Monday, 11 May 2009

Cholera in Hyderabad: WHO norms on disinfection thrown to the winds

Syed Akbar
Hyderabad, May 10: State health officials have flouted all medical safety norms by not isolating cholera patients and disinfecting the bodies of victims before funeral.

Officials did not bother to invoke the cholera prevention and control guidelines for the simple reason that they do not want to admit the diarrhoeal deaths at Bholakpur here as those of cholera. While they await reconfirmatory reports from the National Institute of Cholera and Enteric Diseases, the death roll has gone up to 12 and dozens of fresh cases continue to pour in at various city hospitals.

Andhra Pradesh has been listed as a State endemic to cholera and yet it does not have the mandatory cholera monitoring committee. A week has passed since the acute diarrhoeal disease broke out and the authorities concerned do not bother to constitute the panel to oversee the control and preventive measures. Joint director (communicable diseases) Ram Swarup admitted that there's no separate panel for cholera but the subject is covered by a state level surveillance committee.

Patients are admitted in a common ward in Fever and Gandhi Hospitals endangering the lives of others. Cholera is highly contagious and those suffering from it have to be kept in isolation or quarantined. The World Health Organisation's global task force on cholera control suggests that severe cases should be isolated from rest of the population. It also suggests that gatherings should be avoided as stool and vomit are highly contagious and spreads fast. Cholera patients have to be in a
special ward, isolated from other patients.

The authorities also failed in their duty to disinfect corpses with chlorine solution. Health guidelines stipulate that mouth and anus of the bodies should be filled with cotton wool soaked with chlorine solution. Officials said they did not disinfect the bodies as only one death was reported in hospital while others died at home.

They also ignored the WHO's standard warning that a place might be facing an outbreak very soon if there are an unusual number of acute diarrhoeal cases in a week and patients from the same area have similar clinical symptoms. Dozens of cases were reported from Bholakpur locality but the authorities failed to sound a general public alert on cholera.

The Greater Hyderabad Municipal Corporation equally shares the blame. Its sanitation supervisors are supposed to test water quality on daily basis, but they did not. They acted only on May 4 after several cases of diarrhoea were reported from Bholakpur.

GHMC chief medical officer Dr M Jayaram washed off his hands arguing that private hospitals do not send data to them. But he had no answer asked about the data from government hospitals. The authorities waited for half a dozen deaths to swing into action by distributing chlorine tablets and ORS packets and setting up medical screening camps.

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