at Berklee College of Music, in Boston, Massachusetts. Choose anything that triggers a positive image, like your wedding-dance song or the music that played during a first date or at the first rock concert you went to as a teenager.

Breathe deeply: “ I touch my middle finger and thumb together on each hand to signal to myself that I should stop what I’m doing and take a deep, cleansing breath,” says Sharon Wren, a mom of two in East Moline, Illinois. “It sounds goofy, but it works. You can do it wherever you are - in the grocery store or even at a parent-teacher conference.”

Say your CBA’s: “When I’m upset, I recite the alphabet backward,” says Ann Eide, a mom of one in Columbus, Mississippi. “I really have to concentrate on the letters, so by the time I get to ‘P,’ I’ve forgotten what was bothering me.”

Connect with a grown-up: Social support is one of the most effective coping mechanisms we have when we’re feeling anxious and stressed, say experts. If you can’t reach a friend on the phone, send a quick message.

Turn the world upside down: “I lie across several stairs upside down,” says Annette Nikolich, a mom of two in Lake Barrington, Illinois. “I’m not sure how it started - I think I probably just collapsed one evening after chasing a preschooler and a toddler all day.

It must have something to do with all that blood rushing to my head, but since then, whenever I’m going insane, a few minutes upside down on the stairs totally changes my outlook and mood.”

Laugh it off: Numerous studies show that laughter lowers your levels of cortisol, which is a stress hormone. So go ahead and giggle out loud at your husband’s bad knock-knock jokes - it’ll make you both feel good.

Get busy in bed: Having sex releases endorphins that improve your mood and decrease symptoms of stress. (No instructions needed.)

Spritz off stress: “I use lavender essential oil to get calm,” says Marguerite Wright, a mom of four in Dixmoor, Illinois. “I put it in a plug-in diffuser or add a few drops to distilled water in a spray bottle and spritz it on myself, the kids, and all over the house.”

Rub the right way: No, we’re not talking about getting a massage; we’re talking about *giving* one - to your baby.

Research shows that when women massage infants, their levels of the stress hormone cortisol drop, which in turn calms them down, says Tiffany Field, Ph.D., director of the Touch Research Institute at the University of Miami School of Medicine.

Before putting on your baby’s pj’s, dab a few drops of baby oil onto your fingers and give her a rubdown. If you’re unsure of your technique, don’t worry. “Moms know instinctively how to massage,” says Field.

Six ways to avoid dying of a surprise heart attack

The facts are scary: Despite the progress made against heart disease in the past several decades, almost half the people who die suddenly from a heart attack or other cardiac problem have no prior symptoms.

Even knowing someone’s risk factors for heart disease, it’s often tough to pinpoint who will actually go on to get the disease. And once blood flow to the heart muscle is blocked and a heart attack happens, it’s not exactly clear why some people experience sudden cardiac arrest which killed *Meet the Press* host Tim Russert recently, and others don’t.

Those uncertainties, however, don’t mean that you are powerless to protect yourself from dying of a heart attack. Here are steps to take to improve your odds:

1. Follow the standard prevention guidelines.

The American Heart Association has three basic tips for preventing heart disease, stroke, and heart attack. Don’t smoke, be more active, and make good nutritional choices. This is good general health advice, regardless of your heart disease risk.

2. Exercise.

Yes, we mentioned it above, but it’s worth repeating.

“Exercise raises good cholesterol and lowers bad cholesterol”, says Rob Michler, director and chairman of heart surgery at the Montefiore-Einstein Heart Center in New York. Worrying that exercise is going to give you a heart attack is not a valid excuse for skipping it; while it’s true that exercise raises your odds of a heart attack in the moment, the long-term benefits vastly outstrip this short-term risk. (Still, check with your doctor first if you’re obese, have health problems, or haven’t exercised in years.)

3. Know your risk

Find out your Framingham risk score, which gives the odds of heart attack or heart disease-related death in the next 10 years. It requires you have certain basic information, like your cholesterol numbers and blood pressure.

This score isn’t perfect, especially for young people and for women, who can find alternative ways to gauge risk, but it’s a good place to start. Talk to your doctor about your risk score, and do something about what is controllable, like your weight or tobacco habits.

“Recognize when you have a risk and modify that risk as much as you can,” says Steve Owens, a cardiologist at the University of Kansas Hospital in Kansas City, Kan.. If your odds of heart disease are high enough, talk with your doc about the pros and cons of medications like statins or aspirin.

4. Get a family history

“Your genetic profile is the one risk factor we can’t modify,” says Michler. But if you have a family history of early-onset heart disease, tell your doctor even if you’re in perfect health yourself.

If your father had a heart attack at 40 (even if he survived it), that’s crucial information about your possible genetic risk.

5. Know the symptoms of heart problems

It’s not just crushing chest pain.

U.S. News wrote recently about how to know if you’re having a heart attack and what to do about and also looked at how women may not be alert to the signs of heart disease.

6. Learn CPR. Clearly, you can’t perform it on yourself, but you can help someone around you who is experiencing cardiac arrest. “If people can make it until EMS arrives, then their chances of survival are wonderful,” says Judith Hochman, clinical chief of cardiology at New York University, who says she’s seen three recent cases of patients saved by CPR.

The American Heart Association says it improves survival two to threefold and recently urged laypeople to learn how to do it. And it needn’t be complicated: Chest compressions alone can help heart attack victims. Meantime, if you’re in a public space like a gym or casino when someone has an attack, look for an automated external defibrillator, Hochman advises.