Pakistan/Kasmir: Gastroenteritis

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Source: http://www.dailytimes.com.pk/default...-6-2008_pg11_5

Gastroenteritis hits Rawalpindi

* 611 cases reported to RGH, 1,052 to HFH in June

By Terence J Sigamony

RAWALPINDI: Over 1,600 cases of gastroenteritis and 68 suspected cases of cholera have been reported so far to the allied hospitals this month.

According to the data collected by Daily Times, 611 gastroenteritis patients, including 352 males and 259 females, were admitted to Rawalpindi General Hospital (RGH), while on average 20 to 30 patients were daily visiting the hospital with complaints of stomachache and vomiting.

RGH Acting Medical Superintendent Dr Fiaz Ahmed told Daily Times that they were admitting only those patients who were in critical condition, while others were discharged after necessary medication.

The situation may deteriorate in coming days if the authorities concerned do not take preventive measures, said Ahmed.

He said cases of cholera were also on the rise among children, as in June 68 suspected cases were reported to RGH. Of the 45 stool samples sent to National Institute of Health, Islamabad, 16 were tested positive and 22 negative, he said, adding, the administration was awaiting seven results.

Though no cholera case was reported to Holy Family Hospital (HFH), the number of gastroenteritis patients was on the rise, as 1,052 such cases were reported to the hospital in June including 290 men, 242 women and 520 children.

HFH Emergency Department?s Chief Medical Officer Dr Rashida Ahmed said they were reporting the cholera cases directly to District Health Officer.

She said food should be thoroughly cooked and eaten hot. ?Cook and eat the same day? is the golden rule. ?Fast food like ?dhai bhalay?, ?channa chaat?, ?chatni?, ?raita? and ?salads? should be avoided. Leftover food should be stored in refrigerators as early as possible and consumed after heating it well,? said Dr Rashida.

District Headquarters (DHQ) Hospital Director Emergency Department Dr Irfan Khilji said gastroenteritis outbreak had hit several localities of Rawalpindi. He said the number of such patients coming to the DHQ Hospital was not alarming like at the other two allied hospitals, as maximum eight patients were visiting the hospital daily.

He said gastroenteritis was an infection of stomach and intestine. It is a group of diseases caused by various viruses, bacteria or their toxins and parasites. The most common symptoms are diarrhoea and vomiting. Gastro is normally mild and most symptoms will resolve within a few days, however, if symptoms are severe, hospital treatment may be required, said Dr Irfan. He said patients suffering from gastro should be given a lot of fluids or Oral Rehydration Salt (ORS).

?If you or your children have complaints of gastro, you should not return to work, or let your children go to school, or nursery until 48 hours have passed after your last episode of diarrhoea or vomiting,? said Dr Irfan. He said patient?s usual food and drinks should not be withheld.

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Re: Pakistan: Gastroenteritis hits Rawalpindi

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http://www.dailytimes.com.pk/default.asp?page=2008%5C06%5C29%5Cstory_29-6-2008_pg11_3

Pindi on verge of epidemic outbreak

RAWALPINDI: The flooding of the city?s densely populated low-lying areas by rainwater accumulated from the early Saturday morning rainstorm might cause an outbreak of serious epidemics in the city. Dr Waseem Ahmed, a general physician, said this while talking to Daily Times on Saturday. He said a delayed action by the government to address this serious issue would expose the residents of Rawalpindi to gastroenteritis, malaria and different skin diseases. Executive District Officer (Health) Dr Zafar Iqbal Gondal said soon their workers would start spraying ponds and pools to check the outbreak of epidemics. staff report

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Re: Pakistan: Gastroenteritis hits Rawalpindi

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Gastroenteritis outbreak in Astanpora Brein, 50 families affected

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Srinagar, July 11: The health authorities have detected outbreak of gastroenteritis and isolated cases of jaundice in Astanpora area of Brein and have said that 70 per cent of the population has been affected with the disease.
?Presently 60-70 per cent of the people comprising of 50 households in uphill Astanpora area are affected with gastroenteritis,? the head of the department Social and Preventive Medicine (SPM) Government Medical College, Dr Muneer Masoodi told Greater Kashmir.
He said the outbreak started on July 5 when 10-15 people started with symptoms of fever, malaise and diarrhea.
?The number of cases nearly doubled the second day and since then there has been a gradual increase in the number of cases presenting with fever, nausea, vomiting and loose watery stools (diarrhoea),? Dr Masoodi said.
Dr Masoodi said that two persons Rameez, 17, and Basharat, 15, have been diagnosed as having jaundice following the initial spell of diarrhea whose serum bilirubin levels are reportedly raised. ?The concerned health authorities from primary health centre, Brein had put up camps for initial two days at local darasgah for symptomatic treatment of the cases wherein they have rehydrated around 70 patients of gastroenteritis and has carried out health education activities. No referrals and deaths have been reported till now,? he said.
The head of department attributed the outbreak of disease to the water contamination. ?The inquiry revealed that the area is being supplied with tank water whose source was a stream fed by an uphill spring Gofbal. On inspection of the tank, it was seen to be covered with lid and that the water had been treated with bleaching powder (for chlorination). The people revealed that the tank had been cleaned by the people after the outbreak, but the team observed that the tank opening had spider webs, impressing that it hadn?t been cleaned recently. Water samples were taken by the PHE Department, the results of which are not known and there had been no prior treatment of the water at source or at consumer level,? Dr Masoodi said.
As per the initial survey, he said the outbreak seems to be water-borne in nature with single point-source and propagated outbreak of infective nature. ?Presently the situation is not threatening and is under control. But water sample testing by independent agency and serological investigation of reported jaundice cases should be done,? he said. Dr Masoodi said the department of microbiology, GMC has been asked to send a team to collect water samples from the feeding channel to the water tank and at consumer level. He said blood samples may also be taken from reported jaundice cases.
The head of the department has cautioned the people to consume the boiled water and asked the concerned PHE authorities be to provide safe, treated, potable drinking water to the inhabitants of village Astanpora, Brein, Nighat.

