/
Heat and Human Health Dr Akshay Kumar Heat and Human Health Dr Akshay Kumar

Heat and Human Health Dr Akshay Kumar - PowerPoint Presentation

lydia
lydia . @lydia
Follow
343 views
Uploaded On 2022-06-28

Heat and Human Health Dr Akshay Kumar - PPT Presentation

Assistant Director National Programme on Climate Change and Human Health National Centre for Disease Control Ministry of Health and Family Welfare February 14 2020 Heat Year 20152018 four warmest years on record globally ID: 927329

related heat temperature wave heat related wave temperature health illnesses deaths surveillance maximum 2019 disease illness days india pradesh

Share:

Link:

Embed:

Download Presentation from below link

Download Presentation The PPT/PDF document "Heat and Human Health Dr Akshay Kumar" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

Slide1

Heat and Human Health

Dr Akshay KumarAssistant DirectorNational Programme on Climate Change and Human HealthNational Centre for Disease ControlMinistry of Health and Family WelfareFebruary 14, 2020

Slide2

Heat

Year 2015-2018 four warmest years on record globallyIn India, 11 out of 15 warmest years were during recent fifteen years (2005-2019)Five-six heat wave events every year-northern parts (March-June/July)

Slide3

Heat-Wave Definition

World Meteorological OrganizationFive or more consecutive days during which the daily maximum temperature exceeds the average maximum temperature by five degrees CelsiusIndia Meteorological DepartmentHeat wave is considered if maximum temperature of a station reaches at least 40°C or more

for plains, 37°C or more for coastal stations and at least 30°C or more

for hilly regions

Slide4

Heat-Wave Criteria

Based on Departure from NormalHeat Wave: Departure from normal is 4.5°C to 6.4°CSevere Heat Wave: Departure from normal is >6.4°CBased on Actual Maximum Temperature (for plains only)Heat Wave: When actual maximum temperature ≥ 45°C

Severe Heat Wave: When actual maximum temperature ≥47°CTo declare a heat wave, the above criteria should be met at least at two stations in a Meteorological sub-division for at least two consecutive days.

Slide5

Heat-Wave Alerts

IMD issues forecast and warnings for all weather related hazards every day (short to medium range)Exclusively heat-related warning since 2017

Slide6

Warning

Impact

Suggested Actions

Nil

Comfortable temperatures

No cautionary action required

Heat wave conditions at district level, likely to persist for 2 days

Moderate temperature. Heat is tolerable for general public but moderate health concern for vulnerable people e.g., infants, elderly, people with chronic diseases

Avoid heat exposure

Severe heat wave conditions likely to persist for 2 days

With varied severity, heat wave is likely to persist for 4 days or more

High temperature. Increased likelihood of heat illness symptoms in people who are either exposed to sun for a prolonged period or doing heavy work.

High health concern for vulnerable people e.g., infants, elderly, people with chronic diseases

Avoid heat exposure- keep cool. Avoid dehydration

Severe heat wave likely to persist for more than 2 daysTotal number of heat severe heat wave days likely to exceed 6 daysVery high likelihood of developing heat illness and stroke in all ages.Extreme care needed for vulnerable people

Heat Wave Warning

Slide7

7

Warning

ImpactSuggested Actions

Nil

Normal activity

Heat wave conditions at district level, likely to persist for 2 days

a. Avoid heat exposure b. Wear lightweight, light-coloured, loose cotton clothes c. Cover your head

Severe heat wave conditions likely to persist for 2 days

With varied severity, heat wave is likely to persist for 4 days or more

a. Avoid heat exposure- keep cool, avoid dehydration b. Wear lightweight, light-coloured, loose cotton clothes c. Cover your head

d. Drink sufficient water-even if no thirsty

e. Use ORS, homemade drinks like lassi,

torani

(rice water), lemon water, buttermilk, etc

f. Avoid alcohol, tea, coffee and carbonated soft drinksSevere heat wave likely to persist for more than 2 daysTotal number of heat severe heat wave days likely to exceed 6 daysAlong with suggested action for Orange alert, extreme care needed for vulnerable people.Heat Season (March-July)Issue advisories as per alerts

Slide8

Temperature/Humidity Index by NOAA, for USA

Slide9

Heat-Health

Global250,000 excess deaths/year between 2030 and 2050 due to climate change induced malnutrition, malaria, diarrhoea and heat stress combined 70,000 excess deaths in Europe (2003) and 56,000 excess deaths in Russia (2010)

*Climate Change and Health. WHO. Available at https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health

Slide10

Heat-Health

India24,223 death from year 1992-2015**National Guidelines for preparation of action plan-prevention and management of heat wave. National Disaster Management Authority. 2019

