Diarrhoea, typhoid, hepatitis hit children

Rawalpindi
Acute diarrhoea, typhoid and hepatitis-A have severely hit child population in the district and the number of child patients reaching allied hospitals in town with the preventable but deadly infections is continuously on the rise.
On average, 60 to 70 per cent of total child patients reaching paediatrics departments at Benazir Bhutto Hospital and Holy Family Hospital are with diarrhoea while majority of the rest of the patients are with typhoid and hepatitis-A, said Head of Paediatrics Department at Rawalpindi Medical College and allied hospital Professor Dr. Rai Asghar while talking to 'The News' on Monday.
He said diarrhoea having much higher mortality rate along with typhoid and hepatitis-A can easily be prevented by adopting simple precautionary measures. All the three infections are water-borne infections and with the use of boiled water for drinking can save children from the deadly health threats, he said.
It is important that two of the three teaching hospitals in town namely BBH and HFH operate paediatrics departments. According to data collected by 'The News', the two hospitals are receiving as many as 350 to 400 child patients including infants with complaints of diarrhoea daily after the onset of heat spell. The total number of patients reaching paeds departments of the two hospitals daily is 500 to 600 on average.
The major cause behind incidence of the three infections is lack of availability of clean drinking water and insufficient awareness among parents, said Dr. Rai while responding to a query. He said to avoid these infections, there is no need of giving mineral water to the children and infants instead they should be given water after rolling boiled for over five minutes for drinking.
He said hepatitis A is caused by hepatitis A virus, typhoid is caused by bacterium Salmonella Typhi and diarrhoea is caused by E-Coli and Rota virus. All these are found in water and incidence of the three infections can easily be prevented by only using clean drinking water, he explained.
He said the main symptom common in the three infections is high-grade fever though continuous high grade fever up to 103 or 104 degree centigrade is a symptom of typhoid. In typhoid, temperature does not touch baseline that is 98.6 degree centigrade even after use of antibiotic for at least three to four days, he explained.
He added if a child is suffering from persistent high grade fever only and no other symptom is developed, it means the child has contracted typhoid.
Hepatitis-A has three major symptoms apart from high grade fever including severe anorexia (loss of appetite), persistent vomiting and abdominal pain while in diarrhoea, a child or infant suffers from vomiting and loose motion, explained Dr. Rai. He said the cause of death among children having diarrhoea is dehydration and it should be avoided.
To a query, Professor Rai said majority of the total child patients reaching allied hospitals are with complaints of acute watery diarrhoea because of Rota virus or E-coli infections. Child patients reaching allied hospitals with severe dehydration are admitted to wards but with mild to moderate dehydration are given ORS (Oral Rehydration Solution), he said.
He added that as soon as diarrhoea starts in a child or infant, mother should start giving ORS to the child but not through feeders (Feeding Bottles) as these are major source of infection. ORS should be given through cup and spoon, he said.
He suggested that mother should wash hands before preparing ORS and clean drinking water should be used for the solution. In case of dehydration, a child should be given more fluids. Feeding of the child or infant having diarrhoea should not be stopped. If the patient is of the age over six months, the child should be given banana that contains potassium, yoghurt and rice in the form of 'Khichri', he said.
He added that Zink syrup should be given to a child patient of diarrhoea for 14 days. No anti-emetic drugs should be given to stop vomiting in diarrhoea as it may cause serious harms. Anti-diarrhoea drugs and anti-biotic are also contra indicated in majority of the cases of diarrhoea, in over 70 per cent of the cases, though they may be used by physicians for treatment in cases of bloody diarrhoea, he suggested.
Professor Rai said diarrhoea is self-limiting that lasts from three to five days normally and the most important thing to save a child's life is to give ORS to avoid dehydration.
To avoid infections including hepatitis A, typhoid and diarrhoea, children should be given clean drinking water and their hands must be washed thoroughly before and after every meal and after going to toilet. Children should not be allowed to consume locally prepared juices including sugarcane juice, ice creams and soda prepared at vendors. Parents should avoid using dishes brought from market for 'Iftar' during Ramazan as consumption of a single contaminated dish can cause infection not only among children but also in adults, he said.
To save life of a child or infant in case of diarrhoea, he must be prevented from dehydration and all parents must be aware of the fact that dehydration in result of diarrhoea causes death among children, concluded Professor Rai.