The heatwave in Karachi has caused an uptick in children’s hospitalization from diarrhea with doctors worried that Cholera may be surfacing as well.

Over 40 children have been admitted to the ER and gastrointestinal ward of the National Institute of Child Health in Karachi. “An outbreak of Cholera is expected because people ate out with their children during Eid,” said Dr Nasir Saleem, the director of NICH. He worried that higher temperatures would lead to more Cholera cases. Right now, the children are being tested because of their symptoms. At least three percent are suspected Cholera cases.

Ketchup and chutneys have chemicals which are supposed to be kept at a certain temperature but if not maintained, can lead to Cholera, he said.

Cholera is an acute infection of the small intestine caused by the bacterium Vibrio cholera. A person gets extreme diarrhea as a result of which their body rapidly loses fluids and salts or electrolytes (essential for cell function). Diarrhea is also caused by bacteria and involves frequent trips to the bathroom as well. Contaminated water, shopworn food, summer heat and a lack of proper sanitization lead to diarrhea and Cholera.

NICH Deputy Director Dr Liaquat is also the focal person for the Sindh Cholera program. He explained that a diarrhea-infected child can survive a week or two but the cholera patient is more dehydrated. A cholera patient passes white stool, which is why it is called “rice-water” stool.

Three percent of cases are expected to emerge as Cholera, said doctors. Samples have been sent for testing, which may take a few days.

“In winter Cholera is caused by viral infections but during the summer bacteria causes it,” explained Dr. Arit Prakash, a pediatrician and child specialist at NICH.

Loose motions and vomiting are common in diarrhea but Cholera is more extreme. “Cholera cases can be described as infants dying by loose motions,” said Dr Prakash. If you are so dehydrated, you can go into shock. If the person is extremely dehydrated it is sometimes even difficult to even find a vein to attach the drip to rehydrate, he said.

He said that children who ingest tap water by mistake often get sick from it.

“Ideally you treat this with ORS at home but if the child is not taking it, then doctors use Ringer lactate solution,” said Dr Prakash.

Basic treatment for diarrhea is ORS and use of zinc. The same goes for cholera as well. “With better fluid management a patient can make a prompt recovery,” said Dr Liaquat. “A normal patient under the age of 12 years recovers usually in 48 hours.”

• Essential tips:
  1. Use boiled water
  2. Eat freshly prepared food
  3. Maintain hygiene

Town health departments provide people living in informal settlements with chlorine tablets of 250 mg and 500 mg so they can add to their water supplies. The government chlorination program, in association with the WHO, is carried out by the district health office. Lady health workers also distribute the tablets.

NICH has a separate counter at its Emergency ward for diarrhea cases. It receives patients from all over Sindh, Quetta and even from Afghanistan. It has 20 beds in the gastro ward where they can accommodate a maximum of 40 children.