New Delhi: Flood-hit Kerala, already grappling with vector-borne diseases such as dengue and chikungunya, now also faces the threat of water-borne illnesses, with public health experts warning of an outbreak of cholera, typhoid, hepatitis and leptospirosis.

The state has already recorded 846 cases of dengue fever, 191,945 cases of acute diarrhoeal disease (ADD), 518 cases of malaria, 34 cases of chikungunya and 225 cases of leptospirosis, according to the directorate of health services (DHS), Kerala. The numbers are expected to rise further with flood waters accumulating everywhere, according to doctors.

“Kerala faces the threat of an outbreak of water-borne diseases such as cholera and hepatitis and vector-borne diseases such as malaria and dengue. Because of the lack of safe drinking water there may be an increase in people suffering from diarrhoea, typhoid and leptospirosis, a bacterial disease that is transmitted through contact with water or damp surfaces," said Nirmal Kumar, head of the department of gastroenterology, Venkateshwar Hospital, Dwarka, New Delhi.

“Its symptoms include fever, chills, abdominal pains, vomiting and diarrhoea. However, it should not be an epidemic but the situation is very serious. Exposure to floodwater can increase the risk of skin rashes, ear, nose and throat problems and conjunctivitis," he said.

Doctors have said that vaccination in flood-affected areas can prevent the outbreak of certain communicable diseases.

Health experts have said that hygiene should be maintained to keep diseases at bay.

“The major causes of diseases associated with flooding is the contamination of drinking water. Stagnant water pools caused by heavy rainfall or the overflow of rivers act as breeding sites for mosquitoes and, therefore, increase the exposure of the disaster-affected population to infections such as dengue, malaria," said Jeevan Aggarwal, senior consultant, internal medicine, Fortis Hospital.

“Ensuring safe drinking water is essential following flooding to reduce the risk of water-borne diseases. It is advised to promote good hygiene practice, ensure boiling or chlorination of water," he said.

The central government has yet not got involved in efforts to control the expected disease burden as healthcare is a state subject, but officials of the Union ministry of health and family welfare in New Delhi have said that if the state seeks help, a special medical team will be sent.

“Rescue operations are taking place in Kerala. We need to wait for the flood water to recede, only then will the medical relief team come into action. In floods like the one in Uttarakhand there were trauma cases. However, the Kerala flood is different. First, we need to rescue people then control any spread of diseases," said P. Ravindran, director, emergency medical relief (EMR), Union health ministry.

Non-governmental organizations have also come forward to help people in flood-hit areas. Medical specialists from the Amrita Institute of Medical Sciences & Research Centre in Kochi, as well as the Amrita Kripa Charitable Hospitals in Kollam and Kalpetta, have reached the flood-ravaged areas.

In areas such as Wayanad and Alappuzha, doctors have been conducting medical camps and providing medical treatment.

In some places doctors have had to provide medical assistance in boats.

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