Flood-Related Diseases

[philw]

These days it's not easy to detect who is joking, who is serious, who is real, who is fake, what is sarcasm.

It is an unfortunate fact that only a fraction (less than half) of donations to charities actually goes toward helping people.

Most goes toward salaries, even for volunteer organizations (only the lowest rung of members work for free).

It's not so easy for charity organizers to divert services.

But even goods can be skewed.

His Majesty the King is quietly donating millions in food aid.

But some of it is being repackaged to give recipients the impression it came from other sources.

That is really low.

From the news I hear, only white hats this time around (much to the dismay of the PM) is the Thai Army.

They are helping the people and also the big Japanese investors by using their big equipment and trucks to rescue not only people but large pieces of manufacturing equipment.

God bless the King and God bless the Thai Army.

They are DOING something and they are doing really HELPFUL things and doing SENSIBLE things.

I've heard nothing but good and positive things since the beginning regarding both those institutions.

And I didn't ask or prompt anyone.

People just GUSH their appreciation for the few people really doing things.

HRH the youngest princess was out telling people how to stay healthy and avoid disease LONG before this doc said anything.

And she was out there telling them personally, not writing stories in the English language Nation for people to buy -- if they can read English and if they have any money left.

The King even told the people who came to save the palaces that palaces come AFTER the people and they should go help the suffering HUMANS before property.

This debacle is clearly showing who are the WHITE HATS and who are the BLACK HATS and who have the black hearts.

The EM balls for cleaning up standing water was a brilliant idea. Who proposed that one?

There are plenty of smart Thais willing to help if the gangsters and their cronies would just get outta the way.

...and how i wish, I could answer to this...

Yes, well said DocN.

[webfact]

Disease Risk in Floodwater (BNH Hospital): http://www.bnhhospital.com/en/newsdetail.aspx?id=155

Disease Control advises women not to wade in flood water due to higher risk of infections. Wear plastic pants or wash asap /TANN

[webfact]

Bang Chan Industrial Estate plans to suspend op when water in Bang Chan & San Saeb Canal >1.5M, evacuate >1.7M /TANN

[TallGuyJohninBKK]

I saw a TV news report the other day, I think it was Spring News on cable, where the female reporter was wearing a full body water-proof suit like river fishermen wear, the kind held up by suspenders and with the material going chest-high...

Then, on her arms, she had some kind of full knit cloth covering almost like workout socks, covering from shoulder to wrists. She was wearing that garb even when she was out of the water and interviewing people on dry land (near the flooded areas).

Looked strange as h*ll, but she's probably doing the right and safe thing under the circumstances. Don't see most other reporters taking those kinds of protections.

It shocks/amazes/dismays me when I see Thai adults and kids wading around in the flood waters wearing nothing but shorts and t-shirts.

And then there was the Chula health professor who supposedly said it was OK to wash one's face with flood waters...just don't drink them....

Sometimes... I think this place is just total .....

[BinDhumm]

I saw a TV news report the other day, I think it was Spring News on cable, where the female reporter was wearing a full body water-proof suit like river fishermen wear, the kind held up by suspenders and with the material going chest-high...

Then, on her arms, she had some kind of full knit cloth covering almost like workout socks, covering from shoulder to wrists. She was wearing that garb even when she was out of the water and interviewing people on dry land (near the flooded areas).

Looked strange as h*ll, but she's probably doing the right and safe thing under the circumstances. Don't see most other reporters taking those kinds of protections.

It shocks/amazes/dismays me when I see Thai adults and kids wading around in the flood waters wearing nothing but shorts and t-shirts.

And then there was the Chula health professor who supposedly said it was OK to wash one's face with flood waters...just don't drink them....

Sometimes... I think this place is just total .....

A heath professor said this? Thats mad. A drop of fecal infected water in the eye does the job. Were was this posted? The man must be out of his mind! By statement of the Government officials there are about 700 000 people sick related to floods already. NOT SAIING WHAT THEY HAVE!!!!! That can be anything. As written by me earlier, flood related diseas ARE already slowly showing up. Lets wait for another week......than see.

Edited November 8, 2011 by BinDhumm

[TallGuyJohninBKK]

Re the Chula professor's comments, I believe, those were reported via Twitter from some local news media posters a week or so back... I don't know if the remarks also made their way into any Thai or English news media articles. The info I saw didn't specify the name of the prof. But the supposed comments drew a lot of derision.

