Outbreak of diseases increases after 2010 floods?

I don’t know whether people know it or not but number of diseases are spreading or re-surfacing in Pakistan since the start of 2013. Four major diseases have been reported by the local Television stations of Pakistan, one of them was declared epidemic while three others are re-surfacing again.

Name of the diseases in Pakistan

Following are the major diseases that are prevailing in the country;

1. Measles
2. Dengue Fever
3. Newcastle Disease Virus (NDV)
4. PAM (Primary Amoebic Meningoencephalitis)

Measles

• In 2013: 290 deaths with 22,680 cases according to WHO

Pakistan is experiencing the worst Measles outbreak since 2008. The increase in Measles outbreak can be contributed to the frequent floods that have been witnessed since 2010. According to the World Health Organization (WHO) in 2012, 310 deaths were reported while 14, 984 cases came forward. This year WHO say that the ‘track is much worse’ than 2012.

After experiencing torrential monsoon rains and floods in 2010, 2011 and 2012, Sindh was the first Pakistani province to report outbreak of Measles in December 2012, almost all deaths were of children who lived in the flood and rain-affected areas according to Asian Human Rights Commission. After Sindh, severe measles outbreak was reported in Punjab province including the provincial capital Lahore with the latest death of a child from Rahim Yar Khan city of Punjab on July 23.

What is Measles?

Measles is also know as Rubeola or Morbilli, it is an infactious viral disease that causes red rash on skin and fever. Children are highly vulnerable to Measles if vaccines are not used. Since 2005, a Measles Vaccine by the name of Measles-Mumps-Rubella-Varicella combo (MMRV Vaccine) is available which is said to have long lasting effect.

Symptoms

Following are the symptoms of Measles according to the UK National Health Service;

• Cold-like symptoms.
• Red eyes and sensitivity to light.
• Fever.
• Greyish white spots in the mouth and throat.

Dengue Fever

• In 2013: four deaths with eleven cases according to Daily Times

Pakistan is not been new to Dengue disease but during the last few years it has started spreading rapidly especially during the monsoon season. The first case of Dengue was reported in Karachi in 1994 and after that it has been slowly slowly spreading towards the northern parts of Pakistan. In 2007, a sharp increase in Dengue cases were reported in Pakistan especially in Karachi and that year the diseases rapidly engulfed Lahore city.

Punjab province already experienced a major Dengue Outbreak in 2011, although this year most cases and deaths are coming from Karachi. Dawn Newspaper on July 24 has reported that first Dengue hemorrhagic fever virus was found in the blood of a woman in Lahore with doctors expressing their fear that Dengue fever can return to Punjab later in 2013.

What is Dengue fever? 

There are four types of Dengue, with two major types. Since 2007, two types of dengue diseases occurred in Karachi while in 2008, another third type of Dengue disease occurred in Lahore and in 2011 all four types of Dengue fever were present in Punjab province;

1. Dengue fever
2. Dengue hemorrhagic fever

Dengue fever (DF): The symptoms of dengue fever are like severe, flu-like illness. DF usually affects infants, young children and adults. DF is rarely fatal.

Dengue hemorrhagic fever (DHF): DHF is a complication of the disease that can be fatal. It usually occurs if you have dengue infection more than once. The symptoms of DHF are similar to DF but the condition of the patient show rapid deterioration 2-5 days after the fever starts. If the disease is not severe, the signs and symptoms decrease after the fever resolves. Patients with severe disease can unexpectedly deteriorate after a few days of fever and develop bleeding from the nose, gums, mouth or in the skin, which leads to purplish bruises. In some of these patients after the fever resolves signs of circulatory failure (low blood pressure or shock) develops which can rapidly progress to severe shock or turn lead to death within 12 to 24 hours.

Symptoms

Following are the symptoms of Dengue fever according to the UK National Health Service;

• Severe headache.
• Pain in eyes.
• Severe aching in your bones and joints.
• Severe muscle pain (myalgia) of the lower back, arms and legs.
• Abdominal pain, feeling sick and being sick.
• Feeling cold.
• Flat red skin rash.
• Facial flushing.
• Loss of appetite.
• Sore throat.
• Abnormal bleeding, blood coming from nose, mouth or during urine.

Newcastle Disease Virus (NDV)

• In 2013: 60 peacocks died in south-eastern Sindh according to Express Tribune

Newcastle Disease Virus (NDV) is not new to Pakistan. In 2003, peacocks died from the same disease but at that time authorities took an early action. In February 2011, a milder version of NDV that caused the birds of Thar region to have swollen eyes and loss of appetite. In 2012, a deadly outbreak of Newcastle was observed that killed 300 peacocks in Sindh due to drought conditions in eastern parts of Sindh.

This year 60 peacocks have died in the same areas of Sindh that is experiencing unusual weather since 2011 that is mix of drought and abnormal high rains.

What is Newcastle disease virus (NDV)?

The virus is named after the city of United Kingdom as it was first reported in 1926. Newcastle Disease Virus (NDV) mostly affects birds that include poultry as well as wild species. Being a bird disease, it spreads rapidly to due migration of wild birds from one place to another due to which outbreaks can occur frequently. Sadly there is no treatment for this disease but effective vaccine may help to reduce the chance of major outbreaks.

Symptoms of NDV

Other than causing seasonal flu-like symptoms or mild eye infection, the Newcastle disease is harmless to human beings. Following are the symptoms of Newcastle disease virus in birds that affects the metabolism and neurological systems of the bird such symptoms disfigures the beauty of Peacock;

• Loss of appetite.
• Coughing.
• Sneezing.
• Diarrhoea.
• Loss of feathers.
• Drooping neck.
• Depression.
• Nausea.
• Whirling and spinning.

PAM (Primary Amoebic Meningoencephalitis)

• In 2013: Two people lost their lives according to Dawn Newspaper

This water-borne disease is confined to Karachi at the moment and it’s first case was reported in 2009 according to the Express Tribune and since 2011 it’s cases are increasing in the metropolis. It is a very rare disease found in some states of U.S and Australia, in 2012, 22 people lost their lives in Karachi few were reported to have recently swam while 13 cases showed that the victims had no history of swimming which made the doctors believe that infection might have occurred due to wudu – وضو (Islamic ritual before Salah) according to Dawn Newspaper.

What is PAM (Primary Amoebic Meningoencephalitis)?

It is a water-borne disease, the deadly infection occurs when Naegleria fowleri, an amoeba that is found in rivers, lakes, springs, drinking water networks and poorly chlorinated swimming pools travels into the nose and starts affecting the brain. Drinking waters and Swimming pools should be properly disinfected with recommended percentage of chlorine. Precautions should be especially during wudu.

Symptoms

This infection is very serious, it has 98% fatality rate. Following are the symptoms of Naegleria fowleri according to the CDC;

• Changes in taste and smell.
• Headache.
• Fever.
• Nausea.
• Vomiting.
• Stiff neck.
• Confusion.
• Hallucinations.
• Lack of attention
• Seizures.

People left at the mercy of diseases!

‘2011’s Dengue Outbreak, 2012’s Newcastle Outbreak  and 2013’s Measles’s Outbreak’

It is quite disturbing that Pakistan remains under the grip of various diseases with increase in cases after the 2010 floods while the process of vaccination is slow, the reason for re-surfacing of some virus. The International Health Authorities should immediately look into Pakistan’s health care system as the government is taking little interest in the deteriorating situation if the International community does not look into the matter then such infections would only spread, classic example is that of Pakistani Polio virus that was detected in Egypt and Israel. We Pakistanis can only take precautions and spread the information about diseases that can help the Pakistani nation!