The monsoon is a season we all look forward to, having had enough of the summer heat. Nature just soaks the wet showers and flourishes in this season and so do disease producing micro-organisms. So much so that approximately three million people die every year due to the diseases caused by them. So if you want to enjoy the season like all other nature’s creations, you need to protect yourself against or tackle the maladies that are common during this season.
Malaria
It is a mosquito-borne infectious disease caused by a protozoan parasite called plasmodium and is transmitted only by anopheles mosquitoes. It is the most prevalent disease in the world and records one million deaths annually [as per World Health Organization].
Malaria can also spread through blood transfusion, contaminated needles and organ transplants. In India, two types of malaria are prevalent—falciparum and vivax malaria.
The common symptoms are fever with chills and muscle pains. The liver and spleen may get enlarged. Malaria follows a classic cyclic paroxysm consisting of:
- Cold stage: chills and shaking
- Hot stage: warm, headache, vomiting
- Sweating stage: weakness
- Resting stage.
Then the cycle repeats.
In severe cases, malaria can lead to cerebral involvement, renal failure, and liver failure. Sometimes, it can also lead to multiple organ failure and death. Along with associated symptoms, malaria is diagnosed with the help of laboratory tests that detect the parasite or malaria antigen in the blood.
Treatment involves the use of anti-malarial drugs. Malaria caused by Plasmodium vivax is prone to relapses, as the parasite can survive in the liver. To prevent relapses, drugs may have to be administered for a month.
Viral hepatitis
Hepatitis A and E are included in the viral hepatitis category and lead to hepatitis [inflammation of the liver] in the monsoons. It is spread through faeces and one can get infected through close contact with the infected person, eating contaminated food or drinking contaminated water.
Symptoms include nausea and aversion to food, vomiting, jaundice, low-grade fever, fatigue, pain in abdomen, especially on the right side, dark-coloured urine, loss of appetite and muscle pain.
Diagnosis is through detection of antibodies in the blood. There is no medication to treat or cure viral hepatitis. Medications to support the liver and a high carbohydrate diet are advised. Vaccination is the best form of prevention in this case. For Hepatitis A vaccination is available, while there is no vaccine for Hepatitis E.
Typhoid
Typhoid, also called enteric fever, is a bacterial infection that spreads by contaminated food, drink, or water.
Symptoms include fever, abdominal pain, loss of appetite and malaise [general feeling of tiredness, weakness]. As the disease progresses, there is high fever and diarrhoea. A rash, characteristic only of typhoid called ‘rose spots’ [small red spots on chest and abdomen], appears in some cases of typhoid. A blood culture during first week of fever can show the presence of the bacteria in blood. A test to detect the antibody can be done in the second week. Stool cultures can also be used for diagnosis.
Using antibiotics is the primary treatment mode to treat typhoid. However, with resistance developing, it is advised to use antibiotics selectively. Vaccination, every three years, is a good prevention tool for typhoid.
Gastroenteritis
Gastroenteritis is acute inflammation of the lining of the stomach and bowel due to infection from contaminated food or water. Its symptoms include vomiting, diarrhoea, abdominal cramps, nausea, weakness and fever, presence of mucus and blood in stools, loose motions and dehydration. The best treatment for gastroenteritis is to ensure that the person is adequately hydrated. So the patient should consume plenty of fluids. In case the affected person has vomiting, or is severely dehydrated or has a low urine output, s/he should be immediately rushed to the hospital for intravenous fluid administration. Antibiotics can be used in case of bacterial diarrhoea or dysentery.
Gastroenteritis can be prevented by keeping in mind the following:
- Avoid uncooked and stale foods, especially in monsoons.
- Drink only properly purified water in monsoons.
- Keep your nails cut short and wash hands thoroughly before eating food.
- Store food in a well-ventilated cool place, free from flies.
- Keep the kitchen thoroughly clean.
Cholera
Cholera is an infection of the small intestine caused by the bacterium vibrio cholerae. It causes a large amount of watery diarrhoea.
Symptoms include profuse watery diarrhoea with rice water like stools with a fishy smell; rapid dehydration, dry skin, mucous membranes or mouth; excessive thirst; low urine output; abdominal cramps; nausea; and vomiting. Stool testing is the best diagnosis to confirm the cholera. The aim of treatment is to replace fluid and electrolytes lost through diarrhoea. Antibiotics help treat the infection.
Chikungunya
Chikungunya fever is a viral illness that is spread by the bite of infected mosquitoes and resembles dengue. A stooped posture resulting due to arthritis is a classic symptom. It spreads by the bite of an aedes mosquito, primarily Aedes aegypti species. Humans are thought to be the major source or reservoir.
Symptoms include fever, arthritis, photophobia [morbid fear of light], nausea and vomiting and sometimes rash. Symptoms last for up to 5 – 7 days. Arthritis is seen in 3 – 5 per cent of the patients. The diagnosis is done by blood tests like ELISA and treatment is generally based on symptoms.
Leptospirosis
Leptospirosis is a serious illness common in tropical countries with heavy rainfall. Infected rats, other mammals and other wild and domestic animals pass the bacteria in their urine. Flooding after heavy rainfall helps spread the bacteria in the environment.
Symptoms include fever, headache, chills, nausea and vomiting, eye inflammation, and muscle aches. In more severe cases, the illness can result in liver damage and jaundice [yellowing of the skin and white of the eyes], kidney failure, and internal bleeding. People who are seriously ill with leptospirosis often need to be hospitalised.
Special blood tests to detect the antibody levels in the blood help diagnose the condition. Antibiotics are available to treat the disease. Treatment should be started at the earliest to prevent serious complications.
Being forewarned is forearmed. Watchout for these symptoms, take care to treat them on time so you can enjoy the rains.
Diarrhoea in children
By ARCHANA Kavalakkat
Diarrhoea is the frequent passage of loose and watery stools and is caused by bacteria or viruses. If unnoticed, it can harm your child.
Check if your child shows any of these symptoms:
- Passes very large watery stools, which look like ‘rice kanji’
- Unable to retain ORS due to excessive vomiting
- Has signs of dehydration such as, sunken eyeballs, dry tongue, and demands a lot of water
- Dull, drowsy or irritable
- Refuses to take anything orally and prefers to sleep
- Check if s/he passes very less and concentrated [dark coloured] urine
- Breathes faster than normal
- Has cold extremities and looks pale.
If any of these signs are present, visit your doctor without any delay.
Helpful hints
- Give your child plenty of liquids, orally. Give her home-made items like dal water, rice kanji, coconut water, thin butter milk and bland vegetable or chicken stock.
- Use oral rehydration solutions [ORS]. But be careful while preparing them as it can lead to dangerous side-effects if not prepared as per instructions.
- Avoid milk in bigger children. In smaller children and infants, however, milk may be given in 50 per cent dilution till the stools are watery, then increase the concentration.
Archana Kavalakkat, MD, DNB, is a consultant paediatrician at Dr L H Hiranandani Hospital, Thane, Mumbai
My mother in law (65 yrs) was suffering from loose motion and then developed vomiting after checking the doctors have said that her intestine is infected/damaged she lives 1000 km away from us. What could be the infection and what can be the cure /remedy is it treatable/operable. How should we proceed in this case.