Intestinal, Vector-Borne and Zoonotic Diseases

Faeco‑oral diseases

• Low‑osmolarity ORS: 245 mOsm/L (Na 75, glucose 75, K 20, Cl 65, citrate 10 mmol/L). Zinc 10 mg (< 6 months) / 20 mg × 14 days.
• IMNCI: Plan A (no dehydration), Plan B 75 mL/kg over 4 h, Plan C IV RL 100 mL/kg (30 + 70 split). Dysentery → antibiotic; persistent ≥ 14 days.
• F‑diagram: sanitation is the primary barrier. Stop Diarrhoea Campaign; ORS Day 29 July; rotavirus vaccine (2016).
• Cholera: O1 (El Tor; Ogawa/Inaba), O139; incubation hours to 5 days; rice‑water stools; doxycycline 300 mg single (adults), azithromycin (children/pregnancy); OCV 2 doses; no mass chemoprophylaxis.
• Typhoid: human reservoir; chronic carriers 2–5% (gallbladder); blood culture in week 1; TCV; XDR typhoid.
• Hepatitis: A, E faeco‑oral; B, C blood. HBV chronicity 90% if perinatal. Birth dose within 24 h + HBIG for HBsAg+ mothers. HCV cured by DAAs. HEV severe in 3rd trimester. NVHCP 28 July 2018.
• Food poisoning: 1–6 h S. aureus / B. cereus emetic; 8–16 h C. perfringens; 12–72 h Salmonella; botulism: descending paralysis, clear sensorium.
• NDD: 10 February and 10 August, albendazole 400 mg (200 mg at 1–2 years), ages 1–19.

Vectors

• Anopheles: malaria; spotted wings; rests at an angle; larva parallel, no siphon; eggs with floats. An. culicifacies (rural), An. stephensi (urban), An. fluviatilis (hills).
• Aedes aegypti: dengue/chikungunya/Zika; day‑biter; artificial containers; black‑white stripes.
• Culex quinquefasciatus: filaria (polluted water); C. tritaeniorhynchus: JE (rice fields). Mansonia: Brugian filaria (Pistia).
• Sandfly: kala‑azar; rat flea: plague (cheopis index > 1); louse: epidemic typhus; Haemaphysalis: KFD; chigger mite: scrub typhus.
• IVM: environmental → biological (Gambusia, guppy, Bti) → personal → chemical. IRS up to 6 ft for sandflies; kill fleas before rats.

Malaria

• Man = intermediate host; mosquito = definitive host. Hypnozoites (Pv, Po) → relapse.
• API = cases/population × 1,000; ABER = examined/population × 100 (≥ 10%); SPR, SfR, AFI. Infant positive = local transmission.
• Pv: chloroquine 3 days + primaquine 0.25 mg/kg × 14 days. Pf: ACT‑SP (ACT‑AL in north‑east) + single‑dose primaquine. Severe: injectable artesunate.
• NFME 2016–2030: zero indigenous cases by 2027, elimination by 2030. Cases and deaths down ≈ 80% (2015–2025).

Arboviruses, LF, kala‑azar, rabies, zoonoses

• Dengue: DENV 1–4; critical phase around defervescence; warning signs; NS1 (≤ day 5), IgM (≥ day 5); paracetamol only. HI, CI, BI = positive containers/100 houses. National Dengue Day 16 May.
• JE: birds (reservoir) → Culex tritaeniorhynchus → pigs (amplifiers) → humans (dead‑end). SA 14‑14‑2 at 9–12 and 16–24 months; adult JE vaccination. AES: also scrub typhus, litchi hypoglycaemia.
• LF: W. bancrofti nocturnal; night smear 8:30 pm–12:30 am; FTS antigen test; MDA DA or IDA (2018); ≥ 65% ingestion; TAS; MMDP; target 2027.
• Kala‑azar: L. donovani, P. argentipes, human reservoir; rK39; single‑dose L‑AmB 10 mg/kg; PKDL; IRS alpha‑cypermethrin; < 1/10,000 per block reached 2023; validation needs 3 years.
• Rabies: wash 15 min; Cat I none, Cat II vaccine, Cat III vaccine + RIG (HRIG 20 IU/kg, ERIG 40 IU/kg infiltrated). IM Essen 0‑3‑7‑14‑28; ID 0‑3‑7‑28. Previously vaccinated: days 0 and 3, no RIG. NAPRE: zero by 2030; dog vaccination ≥ 70%.
• Leptospirosis: rat urine, floods; Weil's disease; doxycycline 200 mg weekly prophylaxis. Scrub typhus: eschar; doxycycline/azithromycin. KFD: Shimoga 1957, ticks, monkey deaths. Brucellosis: raw milk. Plague: Surat 1994.