Waterborne Diseases Biggest Risk

What is the main health risk after the cyclone?

The primary risk following the flooding of the delta region is the outbreak of diseases spread by contaminated water, such as diarrhea, cholera and typhoid. Aid agencies on the ground report that flooding and broken pipes have allowed sewage, toxins and groundwater into the water supply. Lakes, rice paddies and streams are also dirty because they are littered with corpses. Stagnant water is providing a breeding ground for bacteria and mosquitoes. According to Save the Children, more than a third of deaths in previous similar disasters have been caused by waterborne diseases.

Which diseases pose the most immediate threat?

Initially, the most likely killer is acute watery diarrhea, which causes dehydration. Those most at risk are under-fives, the sick, the old and the pregnant. Cholera, which causes severe diarrhea and vomiting, is the next major worry. In severe cases people suffer progressive organ failure as they get weaker. It can spread rapidly in areas where there is poor sanitation because the bacterium can be spread in human feces. There are already reports of an outbreak in the Irrawaddy delta. Other threats include typhoid and hepatitis A, both passed on by contaminated food and water. Symptoms of the former include fever, abdominal pain, appetite loss, constipation or diarrhea. Without treatment it is fatal in 10% of cases.

What about later on?

Within two weeks there could be outbreaks of malaria and dengue fever, which are both spread by mosquitoes. The malaria parasite infects the liver and destroys red blood cells. It initially causes flu-like symptoms. There can also be diarrhea, coughing and jaundice. Without treatment it can kill by causing anemia and by clogging the capillaries that carry blood to the brain or other vital organs. Another threat is posed by dengue fever, which is endemic in Burma. Symptoms include fever, joint and muscle pain, nausea and vomiting. Some sufferers develop severe bleeding known as dengue hemorrhagic fever, which can be fatal. There is no specific treatment, although most people recover in two weeks.

What other health risks are there?

Survivors also risk contracting tetanus and infections from injuries as they rummage through their destroyed homes. Overcrowded conditions in shelters for homeless survivors often also lead to outbreaks of childhood diseases such as measles, mumps, rubella, whooping cough and chicken pox. Women are also at risk of vaginal infections caused by wading through polluted water. This can cause infertility.

What can be done to address the risks?

Immediate efforts are focused on restoring water supplies and sanitation. Unicef is sending 3m water purification tablets to Burma, sufficient for 1.3m gallons (5m liters) of water - enough for 200,000 people for a week. Meanwhile aid agencies are preparing water tanks and pipes. Sanitation can be improved with new community latrines. Waterborne diseases can be treated with medication and rehydration kits. Providing bedding treated with insecticide and mosquito nets should curtail the spread of malaria and dengue fever. Vaccination programs can tackle outbreaks of childhood diseases.