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Monday, 28 February, 2000, 19:26 GMT
Mozambique flood: the threat of disease
Mozambique floods
Floods threaten disease on a massive scale
The human tragedy of the Mozambique floods will not end as the waters recede - diseases including cholera and malaria will flourish.

What are the main disease threats?

The prime threat is likely to come from cholera, an infection of the gut which causes chronic diarrhoea and vomiting.

This can lead to severe dehydration and, in extreme cases, death. It is caused by contaminated water and food.

It is at its most deadly following natural disasters such as floods because treatment facilities are not available.

Other conditions likely to be rife include dysentery, which causes nausea, loose stools, weight loss, abdominal tenderness and occasional fever.

Stranded
The risk of malaria is greater with people sleeping in the open
Rarely, the parasite responsible for dysentery invades the body beyond the intestines and causes a more serious infection.

The virulence of E coli 0157 is also likely to increase - E. coli symptoms can range from mild diarrhoea to abdominal cramps and blood in the stools.

Some E coli sufferers also suffer from a complication - haemolytic uremic syndrome (HUS), which kills red blood cells and can cause kidney failure and even death.

Malaria

As well as water-borne disease, malaria and dengue fever passed by mosquitoes are also expected to be common.

Most people survive a bout of malaria after a 10-20 day illness. The symptoms include high fever, followed a few hours later by chills. Two to four days later, this cycle is repeated.

Flood victims queue for medical aid
Flood victims queue for medical aid
The most serious forms of the disease can affect the kidneys and brain and can cause anaemia, coma and death.

Bohumil Drasar, professor of bacteriology at the London School of Hygiene and Tropical Medicine, said: "They will get cholera because of the natural habitat and because of being spread widely by faecal contamination of water.

"The other thing I would worry about would be dysentery. It is often more devastating than cholera for children."

How are they spread?

Contaminated water supply will be the key danger, particularly from pit latrines washed out by the floods.

Dysentery is transmitted from person to person, but bacteria levels will be up.

Mosquitoes, carrying malaria and dengue fever, will thrive in stagnant pools left behind when the flood waters recede.

What can be done?

Cholera and dysentery can be treated with antibiotics, but the bacteria are increasingly resistant to the drugs.

The main response to both diseases is rehydration treatments. The problem will be getting supplies - and clean drinking water - to the people who need help.

Setting up water filtration systems to eradicate water-borne diseases will be important.

Bed nets impregnated with anti-malarial chemicals will help stop transmission of the disease.

What will be the timescale?

Professor Drasar said: "Cases which are water-borne will be starting now. Once the water goes down, it will have affected mosquito breeding - there will then be transmission of malaria and possibly dengue fever."

He said emergency aid was needed immediately, but a long term effort, lasting at least six months, would be required to bring disease under control.

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