[petedk]

I saw a TV news report the other day, I think it was Spring News on cable, where the female reporter was wearing a full body water-proof suit like river fishermen wear, the kind held up by suspenders and with the material going chest-high...

Then, on her arms, she had some kind of full knit cloth covering almost like workout socks, covering from shoulder to wrists. She was wearing that garb even when she was out of the water and interviewing people on dry land (near the flooded areas).

Looked strange as h*ll, but she's probably doing the right and safe thing under the circumstances. Don't see most other reporters taking those kinds of protections.

It shocks/amazes/dismays me when I see Thai adults and kids wading around in the flood waters wearing nothing but shorts and t-shirts.

And then there was the Chula health professor who supposedly said it was OK to wash one's face with flood waters...just don't drink them....

Sometimes... I think this place is just total .....

A heath professor said this? Thats mad. A drop of fecal infected water in the eye does the job. Were was this posted? The man must be out of his mind! By statement of the Government officials there are about 700 000 people sick related to floods already. NOT SAIING WHAT THEY HAVE!!!!! That can be anything. As written by me earlier, flood related diseas ARE already slowly showing up. Lets wait for another week......than see.

There was a photo in the Bangkok Post of a guy sitting outside Central lad Prao brushing his teeth in the flood water.

I noticed today that several people were wearing plastic waders in the shopping centers. They weren't just walking through but were shopping and eating meals. Surely that is also dangerous in that their skin cannot breath and there is a danger of skin diseases.

[weka]

Sorry to use this topic for what it's intended for...

What's the best way to treat insect bites when you HAVE to go in the water?

Would it be something like, applying alcohol and dettol cream immediately after getting out of the water, and covering with band aid, each time?

I have to walk in the water occasionally (no choice) and I have quite a few insect bites from the beaches at Hua Hin actually.

Some of these have broken the skin and I'd like to learn the best way to keep them clean.

Thanks

[BinDhumm]

Sorry to use this topic for what it's intended for...

What's the best way to treat insect bites when you HAVE to go in the water?

Would it be something like, applying alcohol and dettol cream immediately after getting out of the water, and covering with band aid, each time?

I have to walk in the water occasionally (no choice) and I have quite a few insect bites from the beaches at Hua Hin actually.

Some of these have broken the skin and I'd like to learn the best way to keep them clean.

Thanks

Well best is NOT to get in contact with these waters. If you HAVE TO , I would use quadriderm(ask pharmacy anti virus, fungi and bakteria in one) and cover them THICK with this cream BEFORE entering the water. Afterwards, wash With 70% alcohol and apply cream again, then cover with dry band aid.Spray on band aid is a good solution too. Bandaids WILL just keep the wound wet when used in water. Anyway, if these bites are open and red already, best is to avoid ANY contact to these waters, as it rises your chance for serious infections dramaticly. So called waterproof bandaids are usually never waterproof.

Edited November 9, 2011 by BinDhumm

[weka]

Sorry to use this topic for what it's intended for...

What's the best way to treat insect bites when you HAVE to go in the water?

Would it be something like, applying alcohol and dettol cream immediately after getting out of the water, and covering with band aid, each time?

I have to walk in the water occasionally (no choice) and I have quite a few insect bites from the beaches at Hua Hin actually.

Some of these have broken the skin and I'd like to learn the best way to keep them clean.

Thanks

Well best is NOT to get in contact with these waters. If you HAVE TO , I would use quadriderm(ask pharmacy anti virus, fungi and bakteria in one) and cover them THICK with this cream BEFORE entering the water. Afterwards, wash With 70% alcohol and apply cream again, then cover with dry band aid.Spray on band aid is a good solution too. Bandaids WILL just keep the wound wet when used in water. Anyway, if these bites are open and red already, best is to avoid ANY contact to these waters, as it rises your chance for serious infections dramaticly. So called waterproof bandaids are usually never waterproof.

Thanks BinDhumm - appreciate the advice and agree about avoiding the water. Unfortunately there are a lot of us in the suburbs with not too many choices

[TallGuyJohninBKK]

If possible, get some rubber wading boots.. knee or hip high, if possible.

Surprisingly, seen a lot of Thai vendors selling them lately...as you might expect...especially around the edges of flood areas.

[TallGuyJohninBKK]

MCOT News: BANGKOK, Nov 9th - Prime Minister Yingluck Shinawatra Assured the Eng Public today that Tap Water is Safe for consumption and up to Standard during her Visit to a Water treatment Plant on Wednesday Morning.

Did they finally manage to fish the severed human leg out of the water canal???

