Health Tips

Diseases to Watch Out for During Flood

With the heavy rainfall climatic nature of Malaysia especially between April - September (Southwest) and October- March (Northeast), floods have become an annual occurrence usually by the end of the year. With that said, as we are entering November soon, water-borne diseases are expected to be on the rise. Hence it is of utmost importance that the public is aware of these diseases and start taking actions to prevent or treat them should they happen. 

This is proven from last year’s major flood in 2021 across Peninsular Malaysia where cases of leptospirosis, malaria and dengue are reported to increase almost three-fold during the flood season. Post-flood diseases such as diarrhea, cholera, typhoid and dysentery should also be paid attention due to the changes in environment, poor sanitation and standard of hygiene, contaminated water supply and the greater susceptibility of humans to pathogens that causes flood victims to be vulnerable to them. So, what are some of the diseases to seek out in preparation of the possible flood? Continue reading!

1. Water and Food Borne Disease
   Since floods are all about overflowing of water due to different various factors (ie: climate change, clogged drains, deforestation etc), water and food borne diseases are to be expected. Typhoid fever, cholera, hepatitis A, dysentery and food poisoning are common examples of water and food borne disease. 
   
   1a) Typhoid fever: Caused by a bacteria known as Salmonella typhi, this disease may cause symptoms such as prolonged fever, fatigue, headache, loss of appetite and some typical gastrointestinal signs (nausea, abdominal pain, diarrhea). The incubation period is 6-30 days after being infected by the bacteria and it is mostly spread through fecal contamination of infected food and water or by person-to-person contact.
   
   1b) Cholera: Caused by Vibrio Cholerae, this disease causes the infected person to have chronic, watery diarrhea which can cause severe dehydration and in severe cases, death if not treated immediately. A person will get cholera infection of the intestine either by eating food or drinking water that is contaminated with the said bacteria. The incubation period is about 1-5 days.
   
   1c) Hepatitis A: A contagious liver disease caused by Hepatitis virus A through the ingestion of water or food that is already contaminated or through direct contact with someone who is already infected. Not all individuals will exhibit symptoms of hepatitis A; some of which includes fatigue, fever, diarrhea, abdominal pain, jaundice (yellowing of the skin and whitening of the eyes). One tricky part about Hepatitis A is that it may incubate for approximately 2 to 7 weeks.
   
   As seen from the diseases mentioned above, they all share similar symptoms where they often manifest themselves as mainly gastrointestinal symptoms after potentially consuming food or water contaminated with hepatitis A virus. While these symptoms may seem typical, they can be highly contagious and potentially life threatening if not treated appropriately.

   Prevention:
   (a) Ensure water to be consumed is either bottled or boiled.
   (b) Only eat freshly cooked meals and avoid eating raw food
   (c ) Peel the skin of fruit before eating
   (d) If eating out, choose food handlers who had received anti-typhoid injection
   (e) Maintain personal hygiene and wash hands with clean water and soap at all times
   
   

2. Leptospirosis
   Leptospirosis is an infectious disease caused by Leptospira sp bacteria usually found in the urine of rats, cats, dogs, cows etc. This disease is transmitted through direct contact or drinking or showering with flood water that has been contaminated with the urine of animals that have been infected with said bacteria. The bacteria can find its way to our body through skin or mucous membranes (eyes, nose, or mouth) especially when the skin has an open wound from a cut or scratch.
   
   Symptoms of leptospirosis are broad, ranging from fever, headache, nausea, vomiting, muscle pain, rash, to dark coloured urine. While person to person transmission is rare, it is still possible and hence precautionary measures are to be prioritized.
   
