A combination of monsoon showers and children going back to school has doubled gastroenteritis cases in the Capital this week.
“Just yesterday, I got four children with symptoms of pain in the belly, fever, vomiting, diarrhoea and no appetite,” said Dr Anupam Sibal, paediatric gastroenterologist, Apollo Hospital.
“Most infections occur in schools, where children share water or eat exposed foodstuff in the school canteens.”
Heat and humidity are just the combination that bacteria, viruses and parasites need to proliferate, causing food and water-borne outbreaks. While there is no reliable data on gastroenteritis cases in India each year, diarrhoea accounts for 13 of every 500 newborn deaths – 47 per cent of India’s infant mortality rate of 55 deaths per 1,000 births in 2007.
Apart from safe water, you have to be careful of the quality of meats and milk and its products in this weather, say experts.
“Meats, milk, yoghurt and cheeses like paneer spoil very quickly, so eating them freshly cooked at home is the safest bet,” said Dr Ajay Kumar, senior gastroenterologist, Apollo Hospital.
“As far as possible, heat the food before eating as it is the most effective way to kill bacteria in food.”
Heating works most of the time, but not always.
“Stale rice is a leading cause of gastroenteritis in India. Cooked rice harbours food-poisoning bacteria called Bacillus cereus, which forms a hard outer coating (spore) to protect itself from heat,” said Dr Sashi Khare, senior consultant microbiologist, National Institute of Communicable Diseases.
When cooked rice is cooled, she explained, the spores germinate, producing more bacteria that produce toxins.
“Re-heating rice destroys some of the bacteria but not the toxins, which cause stomach upsets.”
The causes of food contamination can be one of many. It can be micro-organisms such as salmonella, campylobacter, E. Coli, cholera; parasites (such as fasciola, echinococcus, taenia solium); and naturally-occurring bio-toxins (such as mesotoxins in rice and mycotoxins in fungi).
“What is worrying this year is that many people are not responding to Norfloxacin, the antibiotic of choice. We have to now prescribe stronger antibiotics such as Ofloxacin for bacterial infection along with Ornidazole for cramps,” said Professor S.K. Sarin, professor of gastroenterology, Maulana Azad Medical College.
If the cause of the disease is a virus, you have to just replenish the water lost and wait for the infection to get over in four to five days.
“Usually, drinking water with salt and sugar is enough, but you need a doctor if the acute diarrhoea and vomiting doesn’t allow you to drink or eat at all, or the fever stays high (over 102° Celsius) with headache, abdominal cramps and vomiting,” says Dr Kumar.