Chandigarh, July 14
Dr Mohinish Chhabra, a gastroenterologist, has emphasised that the cholera cases reported in some parts of Chandigarh should serve to heighten awareness about the diseases in the public rather than creating a scare. At the same time, every gastroenteritis case should not be taken as a cholera case.
In a talk with TNS here today, Dr Chhabra, who is a consultant gastroenterology at Fortis Hospital, Mohali, said during the monsoon, acute diarrhoeal illnesses were a major public health problem. For centuries, most people had reeled under the mistaken assumption that it was important to rest the gut during the diarrhoea.
According to Dr Chhabra, normal food intake should be promoted, if the person is able to eat, and in case of dehydration Oral Re-hydration Solutions (ORS) should be used. Unnecessary prescription of drugs and antibiotics do more harm than good in the treatment of diarrhoea. Antibiotics should be considered when the cause of diarrhoea is identified as shigella, typhoid or cholera. Anti-motility drugs like Loperamide should not be used. To avoid diarrhoeal illnesses it is very important to handle food well. The time between preparation and consumption should be kept short. Food must be adequately cooked and heat must penetrate the centre of the food leaving no cool spots. Food premises must be kept free from flies, mice, rats and dust. Food should not be left in warm pantries because few germs can multiply to a couple of million in a few hours. Food not eaten should be properly refrigerated in temperatures less than 4 degrees Celsius.
Heavy rainfall usually brings with it acute viral hepatitis (A and E) or jaundice. According to Dr Chhabra, the major route of transmission is contaminated water, food and milk. There is a phase of mild fever, nausea, vomiting and loss of appetite before the appearance of jaundice. Once jaundice appears, the fever subsides and appetite improves. The commonest practice is to restrict fats in diet, which leads to a marked weight loss. However, fats should be restricted through the phase of vomiting and later when vomiting subsides normal diet should be resumed. Another common practice is the advice of complete bed rest but normal activity can be carried within tolerance limits.
There is usually spontaneous resolution of jaundice within four to six weeks in uncomplicated cases. One should avoid consumption of liver tonics readily available in the market. The precautions one can take to avoid jaundice are to wash hands properly before eating and after using the toilet. As important is drinking purified water by boiling it and ensuring that it is chlorinated adequately.
