Sunday, December 10, 2023

Keep healthy despite weather changes

Reading Time: 4 minutes

On 19 August 2023,  Health Live @ Seniors Today hosted their weekly webinar with Dr Vedavati Purandare, a Senior Physician who spoke on and answered questions about Monsoon Related Illnesses and Care.

Dr Vedavati Purandare is  Head of Clinical Care, Seniors Consultant Physician and Diabetologist at Chellaram Diabetes Institute, Pune.

An MBBS and MD Medicine from the BJ Medical College, Pune, she has clinical and teaching experience of nearly two decades. She has received the coveted Dhirubhai Ambani Scholarship and was awarded with the Late Mr Vasant Bam prize for her academic performance.. She has a number of scientific publications in national as well as international medical journals. Her work on ‘Renal disorders in Diabetes’ was presented in a conference at Spain

Dr Purandare is regional faculty for Advanced Certificate Course in prevention and management of Diabetes and CVD. She is also faculty for the MUHS fellowship at the Chellaram Hospital. She teaches theoretical and practical aspects of diabetes to undergraduate , post-graduate medical students and paramedical staff. She also conducts educational and awareness lectures /sessions for lay persons on various aspects of diabetes and lifestyle diseases. She submitted a dissertation on diabetes and kidney disease to the University of Pune and was conferred with a Ph D (Medicine) degree in February 2022.

Monsoon is a pleasant transformation from a hot, scorching summer to a rainy and cooler season.

In addition to the rain, clouds and relief from the heat, we also have some illnesses which are more commonly seen in this season. This is because of the stagnant rain water which accumulates in the roadside areas, artificial water bodies, etc. which makes for a good breeding ground for mosquitoes.

Most of the monsoon diseases are mosquito driven diseases which are common during the rainy season.

Most of the monsoon related illnesses have common symptoms such as:

  • Sore throat
  • Fever
  • Body aches
  • Lethargy/ easy fatigability
  • Reduced appetite
  • Dengue fever:-

Dengue fever is a mosquito / vector borne disease seen commonly during the monsoon season.

It is also called Break Bone Fever.

It is a vector borne disease, Adese mosquito being the vector.

This mosquito breeds on clean, stagnant water.

They are day- biters

A patient with dengue fever will present with the following symptoms:

  • Severe muscle and bone pain
  • Severe headache
  • Pain behind the eyes- retro orbital pain
  • Rash
  • Diarrhoea

Blood investigations that can be done to diagnose dengue. These include:

  • Dengue NS1 Antibody
  • Complete Blood Count- especially the Platelet Count.

Platelet count is an important parameter which needs to be looked at when investigating a patient with dengue. This is because the dengue virus typically attacks the blood cell line-platelets. If the platelet counts gradually reduce, the chances of bleeding is high.

Increase in the Hb in a patient with dengue is not a good sign. Hemoconcentration means that the fluid from the blood is entering into the third space which is the pleural, abdominal area.

There is no specific treatment for dengue. But rest and hydration are very important modalities.

  • IV fluids
  • Oral fluids (4-5L of water)
  • Rest

If the patient is tolerating food and water orally, eating healthy, and does NOT have a low platelet count, in that case, the patient can be managed at home with rest, hydration and a healthy diet.

To treat the fever of dengue fever, use only paracetamol. Do not take NSAIDs such as Combiflam, aspirin.

Most of the patients, 99% of patients of dengue fever recover.

If a patient has had a history of dengue fever in the past, in such patients we need to be more cautious and keep the patient under observation, because in such patients, the chances of complications related to dengue fever are high.

Prevention of dengue:

  • Avoid mosquito bites and breeding
  • Cover water containing bodies and container
  • Use mosquito nets and repellents
  • Wear full sleeves clothes
  • Fumigation
  • Malaria:-

Vector: anopheles mosquito which breeds on stagnant, dirty water

Malaria fever is associated with chills and rigors. In addition to this, a patient with malaria can also present with symptoms like:

  • Jaundice
  • Body aches
  • Vomiting
  • Loose motions/ diarrhoea

These patients might also have a positive history of travel from a malaria endemic area/ region.

In patients with malaria, we need to be vigilant with

– Blood investigations

– Platelet count

  • Liver function tests

There are different types of malaria, such as

  • Plasmodium vivax
  • falciparum
  • ovale

It can be a single Malory or a combination

  • Leptospirosis:-

It is not a very commonly seen bacterial illness. But is a monsoon related illness nonetheless.

These patients have 3 prominent symptoms:

  • High grade fever
  • Bleeding from the eyes- conjunctival bleeding
  • Jaundice

This is a bacterial disease which is caused by rodent urine, or even dog or human urine. The infected urine, from the infected urine comes in contact with the human body, through direct skin contact- through a break in the skin of the human.

Treatment modalities:

  • Antibiotics
  • Hydration
  • Rest
  • Cholera

Apart from all the monsoon related fevers, we also have patients who present with loose motions in the monsoon season.

Cholera is a disastrous disease, which causes loose motions which if not treated on time and not hydrated well enough, can have detrimental effects and lead to mortality and morbidity.

Patients present with severe diarrhoea. Which is characteristically “rice water diarrhoea” in nature. It can lead to severe dehydration.

Food and water hygiene is very important.

Avoid consuming tap water from an unknown source while travelling.

Avoid consuming cold, raw food while travelling. Eat only hot and well cooked food while travelling.

Cholera is a vaccine preventable disease. 80% of the cases are easily preventable by taking the vaccine. The vaccine can be offered to people travelling to cholera endemic areas/ regions.

  • Enteric/ Typhoid fever:-

This is another monsoon related illness which causes-

  • High grade fever. Step ladder fever is characteristic of typhoid fever- wherein the fever increases everyday and does not touch baseline.
  • Loose motions
  • Vomiting
  • Abdominal pain

To diagnose enteric fever blood investigations such as a blood culture which shows growth of Salmonella typhi.

These patients are treated with long term antibiotics. Because if not treated properly, there are high chances of relapse.

  • Influenza

Also called flu or flu like illnesses are very common in the monsoon season.

These patients have upper respiratory tract symptoms, which include:

  • Runny nose
  • Sneezing
  • Headache
  • Sinusitis
  • Extreme tiredness
  • Cough
  • Shortness of breath
  • Light headed was

There are various types of influenzas such as H3N2, swine flu, covid,

Every year we are advised to get flu shots to protect ourselves from the influenza virus.

These patients too can be managed easily at home with

  • Antipyretics
  • Hydration
  • Rest

Once the viral load comes down in the blood, the symptoms also resolve.

Any patient with fever is losing water through his skin as well which is joy accounted for. This is why adequate hydration is very important in patients with fever.

If a patient with fever also has body ache, extreme nausea and decreased urine output it means that the hydration of the patient is inadequate.

Dr Noor Gill
Dr Noor Gill, MBBS, deciphers the space between heartbeats, figuratively and literally. Powered by frequent long naps and caffeine, she believes that “knowledge without giving back to society is meaningless” and works to make caring cool again.

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