Times of India
30 March 2010
By Pratibha Masand
Mumbai, India

It took a little more than a week for 37–year–old Worli resident Suren Naik’s family to realise that the fever and body ache he had been complaining about was actually an attack of jaundice. “We ignored his fever for a week before he started vomiting almost continuously. His eyes took on a yellow tinge. It was then that we realised he was suffering from jaundice,” said his mother Swapnali.

Civic hospitals have noted a rise in the number of people suffering from jaundice. For instance, at Kasturba Hospital alone, there are around 180 patients battling the infection. While BMC officials admitted that there has been a sudden rise, they were unwilling to give the exact figure. “We used to get around 250 cases of jaundice a month. In the last fortnight, the numbers have gone up slightly,” said Dr Daksha Shah from the epidemiology cell of the BMC.

The death of three pregnant women suffering from jaundice is also a worrisome trend, say doctors, who believe that the city is seeing its first outbreak of the infection. A number of private hospitals, too, are witnessing this trend. Dr Hemant Thacker, consulting physician, Jaslok Hospital, said: “There was a rise in jaundice cases a few weeks ago, but now it seems to have reached a plateau. We get around three cases in a week.”

Doctors attribute the outbreak of jaundice to the water scarcity that Mumbai is facing. This, they believe, has forced citizens to look at alternative sources of water, which are often contaminated with the Hepatitis E virus known to cause jaundice.

“A fortnight ago, there was a pipe burst in our area,” said a Worli resident who has been diagnosed with jaundice. Over 50 residents in Worli began showing symptoms of jaundice. “We had all taken ill because the water we consumed from private tankers was contaminated,” she said. But now, it’s not just residents of Worli, but people across the city who are showing symptoms of infection.

S K Gupta, a private geologist who has been helping the BMC identify alternate sources of water, said, “There are so many nullahs connected to the BMC pipelines. Even if there is a slight leak, the whole supply can get contaminated. These leaks have to be checked and plugged.”

Meanwhile, the BMC has ordered the builders of Panchsheel Housing Society to shift the sewage lines away from the water tanks and pipelines. Recently, the society reeled under an uncontrolled spurt of jaundice. Investigations revealed that the builder had provided an illegal water connection, which was in close proximity to the sewage lines.

Contaminated water is not the only cause. “Liver diseases threaten the organ’s ability to keep up with the processing of bilirubin [see box]. Starvation, circulating infections, certain medications, hepatitis and cirrhosis can cause hepatic jaundice, as can certain hereditary defects of liver chemistry and excess consumption of alcohol,” said Thacker.

Early Signs of the Infection
Jaundice can be identified by the yellowish staining of the skin caused by high levels of the chemical bilirubin in the body. Bilirubin is a brownish–yellow substance found in bile, and is produced when the liver breaks down old red blood cells. Excess amounts of bilirubin produce the yellow appearance. Initially, a person suffering from jaundice will get fever, body ache, nausea and vomiting. As bilirubin levels rise, other symptoms like yellowing of skin and eyes surface The onset of jaundice is similar to that of any other infection. Initially, the patient will get fever, body ache, nausea and vomiting. Jaundice occurs when there is:

• Too much bilirubin being produced for the liver to process
• A defect in the liver
• Blockage of bile ducts that decreases the flow of bile and bilirubin from the liver into the intestines

Precautions

• Boil drinking water
• Avoid consuming roadside drinks
• Use purified water for cooking purposes
• Avoid consuming food from places where water may not be purified
• Clean water tanks every three months
• Mend leakages in your water pipes