SURGE IN DIARRHOEAL DISEASES: Time to take measures to prevent massive outbreaks

By Muhammad Qasim

Islamabad: The season for waterborne diseases has set in and the risk of transmission of endemic communicable diarrhoeal diseases looms large as the existing hot weather conditions are conducive and much favourable for the growth of microorganisms.

The incidences of diarrhoeal diseases are already on the rise in most parts of the country including this region. In extremely hot weather conditions, water reservoirs become scarce whereas the need for water is increased. While there is inadequate and less water available for consumption, the poor supply leads to poor personnel hygiene and sanitation, and effective disposal of waste becomes difficult. Unsafe food handling leads to sporadic outbreaks of diarrhoeal diseases while poor access to health care and poor nutritional status of children are additional factors that exacerbate the situation. Also, hot and humid weather allows bacteria to grow faster which makes the situation more alarming.

Epidemiologist Dr. Muhammad Najeeb Durrani who is Member Global Outbreak Alert & Response Network (GOARN) expressed this while talking to ‘The News’ on rising incidences of water and food-borne diseases including diarrhoeal diseases, gastroenteritis, viral hepatitis (A&E), typhoid and paratyphoid fever along with other seasonal threats.

Dr. Durrani said in many parts of the country, the population does not have access to clean potable water. In others, where public water supplies are available, system failures can place entire communities at risk of contracting diarrhoeal diseases increasing the burden of diseases on already weak and deficient health infrastructures.

He added that various human illnesses occur after contact with contaminated water and its consumption. Diarrhoeal diseases outbreaks occur after contamination of drinking water with fecal matter. Most probably, it has occurred in Peer Koh Dera Bugti where hundreds of people have been reported with severe diarrhoea in hospitals along with three deaths.

Drinking contaminated water or eating food washed in contaminated water can cause typhoid fever and its incidences are also on the rise. Dr. Durrani said it is alarming that typhoid is not responding well to third-generation cephalosporins because of multi-drug resistant strain. Salmonella Typhi which causes typhoid fever is endemic in Pakistan, he said.

He added that hepatitis A and E infections are also transmitted by faecal-oral route and their rise is also due to a lack of access to safe water and sanitation.

He said the need of the time is to have surveillance of these diseases and accurate data for timely action. Hospital and laboratory-based surveillance can enable the health authorities to determine the geographical distribution of water-borne diseases and take immediate measures.

It is important that the number of cases of acute watery diarrhoea is on a sharp rise in Rawalpindi and its adjoining areas. When asked, Dr. Durrani said the risk of diarrhoeal disease outbreaks is always higher in poor localities where sewerage disposal is compromised. Water supply lines that pass through nearby sewage get contaminated causing epidemics.

He said municipal authorities should check the water supply chain and distribution lines for any leakage or mixing with nearby running sewage to prevent major epidemics. Chlorination of water at the source is a must but it is ignored more often. Chlorination saves human lives by clearing water from microorganisms, said Dr. Durrani. Chlorination is the only available preventive measure for safeguarding communities from waterborne diseases.

He added that preventive measures at the individual level are also needed to avoid waterborne diseases. People should use boiled water for drinking. The water must be placed on heat to boil till the pill rolling of bubbles is seen, then cooled at room temperature for consumption, he said adding it is the best and safest water for drinking.

In areas where enough fuel is not available, one can store water in glass bottles direct under the sun for its natural cleansing from microorganisms, said Dr. Durrani.