Every Indian has his own unique perspective of the monsoons. But for doctors, it means overburdened hospitals and a rush of patients. For when the skies open up every summer to soothe the scorched earth, they are equally generous in dispersing bacteria and viruses to all and sundry. The consequence: a coughing, aching, fever-wracked population making its way to the nearest doctor.
“There is a definite increase in the number of patients with various ailments in the monsoons,” says S. Budhiraja, chief of internal medicine, Max Healthcare, New Delhi. He adds: “This is basically due to two causes: contaminated food and water, or mosquitoes.” Food and water get more easily contaminated as substances from leaking sewage pipes mix with overflowing rainwater. The rains also cause puddles everywhere—ideal for mosquitoes to breed. So malaria, dengue, typhoid, leptospirosis, dysentery, all become part of the daily household vocabulary.
The symptoms are dangerously common, and easy to dismiss. “Shivering and fever is common to all, and should not be taken lightly,” emphasizes Dr Budhiraja, adding “This could be a sign of a mild viral cold. But it could as well be typhoid or malaria.”
This is the season when colds should not be ignored. Yet, they are relatively easy to prevent with simple commonsense measures, such as maintaining hygiene, eating and drinking safe food and water, and using mosquito nets and repellents.
TYPHOID
Symptoms
Typhoid is endemic through most of north India and is characterized by high fever with chills, sometimes even cough and abdominal pains. About 10% of all cases could be fatal.
Cause
‘Salmonella typhi’ bacteria, of which there are currently as many as 107 different strains. It spreads through water contaminated by urine and faeces. The source of infection could also be contaminated shellfish, vegetables grown in night soil or even contaminated milk and milk products.
Treatment
Antibiotics work well when administered early. Some strains are antibiotic-resistant.
Prevention
Wash your hands thoroughly before eating or cooking, and after visiting the bathroom. Drink only sterilized water and cook food thoroughly. Consume boiled or sterilized milk. Preventive vaccine for typhoid is 60% effective.
DIARRHOEA
Symptoms
It’s one of the most common monsoon ailments. In more severe cases, the patient vomits and has cramps. In extreme cases, it could result in dehydration and kidney failure.
Cause
It’s mostly viral, although if the diarrhoea is due to cholera then the cause is bacteria ‘Vibrio cholerae’. Both the virus and the bacteria spread through water.
Treatment
Constant hydration by oral rehydration salts or good old ‘nimbu pani’. In severe case, the patient may need to be hospitalized and treated with another solution called Ringer’s lactate. In some cases antibiotics also work. It may be common, but it is lethal nonetheless. Without treatment, one in two people could die.
Prevention
Drinking safe water is key. It is important to ensure that food is well-cooked and that raw food such as salads is washed with safe drinking water, not just tap water.
JAUNDICE (HEPATITIS A & E)
Symptoms
The yellow eyes are a giveaway. Other symptoms include fatigue, abdominal pain, fever, loss of appetite, nausea and diarrhoea. Although in most people it has no long-term effects, it can cause liver failure and death in pregnant women.
Cause
The virus causing hepatitis A and E spreads usually by food or water contaminated by the feaces of a person suffering from hepatitis A. Food cooked by an infected person is a common way of spreading the virus.
Treatment
Rest and plenty of fluids.
Prevention
The hepatitis A vaccine is 90-100% effective. Wash hands with soap and water before eating, after going to the bathroom or after changing a diaper. Ensuring the person who cooks and/or serves food in the household maintains the same diligent level of hygiene.
Malaria
Symptoms
It affects almost two in every 1,000 people. Shivering, high fever, headaches and vomiting are classic symptoms. Pregnant women are at high risk.
Causes
It is caused by a parasite called plasmodium which is spread by mosquito bite. There are four types of malaria—Plasmodium falciparum, P. vivax, P. malariae, and P. ovale. P. falciparum and P. vivax are the most common. P. falciparum is by far the most deadly type of malaria infection.
Treatment
Early diagnosis and prompt treatment with anti-malarial drugs.
Prevention
Use mosquito nets or mosquito repellents especially at night. Water should not be allowed to stagnate—this encourages mosquito breeding.
DENGUE
Symptoms
Sudden high fever, headaches, joint and muscle aches. In severe cases, rashes appears on the legs and chest. Some people have only mild symptoms that can be mistaken for viral flu. Children are particularly vulnerable.
Causes
One of four viruses that are spread by the bite of the Aedes mosquito.
Treatment
There is no cure for dengue. Untreated, about a fifth of patients could die. Patients need hospital care, which involves plenty of fluids. In severe cases, the blood platelet count drops drastically and transfusion may become necessary.
Prevention
Aedes mosquitoes bite more during the day, so it is important to be protected at all times. The only other way to control or prevent dengue is to block their breeding. It is essential not to let water stagnate in and around the house in any form and put a little bit of kerosene in water storage tanks.
CHIKUNGUNYA
Symptoms
It is now endemic in India, and often reaches epidemic levels during the monsoon. Symptoms are similar to dengue, with fever and severe joint pain.
Causes
It is caused by a virus of the ‘Togaviridae’ family, and like dengue, is spread by the Aedes aegypti mosquito.
Treatment
Like dengue, there is no treatment. Plenty of rest and non-steroidal anti-inflammatory drugs drugs for joint aches are usually prescribed.
Prevention
As with dengue, prevent water from stagnanting around the house, and keep yourself protected with mosquito repellents.
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