There are three main groups of health risks to the population in the flooded region:
- Physical injuries (cuts, fractures)
- Risk of harmful micro-organisms
- Exposure to harmful chemicals (from agriculture, poisonings from careless use of chemical agents, cleaning chemicals etc.).
If injuries or cuts are small, the surface should first be washed with clean water and then appropriately treated with an antiseptic (Betadine) or 70% alcohol, then to put clean, sterile gauze and / or plaster on wound.
When the wound is deeper, there is a massive bleeding and you should do compression of the affected area with clean gauze, bandage (clean cloth or towel) and immediately to require adequate medical care at the nearest health facility, to prevent consequences that would occur from massive bleeding .
The most common infectious diseases that occur in the affected flooded areas:
- Scabies (Scabies, mange)
It represents infectious, parasitic disease with characteristic skin changes and strong itching. Cause of human scabies is Acarus scabiei var. hominis. Transmission of scabies occur through close (intimate) body contact, when camping, in children living in poor hygienic conditions, indirectly through clothing, underwear and bed sheets. The incubation period of scabies is 4 to 6 weeks. The first and leading symptom is persistent, tortured itching, especially at night expressed between fingers, wrists, elbows, armpits front line, around the chest, belly and waist, genital area in adults.
Scabies spare the face, neck, palms and soles that are still involved in small children and infants. Important diagnostic signs for scabia passageways that are irregular or in the form of a comma, a few millimeters long. At the end of the canal you can see almost to the naked eye, in the form of black point. If you’ve noticed these symptoms the person / persons immediately should go to the nearest health facility.
- Viral hepatitis A (epidemic hepatitis, infectious hepatitis) is an acute viral infectious disease with a good prognosis, rare complications and lower mortality. The disease is transmitted by the faecal-oral route. It is a contagious disease that may occur sporadically or in epidemic form, particularly in poor sanitation after floods or other natural catastrophe. Hepatitis A is an RNA virus belonging to the family Picornaviridae, which is similar to Enterovirus, by its morphological and biochemical properties. The unique reservoir of viral Hepatitis A is human, whether is diseased with typical, atypical clinical or asymptomatic form of the disease. The virus can be found in the stool, blood, bile, and rarely in the urine of infected. The diseased is infected during the second half of the incubation period, and with the appearance of jaundice, infectivity begins to decrease, that lasts a few days after the onset of jaundice.
The main way of transmission is fecal-oral route from human to human (disease of dirty hands) or direct contact, which is accomplished through hands contaminated with feces. Also, the infection is transmitted by indirect contact through contaminated items for personal or general use.
Children are most susceptible to this type of infection, and infectious hepatitis usually has a milder course and shorter runs. The emergence of the virus depends on the sanitary condition of the environment, hygiene and size of the group that is in close contact (family, preschool, school facilities, etc.). Unlike countries with low hygiene standard, hepatitis A in developed countries with better socioeconomic conditions of life occurs in older categories.
An important route of transmission is water, especially in circumstances of poor water supply (individual water facilities and smaller-controlled irregular water supply, particularly after flooding or major accidents). Then hepatitis A usually occurs in the form of massive epidemics with explosive character and affects all age groups.
Food is the rarest way of transmitting, usually one that is not cooked (eg. salads, sandwiches, fruit, seafood, etc.) or cooked food that is secondary contaminated by those who handle food (It is very important to control persons working with food in Centres for public health or the Institute for public health of the Republic of Macedonia!). Incubation from the moment of entry of the virus in the body until the first symptoms of the disease is 15 to 50 days (usually about 30 days).
Symptoms of the disease include: fever, weakness, loss of appetite, nausea and vomiting, and sometimes diarrhea. You may experience pain below the right costal arch, and after a few days of the first symptoms are noticed dark urine (the color of beer), chair of bright color and appearance of yellow skin and whites in the eyes.
The symptoms disappear in 1 -2 weeks, but the full recovery takes longer period (4-6 weeks). Disease can have different clinical course, from asymptomatic form (especially important for the spread of infection) or clinically mild to severe, which can take several months, but that is extremely rare. Symptoms of the disease depend on the patient’s condition, and his age., The disease is mild and often goes unnoticed to the children, especially in the first years of life. However, infection in adults may get harder form. Disease usually resolves spontaneously, and never passes in the chronic form.
Enterocolitis is an inflammatory disease of the lining of the small and large intestine in response to infection or chemical stimulant. Characteristic signs, symptoms of enterocolitis are digestive disorders with signs of intoxication as a result of diarrhea and dehydration. Enterocolitis may be caused by bacteria, parasites, toxins etc. In the medical practice, acute enterocolitis flow with sudden onset of intense abdominal pain especially in the lower half of the abdomen, bloating, frequent urge to defecate, loose stools and some types of enterocolitis has blood and mucus in the stool. Apart from these symptoms, enterocolitis characterize and associated symptoms like fever, lethargy, joint paint, general weakness.
Primary prevention of these infectious diseases is the same as with other infectious diseases, ie Regular maintenance of personal and general higiena. Continuing educations of the population about the daily maintenance of good hygiene practices are the best way to prevention. Proper hand washing with soap and drinking water after each use of the toilet, before and during food preparation, and before any consumption of groceries, is enough to prevent the immediate spread of these infections. Also, it is important to use hygienic drinking water and to take account of the hygienic disposal of waste products.
Measures to combat epidemic
It is mandatory reporting of all cases. Permanent disinfection (during the period of infectivity) and the final disinfection of substances excreted from the patient and the objects which were affected are implemented. Home isolation of patients is sufficient, but the hospital treatment is carried out if there aren’t possibility for home care or in case of severe clinical picture. Conducting epidemiological investigation to determine the mode of transmission of infection, the establishment of the source and / or sources of contamination and their removal.