From the Research
Flood victims should be evaluated for several waterborne illnesses, including leptospirosis, cholera, typhoid fever, hepatitis A and E, cryptosporidiosis, giardiasis, and E. coli infections, with a high index of suspicion due to contamination of water supplies with sewage, animal waste, and other pathogens 1, 2, 3.
Key Waterborne Illnesses to Evaluate
- Leptospirosis, caused by Leptospira bacteria in contaminated water, may require doxycycline (100mg twice daily for 7 days) for treatment, with a single dose of 200 mg doxycycline potentially effective for prophylaxis among flood victims with laceration wounds 4, 3.
- Cholera, caused by Vibrio cholerae, presents with severe watery diarrhea and requires aggressive rehydration plus antibiotics like doxycycline (300mg single dose) or azithromycin (1g single dose) 1.
- Typhoid fever, caused by Salmonella typhi, is treated with ciprofloxacin (500mg twice daily for 7-14 days) or ceftriaxone (2g daily for 10-14 days) 1.
- Hepatitis A and E are viral infections requiring supportive care 1.
- Parasitic infections like cryptosporidiosis and giardiasis may require nitazoxanide or metronidazole, respectively 1.
- E. coli infections often resolve with supportive care but may require antibiotics in severe cases 1.
Risk Factors and Prevention
- Contact with flooding is a significant factor for the occurrence of leptospirosis, with being male, exposure to livestock animals, and having a lacerated wound being risk factors 2.
- A single dose of doxycycline at exposure to flood water could have a beneficial effect in preventing leptospirosis 3.
- Flood control and environmental modifications are expected to reduce the risk of leptospiral infection, with a multi-sectoral effort having long-term benefits 2.