By Dr. Sushila Fonseca

Panaji, August 13, 2019: With the beginning of the monsoons, the scorching temperatures drop and we, Indians, all give a sigh of relief! The parched earth turns green once more and everyone cheers up. But the rains also bring along some unwelcome guests. They are transmitted through the air and water and insects.
Air transmission:

Air transmits infective viruses

 Influenza is caused by most common virus –the influenza virus. The lower atmospheric temperature and high humidity makes a person more susceptible to infection by these viruses. That’s why coughs and colds are very common in this season. It is an infection of the respiratory passages and is characterized by sneezing and coughing, body ache and fever.
Since this virus is air borne and contagious, it spreads easily as it is blown out in every cough and sneeze of an infected person. To control its spread, it is important that the patient covers his/her mouth when sneezing or coughing. To prevent this infection, it is important to keep the body warm, avoid chilled drinks and getting wet. We can also enhance the body’s resistance to such infections, by consuming vitamins, especially Vitamin C.

Water Transmission:

In the humid conditions of the monsoons, house flies and such insects also multiply rapidly and spread germs when they sit and feast on our food. That is why, in this wet season, there is a sharp increase in the incidence of infections like:
 Gastroenteritis and diarrhea, which presents with fever, loose motions and vomiting.
 Enteric fever (typhoid), which appears with headache, high fever that does not drop to normal even after taking an antipyretic, sore throat and loose motions.
 Infective hepatitis (usually Hepatitis A and E). Jaundice, (yellow discoloration of the eyes and skin), vomiting, nausea and fever are the common signs.
To prevent these diseases, it is important to drink boiled water, avoid raw foods and keep all food covered and away from insect pests.
 Leptospirosis -With floods and poor sanitation, germs spread easily in the water, over huge areas. Bacteria like Leptospira are transmitted by infected cattle and rodents, which excrete these bacteria in their urine and stools. These bacteria further multiply in contaminated stagnant pools and flood waters. These bacteria can infect humans through the skin and mucosa to cause a disease called leptospirosis. Therefore, it is necessary to avoid walking (or children playing) in roadside pools or near construction sites and to wash the feet and bathe daily.
Leptospirosis presents in:
1) a mild form with irregular mild fever, body ache, headache and reddening of the eyes.
2) a severe form with symptoms as above and also severe damage to the liver and kidneys causing jaundice and swelling of the feet, breathlessness and unconsciousness, leading to death.

Insect Transmission:

The high humidity and lower temperatures during the monsoon give insects, like houseflies and mosquitoes, an environment conducive for their multiplication. Unfortunately, these insects are also carriers of disease producing viruses and parasites.

 Dengue Fever: The dengue virus multiplies in some mosquitoes (Aedes type; commonly A. aegypti) and is transmitted through the bite of this mosquito, which usually occurs in the day time. It takes about 3 days to a week for the fever to appear, which is a high, biphasic fever with chills. The patient also complains of headache and a mottled skin rash.
To avoid this disease, the mosquito menace must be controlled and clothes that cover the full body, like long sleeves and pants, are recommended.

 Malaria: The malaria parasite, called plasmodium, multiplies and survives in the female Anopheles mosquito. This mosquito bites humans at night. When the mosquito bites a person, it injects its saliva with the parasites into the individual’s skin, from where the parasite travels to the liver, kidneys and other organs and multiplies there. Fever appears after a week. There are various forms of Plasmodium parasites. The two commonly seen in India are P. vivax and P. falciparum. In the case of P. vivax, the fever is an alternate day fever with chills which falls with profuse sweating and a feeling of well-being in the afebrile period. P. falciparum fever is more insidious and may appear every third day. It however has a greater incidence of fatality.

To control mosquito proliferation and so prevent these illnesses, it is important to keep the environment clean and avoid accumulation of stagnant water, by adequately draining it or covering it with oil; outdoor discarded artefacts like discarded tyres and plastic containers must be covered or turned over.

Thus, although the weather is pleasant during the monsoons and the cooling showers are welcome, we must be watchful and avoid the infections that arrive along with the showers!

(Reference book: Know Your Fever by Dr. Sushila Fonseca)