Waterborne diseases are those that are transmitted by drinking unhealthy water. Unfortunately, they are a major cause of morbidity and mortality, especially in children in our country. About 20 per cent of the communicable diseases in India are waterborne. Poor sanitation, improper storage of water and lack of proper waste disposal are the main causes of water contamination.
Following are some of the common waterborne diseases in our population.
Gastroenteritis [diarrhoea, dysentery]
This results from consumption of water contaminated by either viruses [Rota], bacteria [E.coli, salmonella, shigella, cholera] or protozoa [Amoebiasis, giardiasis]. The most common symptom is sudden onset of loose watery stools. It may be associated with vomiting, fever, crampy abdominal pain and blood in stools [dysentery]. Most often these infections are self-limited and last for a few days. Some infections may last for more than 3-4 weeks.
A common complication is dehydration, as indicated by increased thirst, lethargy, dark coloured and reduced quantity of urine. Children are more prone to dehydration than adults. Deaths due to diarrhoea are common in children below the age of five.
Treatment involves hydration, orally or through intravenous supplementation. Oral dehydration solution [ORS] available as a WHO[World Health Organisation] formula is the cornerstone of treatment in children. Short courses of antibiotics are required in few cases.
Viral Hepatitis [Jaundice]
Hepatitis A and E viruses are the most common cause of jaundice in our country. Viral Hepatitis starts with initial period of fever, nausea, vomiting for 3-4 days, followed by onset of jaundice. It usually lasts for 3-4 weeks. It resolves on its own and is, at times, complicated by liver failure. Pregnant women need to be more careful as chances of liver failure are more if hepatitis E develops during pregnancy. No specific medicines are required for treatment. Dietary restrictions are not necessary.
Common treatments with alternative medicines are of questionable benefit and may cause harm in some patients.
Typhoid fever [ Enteric fever]
Infection by certain bacteria [Salmonella typhi and paratyphi] causes this fever. It begins as high grade fever, loss of appetite and lethargy. Blood tests [Widal test, blood culture] are useful in the diagnosis of typhoid fever.
Treatment with antibiotics such as ciprofloxacin, ceftriaxone or azithromycin are an effective cure for typhoid fever.
A person may get cholera by drinking water or eating food contaminated with the cholera bacterium. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. Human behaviour related to personal hygiene and food preparation contributes greatly to the occurrence and severity of cholera.
WHO recommends improvements in water supply and sanitation as the most sustainable approach for protection against cholera. Safe and effective oral cholera vaccines are also available.
Waterborne diseases are easily preventable.
- Consumption of water from unhygienic places should be avoided. Simple boiling of water kills most of theses germs and makes water safe for drinking.
- Vaccination: A vaccine is available for Hepatitis A and can be administered to children. Most adult Indians do not need a vaccine for Hepatis A because clinical jaundice or asymptomatic infection in their childhood makes them immune to the disease. Hepatitis E vaccine is not yet available in the market. Typhoid vaccine is available in oral or injectable form. Immunity through the typhoid vaccine is short and vaccination needs to be repeated every 3-4 years.
Other diseases to watch out for in monsoons
Not all waterborne diseases are caused by drinking water alone. Water can cause diseases in other ways too. Here are few diseases that are related to water though not caused by drinking it.
With stagnating water pools, mosquitoes proliferate and cause malaria. Symptoms include fevers, chills, vomiting, headaches and severe malaise. Of the various types of malaria, the Falciparum subtype can turn complicated and fatal. Treatment includes anti-malarials, and fever control. There is currently no vaccine for malaria. Prevention involves destroying mosquito breeding grounds, and personal anti-mosquito protection. Prevent water stagnating around your home as this is the main breeding ground for mosquitoes.
This disease spreads through germs that inhabit sewers and gutters. During floods, most gutters overflow. Also, people often have to wade through water to reach their destination after heavy downpours. The germs in such waters can enter the body through cuts and wounds, resulting in high fever and jaundice. Treatment prevents complication, though fatalities are known. There is no vaccine against this disease. Prevention, and treatment with antibiotics is recommended.
Dengue fever is another viral disease that spreads through mosquito bites. Dengue infections begin with fever, rash, chills, body ache and can be indistinguishable from the other fevers. Some of these cases turn serious to become Dengue haemorrhagic fever, and need critical care because they can be fatal, if left undiagnosed or untreated.
Asthma and respiratory infections
Due to the high humidity, germs that thrive in wet weathers tend to proliferate, and can result in severe attacks of asthma. Bronchitis and pneumonia are also common. Most asthma sufferers know this, and often take precautions by not going into polluted areas, keeping their houses clean, and avoiding other known triggers of the disease.
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