Beware Of Flood-Borne Infectious Diseases
 

Dangers do not recede with flood as infectious diseases can still pose a threat to victims in post-flood areas.

On the 5th of January 2022, Sin Chew Daily newspaper reported a case where a flood victim passed away from Rat Urine Disease, also known as leptospirosis. After the flood water subsided, the victim was busy cleaning his home and unexpectedly got infected with rat urine. Initially, he experienced symptoms of headaches and sweating. Later on, he lost his appetite, sweated constantly, had slurred speech, and vomited after eating.  

These are all signs and symptoms of Leptospirosis, a bacterial infection that unfortunately costs the life of a citizen.

Poor sanitation and hygiene in flood areas could act as a catalyst for water-borne diseases such as Leptospirosis, Cholera, Dengue fever, Hepatitis A, Typhoid fever & more.

1. Leptospirosis

Image Credits: RACGP

Leptospirosis is a bacterial disease usually transmitted from urine of infected animals to humans. We can become infected through accidental contact with animal urine, or drinking or bathing using contaminated water. This resilient bacteria can survive in the soil or water for weeks to months!

Leptospirosis can be mistaken for other diseases as it can cause a wide range of symptoms. At first, the infected person will have a high fever, followed by sudden chills, headache, muscle aches, vomiting or diarrhea. Most people recover within ~1 week, but some will become ill again after a few days and have health complications such as kidney or liver failure.

Weil syndrome can occur during the second phase of Leptospirosis. Symptoms experienced include fever, jaundice (yellowish skin and white eyes due to liver damage), kidney damage, and bleeding tendency. Other symptoms may also include nosebleed, coughing out blood, or bleeding within the skin tissues, lungs, and, less commonly, digestive tract.

Treatment & Prevention

Do let your doctor know right away if you have symptoms of leptospirosis! Most cases of leptospirosis can resolve on its own. However, some patients do develop complications with significant morbidity and mortality. In general, if the illness is severe enough to come to clinical attention and the diagnosis is recognized, antibiotic therapy should be administered to shorten the duration of illness and reduce the shedding of organisms in the urine. The approach varies with the clinical presentation.

You can prevent leptospirosis by mainly avoiding touching or drinking contaminated water. Below are some ways to reduce the risk of getting infected with leptospirosis:

• Boil water before drinking
• Cover skin cuts or abrasions with a waterproof bandage or other coverings
• Avoid wading, swimming, bathing in floodwater or freshwater sources that may contain animal urine. Shower thoroughly with clean water after swimming in flood water. 
• Wear waterproof protective clothing, gloves, shoes, or boots near floodwater or other water or soil that may be contaminated with animal urine
• Keep food, water, rubbish in closed containers to prevent rodent infestation
• Maintain hygiene by washing hands with soap and water after handling animals or animal products, and avoid touching dead animals with bare hands.

2. Cholera

Image Credits: The New York Times

Cholera is an acute infectious diarrhoeal disease caused by drinking or consuming food contaminated with bacterium Vibrio cholerae. Spreading of cholera bacterium usually occurs in places with poor water treatment, inadequate hygiene, and unsanitary conditions.

1 in 10 people who get sick with cholera will experience symptoms such as severe watery diarrhea, vomiting, leg cramps, which can lead to dehydration, and even death within hours without treatment. Symptoms will usually present after 2-3 days of ingestion of the cholera bacteria.

Treatment & Prevention

Seek for immediate medical attention if you think you or your family members might have cholera! If you experience dehydration, you can start taking oral rehydration solution (ORS), a prepackaged mixture of sugar and salt mixed with 1 liter of water to replace the fluid loss in your body. Antibiotics will shorten the duration and reduce the severity of the disease, but rehydration is more important in this case.

Cholera can be easily prevented by:

• Maintain adequate sanitation by washing your hands with soap and clean water before eating and preparing food. If clean water is unavailable, you can use alcohol based hand sanitiser with at least 60% alcohol.
• Drinking clean water from bottled, boiled or chemically treated water.  

3. Dengue Fever

Image Credits: Centers for Disease Control (CDC)

Standing water can act as breeding sites for mosquitoes, and therefore enhance the potential for exposure of the disaster-affected population and emergency workers to infections. Dengue virus, a mosquito borne viral infection is spread through bites of an infected Aedes aegypti species mosquito. Severe dengue can be life-threatening and hospitalization is required.

The most common dengue symptom is fever with nausea, vomiting, rash, aches and pain (typically behind the eyes, muscle, joint, or bone pain). The symptoms will last for 2-7 days, and most people recover after a week.

Treatment & Prevention

There is no specific medicine to treat dengue. You should treat the symptoms of dengue by:

• Resting, drinking plenty of fluids to stay hydrated
• If you have a fever, take paracetamol to control the fever and relieve pain. Avoid aspirin or ibuprofen which could worsen bleeding.
• See your healthcare provider if you develop a fever or dengue symptoms. Watch for signs and symptoms of severe dengue such as belly pain, tenderness, vomiting at least 3 times in 24 hours, bleeding from nose or gums, vomiting blood, blood in stools, feeling tired or irritable. Symptoms may become severe within a few hours and severe dengue is a medical emergency and requires medical attention at a clinic or hospital.

Preventing mosquito bites can be done through these methods:

• Use of insect repellents
• Remove standing water once a week by emptying and scrubbing items that hold water such as vases or flower pot saucers

It is crucial to stay aware of the dangers of contaminated water & standing water. Remember and pay attention to personal hygiene in the aftermath of the flood:
 

• Always wash your hands with clean water after handling items exposed to flood water that can contain sewage 
• Shower thoroughly with clean water after wading through floodwater
• Do not eat food that is wrapped in a waterproof container 
• Any open wound needs to be cleaned and protected with waterproof plaster or dressing 

#DOC2US X Alpro Pharmacy 𝐋𝐢𝐟𝐞 𝐒𝐚𝐯𝐢𝐧𝐠 𝐌𝐞𝐝𝐢𝐜𝐚𝐭𝐢𝐨𝐧 𝐂𝐚𝐫𝐞 𝐏𝐫𝐨𝐠𝐫𝐚𝐦 pledges to help flood victims with free medication and medical consultation. Find out more about the T&C & how you can reach out for help here

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Reference:

1. Centers for Disease Control and Prevention (CDC). Hurricanes, Floods and Leptospirosis. Available from https://www.cdc.gov/leptospirosis/exposure/hurricanes-leptospirosis.html
2. MSD Manual Consumer Version. Leptospirosis. Available from https://www.msdmanuals.com/home/infections/bacterial-infections-spirochetes/leptospirosis
3. The Jakarta Post. Six common diseases to watch out for during flood. Available from https://www.thejakartapost.com/life/2020/01/02/six-common-diseases-to-watch-out-for-during-floods.html
4. Centers for Disease Control and Prevention (CDC). Cholera. Available from https://www.cdc.gov/cholera/general/index.html
5. Centers for Disease Control and Prevention (CDC). Dengue. Available from https://www.cdc.gov/dengue/symptoms/index.html#anchor_1555426819180
6. Centers for Disease Control and Prevention (CDC). Hepatitis A. Available from https://www.cdc.gov/hepatitis/hav/afaq.htm#A1
7. NHS. Typhoid fever. Available from https://www.nhs.uk/conditions/typhoid-fever/
8. Centers for Disease Control and Prevention (CDC). Malaria. Available from https://www.cdc.gov/malaria/about/

Written by

Ms. Rosamund Koo Wei Xin