Water is the fuel for everything

Water borne diseases and prevention

Water is the most important of all the necessities for the sustenance of life. It is necessary for drinking, cooking, bathing, washing, ablutions, domestic sanitations and human industries. For drinking and cooking require very pure water and remaining require pure or clear water. Water can become a vehicle of a group of diseases or infections because the fecal contamination of water is extremely common, so that a strict vigilance and control to be maintained at all times. Water may create also unhealthy conditions if some organic and inorganic poisons like lead and arsenic are present and also absenting of fluorides cause dental caries and absence of iodine causes goiter. The water borne infections are cholera, diarrhea, dysentery, typhoid group of fever, hepatitis, poliomyelitis and some intestinal worms. Fae cal contamination of water supplies can occur by direct surface pollution through sewage, through leaking pipes, washing linen soiled by excreta by persons whose hands are soiled by infective material. Water borne epidemics are explosive and continue for some time even after the original water supply ceases to be the sources of transmission of infection. Rain water constitutes the primary source. A part of water received is evaporated on the surface of the earth, and a part is held upon the surface to form surface water and rest goes into the earth to form under ground water, so classified as rain water, surface water and underground water. Rivers and streams are natural drainage channels of the land. Avoidance of contamination and its subsequent purification is very difficult at all times especially during rainy season.

Selection and protection of water source

It is very important that to achieve a purified and safe water supply for human consumption, for which the proper source and tapping site should be selected keeping in mind the liability and degree of pollution and its dilution, power of self purification, daily yield, duration for which available, wholesomeness of water and approach to the area. Periodical inspection and repairs of the well should be carried out. The area around the source, taping point and delivery point should be protected against pollution by fencing and prohibiting entry of animals and unauthorized persons bathing and washing. Springs should be provided with coping and parapet.

The aim of water purification is to diminish organic and inorganic suspended impurities, pathogenic organisms and harmful salts and poisons in water. Clarification of water followed by sterilization by various methods renders the water safe for human consumption. Clarification removes suspended matters and sterilization kills intestinal pathogenic organisms. The elimination of harmful salts from water is a problem and no simple method has been devised yet in the field. Sterilization with out clarification may be carried out if water is beyond any doubt of pollution and visibly clear or under urgency. Some times water may appear clear that clarification may seem to be unnecessary. Hence, minute particles of suspended impurities may be present in clear water which may produce ill effects when consumed and also increase the deviation of chlorine used for sterilization. Filtration is superior sedimentation if the suspended matter is not too dense.Sterilization of water is carried out by chlorine. Boiling is the best method of destroying all living organisms. But it is not practicable to boil water for urban population or in large communities. Chlorine has been found very efficient to achieve the objects of water sterilization to eliminate ova,cyst and pathogenic organisms.

Water sterilizing method

Water sterilizing powder(wsp)is used as mixture of 80% bleaching powder and 20% quick lime known as also 'stabilized bleach' is used for water sterilization.Its available chlorine should not be less than 25 percent. Chlorine solution can maintain its strength for weeks if properly corked in brown bottles.

Purification of water in swimming pools can be carried out once a week at least 10 to 20 percent of the water should be replaced by a fresh inflow daily,when the continuous inflow or daily change of water is not possible.When the bath is emptied,the sides and floor should be thoroughly scrubbed and washed with lime before refilling.

Examination of water and its source of supply

The appearance and taste of waters afford no warning of contamination.there are 3 inspection of the laboratory methods are available known as the physical, chemical and bacteriological examinations each having its own merits. They are necessary while investigating the out breaks of water borne diseases and for a routine check on supplies in cities and towns,etc.Hygiene inspection of source and surroundings and site of water supply is conducted by making a plan and following it regularly. This should include the presence of any habitation on the bank of the stream or near the water source, presence of any water logging nearby,sanitation of the surroundings,presence of any waste disposal area, latrines or urinals,cattle sheds or horse stables in the vicinity or surface pollution especially including human and animal waste products and industrial wastes effecting the portability and purity of water. And also presence of amount vegetation in the vicinity in the water source or reservoir,use of source by local people and their health including presence of enteric fevers,infective hepatitis,gastrointestinal infections and etc,should be considered.The site for obtaining water for human consumption from the selected source should also be  properly examined before final selection.

Control action on occurrence of the diseases.

Drinking water must be super chlorinated, washing and bathing water should be chlorinated, milk must be boiled if not pasteurized or if any doubt has to the efficiency of pasteurization or any possibility of contamination after pasteurization,cream and butter should be obtained from reliable sources only, consumption of ice cream unless its origin is absolutely beyond suspicion, should be prohibited. Notification of occurrence of water borne diseases like cholera should be carried out to higher health authorities.Control of food and drink is the most important method of control of an out break of major water borne diseases, namely, diarrheas, dysentery, cholera, salmonella infections like typhoid, polio and leptospirosis.

