PESHAWAR: The health department has issued guidelines to the administrations of all districts on how to prevent the outbreak of acute watery diarrhoea and cholera during the ongoing monsoon season.

According to officials, the country has recorded 129 confirmed cases of cholera this year. Of them, 25 are reported in Khyber Pakhtunkhwa.

The diarrhoea cases total over 500,000 and 10,000 of them are of acute watery diarrhoea.

The health department sent those guidelines to the district health officers, local governments, water, food and sanitation departments saying cholera is a bacterial illness caused by consuming food or water contaminated with the bacteria Vibrio cholera. A multifaceted and approach comprising surveillance, water, sanitation and hygiene, social mobilisation and timely treatment is required to prevent and control it.

Province has recorded high incidence of two diseases

The department said regular monitoring of hygiene and cleanliness standards of hotels, restaurants and food points, ice factories, street vendors and water reservoirs was important to control its spread through regular liaison among relevant departments.

It asked for the building of hospital capacity to manage patients as well as the stockpiling of essential medicine kits at healthcare facilities with a focus on health education campaign through active community participation particularly aiming vulnerable populations. It asked the authorities to ensure chlorination of water as well.

The officials said currently, cholera clustering was reported in children under four years of age in Sindh and Khyber Pakhtunkhwa provinces.

They said the number of cholera cases had gradually increased since February but no death from it was reported.

The officials said symptoms of the disease ranged from mild to severe and included profuse watery diarrhoea, nausea and vomiting. Diarrhoea ranges from mild to severe; which can cause severe dehydration and death within hours of onset if not treated timely.

They said cholera transmission was closely linked to inadequate access to clean water and sanitation facilities, while poor and congested localities were at greater risk of having epidemics as the pipes supplying clean treated water were usually old, rusted and damaged and sewage pipes and open sewage lanes were running side by side.

The officials said if all those conditions were not checked, water­-borne diseases would break out.

They said hot and humid weather made condition favourable for the multiplication of micro-organisms.

The officials said cholera was transmitted by the fecal-oral route and patients got symptomatic after ingesting contaminated food or water, while typical at-risk areas included peri-urban slums, and camps for internally displaced persons or refugees, where minimum requirements of clean water and sanitation were not being met, could increase the risk of cholera transmission.

They said to control such epidemics, scale of public awareness should be raised regarding the significance of washing hands with soap and water regularly, especially after using toilet, changing diapers and before preparing food or eating, take safe drinking water boiled or chlorinated or bottled water and avoid eating uncooked vegetables and unwashed fruit and prefer taking home made fresh meals.

The officials said the department organised training sessions for healthcare providers regarding management of acute watery diarrhoea and cholera cases.

They said all acute watery diarrhoea cases weren’t cholera and instead, only a few tested positive for the disease.

The officials said the areas, where people consumed spring or river water, had high incidence of acute watery diarrhoea, so the sinking of tube wells and chlorination of water were required.

They said there was a designated unit of integrated disease surveillance and response at directorate-general health services, whereas the district disease surveillance and response units had been established to report cases of communicable diseases, including acute watery diarrhoea.

The officials said during monsoon season, the number of acute watery diarrhoeaoutbreaks increased and every outbreak was responded with preventive, curative and health education intervention.

Published in Dawn, July 31st, 2022