​Navigating monsoon season: Health impacts and safety precautions

February 9, 2024
By Dr Mohd Khalis Abdul Rahim,
Consultant Emergency Medicine Specialist,
​Sunway Medical Centre (SMC)
​According to MET Malaysia, the monsoon season is expected to persist until March 2024, bringing with it the potential for thunderstorms, strong winds, and flash floods. The heightened risk of flooding during this period has been associated with a range of health concerns, including waterborne diseases, mosquito-borne illnesses, and mental health impacts. The Taman Sri Muda floods in 2021 that claimed 50 lives, necessitated the evacuation of 400,000 people, and resulted in an estimated financial loss of RM6.1 billion serve as a stark reminder of the devastating consequences of such disasters, prompting a closer examination of the health implications and safety precautions necessary during the monsoon season.

Health impact of monsoon and flood disasters
In Malaysia, especially during the monsoon season, floods significantly threaten public health, particularly in a tropical climate, causing various health issues that can have long-lasting consequences. With garbage and contaminated water overflowing into reservoirs and waterways, the risk of infectious diseases looms large. Some of the common health impacts of floods include:
  • Waterborne diseases that spread through contaminated water and food can be common during and after floods, such as typhoid fever, cholera, hepatitis A, dysentery, and food poisoning. These diseases cause symptoms such as diarrhoea, vomiting, fever, abdominal pain, and headache.
  • Leptospirosis is a bacterial infection, transmitted through contact with animal urine, is particularly prevalent in post-flood environments. Symptoms include fever, headache, nausea, abdominal pain, and jaundice.
  • Dengue fever, transmitted by Aedes mosquitoes, increases significantly after floods due to stagnant water breeding grounds and excessive rainfall during monsoon season. It can cause severe symptoms such as high fever, headache, muscle and joint pain, nausea, and vomiting.
  • Malaria is a mosquito-borne disease caused by Plasmodium parasites, primarily transmitted through bites of infected female Anopheles mosquitoes. The disease is more prevalent in tropical regions where these mosquitoes thrive. During monsoon seasons, marked by heavy rainfall and warmer temperatures, mosquito breeding increases, elevating the risk of malaria transmission.
  • Upper respiratory infections are a significant concern post-floods due to crowded, nutritionally poor environments where overcrowding, poor nutrition, and limited healthcare facilities contribute to the heightened risk.
  • Dehydration is often a health concern, especially in areas with natural disasters like floods due to the lack of access to clean water that can lead to chronic and severe complications and even death.

Dehydration is a major concern in flood-affected individuals, particularly those grappling with foodborne illnesses like food poisoning and diarrhoea. Vulnerable populations, including children, infants, and senior citizens, are at higher risk due to their sensitivity to fluid loss. Individuals with chronic health conditions, such as diabetes, heart or kidney failure problem also face elevated risks.

Dehydration can lead to severe complications such as electrolyte imbalance, which can affect the normal functioning of cells and organs, leading to muscle cramps, weakness, and in severe cases, cardiac issues. Other complications include kidney or urinary problems, impairing cognitive function leading to difficulty in concentration, confusion, and impaired memory. In extreme cases of dehydration, life-threatening situations such as hypovolemic shock may arise. This type of shock occurs when reduced blood volume leads to a decline in blood pressure.

Dengue health concerns
The Aedes mosquito has a distinctive black-and-white striped body and prefers to breed in clean, stagnant water. There is usually an upward trend in dengue cases in Malaysia, especially during the monsoon season, as places susceptible to stagnant water tend to increase. This is why Malaysians have to be extra vigilant when it comes to taking precautionary steps such as using mosquito repellent or natural repellents that use plant-based extracts, such as citronella, eucalyptus and other essential oils when sleeping or outdoors, frequently checking and removing stagnant water from your home that can help prevent the spread of dengue fever.

With insect-borne diseases such as dengue and even malaria that have the potential of being fatal or severe for patients, it is highly imperative to seek medical help and get tested if you have high fever, muscle ache, joint pain, fatigue, nausea and vomiting, abdominal pain and bleeding tendencies as it could be life-threatening.”

Mental health impact
Several studies have found that direct and indirect exposure to floods can lead to a range of negative mental health impacts, including post-traumatic stress disorder (PTSD), psychological distress, depression, and anxiety, which can be at an elevated rate compared with those unaffected by flooding.

With disasters like floods, mental health symptoms such as stress, PTSD, anxiety, and depression become more prevalent. From my experience with the Taman Sri Muda floods, there were patients whose PTSD symptoms persisted up to few months and years, especially affecting those low income group.

Safety tips for monsoon season
With the increased risk of flooding and other health concerns during monsoon season:
  • Drink safe and clean water: Only consume water that has been boiled or bottled. Avoid untreated water.
  • Consume cooked food: Only eat cooked meals kept hot. Peel fruits and avoid raw food.
  • Practice good hygiene: Wash your hands frequently with soap and clean water. Use sanitation facilities properly and dispose of waste correctly.
  • Use mosquito repellent to protect you and your loved ones from being bitten by the Aedes mosquito, causing dengue fever.
  • Check and remove stagnant water so the Aedes mosquito does not have the opportunity to breed in your home.
  • If you experience fever, diarrhoea, vomiting, or other health concerns, seek medical attention immediately, even after the disaster.
  • Avoid playing in floodwaters or rivers: Keep children away from floodwaters to prevent injuries and the spread of diseases through stagnant and contaminated water or from rodents and animals, including snakes in the floodwater.
  • Turn off electrical switches, water supply, and gas valves before leaving home to prevent accidents.
  • Prioritise the safety of vulnerable individuals: if you have preexisting health conditions such as diabetes or if your loved ones are part of the vulnerable population such as infants, elderly and pregnant, getting help and taking extra care during floods or monsoons is essential.

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