Weathering the Storm: How Malaysians can Stay Safe during the Monsoon Season

January 12, 2024

Dr Lim Eu Jack

By Dr Lim Eu Jack, Consultant Emergency Physician at Sunway Medical Centre, Sunway City (SMC) and Dr Mohd Khalis Abdul Rahim, Consultant Emergency Medicine Specialist at Sunway Medical Centre (SMC)

According to MET Malaysia1 the monsoon season will continue until March 2024. The update also warns of thunderstorms, strong winds that could lead to flash floods and potential structural and property damage. With the risk of increased flooding, several studies have found increased rates of diarrhea (including cholera and dysentery), respiratory infections, hepatitis A and E, typhoid fever, leptospirosis, and diseases borne by insects have been described as occurring after floods^2[i]. In Malaysia, dengue incidence increased during the two monsoon seasons, from October to March and late May to September³.

Dr Mohd Khalis Abdul Rahim

The Taman Sri Muda floods in 2021 claimed almost 50 lives, necessitated the evacuation of about 400,000 people, and resulted in an estimated financial loss of RM6.1 billion⁴. One cannot help but imagine the fears of history repeating itself.As Malaysia grapples with the recurrent challenges posed by monsoons and potential disasters, it is imperative to raise awareness of the health impacts and potential safety tips that can be a powerful tool to navigate the turbulent waters with resilience, preparedness and shared responsibility for our health.

Dr Lim Eu Jack, Consultant Emergency Physician at Sunway Medical Centre, Sunway City ( SMC) and Dr Mohd Khalis Abdul Rahim, Consultant Emergency Medicine Specialist at Sunway Medical Centre (SMC), shed light on these critical health concerns that can occur during the monsoon season.

Health impact of monsoon and floods

In Malaysia, especially during the monsoon season, floods significantly threaten public health, especially 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 include⁵.

• 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 diarrhea, 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.

Dr Khalis, who was also involved in the health and rescue during the Taman Sri Muda floods, shared that dehydration was one of the most common health concerns during the flood due to access to clean water. Dr Khalis continues, “As a healthcare professional, dehydration is a major concern in flood-affected individuals, particularly those grappling with foodborne illnesses like food poisoning and diarrhea. 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.”

Dr Jack adds, “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 concerns during monsoon season

The Aedes mosquito has a distinctive black-and-white striped body and prefers to breed in clean, stagnant water. Dr Jack shares, “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 usingmosquito 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.”

Dr Jack also adds, “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,⁶ which can be at an elevated rate compared with those unaffected by flooding⁷.

Dr Khalis adds, “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, Dr Khalis and Dr Jack share their advice, which includes:
• 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.

SOURCES:

1 https://www.met.gov.my/assets/content/siaran_media/default/7%20November%202023%20-
%20Kenyataan%20Media%20Permulaan%20Monsun%20Timur%20Laut.pdf

2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118941/

3 Epidemiology (2012-2019) and costs (2009-2019) of dengue in Malaysia: a systematic literature review – International

Journal of Infectious Diseases(ijidonline.com)

4 https://www.iseas.edu.sg/wp-content/uploads/2022/03/ISEAS_Perspective_2022_26.pdf

5 Floods and Risk Of Disease – PORTAL MyHEALTH

6 Mental-Health-Impact-of-Floods.pdf (blackdoginstitute.org.au)

7 Flooding has a big impact on people’s mental health – NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol

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