Diarrhoea outbreak: 450,000 patients in three months

More than 450,000 people all over the country have been diagnosed with diarrhoea. Of them, more than 55,000 patients have been treated at the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Some 23 per cent of the patients admitted at the icddr,b have severe diarrhoea or cholera.

According to the icddr,b and the Institute of Epidemiology, Disease Control and Research (IEDCR), diarrhoea patients are common. However, the number of patients this year is higher than numbers in previous years.

Speaking to Prothom Alo on Sunday, director of Communicative Disease Control (CDC) unit of Directorate General of Health Services (DGHS), “The incidence of diarrhoea is a bit higher than normal. It has become a matter of concern.”

The health emergency operation centre and the control room of DGHS have given a figure on the number of diarrhoea patients across the country from January to March. According to that figure, a total of 461,611 diarrhoea patients were treated at hospitals. Two of them died.

The highest numbers of diarrhoea cases have been reported in Dhaka division. A total of 159,247 people contracted diarrhoea in this division. The number of infected is the lowest in Barishal division.

The number of infected patients in Mymensingh and Rangpur division has reduced in March as compared to February. The number of diarrhoea patients has increased in the remaining divisions.

However, the people concerned say the real number of diarrhoea patients is higher than the assessment of the DGHS. The DGHS only keeps account of the patients admitted to government hospitals and icddr,b’s hospital in Mohakhali. A number of patients seek treatment at the private chambers of the physicians. At the same time, many do not go to physicians in case of normal diarrhoea. They simply buy oral saline from the pharmacies instead of going to doctors.

More than 1,000 patients have been admitted to the hospital of icddr,b on daily basis since 16 March. In the first 11 hours of Sunday, as many as 402 patients were admitted there.

The hospital was crowded with patients, their relatives, physicians, nurses, other health workers and security guards.

Sometimes four or five patients were seen coming together. The patients were of all ages. In the case of a few patients, it was observed that they were being put to bed without the registration process. Even their treatment started without completing the registration process as they were in critical condition.

The number of patients admitted to the hospital rose 488 by 12.00pm. That means that some 86 patients were admitted in one hour.

As the number of newly admitted patients was high, so was the number of patients recovered. Authorities say 80 per cent of patients are being sent home within 24 hours of admission. All the patients of this hospital are being treated free of cost.

Prof Tahmid Ahmed, executive director of icddr,b visited the hospital before 12.00pm. He told Prothom Alo that the health directorate has been informed about the increase in the incidence of diarrhoea since the beginning of March.

Asked if icddr,b has taken any initiative to test the water in Dhaka, Tahmid Ahmed said, "We have contacted Dhaka WASA in this regard. We have suggested them increase the amount of chlorine in water.”

Diarrhoea and cholera are water-borne diseases. Chlorine kills the germs in the water.

IEDCR has sent two teams of health workers in Barguna and Narsingdi to identify the reason behind the diarrhoea outbreak. Speaking to Prothom Alo, Prof Tahmina Shirin, director of IEDCR, said that they have also taken initiatives to test the water at certain places apart from those two districts. The results of tests would be sent to the disease control unit soon.

In March, a total of 29,681 patients were admitted to the hospital of icddr,b. Of them, some 23 per cent or 6,826 were cholera patients.

Speaking to the officials of icddr,b and IEDCR it was learned that mainly three types of patients are coming to hospitals. Some of the patients are suffering from acute dehydration. Some are partially suffering from dehydration and the remaining patients are not showing any symptoms of dehydration despite being diagnosed with diarrhoea.

Speaking to Prothom Alo, chief scientific officer of IEDCR, ASM Alamgir said diarrhoea is caused by viruses and bacteria. Children contract diarrhoea due to rotavirus. In addition, three types of bacteria cause diarrhoea. Bacteria called ‘vibrio cholerae’ cause cholera or acute diarrhoea.

People concerned say, the symptoms of cholera include acute dehydration and subsequent weakness, loss of skin elasticity and acute thirst. If someone exhibits these symptoms, he or she should be immediately admitted to the hospital. These patients have the risk of fatality due to dehydration.

Two people have died of diarrhoea so far this year in the country. One of them was from Laxmipur and the other was from Cox’s Bazar.

Public health experts say that people have become much more aware in the last few decades. People go to pharmacies and buy oral saline or go to hospital if they are diagnosed with diarrhoea. For these reasons, the diarrhoea or cholera related casualties have reduced in the country.

When asked, what the health directorate is doing in the current context, prof Nazmul Islam, director of the disease control unit told Prothom the physicians are being trained in diarrhoea management. Hospitals are stockpiling diarrhoea medicine, saline. The health department is monitoring the situation across the country.

According to icddr,b, initiatives should be taken to create awareness among the people, water should be used after boiling to avoid diarrhoea, people should avoid eating uncovered food near the streets, people should wash their hands with soap before and after eating and children should not be fed with feeders.

In case of diarrhoea, one packet of saline should be mixed in half a litre of water, the patient should be given more liquid food in addition to saline and the patient should not be given soft drinks or fruit juice or grapes.

In case of diarrhoea in children, every time a child passes stool, it must be administers as many teaspoons of oral saline as the number of kgs it weights or the same as the amount of stool it has passed. If the child vomits, he or she should be fed slowly, for instance, one spoon at a time after every three or four minutes. In addition to oral saline, infants under two years of age must be given breast milk.