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Pakistan Floods Bring 'Triple Whammy' of Diseases

September 9, 2010 – The major cause of death and harm to Pakistan flood victims will be a "triple whammy" of cholera, malaria and gastrointestinal disease, says Paul Roepe, co-director of Georgetown's Center for Infectious Disease.

The heavy monsoons that triggered flooding in Pakistan put an area the size of England under water and affected at least 20 million people, according to the United Nations. Deaths were estimated at 1,600 in mid-August.

"Health issues existed before the floods, but the floods are exacerbating the situation," says Roepe, professor of chemistry and professor of biochemistry and cellular and molecular biology. "We're about to enter the rainy season in Pakistan. Normally they would expect 100,000 to 200,000 cases of malaria over the next couple months, but they'll have more cases and more deaths for sure because of the flooding."

Roepe says refugees from the flood are moving from areas where malaria is nonendemic to where it's endemic.

"If you get malaria as a kid and survive, you're pre-immune, but if you never had it before and you get it and don't get treated, the risk of death is enormously higher," Roepe explains.

Pakistan also is one of only a few countries in the world that has similar levels of two kinds of malaria – one is the most lethal form. He's concerned whether there will be enough doctors available to correctly diagnose and treat the different types of malaria.

Illness from contaminated, virus and bacteria-filled water is the immediate threat, Roepe says.

"Diseases from unclean water lead to gastroenteritis, a spectrum of diseases that, if left untreated, lead to severe dehydration and dysentery," Roepe notes. "Untreated, most of these diseases can kill you."

Cholera, also caused by bacteria, can kill people within hours by causing diarrhea-based dehydration, he says.

The professor is concerned that while the United States has pledged money and supplies, some countries haven't given anything.

"We're not talking about expensive treatments or prevention measures," Roepe says. "A malaria bed net is $1 and rehydration solution costs pennies. It's tragic to watch people die when the things that could save them cost so little."

Roepe speculates that aid has been inadequate in Pakistan because of the war being fought on its border, justified apprehension of its government and global security and economic issues.

But the scientist says that if people are committed to "helping innocent kids and people who have nothing to do with the government" they should work for or support organizations such as the U.N., CARE and Doctors Without Borders that are not part of Pakistan.

"I have no patience for people who sit around talking about politics while hundreds of thousands of kids are dying," Roepe says. "That's morally reprehensible to me."

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