Thursday, October 27, 2011

The perils in the water

Special to The Nation October 27, 2011 4:06 am
The perils in the water

Amid the flood's destruction and disruptions, stay mindful of the less visible dangers

Major flooding brings serious, immediate and longterm health issues, even with the most effective healthcare system. The initial disruption of medical services aggravates the plight of those affected.

According to the Health Ministry, the current flooding has affected the health of more than 700,000 people - and the disaster appears to be far from over.

Below we examine the key health risks stemming from the unusual sanitary con¬ditions, along with some preventive measures.


People spending a lot of time in the water are at risk not just of drowning and electrocution but also several other dangers.

They could face severe skin infection from the multiple toxins that escape from inundated factories and farms and the sewage of housing estates. Scratches and other injuries are unavoidable, worsening the risk.

Leptospirosis - also called haemorrhagic jaundice and, in Thailand, roke chi noo - is a disease directly linked to contact with polluted water. Its source, as the Thai name indicates, is rat urine.

Outbreaks have been common in the Northeast amid flooding, with cases num¬bering as many as a few thousand each year. People contract leptospirosis directly from drinking contaminated water, but also through lesions on the skin or via the mucous membrane.

Long exposure into the water often leads to fungal infections on the legs and feet. Intense fullbody cleansing is required when exposed. Any damaged skin must be extremely well disinfected, and if the wound is severe, see a medical practitioner for a possible immunisation booster.


Bites from insects, particularly centipedes, or reptiles can occur as flooded urban areas bring wild animals into contact with people.


Water contaminated by microorganisms is a major concern. Lots of waterborne communicable diseases can spread, such as Hepatitis A, E coli bacteria, staphylococcal endotoxins and enterovirus (which infects the gastrointestinal tract and can spread to other parts of the body), and to a lesser extent typhoid fever and poliomyelitis.

Acute diarrhoea and food poisoning can result from ingesting contaminated water, even in small amounts.

Cholera, usually a major flood concern in tropical countries, is fortunately very rare in Thailand. However, since minor cholera outbreaks occurred from 2007 to 2009, it's wise to be on guard.

To protect against these waterborne diseases, obey the rules of basic hygiene, especially drinking safe water and proper hand washing prior to eating.

Flooding often increases the risks of "vector-borne" diseases, namely malaria, dengue fever and Japanese encephalitis, all of which are transmitted by mosquitoes.

In fact, the initial flood surge can wash away insect breeding sites, so the number of cases might not increase at the flood's outset. However, once the waters recede, all the puddles and ponds that remain become breeding places, and after about two months, mosquitoborne diseases usually appear.

In the flooded North and Central regions, an outbreak of dengue fever is more likely afterward than malaria or encephalitis.

This vast crisis has also displaced many people, forcing thousands into confined improvised shelters. The high density in such places can spur communicable diseases such as influenza, meningitis and measles. It's wise to make sure everyone's immunisation is up to date, especially children.


Natural disasters induce high levels of stress, both emotionally and physically - from the extra effort expended to move personal belongings.

Flooding brings unprecedented stress when home and property are destroyed or even simply at risk of damage. In the flooding that inundated western Queensland in Australia earlier this year, the main complaint at hospitals was stressrelated chest pain.

Stress affects adults and children in different ways and, even if severe, it is too often neglected or underestimated. Stress lowers our ability to fight the very infectious diseases that become more common during these times. High and continuous stress can lead to dangerous depression. It's best to get a medical opinion.


Every cloud has a silver lining, as they say, and it's just a matter of time before things return to normal. Meanwhile, amid the dreadful current hardships, it is essential to stay focused on healthy living.

Do your best to maintain a proper diet, to take special care of the skin if exposed to floodwater, and - in the interest of managing your stress as much as possible - to maintain your compassion. It is by no means inappropriate to engage family and neighbours in some fun pastimes to keep their spirits up.

Dr Lalande, The Nation's Health Matters columnist, is managing director of CEO-Health, which provides medical referrals for expatriates in Thailand. He can be contacted at

Flood hotlines

1669 - Ambulance and medical assistance from the Public Health Ministry’s Emergency Medical Services.
1111 press 5, 1131 - Flood Help Centre at the Flood Relief Operations Centre (FROC). Or call (02) 241 1749 , (02) 504 3569 and (02) 534 1911 .
(02) 504 3027 - For English at FROC.
(090) 418 052529 - The Mirror Foundation, an NGO coordinating floodrelief with FROC.
4567892: Free emergency SMS provided by the ICT Ministry.
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