There is no epidemic at the moment, but the cholera epidemic in Syria is alarming

SAFAKNA TURKEY – Istanbul University, Istanbul Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, lecturer and president of KLİMİK, prof. Dr. Serap Shimshek Yavuz, one of the members of the association, prof. Dr. Esin Senol, prof. Dr. Alpay Azap and Assoc. Dr. Selçuk Ozger conducted investigations in Hatay, Dörtyol, Iskenderun, Antakya, Adiyaman, Besni, Elbistan, Gaziantep and Kahramanmarash. Assessing the risk of infectious diseases in the region, prof. Dr. Yavuz said that there is no talk of epidemics yet, that the next week is very critical in this regard, and that this period should be very effectively assessed in terms of precautionary measures. Noting that search and rescue teams and first aid teams played an active role in the field during the first week, prof. Dr. Yavuz noted that from now on, public health professionals and infectious disease specialists will play a more active role in the region in terms of the risk of an epidemic disease and the period when the risk of an epidemic will increase.

“IF WE LOSE THIS WEEK, WE CANNOT PREVENT THE EPIDEMIC”

prof. Dr. Emphasizing that he had not seen as much destruction as a 1999 earthquake survivor, Yavuz said: “After these weeks, it is necessary to be very careful about infectious diseases and epidemics due to the lack of infrastructure capacity. This week is very critical for us to complete all preparations. If we take sufficient precautions at this stage, we will have a chance to suppress the epidemic before it happens, or even if it happens. Therefore, as an association, we recommend not to waste this week. There is a “no problem, it’s okay, we’ll take care of it” approach in the region, especially among managers. But people there have very serious problems. Everyone really wants to work together. “This is a very big event and it is very important to cooperate.”

“CURRENTLY THERE IS NO EPIDEMIC, BUT IT CANNOT BE AVOIDED IF WATER IS NOT SUITABLE”

Emphasizing that the rumors about the epidemic in the region are not true, prof. Dr. Yavuz noted that if the necessary precautions are not taken in a short time, many infectious diseases, especially diarrheal infections, can spread rapidly. prof. Dr. Yavuz warned: “After the earthquake, most water-borne diseases are very unpleasant. In this sense, there is no shortage of drinking water. But there is not enough toilet and technical water, that is, there are not enough rooms in terms of cleaning. We say: wash your hands so you don’t get sick. The most common diarrheal diseases. Drinking water and toilets are a critical need in an epidemic. Even in the tent cities there were not enough toilets. From our point of view, providing drinking water and toilets, of course, and providing shelter in containers as soon as possible is very important. There is also a need for very thick clothing.”

BORDERLINE RISK for cholera

Noting that the cholera epidemic in Syria is alarming, Prof. Dr. Yavuz said: “There is a cholera epidemic in Syria. Again cases of cholera were seen at the border. Therefore, for the early detection of cholera, it is necessary to expand the rapid diagnostic capabilities in the region as soon as possible with mobile teams and without the need for equipment. Pointing out that it is very important to start using point-of-care tests immediately, Prof. Dr. Yavuz said: “It should be possible to test in the field (at the bedside) for streptococcus, influenza and Covid. This helps to identify the sick at an early stage, at least remove the sick person from the environment and prevent infection. The speed of the epidemic can be reduced. Again, there are kits that can be used for the early diagnosis of diarrheal diseases that are cheaper. This should also be provided. Secondly, we are concerned about contact-transmissible infections. Scabies is one of them, it can spread very quickly among people living in crowded places. There is no epidemic of scabies at the moment, and special solutions are provided in the region in case of an epidemic. In addition, the upper respiratory tract infections that we talked about before the earthquake again pose a great risk to the region. Among them, you can see invasive (deeply located) forms of beta-hemolytic streptococcus (Streptococcus A). Therefore, antimicrobial treatment of a group for infectious diseases may be required,” he said. Stating that a large number of broad-spectrum antibiotics have also accumulated in the region, but simpler forms of antibiotics should be used instead. Dr. Yavuz noted that otherwise a serious risk of antibiotic resistance.

“NOT EVERYONE NEED A TETANUS VACCINE”

Noting that tetanus shots should only be given to those who have been injured and there is no need to vaccinate everyone in the region, Prof. Dr. Yavuz also indicated that the region’s risk in terms of rabies has increased. prof. Dr. Yavuz said: “Because the number of homeless animals has increased abroad and in Turkey we also call it pet rabies; in other words, since stray dogs may have rabies, the number of bites in that direction may increase. Because everyone is outside now. There were problems with the rabies vaccine in Turkey, but enough vaccines were delivered to the earthquake area. There was a problem with the supply of rabies vaccine throughout Turkey, I do not know at what stage it is, but at the moment there is no shortage of rabies vaccine in the earthquake zone. Citizens should not be afraid in this sense. The biggest problem is childhood vaccinations. Primary health care (family medicine) services are currently severely disrupted. We learned that this will be done with the help of mobile medical teams. But the people providing primary care are themselves victims of the earthquake. They are trying to install it using commands from outside. Another problem is that most of Antakya’s medical facilities are located outside the city. A citizen who feels unwell is forced to call an ambulance to the tent city in which he is staying to see a doctor. There must be a decision on transportation so that there is no delay in going to the doctor. In addition, epidemic monitoring must be carried out in writing, even by hand. It was initiated for 5 diseases such as diarrhea, rashes, respiratory diseases. It is very important for us to detect the epidemic in time. It has started in 5 provinces and we expect it to be extended to the remaining 6 provinces,” he said.