In 294 million households countrywide, this is a time to gear up for the onset of infections and diseases that flourish in the damp, wet environments. Children are especially vulnerable – Kiran Balimane & Cynthia John

The bountiful monsoon which has spread across most parts of the country, has cheered farmers worried about incomes, and politicians and the common man apprehensive about inflation indices.

But the monsoon season is also a time of floods, landslides, water-logged and pot-holed streets and numerous infections and illnesses. In 294 million households countrywide, this is a time to gear up for the onset of infections and diseases that flourish in the damp, wet environment. Especially in India’s ill-governed and badly maintained cities and towns vector-borne, water-borne, respiratory and other infectious diseases attack vulnerable children prompting frequent down-time, school absenteeism and parental anxiety. In the post-Covid era, many previously common-place and innocuous rainy season viruses have mutated into life-threatening life-forms.

According to the laid-back Union ministry of health and family welfare, there is a “marked rise” in cases of illnesses such as gastroenteritis, dengue, and respiratory infections during the current monsoon season. More specifically the World Health Organisation (WHO) reports that over 3.4 million people in India are affected by waterborne diseases such as dengue during monsoons. Children with developing immune systems are especially vulnerable to viruses that thrive in the rains.

For instance during the month past, Bengaluru, the ICT (information communications technology) hub city has reported a spike in the number of children struck down with respiratory illnesses and early influenza.

Dr. Srikanta J.T, who practices paediatric interventional pulmonology at the city’s premier Aster CMI Hospital, told the local daily Bangalore Mirror (August 9) that in 15 days, over 25 children have been treated for influenza at his hospital. “While the weather itself does not cause illness, it creates an ideal environment for viruses to thrive. Over 25 children have been treated by me for influenza with some requiring hospitalisation. Fever, chills, bodyache, dry cough, headache, eye and throat pain, rhinitis and stuffy nose are some of the common symptoms. As schools start and there is significant fraternizing of children, this provides an ideal environment for viruses to replicate, leading to a significant increase in respiratory viral infections, mainly influenza,” says Dr. Srikanta.

In our monsoon special cover story, we present advice from well-known pediatricians, health and wellness experts on preventive measures parents need to take to protect children from common monsoon afflictions.

Preventive measures
According to Jaya Sachdev, a Delhi-based parenting, wellness and life coach, the risk of contracting monsoon infections can be reduced by encouraging children to practice personal hygiene, and parents maintaining a dry and clean home. Her recommendations:

Personal hygiene. Teach children the importance of washing their hands frequently with soap and water. Several studies have found that thorough handwashing reduces the risk of diarrheal diseases by 42-47 percent. Instruct and drill children that they should wash their hands (scrub for at least 20 seconds, cleaning the areas between the fingers and under nails) before meals and after toilet use. Also ensure that they cut nails short and keep them clean to prevent accumulation of dirt and germs.

Keep your home dry and clean. Make every effort to keep your home, footwear and clothes clean and dry. Damp clothes and footwear prompt skin infections and fungal diseases. Parents need to ensure that children wear clean and dry clothes, and if they get wet, they should change immediately to avoid skin irritation. Waterproof footwear is also advisable to protect against rain. Additionally, rainwater is usually contaminated, and children should take a shower after being outside in the rain to wash off harmful germs.

Drink clean water. Drinking clean and safe water is crucial during the monsoon season, as waterborne diseases tend to spread rapidly this time of the year. Parents should provide children boiled or filtered water and discourage them from consuming wayside water/beverages. Provide a water bottle to carry to school, tuition, sports classes, etc, and instruct them to remain well-hydrated through the day.

Balanced diet. A balanced diet rich in nutrients is vital to boost children’s immunity during the monsoon. Include fresh fruits and vegetables in children’s meals, especially oranges and guavas which are vitamin C intensive. Hot homemade soups and herbal teas are also beneficial, providing hydration and nourishment to ward off infections. Discourage intake of street food and unhygienic snacks, which can lead to stomach infections.

Mosquito safety. Mosquito-borne diseases, such as dengue and malaria, pose grave risk during the monsoon season. They breed in stagnant water which is fertile breeding ground for mosquitoes. Parents should take preventive measures, including using mosquito repellents and dressing children in long-sleeved clothing and trousers to minimise exposure to mosquito bites. Moreover keep home windows and doors closed especially at sundown and use mosquito nets at night.

