PREVENTION OF DIARRHEA / DYSENTRY / FOOD POISIONING
Breast feeding and proper weaning
- During first 4-6 months of life, baby should be given exclusive breast feeds. This means that no other fluid (such as water, tea, juice, animal milk or powder milk) to be given at all. Breast milk has certain protective factors which protect the child from diarrhea. Also it is clean, hence there is no chance of contamination with germs.
- If milk other than breast milk is to be given, it should be given by spoon and bowl, NOT BOTTLE. Bottle should be avoided as it can not be cleaned properly. If it has to be used, it should be boiled for at least 15 minutes in water before each feed.
- Complementary foods can be given anytime after 4- 6 months. Hygienic practices (see below) should be employed while preparing them:
- Wash hands before preparing and before feeding.
- Prepare food in a clean place.
- Wash uncooked food in clean running water.
- Cook / boil well for at least 15-30 minutes.
- Keep foods covered.
- Food should be eaten as early as possible after cooking.
- If food is to be taken 2 hours after preparing, reheat the food till it is thoroughly hot. Do not eat reheated food if it starts to smell.
- Feed the child with a clean bowl and spoon.
Drink safe water
- Collect water from cleanest source and keep water for drinking separately.
- Water can be treated to make it safe (if the safety of source is uncertain) by :
- Boiling – Bringing water to boil once is enough.
- Chemical disinfection – Iodine or chlorine tables can be used (Iodine provides better disinfection).
- Water filters
- Sedimentation filters
- Particulate filters
- UV filters
- Avoid drinking water sold through trolleys, fruit juices prepared in shops and drinks containing commercial ice.
Wash hands thoroughly with soap
- after defaecation.
- cleaning a child who has defaecated.
- before preparing food.
- before eating.
Safe disposal of stools
- As germs of diarrhea are excreted in stools, proper disposal of stools is necessary to prevent spread of diarrheal agents.
- Family should have access to a clean functioning sanitary latrine
Vaccination / Immunization
- Vaccination of children for measles can reduce incidence and severity of diarrheal illness as measles not only predisposes the child to diarrhea by lowering immunity, it also increases the chances of complications.
- Vaccination against rotavirus (a major cause of diarrhea in children) is available and it not only prevents but also reduces severity of rotavirus infections.
- Injections are given between age of 6 weeks to 1 year.
- 3 doses are given at 2 months intervals.
- Consult your doctor for more information.
- Vaccine against cholera (diarrhea due to a bacteria called vibrio cholerae) is also available but it is effective only in 30-50% cases. Each dose schedule protects an individual only for six months.
- Dosage schedule consists of 2 equal doses injected (subcutaneously 0.5 ml in adults and 0.3 ml in children) at interval of 4 to 6 weeks.
- Protective value is only 50% and it protects for 4-6 months only. Therefore booster injections are required every 6 months.
- Work is in progress for more effective oral vaccines.
- Vaccination against typhoid can reduce diarrheal illness and mortality due to typhoid.
- A single dose of 0.5 ml (both in children above 2 years and adults) injection (intramuscular) gives rapid protection (15 days -3 weeks) for 3 years.
- Oral typhoid vaccines are also available in form of a capsule. Three doses of one capsule each on day 0, 3 and 5 protects for one year. It is recommended in children above 6 years and adults.
Prevention of malnutrition
Malnutrition not only predisposes to diarrhea by weakening immunity of body against infections, it also increases risk of complications specially in children. Therefore, prevention of malnutrition by proper diet is important in both the treatment and prevention of diarrhea.
Prevention of food poisoning
- Avoid eating raw / uncooked foods e.g. salads, raw vegetables, unpeeled fruits, unpasteurized milk and dairy products, raw meat and shellfish.
- Peel fruits yourself and wash vegetables thoroughly under running water before eating.
- Some seafood (even well cooked) may be unsafe because of presence to toxins in its flesh.
- Promptly refrigerate leftovers and foods to be eaten later than 2 hours after preparation to prevent growth of bacteria.
- Thaw frozen foods in refrigerator and not outside. Do not refreeze foods once they have been thawed.
- Hands, preparing surface (cutting board, knife) and utensils should be washed with soap after handling raw meat, poultry, seafood or eggs.
- Persons ill with diarrhea or vomiting should not prepare foods for others.