Kerala Floods 2019
While many adults had skin infections between toes, children have been showing signs of invasive fungal infections such as respiratory infections.

The rains in Kerala have abated, the resultant floods have receded, some people have started returning to their houses and many are still at the relief camps. Even as rescue operations, relief efforts and rehabilitation process are underway, doctors in the state have expressed concerns over the health issues that generally follow natural calamities like floods.

After the 2018 deluge, there was a spurt of diseases in Kerala, including leptospirosis, gastroenteritis, typhoid and dengue, among others. This year, the doctors have particularly noted that fungal infections are increasingly being seen among those who were exposed to the floodwater.

Doctors from the Kerala branch of the Indian Medical Association (IMA) have come forward to provide medical care at several flood relief camps. At a relief camp in Kozhikode, the doctors noted that nearly half of the people there showed signs of a fungal infection. While many adults had skin infections, especially between toes, several children have been showing signs of invasive fungal infections such as respiratory infections.

Long-term exposure to flood waters puts people at risk of coming in contact with certain pathogenic fungi, which may cause aggressive infections. It could even weaken one's immune system.

Fungal infections can either present superficially on the skin or in more severe cases, it may be invasive and cause further issues. In a natural disaster, such as a flood, it becomes easier for someone to contract such an infection.

“It is well documented and studied that following certain natural calamities, it is common for us to see certain diseases. Fungal infections of the skin, in particular, are extremely common following any flooding,” states an official from the office of Kerala Health Minister, KK Shailaja.

Signs of a superficial (skin) fungal infection include itching, scaling or flaking between the toes or fingers. These are signs of what is called intertrigo, or inflammation of the skin. It can be treated with antifungal ointments, creams and tablets.

Link between invasive infections and natural calamity

Compared to superficial infection, an invasive infection is a major cause for concern. A 2014 study by the Centers for Disease Control and Prevention (CDC) elucidates the link between invasive fungal infections and natural disasters.

According to the study, seasonal changes and weather effects probably contribute to the growth and distribution of many pathogenic fungi. An environmental disruption, on the other hand, is “a key factor in the dispersal of these organisms and their resulting potential for causing infection”.

“Both small-scale earth-disrupting activities (such as excavation or construction), and events affecting larger areas (such as earthquakes, tsunamis, and tornadoes), have been linked to the occurrence of fungal infections. Natural disasters can cause large-scale disruption of fungal habitats, which can lead to clusters of respiratory, cutaneous (relating to or affecting the skin), or other forms of fungal disease,” reads the study.

Fungal infections do not easily manifest in normal conditions, but the conditions following a natural disaster (such as stagnant water and damp air) make it conducive for fungi to invade. The symptoms may vary depending on the individual and often times diagnosis is based on thorough examination by a health expert.

How to stay safe?

“First and foremost is to take basic hygiene measures,” says Dr Srujit of the IMA.

“It is important to keep the skin dry, especially the areas between fingers, toes, underarms, groin and other parts where the sweat can easily get trapped. For those presenting with itchy or flaky skin, we prescribe certain antifungal medications and ointments,” he explains.

Additionally, avoiding moist spaces and drying clothes completely also help to prevent fungal infections. 

Also read: Health officials in Kerala, K’taka advise caution against diseases seen after floods