** Integrated Disease Surveillance Programme. National Centre for Disease Control

Year

Heat Related Illness Death**

2015

2040

2016

1111

2017

384

2018

25

2019

215

Slide11

Heat-Related Illnesses

Effects of exposure to heatDirectly heat related (Heat related illnesses)Contribute to worsening of respiratory and cardiovascular diseases, electrolyte disorders and kidney problems.TypesMinor

- Heat rash, heat edema, heat tetany, heat cramps, heat syncopeMajor- Exertion associated collapse, heat exhaustion, heat stroke

Slide12

Heat Related Illnesses-Minor

Heat rash

Heat tetany

Heat

edema

Diffuse, pruritic, maculopapular or vesicular rash

, often with insulating clothing

Mild

edema

of dependent areas like hands, feet and ankles

Rare and self limiting condition, seen in patients exposed to short, intense heat conditions

Slide13

Heat Related Illnesses-Minor

Heat syncope

Heat cramps

Painful, involuntary, spasmodic contractions of skeletal muscles

Seen with prolonged standing in hot environment

Slide14

Heat Related Illnesses - Major

Heat Exhaustion

Heat Stroke

Sweaty/diaphoretic

Dry skin

Central Nervous System function is preserved

Central Nervous System impairment

Core body temperature 37

0

C to 40

0

C (98.6

0

F to 104

0 F)Core body temperature 400 C to 440 C (1040 F to 11.20 F)Feeling overheated, lightheadedness,exhausted and weak, unsteady, feeling of vomiting, sweaty and thirsty, inability to continue activitiesSevere overheating; profound weakness; disorientation, notfully alert, convulsion, or otheraltered mental status

Slide15

Agencies

National Disaster Management Authority (NDMA) take the lead role in all sector coordinationMinistry of Health and Family Welfare (MoHFW)Emergency Medical Relief (EMR) is the main leading agency since 2015National Centre for Disease Control (NCDC)

Integrated Disease Surveillance Programme (IDSP) has an established structure upto sub-district level: surveillance since 2015National Programme on Climate Change and Human Health (NPCCHH) in 2019

Slide16

Ministry of Health & Family Welfare

Slide17

Content

Basic physiology of heat gain and lossEtiology and Pathophysiology of Heat related illnessesRisk factorClinical manifestationsManagement

PreventionPublic health action plan: surveillance, heat health event investigation, pre hospital and hospital care, logistic, training, awareness

Slide18

Integrated Disease Surveillance

Programme (IDSP)Programme under National Health Mission (NHM) with Objective

of “Strengthening of Disease Surveillance System for epidemic prone diseases to detect and respond to outbreaks”.

Organization StructureCentral Surveillance Unit (CSU)

State Surveillance Unit (SSU)

District Surveillance Unit (DSU)

Slide19

Diseases Under Surveillance

Measles Diphtheria Pertussis Chicken Pox Malaria

Dengue / DHF / DSS ChikungunyaMeningitisAES/JEEnteric Fever

Fever of Unknown Origin (PUO)Acute Respiratory Infection (ARI) / Influenza Like Illness (ILI)Snake Bite

Dog Bite

Pneumonia

Acute Diarrhoeal Disease (including Acute Gastroenteritis)

Bacillary Dysentery

Viral Hepatitis

Leptospirosis

Acute Flaccid Paralysis < 15 Years of Age

Any other State Specific Disease

Unusual Syndromes

Slide20

Heat Related Illnesses surveillance

Heat related illnessesNew cases reportedNew suspected deaths New confirmed deathsCumulative no.

Slide21

The 23 vulnerable States/UTs

Jammu & Kashmir

Punjab

Haryana

Delhi

Rajasthan

Gujarat

Maharashtra

Goa

Karnataka

Kerala

Himachal Pradesh

Uttarakhand

Uttar Pradesh

Bihar

Jharkhand

Arunachal Pradesh

West Bengal

Madhya Pradesh

Chhattisgarh

Odisha

Andhra Pradesh

Telangana

Tamil Nadu

Slide22

22

SN.

Name of the State

Cumulative no of cases reported due to Heat Related Illness

 

Cumulative no of deaths reported due to Heat

2015

2016

2017

2018^

2015

2016

2017

2018

1Andhra Pradesh285002180012832309142272323682Bihar10699010

217

-

Nil

0

2

3

Chhattisgarh

379

310

393

153

-

1

0

0

4

Delhi

Nil

8

269

253

-

-

0

0

5

Gujarat

58

447

463

775

17

7

0

3

6

Haryana

2

0

0

0

Nil

Nil

0

0

7

Jharkhand

177

1166

316

45

-

4

0

0

8

Karnataka

NilNil62-Nil209Maharashtra28686313538-79210Madhya Pradesh826254625842201-Nil3111Odisha207111931231359603617712Punjab2000NilNil0013Rajasthan412676246919-99114Tamil NaduNil11711019NilNil0015Telangana807##510720635264541324108016Uttar Pradesh47515582-Nil0017West BengalNilNilNil1-Nil01TOTAL33372351213956361372040111138425State wise distribution of cumulative number of cases and deaths due to heat related illness, India for 2015-2018

Slide23

23

SN.

