During monsoon to post-monsoon period, it is well known that south-west monsoon alongwith much needed rainfall also affects the dynamics of contagious diseases.. Heavy rainfall linked to the monsoon season may create situations favourable for the outbreaks of infectious diseases like Dengue, malaria and typhoid. Infectious fevers like enteric fever (typhoid), malaria and dengue are common diseases in the developing countries like India and are also referred to as tropical fevers. If diagnosed and treated in early stages, these are often cured without significant consequences, however, in severe cases complications may occur leading to prolonged hospitalization and/or death.
Dengue and Malaria are caused by virus and parasite respectively and spread by bite of an infected mosquito. Typhoid is caused by bacteria and usually spreads through contaminated food or water. by Dr. Prachee Sathe, Head, Department of Critical Care Medicine, Ruby Hall Clinic, Pune, India shares insights on how oral fluid & electrolytes help patients with Malaria, Dengue & typhoid.
How Can Dengue, Malaria & typhoid lead to fluid & electrolyte deficits?
Dengue, Malaria & typhoid all present with fever along with other symptoms. Fever is associated with increased sweating which leads to loss of fluids and electrolytes. Fever also leads to increase in rate of breathing which can further add up to loss of fluids & electrolytes. Each degree rise in temperature can lead to 25% increase in fluid losses via breathing
Consequently, the body loses not only fluids but also essential electrolytes like sodium, potassium etc. Electrolytes are minerals that have a natural positive or negative electrical charge when dissolved in water. Electrolytes like Sodium and chloride help to maintain body fluid balance while potassium, calcium and magnesium are involved in proper functioning of nerves and muscles. Fluid balance and electrolyte balance are closely linked. The body works to keep the total amount of fluids and the levels of electrolytes in the blood constant.
Cumulatively fever &vomiting alongwith infection can lead to fluid and electrolyte deficits in Dengue due to increased fluid electrolyte losses as well as reduced intake of fluids. Older adults are especially susceptible to dehydration during the febrile phase of dengue. Fluid & electrolyte disturbances are also commonly associated with malaria. Optimal range of electrolytes is necessary for proper functioning of body.Certain drugs used for treatment of Malaria can lead to nausea and vomiting further accelerating fluid and electrolyte deficits. Similarly typhoid is known to cause fluid and electrolyte imbalances.
Impact of fluid & electrolyte deficits in Malaria, Dengue & typhoid
Fluids & electrolyte deficits in these infections makes can make you feel weak, affects your ability to get out of the bed, walk and perform the activities of daily living.
Shock syndrome is one of the fatal complication of dengue infection and can be due to dehydration in severe cases. Careful fluid management and supportive therapy being the backbone of treatment.Similarly, typhoid fever is often associated with vomiting leading to dehydration which if left untreated may lead to severe consequences. Severe malaria may lead to renal impairment, which could get aggravated by low fluid intake, fluid loss due to vomiting, pyrexia, and sweating and dehydration during infections. This can impact recovery from these infections.
How can oral fluid & electrolytes help patients with Malaria, Dengue & typhoid?
Various Indianguidelines have emphasized the role of fluid and electrolytes as one key components for management of these tropical fevers. The association of Physicians of India recommends that supportive measures like oral hydration, appropriate nutrition & correction of electrolyte abnormalities is important to manage typhoid fever. Further, Indian national guidelines for clinical management of Dengue fever recommend oral fluid & electrolyte therapy for Dengue patients with excessive sweating, vomiting or low blood pressure.
If any of these infections is diagnosed, appropriate medication should be used as prescribed by the doctor. Alongwith this, it is essential to give due consideration to addressing fluid & electrolyte deficits.
While there are options of homemade preparations easily available and accessible to address fluid & electrolyte deficits in these infections, ready to serve electrolyte drinks are also available which contain a known quantity of fluids & electrolytes with good taste and convenience as they are ready to be consumed. They can help to restore fluids & electrolytes and can help support person with Malaria, Dengue & Typhoid in the process of recovery.
Overall, it is established Dengue, Malaria and Typhoid can lead to dehydration with a higher risk in children and elderly population. The infection itself or associated with fever & vomiting can lead to fluid & electrolyte deficits. If not addressed, these deficits can lead to certain complications which can delay recovery. Patients can expect to recover faster if these deficits are addressed with an appropriate fluid & electrolyte format.