http://www.greaterkashmir.com/full_story.asp?Date=12_7_2008&ItemID=33&cat=21

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Pakistan, Lahore - Gastroenteritis Patients Flood Hospitals

<table align="center" border="0" cellpadding="0" cellspacing="0" width="600"><tbody><tr bgcolor="#f4faff"><td class="heading_txt" height="20"> Hospitals flooded with gastroenteritis patients</td> </tr> <tr> <td></td> </tr> <tr> <td bgcolor="#efefef"></td> </tr> <tr> <td></td> </tr> <tr> <td class="small_txt" height="20">By By Ayesha Khan and Afeera Khan
7/12/2008</td> </tr> <tr> <td class="small_txt">LAHORE

CITY hospitals are flooded with people suffering from gastroenteritis and diarrhoea spreading because of hot and humid weather coupled with pollution, requiring immediate measures to control the seasonal epidemic as the situation is likely to get worse during Monsoon.

The number of such patients has considerably increased due to changing weather coupled with pollution and OPD and main emergency wards of Mayo Hospital, Children?s Hospital, Jinnah Hospital, Sir Ganga Ram Hospital, Lahore General Hospital and Services Hospital are virtually filled with patients suffering from seasonal diseases. People of all ages particularly children and old people are prone to contracting acute respiratory infections and viral diseases because of hot and humid weather, intake of unhygienic food and alarmingly high smoke pollution in the provincial metropolis.

Experts are of the view that smoky vehicles on urban roads are polluting the environment, which is a major contributing factor in the spread of viral diseases. If air pollution continues to increase, it will pose serious threat of spread of viral diseases and put burden on hospitals.

Hospital administrations are least bothered to take measures such as enhance the number of doctors, set up extra counters for consultation and provision of medicines to patients suffering from acute respiratory infections. ?Patients are at greater risk of contracting viral diseases than to get their maladies cured at public sector hospitals due to clusters of sick patients coming into contact with each other,? said a doctor at OPD ward of Lahore General Hospital.

He said some patients, suffering from minor infections, had to be referred to emergency ward as either they contracted viral infections, were poorly treated or returned without treatment and resorted to self-medication which resultantly multiplied their problems.

Dr AJA Samdani, AMS Children?s Hospital said: ?Humidity level goes up to 80 per cent during prevailing pre-monsoon and Monsoon season, which results in spread of viral infections such as gastroenteritis, diarrhea, bronchitis, chicken pox, measles and cough etc. He said mosquitoes and flies in stagnant ponds spread diseases such as dengue fever. ?The government should take precautionary steps to control such diseases through regular sprays. The district administration should ensure that vendors cover their make-shifts stalls,? he said. He advised parents not to allow their children to buy edibles from make-shift stalls. Parents should cook food properly at their homes and use masks on bikes to avoid direct exposure to pollution outside their houses. As far as medications are concerned, when a person contracts disease, he should go to hospital instead of taking medicines on his own and also avoid consulting quacks. Quacks prescribed antibiotics without any reason which were costly and created complications, he said.

Prof Dr Sajid Maqbool, a leading pediatrician, said Rotavirus gastroenteritis was one of the leading causes of death among children under five years of age and it also caused approximately 600,000 deaths and two million hospitalisations from diarrhea and dehydration worldwide each year. He said Rotavirus posed an exception to typical diarrhoeal disease management rules. While improved access to clean water and better sanitation and hygiene practices are vital to preventing most diarrhoeal diseases, they have done little to reduce the burden of rotavirus infection. For this reason, pediatricians throughout the country prescribe usage of vaccines to eliminate this disease. He said that vaccination was an effective control measure likely to have a significant impact on the incidence of rotavirus disease, having the potential to save precious lives.

Dr Arshad Hamyun, vice-president Pakistan Academy of Family Physicians, said that germs were killed in summer but pre monsoon season was ideal season for the spread of diseases such as typhoid and gastroenteritis. Normally, the ratio of such patients was 5 per cent during normal season, but in this season it increased up to 15 to 20 per cent of the total patients in hospitals. Moreover, skin infections such as boils, pustules and infected dermatitis were in high ratio as well.

He advised the use of ORS, lemonade water and fresh food. Beverages and cut-fruits should be avoided, and people should have boiled water for drinking as ground water gets contaminated due to frequent rains, he said. Moreover, they should avoid quacks as they were not properly educated and did not know the proper usage of drips. Drips had to be administered to a certain level to adults and children which quacks could differentiate and overdose of drips could lead to heart failure.

Dr Shahid Malik, a representative of the Pakistan Medical Association, Lahore, said the current hot and humid weather increased the number of asthma cases, especially among children, in addition to giving rise to skin diseases such as scabies.

He also warned against self-medication for treatment of viral diseases, saying it could aggravate the problem. ?According to the WHO, use of antibiotics is not advisable for curing viral diseases, which are self-limiting diseases within three to five days,? he said and added that even doctors overdo prescribing antibiotics for treatment of such diseases. He encouraged use of remedies such as use of honey-mixed water, Joshanda and gargling and taking steam for treatment of viral diseases. He advised avoiding exposure to sunlight and pollution and increasing water intake.

http://www.thenews.com.pk/print1.asp?id=123648

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