Name of the State Cumulative no of cases reported due to Heat Related Illness

 Cumulative no of deaths reported due to Heat

1

Andhra Pradesh

956

29

2

Bihar

1466

121

3

Chhattisgarh

36604Delhi15705Gujarat58086Haryana007Jharkhand98108

Karnataka

0

0

9

Maharashtra

568

6

10

Madhya Pradesh

4338

2

11

Odisha

1733

0

12

Punjab

0

0

13

Rajasthan

161

3

14

Tamil Nadu

208

1

15

Telangana

1094

42

16

Uttar Pradesh^^

254

1

17

Kerala

1671

1

18

Goa

0

0

19

Uttarakhand

0

0

20

Jammu & Kashmir (Jammu Division)

2

0

Jammu & Kashmir (Kashmir Division)

5

awaited

21

West Bengal

awaited

awaited22Arunachal Pradeshawaitedawaited23Himachal Pradesh00TOTAL14540215State wise cumulative number of cases and deaths due to heat related illnesses, India for 2019

Slide24

District wise distribution of Heat Related Illnesses deaths in India 2019 (N=191)*

Slide25

Heat related illnesses deaths and maximum temperature recorded (

Tmax) on same day in respective block/mandal of four States, India 2019 (N=191)

25

Slide26

Distribution of heat related illnesses deaths according to maximum temperature recorded (

Tmax) on same day in respective block/mandal of Bihar, India 2019 (N=117)

Slide27

Distribution of heat related illnesses deaths according to maximum temperature recorded (

Tmax) on same day in respective block/mandal of Telangana, India 2019 (N=39)

Slide28

Distribution of heat related illnesses deaths according to maximum temperature recorded (

Tmax) on same day in respective block/mandal of Andhra Pradesh, India 2019 (N=27)

Slide29

Distribution of heat related illnesses deaths according to maximum temperature recorded (

Tmax) on same day in respective block/mandal of Maharashtra, India 2019 (N=8)

Slide30

Heat related illnesses deaths and maximum temperature recorded (

Tmax) on same day in respective block/mandal of four States, India 2019 (N=113)30

Slide31

Diseases Under Surveillance

Measles Diphtheria Pertussis Chicken Pox Malaria

Dengue / DHF / DSS ChikungunyaMeningitisAES/JEEnteric Fever

Fever of Unknown Origin (PUO)Acute Respiratory Infection (ARI) / Influenza Like Illness (ILI)Snake Bite

Dog Bite

Pneumonia

Acute Diarrhoeal Disease (including Acute Gastroenteritis)

Bacillary Dysentery

Viral Hepatitis

Leptospirosis

Acute Flaccid Paralysis < 15 Years of Age

Any other State Specific Disease

Unusual Syndromes

Slide32

Revised Surveillance Format-Draft

Instead of all Heat Related Illnesses (heat rash, heat cramps, heat syncope, heat exhaustion, heat stroke)Only Heat Stroke casesInstead of Suspected Heat Related Illness deathsAll cause mortality Suspected Heat stroke deathsConfirmed CVDOther

32

Slide33

Slide34

Slide35

Slide36

Death investigation form

SectionsDeceased’s identifier detailsDeath detailClinical history in past 24 hr before deathOutdoor activity just before onset of illnessIndoor conditions just before the onset of illness

Past Medical conditionsWeather data from IMD

Slide37

Hospital preparedness plan

Pre, during and post heat seasonPrimary health centre (PHC), Community Health Centre (CHC), District hospital (DH)/Medical CollegesInfrastructure and logisticsCapacity buildingIEC/Awareness

Slide38

Treatment protocol for Heat-related illnesses

Clinical Manifestations of heat related illnessesLaboratory workupManagement workflow of suspected heat stroke victims (periphery)Clinical workflow in emergency department

Slide39

System Operation

Reporting timeline and process

Slide40

Highlights of Heat Action Plan

40

Slide41

IEC Poster by NCDC

41

Slide42

IEC on Heat : Rajasthan

42

Slide43

IEC on Heat : Telangana

43

Slide44

IEC on Heat : Tamil Nadu

44

Slide45

IEC on Heat : Punjab

45

Slide46

IEC on Heat : Gujarat

46

Slide47

IEC on Heat : Karnataka

47

Slide48

Media on Heat : Rajasthan

48

Slide49

Media on Heat : Tamil Nadu

49

Slide50

THANK YOU