Magnitude of the Problem & Management of Tropical Fevers-in Smaller Settings (Primary Care Providers to get Ready for the Rainy Season)

 Suresh Krishnarao*

Citation: Suresh K. Magnitude of the Problem & Management of Tropical Fevers-in Smaller Settings (Primary Care Providers to get Ready for the Rainy Season). Medp Public Health Epidemiol. 2022; 1(1): mpphe-202208007.

Abstract

   Pyrexial illness is a presentation associated with tropical environments, include many common infections, like influenza and tuberculosis that occur across the countries. Tropical fevers are defined as infections prevalent in or are unique to tropical & subtropical regions. Some of these occur throughout the year and some especially in rainy and post-rainy season. Febrile patients may also have chronic or recurrent medical problems unrelated to tropical exposure, non-infectious disease e.g., autoimmune, or malignant conditions. Infection of the upper airways is the most common acute illness encountered in the outpatient of smaller settings. The infection is usually caused by viruses including rhinoviruses, influenza viruses, parainfluenza, and respiratory syncytial viruses occurring predominately during annual winter epidemics. Bacterial infection such as acute rhinopharyngitis is uncommon and usually presents with either persistent symptoms of an URTI lasting over a week or worsening course after initial improvement or acute onset with high fever and inflammatory changes confined to the pharynx. Currently India is battling outbreaks of multiple viral and bacterial fevers like Covid 19, Dengue, Chikungunya, Swine Flu (H1N1), Enteric fevers, Monkeypox, tomato fever, Nipah and Zika virus fevers, Chicken pox, Measles, Scrub Typhus, Leptospirosis, West Nile fever, Brucellosis etc. across cities and states. While Public Health approach looks at Tropical Fevers as diseases classified based on Incubation Period, Types of exposure and transmission methods for Control & eradication goals. Clinicians in smaller settings at sub-state capital towns and villages, with limited diagnostic facilities must depend upon Syndromic approach for management. With about 50 outbreaks and more than thousands of cases, currently common febrile conditions in India demand, more clinical acumen though supplementation by diagnostics in most urban areas. This review is based on the clinician’s approach to manage Tropical fevers. 

   

   Materials and Methods: This review is based on the clinical syndromic approach and empirical treatment followed in smaller setting in India. It uses the burden of different fever cases, based on data available from multiple sources, challenges in real time data collection, lack of transparency and availability in public domain and outbreaks data of last 3 years from Integrated Disease surveillance Program for which author had worked in 2006-2013. 

   

   Key Words: Fevers; Tropical Fevers; Viral Fevers; Fever Panel of Diagnostics