MonsoonMonsoonDisease and HealthDisease and HealthDr Shyam Ashtekar

How monsoon changes the plot!How monsoon changes the plot!

How monsoon changes the plot!How monsoon changes the plot!

� Change in temp and humidity

� More growth and survival of germs

� More contamination

Transmission of all germs through � Transmission of all germs through food, air, water, hands, flies, mosquitoes increases.

RainRain--made collectionsmade collections

Polluted water poolsPolluted water pools

Water pools everywhereWater pools everywhere

ManMan made water collectionsmade water collections

More of many diseasesMore of many diseases

� Fevers

� Coughs and colds

� Diarrheas and dysenteries

� Animal bites-esp snake bites� Animal bites-esp snake bites

� Wards and OpDs have more patients

Six kinds of threats Six kinds of threats

(A) Digestive system diseases(A) Digestive system diseases

DiarrheasDiarrheas

� Common

� Loose motions

� > 3 a day

� usually infective� usually infective

� Usually self limiting

� Stops with simple treatments-fluids and salt-sugar, home remedies

Childhood diarrheaChildhood diarrhea

� Risky due to dehydration

� Recognize danger signs

� Start ORS fluids

� Take to a doctor

� Rotavirus vaccines are useful (ROTAVAC) oral dose

DysenteriesDysenteries

� Blood or mucus in stools

� Pain in abdomen

� May be feverMay be fever

� Need to start anti-bacterial medicines

� Ay remedies-Kutaj

� Amebic dysentery tends to be chronic

TyphoidTyphoid

� Continuous fever� Ill feeling, tired, weak� Abd pain� Changed bowel habits� Blood tests (typhidotetc)

� Blood tests (typhidotetc)

� Next week higher fever

� Can be dangerous if there is blood in feces

� Can cause serious emergency

PreventingPreventing TyphoidTyphoid

� Food safety, water safety-avoid outdoor-food

� Public water supply safety

� Typhoid vaccines TY21a-oral � Typhoid vaccines TY21a-oral capsules- on day 1-3-5 for anybody above 5Yrs

� Effective in 7 days, lasts for 3 yrs

� No need for injectable vaccine

CholeraCholera

� Rare these days due to better sanitation

� But stray cases reported

� Can rapidly kill due to water loss

� Vaccine Dukoral to be mixed with 150 ml water mixed with 150 ml water and taken orally. Repeat one dose after 1-5 weeks.

� Booster dose after 2 years

� Another vaccine Sanchol is also available-to be taken in 2 doses

(B) Liver infections(B) Liver infections

HepatitisHepatitis--JaundiceJaundice

HepAHepA

� Hepatitis A is a viral liver disease that can cause mild to severe illness.

� The hepatitis A virus is transmitted through ingestion of contaminated food and water, or through direct contact with an infectious person.person.

� Hepatitis A is associated with a lack of safe water and poor sanitation.

� Improved sanitation and the hepatitis A vaccine are the most effective ways to combat the disease.

Symptoms of hepatitis ASymptoms of hepatitis A

� Mild to severe,

� fever, malaise, loss of appetite, diarrhoea, nausea,

� Abdominal discomfort, dark-coloured� Abdominal discomfort, dark-colouredurine

� Jaundice (a yellowing of the skin and whites of the eyes).

� Not everyone who is infected will have all of the symptoms

Prevention of Prevention of HepHep AA

� The spread of hepatitis A can be reduced by:

� adequate supplies of safe drinking water

� proper disposal of sewage within communitiescommunities

� personal hygiene practices such as regular hand-washing with safe water.

� Vaccine (2 dose) if necessary-for travelers, or those who have frequently eat outside etc

(C) Coughs(C) Coughs and coldsand colds

Often called viral feversOften called viral fevers

� Most cold and coughs are alluded to viral infection

� Rises in rainy season

� Self limiting� Self limiting

� Simple remedies are enough. (kadha etc)

(D) Mosquito borne diseases(D) Mosquito borne diseases

MalariaMalaria

� Very common infection in tropics and subtropics

� Some types dangerous

� Spread by Anopheles mosquito

This mosquito breeds in fresh water, rain � This mosquito breeds in fresh water, rain pools, lakes, streams etc

� Fever +chills, aches. Fever usually alternate day

� Simple treatment available (chloroquin for simpel type), artesunate for dangerous type.

Aedes mosquitoAedes mosquito

DengueDengue

� Symptoms include

� Afever,

� Aheadache,

� Amuscle pains � Amuscle pains

� Ajoint pains,

� Aa characteristic skin rash that is similar to measles.

DengueDengue

Dengue feverDengue fever

Dangerous phase of dengueDangerous phase of dengue

� In a small proportion of cases the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, low levels of blood bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs.

Treatment and preventionTreatment and prevention

� Treatment

� Simple dengue fever-treat with paracetomol, rest

� Prevention

� Reduce breeding spots every week-CITIZEN ACTION is imp� Take to a doctor for

more tests if necessary, esp if there are danger signs.

imp

� Nursing patients in mosq nets

ChikenguniyaChikenguniya

� Chikungunyais a relatively rare form of viral fever ("debilitating non-fatal viral illness."

