BANGLADESH: Unusually early outbreak of diarrhoea in Dhaka

Previously reported from March 3rd:

BANGLADESH: Drive to stem bird flu in backyard farms
DHAKA, 3 March 2009 (IRIN) - The Bangladesh authorities, with assistance from the UN Food and Agriculture Organization (FAO), have employed 300 field volunteers since October 2008 to strengthen surveillance of bird flu in rural areas.
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“The coming three months are crucial. Then the [June] monsoon rains will ease the situation,” said Mohammad Abu Bakr, a livestock worker at Jibika-CLP (Char Livelihood Programme), an NGO funded by the UK’s Department for International Development (DFID),...
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Scientists concerned
Some scientists, however, are particularly concerned about the risk in backyard farms.
“Backyard farms are in the rural areas where people are poor and ignorant. They also have very poor access to the media. They do not know much about bird flu or preventive practices,” said Habibur Rahman of Bangladesh Agricultural University.
Cases of bird flu in backyards often go unreported, posing a risk not just to birds but also humans, say scientists and government experts.
“The increasing outbreaks in backyard farms are disturbing. Human infections occur mainly from backyard farms,” said Rahman.
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http://www.irinnews.org/Report.aspx?ReportId=83265

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.

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.
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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.
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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.
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