Prompt treatment. If children fall ill, consult healthcare professionals for immediate treatment. While home remedies provide relief for common monsoon-related ailments such as cold and stomach infections, they cannot replace expert medical treatment.

Vaccination
Rainy weather increases the risk of children contracting the flu, typhoid, and hepatitis. While it’s important to ensure that children’s mandated vaccinations are up-to-date, medical practitioners advise parents to seriously consider vaccinating children against flu, typhoid and Hepatitis A.

“Youngest children and elders with weak immune systems are particularly susceptible to infections during the monsoon season. Ensure children don’t miss their normal vaccination schedule. In addition, special vaccines against flu, typhoid and Hepatitis A are helpful in protecting children from serious illness and complications. Parents also need to regularly monitor children with a history of respiratory diseases such as asthma and bronchitis during the monsoon, ensuring timely adjustment of medication to prevent serious complications,” warns Dr. Saurabh Khanna, lead consultant, paediatrics and neonatology at the C.K. Birla Hospital, Gurugram.

Home remedies
While medical diagnosis, assessment and treatment is essential to treat illnesses in children, parents can supplement them with home remedies which are scientifically proven and effective in alleviating symptoms. Dr. Ather Pasha, consultant, internal medicine, CARE Hospitals, Hyderabad, suggests these useful home remedies for common monsoon ailments.

Common cold and flu.“Ginger tea is an effective home remedy to alleviate cold and flu symptoms. Boil fresh ginger slices in water and add honey and lemon to taste. Give children this concoction two-three times a day; it will soothe sore throats and reduce inflammation. Steam inhalation is also effective for easing chest congestion. Add a few drops of eucalyptus oil to hot water and get children to inhale the steam to clear nasal passages. Moreover, turmeric milk, prepared by mixing half a teaspoon of turmeric in warm milk, can be given to children before bed to boost immunity and reduce inflammation,” says Dr. Pasha.

Dengue fever. Dr. Pasha also recommends papaya leaf juice for debilitating dengue. “Crush papaya leaves and extract its juice. Children should be administered 1-2 tablespoons twice a day to increase their platelets count,” he advises. Giloy juice, made by boiling giloy stems in water and drinking the strained liquid twice daily, is also very beneficial. Ensure children remain well-hydrated with fluids such as coconut water, ORS (Oral Rehydration Solution). Fresh fruit juices should be given under advisement of a doctor.

Malaria. Cinnamon is a potent home remedy for malaria. Boil a teaspoon of powdered cinnamon, add a pinch of pepper powder and honey and administer once daily. Fresh grapefruit juice is another antidote to malaria. “Additionally, basil (tulsi) leaves boiled in water and consumed as a decoction twice daily, alleviates malaria symptoms and boosts immunity,” he says.
Cholera. Regular intake of Oral Rehydration Solutions (ORS) is critical to prevent dehydration during a cholera illness. Lemon juice mixed with water and a pinch of salt maintains electrolytes balance. Ginger tea, known for its anti-inflammatory properties, reduces stomach discomfort and inflammation.

Typhoid fever. Typhoid, spread through contaminated food and water, manifests as high fever, weakness, stomach pain, headache, and loss of appetite. Dr. Pasha recommends apple cider vinegar as a useful home cure. “Mix a teaspoon in water and give it to children to drink before meals to maintain energy levels and promote recovery. Basil leaves boiled in water and drinking the strained liquid daily reduces fever. Garlic, with its antimicrobial properties, is another effective remedy. Consume two cloves of raw garlic on an empty stomach; it combats bacteria causing typhoid,” he advises.

Gastroenteritis. Ripe bananas replenish potassium lost due to diarrhea. Rice water, obtained by boiling rice and straining the water, soothes the stomach during a gastroenteritis infection.

Fungal infections. For fungal skin infections, Dr. Pasha advises use of neem, well-known for its antifungal properties. It can be applied as oil to the affected area or used in bathing water. Tea tree oil, diluted with a carrier oil, is also effective in reducing fungal infections. Garlic, crushed and applied to the infected area or included in the diet, kills fungus.