Prevention

A safe and purified and adequately chlorinated and protected water supply and proper disposal of sewage and night soil,safe and protected milk supply,protected wholesome food,washed raw vegetables and fruits in super chlorinated water,healthy habits as regards eating,drinking and defecating,personal hygiene,a prohibition on employment of persons who may be carriers to handle food and water are the main important preventive measures.Regular preventive inoculation in epidemic areas is a single effective important measure.  

Yellow fever and prevention

1.It is an insect born communicable disease conveyed to human beings by the bite of an infected vector mosquito,Aedes aegypti and culex fatigans etc,caused by the causal organism is a specific filterable virus similarly related to dengue fever and characterized by influenza,Jaundice and presence of albumen in urine.It starts from a symptomless form and leads to severity rapidly fatal infection.The average mortality rate is about 10%.According to type of locality of occurrence the disease is distinguished as urban,rural or jungle yellow fever.It is not present in India.The main important animal reservoir is the monkey,in endemic areas approximately 30% monkeys are infected.Monkey is the only reservoir for jungle yellow fever.

2.Source of infection is by a infective human case or monkey is the root of spread of infection in an endemic area.The immediate source of infection for an individual is the infected vector mosquito which has fed a blood meal on an infective human case or monkey.Man possess no natural immunity against the disease.The main vector mosquito Aedes agypti  bites by day and by night which raid the outskirts of plantations;further spread in community is carried by Aedes agypti.Incubation period in human beings are 2 to 6 days and in mosquito vector species are 8 to 15 days depend upon climatic conditions.Mosquito remains infective so far the rest of its life.An infected person can spread infection for about 4 to 6 days,starting from 2 to 3 days after exposure to infection.It is to prevent the entry of such persons in India for which rigorous rules and regulations are enforced.

3.Even though the man possess no natural immunity against yellow fever,an attack of the disease confers full life time immunity.In certain places many adults are immune having had the disease,in their child hood .This immunity can be ascertained by the immune bodies in their blood  by the mouse protection test.Persons in non endemic areas do not have these immune bodies.Yellow fever is confined almost entire areas of of south and central America and to Africa.So far there has no cases of yellow fever in population  India.In India Aedes agypti is wide spread and persons possess no immunity against yellow fever.But yellow fever has not so far entered India due to strict regulations and their rigid enforcement.

4.Preventive measures.All people coming to or passing through yellow fever area are to be immunized against yellow fever,not  more than 6 years and not less than 15 days before entering the infected areas No one has been in a declared yellow fever area is to be allowed to enter India unless such a person ;has had the disease or has been inoculated with in 10 days before entering a yellow fever area.and 19 days before arrival to India or nine days elapsed between the date of leaving a yellow fever area and arrival in India.The person has been quarantined for the balance of the required period.Entry of animals from endemic areas is prohibited.Aircraft which has started from or landed
in a yellow fever area is disinfected by aerosols on arrivals in India,and anti mosquito measures in and around the ports and aerodromes are strictly carried out.

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Prevention from atomic disaster

During the end of the second world war in  1945,in  Hiroshima and Nagasaki in Japan use  of atomic energy as weopen of war was brought the necessity of providing special medical care  for the  victims. The destructiveness of an atomic bomb is due to the most  instantaneous transformation of an atomic energy. As per the formula of Einstein energy equals mass times the square of velocity of light,the fission of a single atom of uranium 235 will yield normally 200 million electron volts .th

come the construction of a weopen having 1000s times the destructive force of TNT. an atomic  explosion produces results due to blast heat radiation,secondary fires and ionising radiation and then taken up in the mushroom of blast and ionised and then gravitating over a long time on a wide area causing i |  contamination by blast hot radiation and secondary fires immediate delayed and persistent radiation. Effects will be inflicted upon living beings and plant life. In the case of burst on the ground or near ground level .the overall blast damage and destruction by heat flash and secondary fires would be less than in the case of an air burst. The heaviest destruction and concentration of persistent radiation will happen near the centre of the explosion. In case of under water burst there will be a minimum of physical damage from blast and fire. Although the proper gamma radiation would be largely absorbed by the water. There will be a radio active rain mixture   of mist and fog in wide area. The biological effects of an atomic explosion on the human body exposed to penetrating and non penetrating ionising radiation effects due to flash and fire and blast and pressure waves.

Effects of heat flash blast and radiation are the main causes of capillary bleeding
In various organs and tissues and necrosis and infections later on. These secondary effects are mostly directed or are due to delayed irradiation. Blood cells in bone marrow and germ cells and malignant cells of the skin and the cells of secretory glands are soon affected.

