Diarrhoeal diseases
In the WHO African region, diarrhoeal diseases are still a leading cause of mortality and morbidity in children under fiveyears of age. It is estimated that each child in the Region has five episodes of diarrhoea per year and that 800,000 die each year from diarrhoea anddehydration. Undernutrition and measles are very commonly associated with this mortality.
The prevention of diarrhoea ultimately depends on the improvement of water supplies and sanitation, which are very expensive butwill eventually occur. The prevention of death from dehydration arising from diarrhoea is straightforward, using cheap oral rehydration salts orsimple home-made fluids. The skills required by workers in health facilities and by mothers at home are easily learned.
Measles
Measles is a highly contagious viral infection that causes severe coldlike symptoms, high fever, and a distinct red rash.
Many people have been alarmed by a report published on the Internet that falsely linked the measles, mumps, and rubella (MMR)immunization with autism. Recently, researchers conducted several comprehensive studies and found no connection between the MMRimmunization and autism.1
How is it spread?
Measles is transmitted when an infected person coughs or sneezes. The virus is most often spread when people first become ill,before the rash develops, and before they know they have the disease. Measles can be spread from 5 days before the rash breaks out to 4 days after therash disappears.
Once you have had measles, you cannot get the disease again. Immunizations also protect you from the virus.
Complications of measles
Measles causes more severe symptoms in adults than in children. People usually recover from measles within 2 weeks, althoughcomplications can develop. These include ear infection (otitis media) and, in rare cases, pneumonia, strep throat, chronic diarrhea,encephalitis, and optic neuritis. In extremely rare cases, encephalitiscan result in permanent brain damage and death.
If a woman gets measles while she is pregnant, the risk of miscarriage or premature birth is increased. However, measlesinfection does not cause birth defects
People who have impaired immune systems or who have poor nutrition are at a higher risk for complications.
How is it treated, and can it be prevented?
In most cases, people recover from measles with rest and care at home. In complicated cases, hospitalization may be required.The measles vaccine prevents the disease symptoms.
Pertussis or whooping cough
Pertussis is a highly contagious infection caused by bacteria that results in fits of coughing that usually end in a prolonged,high-pitched, deeply indrawn breath (the whoop).
Pertussis remains a major problem throughout the world and half the cases occur in children under age 4. An infected personspreads pertussis organisms into the air in droplets of moisture produced by coughing. Anyone nearby may inhale these droplets and become infected. Aperson with pertussis usually isn't contagious after the third week of the illness.
Symptoms begin, on the average, 7 to 10 days after explsure to pertussis bacteria. The infect lasts about 6 weeks,prodgressing through three stages:
- a) mild coldlike symptoms
- b) severe coughing fits
- c) gradual recovery
Doctors have to distinguish between brochitis, influenza, and other viral infections, and perhaps tuberculosis, whichhave similar symptoms. The doctor takes samples of mucus from teh nose and trhoat with a small swab. The sample is then cultured.
Complications have to do with the airway. Infants are particularly at risk for damage that occurs from lack of oxygen after pausesin breathing (apnea) or coughing fits. Children may develop pneumonia, which can be fatal. During coughing fits, air may be driven out of the lingsinto the surrounding tissue, or the lungs may rupture and collapse. Severe coughing may result in bleeding in the eyes. A sore may develop under thetongue if the tongue is pushed against the lower teeth during coughing fits. Coughing may cuase an outpouching of the rectum. Bleeding, swelling, orinflammation of the brain may cuase brain damage and mental retardation, paralysis, or other neurologica problems. Ear infections also developfrequently as a result of pertussis.
Treatment
Severely ill infants are hospitalized because they need nursing care and oxygen. They are kept in a darkened, quiet room and aredisturbed as little as possible. Cough medicines do not seem to be effective. Intravenous fluids may be given to replace fluids lost duringvomiting and because coughing may prevent infants from being able to feed.
Prevention
Immunization is the best prevention against pertussis. The pertussis vacine is usually combined with vaccines fordiptheria and tetanus as the DTP (diphtheria-tetanus-pertussis) vaccine.