[Reasonableman]

MCOT News: BANGKOK, Nov 9th - Prime Minister Yingluck Shinawatra Assured the Eng Public today that Tap Water is Safe for consumption and up to Standard during her Visit to a Water treatment Plant on Wednesday Morning.

Did they finally manage to fish the severed human leg out of the water canal???

after adding chlorine, potassium permanganate and oxygen to the raw water and increasing water filtration, is up to the Water to Produce Standard Tap Water Safe for drinking

[BinDhumm]

MCOT News: BANGKOK, Nov 9th - Prime Minister Yingluck Shinawatra Assured the Eng Public today that Tap Water is Safe for consumption and up to Standard during her Visit to a Water treatment Plant on Wednesday Morning.

Did they finally manage to fish the severed human leg out of the water canal???

after adding chlorine, potassium permanganate and oxygen to the raw water and increasing water filtration, is up to the Water to Produce Standard Tap Water Safe for drinking

I belive, that INIDE the watertreatment plant the water is brilliant......but what about 3 miles away? IF Yingluck will publicly drink it out of the tab in front of cameras in 3 Miles distance , THEN than might be true. PLEASE SHOW US!!!

[BEENTHEREDONETHAT]

I didn't think tap water was safe at the best of times. No way I would trust it now.

[RickBradford]

I didn't think tap water was safe at the best of times. No way I would trust it now.

I live in the 'protected' inner area of Bangkok, but the tap water now definitely contains particulate matter -- looks like a chalk dust residue, and is probably harmless, but just another indication of the way things are going.

Equally important is to check the goods you buy; as supplies inevitably get tighter, vendors will become tempted to let some past sell-by date produce slip through, or rescue possibly flood-compromised produce onto the market.

Example: There is a severe beer shortage in this (tourist) area, and suddenly the only available beer is the previously unheard-of Chang Export. It claims to have been brewed in Ayutthaya on Oct 13, not a long time for bottled beer, but who knows where it's been sitting all the while. It tasted disgusting and was flat, so perhaps under 150cm of flood water.

Check labels carefully for sell-by dates, obviously, but also for any signs of other symptoms of damage -- it's an area of hygiene and health that can only get worse as the supply chain falters.

[Skorz]

I hate centipedes!

Please, don't ever mention centipedes again on this forum. I have frequent nightmares about the 'da carb'.

[BlueTerrace]

MCOT News: BANGKOK, Nov 9th - Prime Minister Yingluck Shinawatra Assured the Eng Public today that Tap Water is Safe for consumption and up to Standard during her Visit to a Water treatment Plant on Wednesday Morning.

Did they finally manage to fish the severed human leg out of the water canal???

Yeah, it was a bit slippery after being in the water, so they waited until it got sucked into the intake duct, then simply scraped it out of the grate along with the placky bags, dead fish and turds. Easy-peasy!

[Familyonthemove]

This thread has certainly drifted :)Does anyone know of a supplier of cheap waders in Bangkok?Or any NGO willing to import and distribute some for free?They would certainly help reduce the risk to aid workers and others who are often in the flood water.

The market opposite Central Chidlom, between Chidlom and Ploenchit BTS is selling waders for 300 THB (street vendor in front of the market) .... they even had size 11 (UK) which is more than most BKK shoe shops can manage and some ladies ones in size 39. I bought some for the team in the office and the quality seems OK for one seasons use. Chinatown also has some serious waders (Salmon fishermen type) for 2000 THB.

One thing not mentioned in the original report was mosquitoes. Surely Dengue will be a risk? Time to stock up on some good repellant.

Edited November 11, 2011 by Familyonthemove

[Scott]

Several off-topic posts have been deleted.

[Scott]

I have to cross a construction area through relatively deep water, over waist high. It's then about a kilometer of wading through the water before hitting dry land. There is a major construction area in the middle of the road, which has to be crossed. Today, I managed to get a nasty gash and scrape on my leg on the way. It bled rather profusely (common since I was in water). The water has been around for over a week and is fairly foul smelling.

It was not possible to make it to a doctor--and the injury, in and of itself, would not require a doctor, but I am wondering what medication I should take. I started a course of antibiotics. Anything else I should do?

[TallGuyJohninBKK]

Scott, based on what you describe and the wound coming into contact with nasty flood water, I'd suggest a doctor check is called for even after the fact.

They'd probably do a good cleaning with an antiseptic solution like Betadine, and then give you at least a topical antibiotic cream, something like Fuciden, which seems to be the common skin antiobiotic prescription ointment here.

