mons diseases kvp

8/9/2019 Mons Diseases Kvp

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MONSOONMONSOON

DISEASESDISEASES

Dr. K.V. PRABHAKARANDr. K.V. PRABHAKARAN


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Common diseases during monsoon

Leptospirosis

Dengue fever

Chikungunya

Viral hepatitis

Diarrhea

Common cold

Typhoid fever etc..


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Leptospirosis (Rat fever)

Caused by Leptospira (diff serotypes)

L.icterohaemorrhagiae-Weils disease

Some serotypes are harmless

Leptospirosis varies from asymptomaticillness to severe disease and may be fatal

too.


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Leptospires are spiral bacteria(6-20micronsx0.1micron)

Actively motile

With one both ends hooked

Usually seen by dark ground m/e


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Where do Leptospires thrive Every mammal has the potential

to become carrier.


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Infected animals may not develop the

disease but become long term carriers

They harbour leptospires in theirkidneys and shed in urine,

contaminating the environment


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Leptospires can survive for weeks inwater or mud.


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How does man get infected ??

by direct or indirect contact with

infected urine,tissues or secretions.


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Leptospira gain entry through

Small areas of damage on the skin or

via mucus membranes.

Rarely enters through waterloggedskin


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Infection more common in certain

occupational groups

Farmers


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Slaughter house workers

Veterinarians etc


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Flooded roadsFlooded roads


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However It is not spread by animal bites or

insect vectors

Man to man spread (very rare)

Congenital leptospirosis rarely occur


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ClinicalClinical featuresfeatures

AsymptomaticAsymptomatic

Simple fever, body acheSimple fever, body ache

JaundiceJaundice

severe fatal illness with renal failuresevere fatal illness with renal failure


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Laboratory diagnosisLaboratory diagnosis

Detection of antibodies to leptospiraDetection of antibodies to leptospira(Igm)(Igm)

Dark ground m/eDark ground m/e

Culture of bacteriaCulture of bacteria


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PreventionPrevention

Rodent controlRodent control Appropriate waste disposalAppropriate waste disposal


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Use of protective foot wear

Cover cuts and abrasions Appropriate disinfection of

contaminated water

Vaccination of livestock pets

Antimicrobial prophylaxis

(doxycycline) in high risk exposurecases.


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Dengue fever (break bone fever)Dengue fever (break bone fever)))


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Highest incidence in SE Asia, India etc

Dengue from Swahili Ki denga pepo(sudden seizure by demon)

Caused by dengue virus (4 serotypes)


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Dengue fever is transmitted byDengue fever is transmitted by

Bite ofBite of A. aegyptiA. aegypti mosquitoesmosquitoes

rarelyrarely A albopictusA albopictus..

Day biting mosquitoDay biting mosquito

Abundant in and around habitationAbundant in and around habitation


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Dengue viruses are transmitted fromDengue viruses are transmitted from

person to person by Aedes mosquitoes.person to person by Aedes mosquitoes.

(mosquito can infect another person only 3(mosquito can infect another person only 3--10 day after10 day after

blood meal)blood meal)


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Why more dengue following rainfallWhy more dengue following rainfall

Peak breeding timePeak breeding time

Aedes mosquitoes breed in smallAedes mosquitoes breed in small

collection and puddles of watercollection and puddles of water


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Coconutshells DiscardedtyresCoconutshells Discardedtyres


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Incubation periodIncubation period 22--7 day7 day Simple dengue feverSimple dengue fever Complicated dengue fever withComplicated dengue fever with

hemorrhageshemorrhages

Clinical features


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Laboratory diagnosisLaboratory diagnosis

Antibodies to dengue virusAntibodies to dengue virus

IgM and IgG antibodiesIgM and IgG antibodies

ELISA testELISA test

Immunochromatographic testImmunochromatographic test


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Control mosquitoControl mosquitopopulationpopulation

Patients withPatients with

suspected denguesuspected dengueshould beshould be

preventedprevented

from mosquitofrom mosquito

bitesbites

(under mosquito(under mosquitonet)net)

Prevention & ControlPrevention & Control


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Infection is rather spread by

movement of personsand not much of mosquitoes


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Viral hepatitisViral hepatitis


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Man gets Infected byMan gets Infected by

Ingestion of contaminated water,Ingestion of contaminated water,food (Shell fish) or milk .food (Shell fish) or milk .

Over crowding and poor sanitationOver crowding and poor sanitation

favors spreadfavors spread


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Viral hepatitisViral hepatitis

Virus multiplies in the intestinesVirus multiplies in the intestines

through bloodthrough blood

Reaches liverReaches liver

HepatitisHepatitis


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Contd..Contd..

Virus is shed in feces of infectedVirus is shed in feces of infected

personspersons

Contaminates water and foodContaminates water and food


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Prevention& ControlPrevention& Control

Improved sanitary practiceImproved sanitary practice

(prevention of fecal contamination of(prevention of fecal contamination of

water and food )water and food )

Effective vaccine is available forEffective vaccine is available forhepatitis A (Two dose 1M)hepatitis A (Two dose 1M)


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Hepatitis E Infection is generallyHepatitis E Infection is generally

mild.mild.

HoweverHowever

It has 20It has 20--40% fatality rate in40% fatality rate in

pregnant womanpregnant woman


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Lab Diagnosis of hepatitisLab Diagnosis of hepatitis

Detection of Ab to Hep A and Hep EDetection of Ab to Hep A and Hep E

Liver Function TestLiver Function Test


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Enteric fever (Typhoid)Enteric fever (Typhoid)

Occurs throughout the yearOccurs throughout the year

Seasonal variations may occurSeasonal variations may occur

Caused byCaused by Salmonella typhiSalmonella typhi &&

paratyphiparatyphi A,B&CA,B&C


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S

ource of InfectionS

ource of Infection

A patient or a carrier.A patient or a carrier.

Mode of infectionMode of infection

Via contaminated water ,Milk & foodVia contaminated water ,Milk & food


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Lab DiagnosisLab Diagnosis Culture of organisms fromCulture of organisms from

blood,feces etcblood,feces etc

Serological test for detection of AbSerological test for detection of Ab--

WI

DAL testWI

DAL test

ControlControl Hygienic measuresHygienic measures


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DiarrheaDiarrhea

In tropical countriesIn tropical countries

Bacterial and protozoal diarrhea tendBacterial and protozoal diarrhea tendto occur in wetter seasonto occur in wetter season


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BacterialBacterial

CholeraCholera -- Via contaminated waterVia contaminated water Rice water stoolsRice water stools

May be rapidly fatalMay be rapidly fatal


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TreatmentTreatment

Prompt rehydration is essentialPrompt rehydration is essential ORS (Oral rehydration solution)ORS (Oral rehydration solution) I/v fluids if necessaryI/v fluids if necessary

Antibiotics like doxycyclineAntibiotics like doxycycline


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Other pathogens

Entamoeba Giardia


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