BANGLADESH: Unusually early outbreak of diarrhoea in Dhaka

Photo: David Swanson/IRIN

Health workers report an upsurge in diarrhoea cases over the past week in Dhaka

DHAKA, 19 March 2009 (IRIN) - As temperatures climb and power outages continue, a lack of safe drinking water has resulted in an unusually early outbreak of diarrhoeal diseases across Dhaka, the capital of Bangladesh.

In the past week over 40 patients an hour were seeking admission at the International Centre for Diarrhoeal Diseases and Research, Bangladesh (ICDDR,B) hospital in the city.

Compared with the same period of last year, the number of patients has trebled. At least three tents have been set up in the ICDDR,B car park to cope with the influx.

More severe cases are being treated with intravenous rehydration treatments and oral rehydration therapy (ORT) accompanied by zinc supplements, while those less severely affected are getting ORT and liquid food.

Since 11 March, an average of 700 patients have been admitted to ICDDR,B each day, and health workers are struggling to cope.

"Usually we don't have more than 250 patients admitted at a time. But this season, as the situation worsens every day, we have had to set up temporary wings. We admitted 811 patients on 14 March and 747 on the 18th,” Shahadat Hussein, head of ICDDR,B’s Longer Stay Unit, told IRIN.

“Usually diarrhoea breaks out in late April. But this year, the diarrhoea season seems to have started early. In mid-March, we are admitting more patients than [in] the average April-peak season,” Hussein said.

Photo: Contributor/IRIN

Doctors at the ICDDR,B hospital in Dhaka keep a daily tally of admissions

Power shortages to blame?

ICDDR,B sources blame increasing temperatures and chronic power outages as the primary cause.

Load shedding is nothing new in this city of 12 million, but with an increase in population and the number of industries, demand for safe drinking water has increased exponentially over the last decade.

Most of the patients are from the slums, areas well known for their inadequate supply of safe drinking water and where residents are largely dependent on groundwater pumped to the surface.

As demand for water rises, the water table continues to fall, and many residents have no choice but to drink contaminated water in the absence of a regular supply.

Hot weather helps bacteria replicate faster, while power outages prevent the smooth distribution of water in the city. The number of diarrhoeal patients is expected to rise in April and May.

Vaccine

Regarding ICDDR,B’s development of a vaccine for rotaviruses - described by the World Health Organization (WHO) as a leading cause of severe diarrhoeal disease and dehydration in infants and young children throughout the world - Shahadat Hussein said that although the vaccine was available in retail outlets, it had not yet been included in the Expanded Programme on Immunisation (EPI).

Both WHO and the Global Alliance for Vaccines and Immunization (GAVI) have declared rotavirus vaccination a public health priority.

As Bangladesh is a GAVI-eligible country, this vaccine may soon be introduced into the EPI, he said.

Diarrhoea is one of Bangladesh’s main health concerns. It is responsible for about 9 percent of deaths among infants under 12 months old, and 10 percent of deaths among the under-fives, according to the health authorities.

Bangladesh has made significant achievements in lowering infant and child mortality rates, but almost 100 children still die every day from diarrhoea, say health experts.

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