There is a visible trend of increase patient load during monsoon seasons due to several potential diseases that can affect the general population including all ages, gender and socioeconomic class. The diseases that are commonly encountered are as follows:
- Acute Respiratory Viral Infection: This is a common occurrence at all age groups with cold, cough, sore throat, headache with or without fever. The layman term these as simple “Viral Illness”. This infection is transmitted through air and mostly seen if the person comes in contact with an infected person. Mostly these are confined to upper respiratory system like pharyngitis, laryngitis and sinusitis but it may extend to involve lower respiratory system (respiratory tract and lungs) as well. The patient develops running nose, throat and eye congestion, weakness and extreme lethargy. Mostly these patients do not see a doctor in the initial phase and take self-medication. They visit a doctor only if do not respond to these medicines or develop severe symptoms and high-grade fever. Not uncommonly these viral infections aggravate and lead to secondary bacterial infection. Such cases require appropriate selection of antibiotics along with other medications for symptomatic relief. In few cases if the infection is not suitably controlled it can lead to serious pneumonias.
- Acute gastro-intestinal Infection: These infections are caused due to contaminated food or water and usually present in form of vomiting, diarrhea, abdominal pain with or without fever. The risk of contamination increases during monsoon season especially with street food and water. The severity of symptoms will depend on the magnitude of infection and sometimes may cause severe dehydration requiring hospitalization for correction of fluid and electrolyte balance.
The types of infections could be viral (viral gastro-enteritis) or bacterial (dysentery). Also specific type of protozoal infections (amebiasis, giardiasis) can be contacted with contaminated food and water. The treatment of these infection is directed towards correction of fluid and electrolyte along with specific drugs to eliminate these pathogens.
- Enteric Fever (Typhoid Fever): Typhoid fever is also caused by contaminated water and food but the disease develops slowly over few days to weeks after ingestion. The usual symptoms are fever, headache, nausea, vomiting, abdominal pain and even cough. Patient may develop rashes on his body. It may be difficult to confirm typhoid fever in the initial phase of clinical symptoms. The specific laboratory investigations can confirm the disease only after few days of the disease. There are several antibiotics that are effective against typhoid fever, however, the selection of a particular drug should be judicious and based on sensitivity pattern in the geographical area. One of the great challenge faced by the doctors is problem of high drug resistance with antibiotics. The earlier drugs that were highly effective in typhoid fever are no longer used due to their ineffectiveness. Newer drugs are being used for cure of this disease or even combination of two or more than two antibiotics are required for complete elimination of the pathogen. It is strongly recommended for both children and adults to take typhoid vaccination to prevent the occurrence of diseased or reduce to severity of symptoms.
- Malaria: India is an endemic zone for malarial infection. Moreover, this disease becomes more prevalent during monsoon due to excessive water logging leading to breeding of mosquitos (night time) at several places. The symptom of malaria is fever usually periodic with extreme headache or body pain. Patient may have nausea, vomiting and extreme weakness. The use of pain killer or fever relieving medicines may give only transient relief and symptoms are aggravated till specific antimalarial drugs are administered. The diagnosis of malaria is confirmed by simple blood test and accordingly the treatment is given by specific drugs. There are 4 different types of malarial parasites that could infect a person. Most common are P vivax and P falciparum. P vivax is relatively simple and easy to treat with fewer complications whereas P falciparum is more complex to treat and likely to cause serious or even fatal complications. The drugs should be taken as per instruction by your doctor.
There should be high emphasis on mosquito control in and around every house and awareness among public about this disease is of paramount importance.
- Dengue Fever: There is an alarming increase in the incidence of Dengue fever in India, a disease which was quite uncommon few decades ago. This disease is caused by day time mosquitos that populate in gardens, construction sites and basements. The mosquito transmits Dengue virus that causes symptoms usually after 3-14 days after infection. The disease has symptoms like malaria with greater severity of body pain especially bone (bone breaking fever). Besides patient may have muscle and joint pain along with characteristic skin rash. On blood examination, there is a decrease in platelet count that alarms to confirm the diagnosis by specific immunologic test. Usually the disease may resolve within a week but few cases can develop life threatening complication Dengue Hemorrhagic Fever resulting into bleeding (very low level of platelets), low BP and shock like state. There is no specific drug against Dengue virus and patient are managed only by symptomatic and supportive therapy. There is a recent introduction of Dengue vaccine by WHO but Govt of India has not approved its use in this population. The safety of this vaccine is still under debate. The strategies to control mosquitos will be hallmark of prevention of the disease.
- Infective Hepatitis: Infective Hepatitis is a liver disease caused by a virus (Hepatitis A) that is transmitted through contaminated food and water. It is usually mild and manifested in form of fever, jaundice (yellow discoloration of skin and eye), abdominal pain that may be associated with loss of appetite, nausea, vomiting and diarrhea. Interestingly many cases may not have any symptoms. The disease last for about 6-8 weeks and treatment is only supportive without any specific drug. There is a specific vaccine to prevent this disease and recommended for both children and adults.
- Skin Disease: There is high incidence of skin diseases during monsoon. The common problems are skin infections both bacterial and fungal due to wet or damp climate. The bacterial infections are folliculitis (boils), and infected eczema. The fungal infections include ringworm (neck, armpits, groin, soles etc.). Athletes foot due to contact of dirty water, fungal infection of scalp, and fungal nail infection. Besides infection patient can experience exaggerated symptoms of chronic eczema where itching and bleeding blisters and patches develop appears on the skin. It is advisable that person should avoid moisture and continuous wetting, keep the skin dry and clean, avoidance of silk, polyester clothing for better breathing through pores and limit the exposure to skin irritants.