Someone earlier in this thread, I think, mentioned some kind of a topical treatment called Quadri...something...which he described as a combined antiobiotic, anti-viral and something else treatment. But I'm not familiar with that and haven't seen it used here...though I also haven't encountered many of those kinds of wounds.

Doctor visits here can be relatively cheap and easy... And I'd suspect by now, they've got their routine down pretty well for handling flood exposed wounds.Better safe than sorry.

Also, self-medicating with antibiotic pills is generally not a good idea. There are all different kinds of antibiotics, with different ones suited for different purposes. Unless you're a doctor or medical type who knows the differences among them, you're not doing right by your health, IMHO.

Edited November 11, 2011 by TallGuyJohninBKK

[webfact]

WHAT OTHERS SAY

Use of antibiotics prudently

Dr Gerard Lalande

Special to The Nation

The current flooding brings many health hazards, but the most common will likely be acute diarrhoea.

Even in normal sanitary conditions it's one of the most common medical concerns, and the large area inundated with polluted water will only increase the number of cases. The logical advice is to avoid ingesting infected water or food.

Acute diarrhoea involves a significant increase in the frequency of bowel movements and/or less solid stools. Viruses, bacteria or parasites invade and inflame the lining of the small intestine, increasing secretion of fluids. A toxin produced by bacteria can result in a similar effect. The patient is often nauseous, vomiting, feverish and suffering abdominal cramps. When diarrhoea is severe or lasts a few days, with persistent vomiting, there are also signs of dehydration.

Of the many types of micro-organisms causing acute diarrhoea, the most common is viral gastroenteritis. The illness lasts three days at most, but there is no blood or pus in the stool. Diarrhoea induced by viruses requires no antibiotics.

Bacteria - most commonly campylobacter, shigella (responsible for bloody dysentery) and salmonella (some strains causing typhoid fever) - can also cause acute diarrhoea by invading the small intestine and colon, leading to bacterial enterocolitis. In these cases, the diarrhoea begins suddenly and can last up to seven days. In the more severe instances, blood or pus is present in very loose or watery stools, indicating the aggressive nature of the bacteria. Fever is often present and signs of dehydration can rapidly appear.

Other bacteria such as strains of E Coli, which usually lives harmlessly in the intestine, can also cause serious illness, either by invading the intestine or producing diarrhoea-inducing toxins. Toxins produced by bacteria are the cause of most short-term food poisoning.

Less frequently, parasites are responsible for acute diarrhoea. Giardia lamblia induces no complications, whereas amoebic dysentery often leads to bloody diarrhoea with severe abdominal pain. Parasitic infections need to be treated with specific medicine and often require the identification of the responsible parasite.

Acute diarrhoea can lead to two types of complications. The first is the infection itself, which can spread beyond the lining of the intestine and reach other organs. Subsequent blood infection (septicaemia) and/or abscesses in various tissues are life-threatening.

Second is the dehydration that results directly from the diarrhoea-induced loss of water and mineral electrolytes. Patients with mild dehydration might experience only thirst and dry mouth. Moderate to severe dehydration can cause hypotension, with fainting, severe weakness, shock, kidney failure, confusion and coma.

Despite the chance of numerous complications, most episodes of acute diarrhoea are short-lived and require no antibiotics. Antibiotics, however, might be needed in the more severe cases, or among patients with pre-existing medical conditions. Signs of dehydration should always be treated with oral solution or by IV when there is persistent vomiting.

In situations like we have at present, when medical access is temporarily limited, antibiotic prescriptions should remain under medical supervision and "self-use" should be discouraged. A study conducted at a Thai medical school revealed a high rate of overuse of antibiotics for acute diarrhoea.

With an expected large number of affected patients in the weeks to come, it's essential to rationalise the use of antibiotics to minimise the risk of developing multi-resistant types of bacteria.

Dr Gerard Lalande is managing director of CEO-Health, which provides medical referrals for expatriates and customised executive medical check-ups in Thailand. He can be contacted at [email protected].

-- The Nation 2011-11-12

[Scott]

Thanks, Tallguy, I do know a little about medicine. I am taking the antibiotics as a prophylactic precaution. I will continue on them for at least 10 days. I did clean the wound very well and have a topical cream. Unfortunately, I can't get to a doctor without wading through the water again, which I don't want to do until I go to work on Monday. If there are no complications, it should be a little better by then.

The scrape and cut are by no means deep. My concern is simply the possible infections from the water and that, I know very little about.

