Outbreak Alert: Diarrhoeal Disease
Several children (and according to my adult physician colleagues; adults as well) have been seeking medical care for a severe diarrhoeal disease over the past many days. Among the children, several have required hospital admission for management of dehydration associated with the often very watery and high purge rate loose stools associated with this diarrhoeal disease. I have talked to a few of my colleagues working in the islands who tell me that they too are seeing similar cases. Previously:
It is quite possible that the number of cases seeking medical care actually represent only a small fraction of the total number of cases as many are likely to be managed at home with home remedies, especially among bigger kids and adults.
Most diarrhoeal diseases that occur in these types of outbreaks are usually viral in origin (caused by viruses). Similarly most of the cases, from the current outbreak, that I have been involved in management have also been, on investigations, identified to be of viral origin. However, a small but significant number have had evidence of bacterial infection.
Diarrhoeal disease often spread via contaminated food and water associated with poor hygiene or use of unclean water. While we wait for the epidemiological data to ring bells at the public health authorities I would like to alert readers of this blog to give extra care to safe and hygienic handling of all food and drinks including drinking water. Improved personal hygiene, especially after use of toilets (particularly by those who have diarrhoeal disease) could help prevent spread. Improving hand hygiene by proper hand washing using soap and water and improved hand hygiene by food handlers (at home and public eateries, etc) is strongly recommended.
Children with severe diarrhoea, especially the very young among them, are likely to become dehydrated very quickly. It is therefore very important to ensure rehydration fluids are used to prevent dehydration by replacing the diarrhoeal losses. WHO ORS packets can be used to rehydrate and maintain hydration. Other locally available fluids such as plain (unsweetened) coconut water is also widely accepted and used.
Please seek care if severe diarrhoea, especially in very young children.
PS:
How to make ORS
Outbreak Alert: Hand Foot and Mouth Disease
What is it?
Hand-foot-and-mouth disease is a mild, enteroviral disease characterized by a fever and vesicular eruption in the mouth and over the hands and feet. It occurs most frequently in children younger than age 5.
How do you get it?
An uninfected child gets the illness when respiratory droplets from an infected child are inhaled. Respiratory droplets are formed during coughing, sneezing and during speech. The virus also gets transmitted when spit or sputum contaminated objects (Eg: Toys) are handled by an uninfected child. Stool contamination (feco-oral) of food and drinking water has also been documented as a transmission mode.
What are it’s signs and symptoms?
After an incubation period of 3 to 6 days druing which the newly infected child remains well, the illness begins with mild fever ranging from 38° to 39° C, decreased appetite, malaise, and, often, a sore mouth. Within 1 or 2 days vesicular lesions appear in the oral cavity, most frequently on the inside of the cheeks and the tongue, but also on the inside of the lips, gums, and hard palate. In the majority of preschool children, but in only some of the infected adults, the oral lesions are accompanied by vesicular skin lesions, most often on the hands and feet and on the fingers and toes, but not infrequently on the palms and soles. Less often, lesions occur on the buttocks or more proximally on the extremities, and rarely on the genitalia. They are generally 3 to 7 mm in diameter and surrounded by a narrow zone of redness. They range from 2 or 3 to 30 or more.
How do you diagnose it?
Diagnosis is clinical, from the symptoms and signs.Blood tests are not required.
Home care:
Patient should be given bed-rest, plenty of oral fluids (not just plain water) and Paracetamol for the fever. In addition, patient’s with this disease should be kept separate from individuals without the disease.
How do you treat it?
Treatment is supportive. The lesions usually resolve in 1 week even without any treatment. Treatment mostly targets reducing discomfort while the body clears the infection by itself.
H1N1 vaccine information.
Moving my private practice to Eve Clinic for Women & Children
Dengue: Follow-up
We are in to Dengue Season 2009 and the signs of things to come are not good.
WHO: Guiding Principles on Complementary Feeding (Weaning foods)
Eliminating measles by 2020?
I will be out of Maldives for 5 days.
Corporatization!
