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Two components of diarrhoeal diseases control
A. Short term
– Assessment and appropriate clinical management of cases
B. Long term
1. Better MCH care
2. Preventive strategies
3. Preventing outbreaks

A. Rehydration therapy,
B. Antibiotics ONLY IF indicated
C. Zinc supplementation and
D. Continued feeding

The clinical features due to various causative agents may overlap and may even be atypical
Following is a list of commonly seen clinical features associated with different agents.
Also, the general principles of diarrhea management are similar for most causative agents.
CLINICAL FEATURES: CHOLERA
• Rice-watery stool
• Marked dehydration
• Projectile vomiting
• No fever or abdominal pain
• Muscle cramps
• Hypovolemic shock
• Scanty urine
CLINICAL FEATURES: E. COLI (ETEC) DIARRHEA

Reference:
K. Park, 2019. Epidemiology of Communicable Diseases, In: Park’s Textbook of Preventive and Social Medicine, 25th ed. Jabalpur, 2019

• Major killer of under 5 children, even though the toll has reduced considerably
– 10% of under-5 deaths in India
– Reduction of mortality mainly due to rehydration tech including ORS
• Under 5 children are estimated to have 3 episodes per year
– Incidence hasn’t changed much but mortality is reduced considerably
– Loss of considerable number of DALYs
• Leading cause of death during disasters and emergencies

As on 23rd March 2020
When to use a mask
• If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection.
• Wear a mask if you are coughing or sneezing.
• Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
• If you wear a mask, then you must know how to use it and dispose of it properly.

As on 22nd March 22, 2020
COVID-19 virus can be transmitted in areas with hot and humid climates

Mission Indradhanush
The percentage of children, who are fully immunized (FIC), was found to be only 65% in 2013-14. This was despite the Universal Immunization Program (UIP) running since 1985 and Expanded Program on immunization (EPI) since 1978.
Mission Indradhanush was launched in December 2014 to:
• Actively achieve full immunization of 90 percent by 2020 and
• Simultaneously to boost the Routine Immunization (RI) infrastructure in the country

A student is often tempted to quickly move on to examination after listening to the presenting complaints.
Clinical history taking should not be taken lightly.
A logically taken history will give rise to a list of probable diagnoses in your mind by identifying patterns of symptoms even before you proceed on to the examination.
Systematically taken history will guide you to:
• Look especially for signs for confirming or ruling out certain disorders upon physical examination and

Rat control measures:
1. Sanitation
2. Trapping: Bait is used. Causes temporary reduction in numbers.
Captured rats must be killed as they become “trap-wise” and avoid traps later