� Fever Which Can Reach 39C, (102.2 F)

� Rash Usually Involving the Limbs and Trunk fatal viral illness."

)caused by an alphavirusthat is spread by mosquito bites from the AedesaegyptiandAedesalbopictusmosquito.

and Trunk � Affecting Multiple Joints Which Can Be Debilitating.

� Headache, ConjunctivalInjection and Slight Photophobia.

ChikenguniyaChikenguniya diagnosis & Treatmentdiagnosis & Treatment

� The diagnostic tests include detection of antigens or antibodies in the

� Self-limiting and Will Resolve With Time.

� No Specific Treatment for antibodies in the

blood, using

� ELISA (or EIA -enzyme immunoassay)

� polymerase chain reaction (PCR).

Treatment for Chikungunya.

� Supportive or Palliative Medical Care With Anti-inflammatories

(E) Bites(E) Bites

KraitKrait

snakebitessnakebites

CobraCobra

ViperViper

Snake fangsSnake fangs--RusselRusselViperViper

(F) (F) LeptospirosisLeptospirosis

LeptospirosisLeptospirosis --spirochatesspirochates

LeptospirosisLeptospirosis

LeptospirosisLeptospirosis

� ALeptospirosis is among the world's most common diseases transmitted to people from animals. The infection is commonly transmitted to humans by allowing water that has been contaminated byanimal urine to has been contaminated byanimal urine to come in contact with unhealed breaks in the skin, the eyes, or with the mucous membranes. Outside of tropical areas, leptospirosis cases have a relatively distinct seasonality with most cases occurring in spring and autumn.

Spread of Spread of LeptoLepto

� Leptospirosisis transmitted by the urine of an infected animal and is contagious as long as it is still moist. Although rats, mice, and moles are important primary hosts, a wide range of other mammals including wide range of other mammals including dogs, deer, rabbits, hedgehogs, cows, sheep, raccoons, opossums, skunks, and certain marine mammals are able to carry and transmit the disease as secondary hosts.

LeptoLepto--symptomssymptoms

� Symptoms of leptospirosis include � Ahigh fever, � Asevere headache, � Achills, � Amuscle aches, Amuscle aches, � Avomiting, � Ajaundice, � Ared eyes, � Aabdominal pain, � ADiarrhea� Arash.

General prevention care for General prevention care for monsoon diseasesmonsoon diseases� Safety of food, vegetables, water,

� Sanitation, disposal of waste

� Handwash before eating, cooking

� Vaccines if necessary� Vaccines if necessary

Water safetyWater safety

� Domestic-chlorine drops, boiling, filters

� Public-treatment, tests, monitoring of water Qmonitoring of water Q

� Outdoor use of mineral water-confirm seal

Food safetyFood safety

HandwashHandwash

Migrant HealthMigrant Health

� Diseases travel with migrant workers

� Esp malaria, dengue etc

� Need to screen migrant groups in risky seasonsseasons

WaterWater--collectionscollections

� Periodic cleaning of water collections-natural and man made

� Avoid ‘hollows’ thrown in garbage0like coconut shellscoconut shells

Avoid mosquito bitesAvoid mosquito bites

� Use nets

� Door/window mesh/nets

� Use repellants

Mosq-rackets� Mosq-rackets

� Fogging rounds

� Mosquito trap https://www.youtube.com/watch?v=pNjyLRQutXs

KumbhamelaKumbhamela....

� Take extra care of all types

� Help the public services for sanitation, cleanliness, reporting of illnesses

� Watch for unsafe food joints, report� Watch for unsafe food joints, report

VaccinesVaccines

� Can take vaccines if necessary

� Typhoid, hepatitis A

� Cholera

� Rotovac (children)� Rotovac (children)

Simple fever treatmentSimple fever treatment

Ayurveda and MonsoonAyurveda and Monsoon

� Ritucharya keeps health

� Rules about eating, work, sleep etc

� Light and digestible meals are imp as AGNI in the stomach is low in monsoonsAGNI in the stomach is low in monsoons

� Avoid too much eating (winter can take more food)

About About ArogyavidyaArogyavidyawebsitewebsite

� Arogyavidya.net

BharatswasthyaBharatswasthyawebsitewebsite� Bharatswasthya.net

About my 2 new booksAbout my 2 new books

Author InformationAuthor Information

� MBBS (1978), MD, Community Health (1985)

� Worked in rural health center, Municipal health dept, medical college, NGOs, Community Health networks, and as Founder Director of School of Health Sciences at YCM Open University

� Study of health systems of China, UK, Germany, USA in 1997-2000 with MacArthur Pop fellowship

61

� Learning material / Marathi and English books for health workers, paramedics, National ASHA program

� Review of health systems, Nutrition programs, training programs etc

� Open info sites for primary care in Hindi bharatswasthya.net , Marathi arogyavidya.net

� Contact: 9422271544 Email-shyamashtekar@yahoo.com, 21 Cherry hills society, Anandwalli Nashik 422013

6/11/2015CHIKITSA-Revamping the Health Sector of Maharashtra-Shyam Ashtekar