INTESTINAL INFECTIONS Dr. Anura Jayasinghe. MBBS, MSc, MD Trend of - - PowerPoint PPT Presentation

INTESTINAL INFECTIONS

• Dr. Anura Jayasinghe. MBBS, MSc, MD

Trend of main water borne diseases in Sri Lanka

2000 4000 6000 8000 10000 12000 14000 16000

• B. dysentery cases

8000 13365 9672 8063 10106 7999 7976 7313 6424 6645 Enteric fever cases 2970 3108 2962 3116 2978 2382 1989 1825 1950 2376 Viral hepatitis cases 1486 2034 2936 2984 2237 2294 2765 5884 1930 6860 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

E coli

 Live in the intestines of people and

animals.

 Most varieties of E. coli are harmless  E. coli O157:H7, can cause severe, bloody

diarrhea

 Expose to E. coli from contaminated water

• r food

E coli causes cont…

 Co

Cont ntami aminated nated food

 Beef:

f: When cattle are slaughtered and processed, E. coli bacteria in their intestines can get on the meat.

 Un

Unpa pasteu teurize rized d milk: lk: E. coli bacteria on milking equipment can get into raw milk.

 Fr

Fresh esh produce:

• duce: Runoff from cattle farms can

contaminate fields: spinach and lettuce

E coli causes

 Co

Cont ntami aminated nated wa water: er: Human and animal feces

 Persona

rsonal l cont ntact: act: E. coli bacteria can easily travel from person to person, especially when infected adults and children don't wash their hands properly. Restaurant workers who don't wash their hands after using the bathroom can transmit E. coli bacteria to food.

Baci cilla lary ry Dysenter ntery

Notified Cases of Bacillary Dysentery 2009

1217 2601 1797 1030 500 1000 1500 2000 2500 3000 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Cases

Bacillary Dysentery 1st Quarte2nd Quarte 3rd Quarte 4th Quarte Badulla 72 80 114 178 Kandy 99 81 50 146 Kurunegala 48 55 88 132 Trincomalee 27 32 60 131 Batticaloa 38 134 73 120 Ratnapura 186 136 116 114 Ampara 10 20 27 100 Moneragala 15 19 69 94 Anuradhapura 25 44 37 86 Polonnaruwa 10 12 51 79 Colombo 49 58 72 77 Kalutara 86 84 129 76 Puttalam 41 42 48 72 Matale 27 34 45 67 Nuwara-Eliya 110 157 96 60 Galle 55 56 99 59 Kalmunai 46 18 28 59 Mannar 11 37 36 56 Gampaha 39 56 34 50 Matara 92 76 60 47 Jaffna 33 39 31 46 Vavuniya 36 1250 336 39 Kegalle 34 55 70 37 Hambantota 26 26 28 32 Mullaitivu 2 Kilinochchi

Shigella causes

 Po

Poor hygi giene ene and inadequate dequate hand d wa washing ng can cause Shigella to spread from an infected person.

 Eating

ing contami minated nated food can cause shigellosis,

 Handling by an infected person who fails to wash

adequately after using the toilet

 Growing in a field that contains sewage  Coming into contact with flies that breed in infected

feces

 Drinking

nking wa water infected ed wi with Shigel gella or swi wimm mming ing in infected water

 Risk

sk facto ctors rs Shigella infection is highly contagious, particularly for children.

Enteric ric Fever

Notified Cases of Enteric fever 2009 461 518 831 566 100 200 300 400 500 600 700 800 900 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Cases

Enteric Fever 1st Quarte2nd Quarte 3rd Quarte 4th Quarte Jaffna 72 88 61 172 Vavuniya 2 144 498 62 Colombo 65 37 75 52 Nuwara-Eliya 57 72 31 45 Badulla 16 11 12 34 Kurunegala 16 24 22 28 Mannar 56 22 21 28 Puttalam 36 20 9 19 Kegalle 12 11 18 18 Trincomalee 4 5 16 Gampaha 19 10 10 15 Kalutara 23 19 7 15 Batticaloa 5 2 8 13 Ratnapura 22 14 11 11 Kandy 9 8 7 9 Matale 14 9 3 9 Matara 4 2 7 Moneragala 7 8 8 3 Hambantota 2 3 1 3 Galle 2 1 3 Kalmunai 5 3 6 2 Anuradhapura 3 1 3 2 Ampara 5 7 Polonnaruwa 10 6 5 Mullaitivu 1 Kilinochchi

Typhoid

 Typhoid fever is caused by Salmonella

typhi bacteria.

 Typhoid fever spreads through

contaminated food and water or through close contact with someone who's infected.

 Signs and symptoms usually include high

fever, headache, abdominal pain, and either constipation or diarrhea.

Weekly Incidence of Viral Hepatitis

Sri Lanka, 2007 - 2009

15 15

50 100 150 200 250 300 350 400 450 500 550 600 650 700 750 800 850 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 Number reported 2007 2008 2009

Hepatitis

 Hepatitis A is a highly contagious liver

infection caused by the hepatitis A virus.

Transmit

 When someone with the virus handles the

food you eat without first carefully washing his or her hands after using the toilet

 Drinking contaminated water  Eating raw shellfish from water polluted

with sewage

 Being in close contact with a person who's

infected: even if that person has no signs or symptoms

 Having sex with someone who has the virus  Receiving a blood transfusion with blood

that contains the virus, though this is very rare

Tr Treat eatme ments nts and drugs ugs

 No specific treatment exists for hepatitis A.  Expect

ect to have ve less energy.

