ISLAMABAD: With the onset of the monsoon rains, the World Health Organisation (WHO)’s collaborating centre for research and training in viral diagnostics has issued two advisories for the prevention of water and food-borne infectious diseases and Naegleria Fowleri (brain-eating amoeba) infection.

The advisories have been sent to the chief commissioner Islamabad, the Capital Development Authority (CDA), all provinces and the health departments across the country to take necessary steps to avoid loss of human lives.

One of the advisories stated that the Pakistan Meteorological Department had forecast monsoon rains between July and September so the health departments should take appropriate steps to minimise the outbreaks of food and waterborne diseases.

“Hot, humid weather and rains spell make the conditions favourable for the multiplication and transmission of micro-organisms responsible for water and food-borne diseases’ outbreaks. Natural water reservoirs get contaminated due to mixing of rainy and sewage water. It can lead to acute watery diarrhoea/cholera/gastroenteritis, enteric fever and hepatitis outbreaks.”

It said water pipes supplying clean water were usually old, rusted and damaged while sewage pipes and open sewage lanes running side by side sometimes got contaminated. So damaged water pipelines should be repaired without delay. Regular monitoring of hotels, restaurants and food points, ice factories, street vendors and water reservoirs should also be ensured.

The health education campaign regarding safe drinking water, hand hygiene, food safety and better sanitation should be launched. Focus should be given to children, vendors and pregnant women because they are at a greater risk of hepatitis.

The second advisory stated that in Pakistan since 2012 a total of 40 fatal documented cases of Naegleria were reported from different tertiary-care hospitals in Karachi (12 fatal cases in 2015). One fatal case was reported in Karachi on June 30, 2016.

It said Naegleria is a rare disease with the mortality rate of over 95pc. The free-living ameba (Naegleria) is found in freshwater environments.

Since detection of the first case in Australia in 1965, more than 300 documented cases have so far been reported from 16 countries. Symptoms are headache, fever, stiff neck, anorexia, vomiting, altered mental status, seizure and coma. Death typically occurs in three to seven days.

“Most Naegleria infections are associated with swimming in warm freshwater lakes. Naegleria can grow in public and private water tanks and pipes, especially with little or no disinfectant. This infection has also been reported when people rinse their sinuses through the nose and cleanses their noses during ablution.”

Ameba is sensitive to chlorination. The municipal public health authorities, therefore, must ensure that adequate levels of chlorine are maintained in the supplied tap water along with strict monitoring arrangements. Awareness and education in the affected areas must also be undertaken to educate the citizens on the requisite preventive measures.

“Any of the suspected cases should immediately be reported to health authorities for corrective measures,” it added.The executive director of the National Institute of Health (NIH), Dr Mukhtar Ahmed, told Dawn that the collaborating centre for research and training in viral diagnostics collected information from across the country and time to time issued advisories so that the health authorities could remain vigilant.

“If a case is reported, not only we keep a check on the patient but also provide support to strengthen the mechanism which is also a part of surveillance,” he said.

Published in Dawn, July 19th, 2016