   Prevention:
   (a) Sanitize as frequently as possible and to ensure the cleanliness of the home environment is in check
   (b) Cover meals with a lid to prevent pests from contaminating
   (c ) Practice proper hand hygiene as well as personal hygiene
   (d) Stay away from flood water and only use clean water
   (e) Wash and dress wounds (if any) accordingly, as to not expose to flood water directly
   
   

3. Dengue fever
   Dengue fever is not foreign to subtropical countries like Malaysia, as a matter of fact dengue has been announced as an endemic due to its high reported cases since before. Unfortunately, this doesn’t help because there are many areas that contribute as potential breeding grounds for aedes mosquitoes after the floods recede, the culprit behind the cause of dengue fever.
   
   One of the signs that may suggest dengue is a sudden onset of fever accompanied with a bad headache, joint and muscle ache, nausea and vomiting, diarrhea, pain behind the eyeball as well as itching hives. The prominent characteristics of dengue fever inflammation are bright red spots that often appear at the lower part of the body or in some cases, may spread to the whole body. Dengue fever should receive immediate medical attention as patients may suffer from more serious consequences such as inflammation of the liver, brain (more common among children) and even the heart muscle. Patients may also be at risk of shock and bleeding if their clinical situation continues to deteriorate
   
   Typically, dengue fever lasts for 5-7 days. With proper treatment (adequate hydration, symptomatic relief) most patients will recover within a week. In the event you have been diagnosed with dengue, it is important to report any cases of dengue to the local health authority so preventive actions can be taken to protect the rest of the community members.
   
   Prevention:
   (a) Ensures there are no breeding grounds for aedes mosquitoes -plastic containers, used beverage cans and polystyrene containers that can hold stagnant water during the flood.
   (b) Apply mosquitoes repellent as often as possible
   
   
    

4. Conjunctivitis
   Also known as the ‘pink eye’, conjunctivitis is a disease that is often seen in flood victims. Conjunctivitis is an infection of the conjunctiva, which is the layer outside of your cornea surrounding the white area of the eye, called the sclera. This disease is contagious and can be spread from person to person through the sharing of personal items such as towels, pillows and handkerchiefs with the infected individual. The signs and symptoms of conjunctivitis include eye pain, red eyes, increased lacrimation (tears), itchy eyes and increased sensitivity to light.
   
   Prevention:
   (a) Wash your hands thoroughly with soap and water after touching the infected eyes and any surface
   (b) Avoid close contact with infected people as well as not sharing any personal items with them
   
   
   Image credit: World Health Organization

Always better to be safe than to be sorry

To better prepare for the possible flood that may happen again, the public has every responsibility to be more aware and to equip themselves with the necessary knowledge on what are the common diseases to watch out for during floods and how to manage them. Basic knowledge on regular hand washing and maintaining adequate personal hygiene is key to preventing outbreaks of flood- borne diseases. To revise the 6 steps on how to thoroughly and cleanly wash your hands, you can visit the CDC sheet here. To learn about skin diseases that are associated with flood, you may refer to our previous article here.

Stay safe everyone!

Written by Janelle Leong, Bpharm(Hons)
Reviewed by Ashwini Nair, MB BCh BAO

References 

1. Floods and Risk of Disease - MyHealth KKM. Available at: http://www.myhealth.gov.my/en/floods-risk-disease/. Accessed on 24th October 2022

2. Flood Waters or Standing Waters. - CDC. Available at: https://www.cdc.gov/healthywater/emergency/extreme-weather/floods-standingwater.html  Accessed on 24th October 2022

3. Six Common Diseases to Watch Out for During Floods - The Jakarta Post. Available at:  https://www.thejakartapost.com/life/2020/01/02/six-common-diseases-to-watch-out-for-during-floods.html Accessed on 24th October 2022

4. Floods create health risks: What to look out for and how to avoid them - The Conversation. Available at: https://theconversation.com/floods-create-health-risks-what-to-look-out-for-and-how-to-avoid-them-181718 Accessed on 24th October 2022

5. Beware of flood-borne diseases - Bernama. Available at: https://bernama.com/en/general/news_disaster.php?id=2036755 Accessed on 24th October 2022

Written by

Janelle Leong, Bpharm(Hons)