• gy. Rest when you

need to. You may need several days off work

• r school in order to recover.

 Find

d wa ways to cope wi with nausea.

• sea. Eat small

snacks throughout the day, rather than three large meals. Try soft, easily digested foods, such as soup or broth, yogurt and toast.

 Give

ve your r live ver a rest. Your liver may have difficulty processing medications and alcohol if you have hepatitis A.

 Lifestyl

estyle e and home me rem emed edies es You can take steps to reduce the risk that you may pass the virus to others. Take steps to:

 Wa

Wash h your r hands ds thoroughly ughly after r using ng the toilet.

• t. Scrub vigorously for at least 10

seconds and rinse well. Dry your hands with a disposable towel.

 Don't

't prepare pare food for others rs wh while you're re activel vely y infected.

• ed. You can easily pass this

highly contagious infection to other people.

Let t others hers kn know w it's 's OK to be be ne near r yo you. u. You can't spread the hepatitis A virus by sneezing, coughing, hugging or sitting next to someone.

Salmonella infection

 Salmonella bacteria typically live in the

intestines of animals and humans and are shed through feces. Humans become infected most frequently through contaminated water

• r food sources: such as poultry, meat and

eggs.

 Typically, people with salmonella infection

develop diarrhea, fever and abdominal cramps within 12 to 72 hours. Signs and symptoms of salmonella infection generally last four to seven days. Most healthy people recover without specific treatment.

Wells

Tube wells

Community water projects

Lake

Stream

Boiling

Filtration

Chlorine tablets

Chlorination

Control and Prevention of Intestinal Infection

 Wash

sh yo your ur ha hands.

• nds. Frequent hand washing

is the best way to control infection.

 Avo

void id dr drinking nking un untreate reated d wa water. er.

 Avo

void id raw w fruit uits s and nd ve vegetabl etables.

• es. avoid

fruits and vegetables that you can't peel

 Ch

Choose se ho hot foods.

• ds. Avoid food that's

stored or served at room temperature. Steaming hot foods are best. it's best to avoid food from street vendors

 To prevent

vent infe nfecting cting othe hers rs

 Cl

Clean ean ho hous usehol ehold d items ms da daily.

• ly. Clean toilets,

door handles, telephone receivers and water taps at least once a day with a household cleaner and paper towels or disposable cloths.

 Avo

void id ha handling ndling food.

• d. Avoid preparing

food for others until your doctor says you're no longer contagious.

 Keep

ep perso sona nal l items ms se separate.

• parate. Set aside

towels, bed linen and utensils for your

• wn use and wash them frequently in hot,

soapy water. Heavily soiled items can be soaked first in disinfectant.

Community Responsibility

 Awareness on diseases  Follow guidelines  Assure hygiene of foods  Prepare own foods  Reduce exposure time  Identify early signs  Seek proper treatment  Good contacts with health services

END

dranura@gmail.com 0716832900

Water requirement

Divide your weight (in kilograms) by 30 (ex. somebody weighing 70 kg is going to need 2.3 liters per day).

Source of water

1. 1.

Rain in

2. 2.

Su Surface face wa water er : Oc Oceans, ans, Rive vers rs and nd st streams reams , t tank nks s , po pond nds s & la lake kes

3. 3.

Groun und d wa water er : sha shallow llow we wells, s, De Deep p we wells ls , Sp Springs ngs

1.

Rain

 Rain

in wa water er is s the he pur urest est wa water er in n na nature ure. . Physically, hysically, it is s clear, ar, bright ht and nd sp sparkl rkling. ing.

 Impuritie

purities s of rain n wa water: er:

 Rain

in wa water er tends nds to become

• me impur

ure as s it pass sses es thr hrough

• ugh the

he atmosphere

• sphere.

. It picks ks up up su suspended spended impu purities rities from m the he atmosphe mosphere re su such h as s dus ust, , microo

• organisms

ganisms and nd gase ses s su such h as s carbon

• n dioxide,

xide, ni nitrogen, trogen, oxy xygen gen and nd ammonia

• nia.

 2.

• 2. Su

Surface ace wa water er

 Contaminate

aminate from human an and animal l sourc urces. es.

 Impu

puri riti ties es: : surfac face e wa washings, ngs, sewa wage, ge, trade e wa wastes es, , and drainag nage e from m agr gricul ultur tural al areas. eas.

 Self-puri

purifi fication cation of rive ver r wa water: : dilution, ion, sed edime mentation, ntation, aer erati tion,

• n, oxidation,
• n, sunl

nlight, ght, plant nt and animal l life, but these se age gencies es are not suffici cient ent to render der the wa water potable. ble.

 Wa

Water r needs ds purifi fication cation before re it can be used ed for drink nking ing purposes. rposes.

 3. Groun

und water ter

 Grou

• und

d water er is super erio ior to surface ace water er, , becau ause se the grou

• und

d itself lf provides vides an effect ctiv ive e filter erin ing g medium ium.

 The

he advan vanta tages ges of ground und water er are:

 (1) It is likely

ely to be free from pathogen hogenic ic agents; nts;

 (2) It

t usual ally ly requir ires es no tr treatmen ment; t;

 (3) The

e supply ly is likely ely to be certain ain eve ven n during ing dry season; son;

 (4) It is less subjec

ect to con

• nta

tami mina natio ion than an surfac ace e water er.

 The

he disadvan anta tages ges of ground und water er are:

 It requir

uires es pumpin ping g or some e arrangem ngemen ent t to lift the water er.

 Well

lls: Shall allow wells ls: Deep p well lls: Spring ings: s: