• The vaccine against rotavirus diarrhea has been introduced recently in the National immunization schedule.
• Oral cholera vaccines are available, which gives immunity to 50-60% of those who take the vaccine, and this immunity lasts only a few months.
• Measles vaccine prevents measles. Diarrhea is a frequent complication of measles
Other vaccines help by preventing infection with vaccine preventable diseases, thereby preventing some parenteral diarrhea.
Three aspects of diarrhea control interventions are measured through indicators:
1. Indicators of Diarrhea Prevention
2. Indicators of Diarrhea Treatment
3. Indicators of ORT use
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