Jaundice. “Sugarcane juice is a tried and tested treatment for jaundice. Also tomato juice with a pinch of salt and pepper imbibed every morning improves liver functioning. Lemon juice, mixed with water, aids liver detoxification and improves overall health,” says Pasha.

Common monsoon afflictions

To treat common monsoon infections, ParentsWorld interviewed experienced medical practitioners and paediatricians in Bengaluru, Gurugram and Hyderabad. They provided symptoms of common monsoon season ailments and infections for parents to look out for.

Dengue. This viral disease is transmitted by the Aedes mosquito, which breeds in stagnant water. Dengue symptoms include high fever, severe headache, pain behind the eyes, joint and muscle pain, rash, and bleeding.

Chikungunya. Another viral disease transmitted by mosquitoes, it is characterised by high fever, severe joint and muscle pain, headache, fatigue and rash. Joint pains can be debilitating and lasts for weeks.

Malaria. Caused by the parasite Plasmodium, malaria is transmitted through the bite of an infected Anopheles mosquito. Symptoms include high fever, chills, sweating, headache, nausea and vomiting.

Typhoid. A bacterial infection spread through contaminated food and water, it manifests as prolonged fever, weakness, abdominal pain, headache and loss of appetite. In severe cases, intestinal bleeding may occur.

Viral fever. This is a common term for infections caused by various viruses. Symptoms include high fever, body aches, muscle aches, headache, fatigue, and sometimes a rash.

Influenza or flu. A highly contagious respiratory disease spread by the influenza virus, it is characterized by fever, chills, cough, sore throat, runny or stuffy nose, body aches, headache, fatigue, sometimes vomiting and diarrhea.

Cholera. A severe diarrhoeal infection caused by bacterium vibrio cholerae, it is spread through contaminated water and food and causes severe dehydration, which can be fatal if not treated immediately.

Leptospirosis. Humans can get infected when they come in contact with the urine of infected animals when wading through contanimated rainwater. Symptoms vary from mild flu-like illness to life threatening conditions affecting multiple organs.

Hepatitis A & E. These are virus induced liver infections spread through contaminated food and water. Symptoms include jaundice, fatigue, abdominal pain, loss of appetite and nausea. Hepatitis E is especially dangerous for pregnant women.

Cold and flu. Common during monsoons due to fluctuations in temperature and humidity. Symptoms include runny or stuffy nose, sore throat, cough, body aches, headache and fever.
Stomach flu aka viral gastroenteritis. This is an intestinal infection characterised by watery diarrhea, abdominal pain, nausea and vomiting, and fever sometimes. It spreads through contaminated food/water.

Safe outdoor play in the rain

In the rainy season, parents tend to limit children’s outdoor playtime for fear of them catching a cold or other infections. But according to Jaya Sachdev, a Delhi-based parenting, wellness and life coach, “it’s important that children play outdoors in all types of weather including the rains to appreciate nature, develop immunity, and gross motor skills”. She suggests some simple solutions for parents to ensure children play outdoors safely during the monsoon.

• Dress children in waterproof jackets and water-resistant trousers. Avoid cotton as it absorbs moisture and becomes heavy. Clothe them in fast-drying fabrics such as nylon and polyester.
• Equip them with waterproof shoes or boots, with good grip, so they don’t slip while playing in wet play areas.
• Select appropriate play areas. Identify parks and playgrounds that have effective drainage for accumulated water. Instruct children to avoid areas with standing water as it is a breeding ground for mosquitoes and other pests. Choose surfaces that have traction to minimise accidents, such as rubberised playgrounds, if possible.
• Instruct children not to play in natural water bodies such as ponds and puddles, and never drink from them. Always provide boiled or filtered water in a bottle when they are outdoors.
• Hydration is important to boost immunity. While playing outdoors encourage children to drink water at regular intervals. If convenient, provide freshly squeezed fruit juices, tender coconut water, and healthy soups for them to drink after play.
• Plan indoor games ready for rainy days when outdoor play is not possible. Board games, art and craft sheets, reading, or indoor sports such as table tennis or badminton are good alternatives.