[BinDhumm]

Thanks, Tallguy, I do know a little about medicine. I am taking the antibiotics as a prophylactic precaution. I will continue on them for at least 10 days. I did clean the wound very well and have a topical cream. Unfortunately, I can't get to a doctor without wading through the water again, which I don't want to do until I go to work on Monday. If there are no complications, it should be a little better by then.

The scrape and cut are by no means deep. My concern is simply the possible infections from the water and that, I know very little about.

Get someQuadriderm cream and rub into wound after cleani ng

with 70% alcohol. Keep wound thick covered. Avoid just taking some kind of antibiotics you don know for prevention. Some bakteria FEED on certain antibiotics. If you do not know, WHAT infection you have, DONT DO THIS! you might make the problem worse.

[jpinx]

I know it's too late for you now but iodine or peroxide or alcohol applied immediately to wounds will clean it and kill most of the bugs. Antibiotics are really bad news unless you know EXACTLY what you are doing and are already suffering. Taking them in advance will make your body less-able to fight of the next big infection. I seem to remember WHO sayng that the microbes will mutate faster than we can invent new antibiotices - all because of over-use. Think about it......

[Scott]

The mutation of strains is a little complex for this thread. The options are: 1) wait until an infection (or more than one develops), have it diagnosed--if they can, since there are probably a lot of not routinely found infections from flood water. 2) Start a course of preventive antibiotics and tend to the wound and try to stay out of the water. Part of the problem of antibiotic use is actually under-use. If you are going to take them, then take a full course and kill the bacteria. Do not stop once the symptoms have quit.

I did clean the wound thoroughly with alcohol once I got home, but this was many hours later. Any serious infection could have entered the blood system by then. That is the reason for the preventive measures--that and the fact that I cannot get to medical treatment without walking through the same water.

[jpinx]

You did the right thing in the circumstances, you obviously know what you are doing I am only making some points for other readers of this thread who might not be as knowledgeable. Have you done the temporarily stick-on plastic bag to keep the water off the wound while you wade? You'll use a lot of sticky tape, but well worth it, and throw away every time. I had a similar situation in India many years ago and had to do this.

[BinDhumm]

The mutation of strains is a little complex for this thread. The options are: 1) wait until an infection (or more than one develops), have it diagnosed--if they can, since there are probably a lot of not routinely found infections from flood water. 2) Start a course of preventive antibiotics and tend to the wound and try to stay out of the water. Part of the problem of antibiotic use is actually under-use. If you are going to take them, then take a full course and kill the bacteria. Do not stop once the symptoms have quit.

I did clean the wound thoroughly with alcohol once I got home, but this was many hours later. Any serious infection could have entered the blood system by then. That is the reason for the preventive measures--that and the fact that I cannot get to medical treatment without walking through the same water.

Sorry, but there are very many kinds of antibiotics. Just to take preventiv whatsoever antibiotics is NOT a solution, as some bakteria FEED on certain antibiotics. Doing this is a little like russian roulette. It MIGHT work, but it mght make things MUCH worse. I lived in Africa and Asia for more than 15 Years and made these mistakes before. Luckily only NEARLY died twice. Bst solution I know and tried myself. Clean wound or cut 3-4 times daily with min. 70 % alcohol or peroxide, cover thick with QUADRIDERM ANTI BAKTERIA, ANTIFUNGUS AND Antiviral combination cream. After having watercontact same prosess IMIDIATELY after leaving water. If wound turns purple and corners swell and releases yellowish liquids, MUST SEE HOSPITAL ON THE SPOT! But up to you.

[robblok]

You did the right thing in the circumstances, you obviously know what you are doing I am only making some points for other readers of this thread who might not be as knowledgeable. Have you done the temporarily stick-on plastic bag to keep the water off the wound while you wade? You'll use a lot of sticky tape, but well worth it, and throw away every time. I had a similar situation in India many years ago and had to do this.

I had a wound (now stitched and its closed after 8 days). I had to put plastic around it.. wrapped it.. taped it.. ect.. it did not work. In the end it will help only a little bit but also it will keep water in the bag once it penetrates. Its good for a short hop through some water. But not for prolonged use.

Now after 8 days of keeping dry i go in the water again (i have to). But after every time i clean the wound (not much wound anymore but have to be careful) I also got a big antibiotic course from the DR. Normally i don't take them but now i did. Wound healed perfectly but hated the sides from the antibiotics. Later i found out that i was at 2-3 times the normal dose.