3.4.1 Diarrhoeal diseases

In emergencies, diarrhoeal diseases are a major cause of morbidity and mortality.  Inadequate water supplies, substandard and insufficient sanitation facilities, overcrowding, poor hygiene, scarcity of soap and malnutrition are the main factors contributing to the occurrence. Malnutrition and diarrhoeal diseases are closely linked: malnutrition contributes to the severity of diarrhoea, and diarrhoea can cause malnutrition. The most common diarrhoeal diseases are shigellosis (the most frequent cause of dysentery), cholera, rotavirus, and e-coli bacillus.

Routine surveillance systems should include indicators to track cases of bloody and non-bloody diarrhoea for all children. Adult mortality, increases in numbers of adult cases, significant increases in bloody diarrhoea, and a rise in the case fatality rate should be an indication to alert medical staff immediately.

Use of oral rehydration therapy (ORT) in accordance with early rehydration is the most critical element to treat and prevent severe morbidity or mortality. In the early phase of the emergency, at least one ORT corner should be set up immediately in the most central health facility with a plan for rapid scale-up to better accommodate the population.