The southern state of India, Kerala has been witnessing the villain face of rains for the last two weeks. The data show that this has been one of the worst floods in almost a 100 years, with the death toll rising to more than 350. Though the water started to recede, and the rescue operations are almost done, the next challenge is to gear up against the possibility of health hazards of the flood and water-borne diseases.

As per the data of state health department, medicine stocks of at least 481 primary health centers (PHCs), 137 community health centers (CHCs) and 19 dispensaries were washed away by flood waters. Though there hasn’t been any reported case of any such diseases, Rajeev Sadanandan, additional chief secretary at Kerala’s health and family welfare department, has written to the Union health ministry for providing antibiotics and medicines for fever, cough, cold, diarrhea and hypertension.  It is reported that the union government has sent 90 type of medicines including antibiotics and medicines for fever, cold, cough, diarrhea hypertension along with those to treat vector-borne and water-borne diseases. The center has also arranged the team of doctors on standby for deployment. Also, as a precaution, the state government has requested private hospitals to help and treat the patients and provide free medicines. Since Kerala has been struggling with vector-borne diseases like dengue and chikungunya, it has been now exposed to a new threat of water-borne diseases. The health ministry has also co-ordinated with other states to extend medicine supplies.
According to various media reports, the public health department of Kerala is already wrestling with skin diseases and fever in the rescue camps which can be considered as the first signs of the outbreak. As several people are staying very close in the rescue camps, it is said that the chances of contracting the skin diseases are comparatively high. There were no reported cases other than fever and respiratory problem from any relief camps. Also, the health department has deployed Ayurveda and Homeopathy doctors in case of an emergency in the flood-affected parts.
“The major problem we are facing is skin infections, especially in the leg.  People who are diabetic and hypertensive have high sugar and blood pressure levels. They are more susceptible to various other diseases because of compromised immunity. However, we have started providing antihypertensive, hypoglycemic drugs as well as ointments for dermatitis,” said Manju P.N., chief executive of the Meditrina Group of Hospitals, Kerala. “Anticipating the epidemic of communicable diseases we need to be vigilant as these camps are vulnerable to communicable diseases. There should not be any case of emergency,” she added. Apart from physical health aids, psycho-social teams from the National Institute of Mental Health & Neuro Sciences will also be deployed as and when requested by the state government.

Possible Water-borne diseases

Below given are some possible water-borne diseases that are likely to outbreak during the current situation of Kerala.

1. Conjunctivitis
Conjunctivitis, also known by the name pink-eye is caused by the inflammation of Conjunctiva, the outer membrane of the eyeballs and the inner lids. It is either caused by bacterial or viral infections. It is highly contagious.

2. Typhoid
Typhoid causes high fever, diarrhea, and vomiting. The disease is caused by bacteria and can sometimes be fatal. It is caused by Salmonella typhi, a bacteria that cannot survive outside the human body.

3. Dengue Fever
A mosquito-borne disease caused by any of the four identified types of ‘Dengue’ viruses. They are transmitted by Aedes mosquitoes. Muscle pain, swollen lymph nodes, headache, fever, aching eyeballs, exhaustion, and rashes are the symptoms.

4. Leptospirosis
Leptospirosis is an infection spread by animals. It is caused by the urine and feces of dogs, rodents and farm animals. Though it is not fatal, it weakens the patients. Swollen limbs, chest pain, headache, vomiting, diarrhea, rashes, and fever are the common symptoms and this disease requires hospitalization.

5. Infections
During the rainy season, cuts and wounds take time to heal. A non-healing wound can be a breeding ground for the bacteria. Most wounds turn infectious from bacteria. Most wounds turn infectious from bacteria originating from normal skin, while others get it from contact with infected external channels like air and water.

What needs to be done?

Being in such a situation, People need to handle both food and hygiene with utmost care to keep the diseases away. Even the health authorities release tips to keep ourselves safe from the water-borne diseases. Relief camps have also started organizing health programmes.

1. Drinking Water
After the floods, we need to clean the wells and tanks before using them. Also, if there is a high level of water in the wells, three-fourths of it should be let out. The health units recommend the use of regular household bleach such as chlorine (sodium hypochlorite) to disinfect water. This will help reduce the risk of cholera and other water-borne diseases. If we don’t have access to the drinking water, it is better to collect rainwater which can be boiled and filtered before drinking. In extreme cases where there is no access to gas or heating mechanisms, people should consider using a folded clean, thin, white cotton cloth to filter water.

2. Food
It is recommended to completely avoid food items which come in contact with the flood water. The food which has been kept in the refrigerator may be unsafe to eat if the power has failed for more than a day.  Wash your hands with soap and water before and after cooking. If soap and water are not available, the Centers for Disease Control and Prevention recommends using an alcohol-based hand sanitizer that contains at least 60% alcohol.  Also, it is not recommended to keep the food items open.

3. Diseases.
We need to be highly cautious against the water-borne diseases. It is important that the people take precautionary steps to prevent or reduce the risk of falling ill after rain or flooding. These include following good personal hygiene, using insect repellents and wearing protective clothing to avoid mosquito bites, keeping the surroundings clean to get rid of potential mosquito breeding sites, etc.

4. Cleaning
While cleaning, it is recommended to avoid direct contact with mud and water since it might be contaminated by oil, gasoline, or sewage. It is through this flood water that most of the diseases spread. If any utensils have come in contact with the flood water, make sure it is washed using detergent and hot water. Also, people who involve in cleaning should wear gloves and covered footwear.

Source: 1. https://www.livemint.com/Politics/wtvLn3CdcT6ROc2HXd7HQO/Kerala-gearing-up-for-disease-outbreak-after-water-recedes.html
2. https://timesofindia.indiatimes.com/india/health-ministry-extending-all-support-to-flood-relief-measures-in-kerala-nadda/articleshow/65471178.cms
3. https://www.livemint.com/Politics/LrItLDoaeU8pt0SpUNS4VO/Kerala-intensifies-vigil-to-prevent-disease-outbreaks-in-rel.html
4. https://english.manoramaonline.com/lifestyle/health/2018/08/18/how-overcome-contagious-diseases-in-wake-of-kerala-floods.html
5. https://english.mathrubhumi.com/health/health-news/guidelines-to-take-care-of-health-after-flood-havoc-kerala-flood-relief-1.3079212
6. https://www.timesnownews.com/health/article/kerala-floods-6-health-and-hygiene-tips-for-flood-victims/272203