Health Tips for Travellers

Nat Chawanid, MD

General Practitioner

Bangkok Hospital Samui

Flood diseases.

Rain brings us fertility to all land on earth. No one said, "We do not need rain". We have to use water to drink, for hygienic care and for agriculture. But sometimes natures give us more than we need. At that moment rain can bring disaster. Not only housing damage but also casualty and death. So we have to prepare to face floods and their consequences in the rainy season. Rain is water condensation in the sky. It seems to be clean. The heavy raining overflows rivers or un-drained water paths, which can cause flooding. Floodwater rapidly becomes contaminated with garbage, soil pathogens, animal waste, animal corpses, human waste and chemicals. Hence it can be risky to have direct contact with floodwater.

Most common endemic diseases in flooded areas are transmitted through the contaminated water, "water-borne disease". Such as cholera, dysentery, hepatitis A, typhoid fever, amoebiasis and leptospirosis.

Cholera presents as an acute severe watery diarrhea caused by Vibrio Cholerae. Shigellae cause Dysentery Diarrhea presented with mucous or mucous-bloody stool, which sometimes is similar to the Amoebic Dysentery. Typhoid fever caused by Salmonella bacteria may or may not present with diarrhea at the onset of infection but its actual clinical manifestation is a type of fever called Enteric Fever. Leptospirosis is a disease caused by Leptospira interrogens, a bacteria released to the flood water or mud from the infected rat or domestic or wild animal urine and then enters the human body via wound or skin abrasion while walking bare-foot through it. We recommend the following if flooding lasts for more than a few days: 1. People who live in flooding area should wash their hands with soap every time after contact, after using the toilet or handling contaminated items as well as before cooking and eating. 2. Prepare adequate clean water supply at least 20 liters per person per day. Be sure that there is no cross contamination of the drinking water, if in doubt, boiling before use is necessary. It should be assumed that all flooded areas where groundwater is used for drinking is already contaminated. 3. Foot cleaning, disinfection of clothes or contaminated belongings and forbidding children to play in the floodwater is also recommended.

For those people in flooded areas, if any ailments occur, go to see the doctor for early diagnosis and treatment before the symptoms deteriorate and complications develop.