Diarrhoeal Disease Season

From November 2009 to May 2010, health measures across the Province will be in place to combat the expected high case-load of children with diarrhoea. The provincial health department in conjunction with the City of Cape Town will establish an integrated system of community- and facility-based interventions aimed at preventing and treating diarrhoea during the annual peak season.

Diarrhoeal disease is especially prevalent during summer when infection spreads fast through increased fly infestation and food and water contamination. If a child with severe diarrhoea is immediately given the proper care and treatment, he or she can recover completely in a few days. But every summer many children get very sick and some of them die. Prevalence is particularly high in areas where there are shared water and sanitation facilities. The 'Hotspot' areas in the Cape Town Metropole where the most cases of fatal diarrhoea were reported for the previous summer were identified as Gugulethu, Nyanga, Phillipi, Browns Farm, Khayelitsha, Delft, Bloekombos, Wallacedene, Langa and Joe Slovo.

Steps taken by the Western Cape Department of Health to address the prevention and management of diarrhoea:

• Health promotion programmes aimed at preventing diarrhoea and promoting appropriate home treatment for dehydration will be intensified.
• Mothers, day-care workers and other child-care providers will be targeted in households and health facilities with an emphasis on:
• Maintaining hygiene and water quality standards, promoting hand-washing in particular.
• Raising awareness of the danger of rapid dehydration, promoting the use of a simple rehydrating home remedy and alerting care-givers to the symptoms calling for immediate medical attention.

Thousands of Community Health Workers, Health Promoters, Environmental Health practitioners, NGOs and volunteers will be deployed to interact directly with community members.

Interventions at Primary Health Care facilities include:

• Rapid triage of all children on entry into the facility, i.e. prioritising children according to the severity of their condition. All clinic staff, including security guards and cleaners will be trained to recognise the signs of severe dehydration and to fast-track children in need of immediate attention
• Well situated and functional Oral Rehydration Therapy (ORT) corners.
• Extended hours for access to Primary Health Care (PHC) services in 'hotspot areas'.
• Short-stay Rehydration Units at primary health care facilities for less severe (yellow triaged) cases (4-5 hours rehydration with hourly assessments.)
• Skilled clinicians are deployed to manage cases and do ward rounds at PHC level.
• Effective Emergency Medical Services viz. Flying Squad, to transport children in need of hospitaliation.
• The Rotavirus vaccine was introduced as from 1 November 2009. This vaccine assists in the management of diarrhoea, but does not necessarily prevent children from getting diarrhoea.