MEETING REPORT
Contributed by: R. Sajith Kumar and Edited by Prathiksha
Emerging and re-emerging infectious diseases in Kerala
The following infectious diseases were identified as the major threats to the people of the State
- Leptospirosis
- Dengue Fever
- Viral Hepatitis
- Typhoid fever
- Respiratory infections (including Influenza)
- Malaria
- Chikungunya Fever
- Japanese Encephalitis
- Diarrhoeal Diseases.
- Measles
- Scrub Typhus
Diseases related to HIV (Human Immunodeficiency Virus), Tuberculosis, Leprosy, Sexually Transmitted Diseases, Rabies and Tetanus were not included for discussion.
Challenges
The following challenges were recognized in relation to the diseases mentioned
Leptospirosis
- Exposure related to bread winning activities (farming etc)
- Late diagnosis and referrals
- Self-treatment / delay in treatment
- Absence of confirmation in many cases of Leptospirosis.
- Need to develop a high index of clinical suspicion among primary care physicians.
Future Work
- Lack of epidemiological studies to explore causal association between various factors contributing to Leptospirosis in our setting.
- Few serovar studies have been done so far.
- Lack of inter-sectoral coordination in Leptospirosis research.
Dengue fever
- Absence of timely alert on the basis of vector indices.
- Ecological mishandling and climate changes
- Lack of civic sense and environmental awareness/hygiene
- Mimicking of disease symptoms with other prevalent diseases.
- Improper/suboptimal treatments
Future Work
More studies on virus isolation and epidemiological studies to be done, as very few have been done so far.
- Disease prediction mechanisms to be designed and put in place.
Viral Hepatitis, Typhoid Fever and Diarrheal diseases
- Poor water quality, (and drinking water scarcity) identified across the State
- Lack of awareness and lack of hygiene among food handlers
- Lack of quality control systems for materials and personnel.
- Increasing trend towards outdoor eating
- Extensive travel for different purposes
- Lack of immunization
- Increasing trend towards education and accommodation in unhealthy surroundings.
- Increasing habit of alcohol abuse
- Prevalence of myths and wrong ideas about jaundice
Future Work
Health awareness and education programmes on the risk factors mentioned above to be designed.
Respiratory Infections (including influenza)
- Overcrowding in public places
- High frequency of travel within and outside the country
- Lack of proper education regarding personal hygiene and sense of civic responsibility
-
- Exposure to flora and fauna in unhealthy surroundings
- Lack of isolation facilities in health institutions
- Reluctance of children and adults to remain isolated, when sick.
- Lack of specific treatments
Future Work
Health awareness and education programmes on the risk factors mentioned above to be designed.
- Steps to enhance awareness among doctors, which lead to late diagnosis and Improper use of medications in hospitals
- Design and implement proper diagnostic facilities in treatment centres
Malaria
- Increase in indigenous Malaria cases in Kerala
- Imported Infections through migrant labourers from States like Tamil Nadu, Rajasthan, Bihar, Orissa and West Bengal
- Lack of coordination, ownership and link between the urban health system and district health system in detection, prevention and control activities.
- Absence of an efficient disease screening initiative for migrant labourers.
Future Work
- Implement steps to rectify the above
- Need for regular and systematic vector studies and studies on the efficacy of vector control covering the entire State
Chikungunya Fever and Japanese Encephalitis
- Lack of environmental sanitation
- Exposure related to bread winning activities (farming, travel)
- Inadequate vector control measures
- Climate changes
- Lack of awareness and co-ordination among health professionals
- Self-treatment
- Lack of proper diagnostic facilities
Future Work: - Steps to rectify the above, as well as health awareness and education programmes among the people about the risk factors and simple preventive and remedial measures that they could follow
Typhus Fever and Ricketsial Diseases
- Lack of awareness about the presence of Rickettsial diseases among health professionals
- Delay in treatment.
- Self-treatment
- Lack of proper diagnostic facilities
- Lack of specific treatments.
Future Work
- More extensive studies on vector types and vector density to be undertaken in the various districts of the State.
- Steps to enhance awareness about the risk factors and to establish proper diagnostic facilities
Measles
- Overcrowding, frequent travel etc.
- Entity of Partial immunization.
- Shift of incidence from childhood to adult stage
- Lack of isolation facilities in health institutions
- Reluctance of children and adults to remain isolated, when sick
- Negative propaganda on immunization
Future Work:-
- Steps to enhance awareness about the risk factors and to establish isolation facilities in health institutions
- Studies to analyse any fall in immunity after adolescence in those vaccinated with live measles/ MMR vaccine in childhood.
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