Protection against atomic explosion. Against explosive flashes and fire and blasts depending on distance from the point of explosion. Concrete reinforced
buildings and deep shelters and trenches etc.afford protection to some extent. Concrete brick and earth have great protective value. Inflammable items like wooden structure catches fire soon.  To avoid internal radiation by inhalation or radioactive air and dust in contaminated area or by ingestion of infected food and drinks no person should enter a contaminated area with out respirator or should not touch food or water unless it has been declared safe by a monitoring team.
The main difference between an atomic disaster and other heavy explosions are the suddenness and magnitude of the former event. Forty thousands to fifty thousands sick and injured excluding dead may occur as a result of one detonation. There is heavy blast damage from the epicentre to a distance of about two km. High wind produces to secondary fires. This is called as the fire storm and the areas by untouched the blast may thus be burnt out mostly. Suitable under ground shelters with thick non inflammable walls and roofs and monitoring of all suspected areas and subjects to be observed. Avoid entry into the area contaminated. Decontamination of persons and equipment at decontamination centres and periodical medical examination of rescue workers and cases of exposed to small doses of radiation. Prohibition of the consumption of suspected food,water, milk. Fruits vegetables, etc.

First aid treatment for atomic bomb casualties.

Treatment of burns. Burns caused by flash and fire will always carry a huge amount of patients. In order to reduce fatalities and disfiguring disabilities these cases will require special treatment. It is,therefore,require special treatment centres known as burn centres with sufficient accommodation.equipment,staff and adequate facilies are made available.
Burns may also be produced by beta particles received in fallout.so that.exposed patients must be thoroughly and quickly decondaminated under a shower with soap.

Multiple injuries. Injuries like fractures and wounds of parts boby will need surgical and sapportive treatment.ln addition to this.decontamination of these patients should be done as they might have received small doses of radiation.

Treatment of radiation injuries. Decondamination of all to  have been exposed radiation is the first procedure. A shower bath with soft soap is the initial  requrement. Early treatment of shock,maintenance water and electrolyte balance.etc.is esential. Then infection and anaemia are to be treated.

Prevention of delayed effects. Those case need constant vigilance.normaly the nervous system and gastro intestinal tract syndromes are lethal with in 2 weeks. People who develop feeling of vomiting and persistent of vomiting after exposure may require medicines and replacement of fluid if necesssry. In some cases it may be the symptoms of
Psychogenic origin. The main problem in survivors  will be associated with bone marrow depression.

The medical need will rise suddenly when radio active disaster occurs in thickly populated cities or industrial areas. Casaulity evacuation squards with special training are necessery. They must have suitable protective clothing. Most people with in a 15 km radius from the detonation of a megaton bomb will be killed by blast and heat.if they are not ln a blast resistant shelter. Training of the public and dessimination of information regarding atomic disaster must be carried out in peace time to make a sense of confidence ln them. Mefical and nursing staff and other staff shall have to be specially trained. Similiarly the relief organidations for the supply of food,water,clothing,etc for life of victims of the explosion are also necessary.
            

Pmkutty.

PREVENTION OF AIR BORNE DISEASES

The important droplet infections or air borne diseases are the common  cold,influenza,tonsilitis,meascles,nasopharingitis,mumps,whooping cough,cerebrospinalfever,rubella

chickenpox,smallpox,tuberculosis,diphtheria.Pneumonia and bronchitis follow upon the upper respiratory diseases followed with laryingitis,naseopharyngitis and tonsilitis.Air borne and droplet infections those which enter the body of the man through air passage and exist for disease causing organisms is the throat,nose of the person who suffers from the diseases or who is a carrier of that particular disease organisam.Such a carrier or patient throws out pathogenic bacteria/virus  through sneezing,coughing,spitting,shoutting or loud talking or laughing and even snoring or breathing.

Some of the small droplets mucoid particles may become air borne and with air current further away and happens much effectively in tthe case of virus,which is due its minute particles size,may cling to a minor particle of droplet.So that a patient suffers from a vital disease has good range of infectivity,even from breathing smoothly.Any one with in that range is liable to inhale the organism/virus-bearing the droplets.Respiratory infections may be transmitted indirectly through use of cups in hotels,canteens and in schools and in other public places,through fomittes,,for example,pillow cases and blankets,napkins and common towels or through childen using others articles such as pensils or toys.It can be transmitted through infected crockery,cutlery,glasses.Dry sweeping of living and sleeping rooms or hospital wards,sharing of blankets in hospitals carry infections between residents of the room.Droplet infections may be conveyed diphtheria,tuberculosis and so on.Air borne infections may make the upper respiratory tract itself their seat of action and a way of entry for infecting some organs or tissues for mumps,cerebrospinalfever,etc.The respiratory system horbours many virus,bacteria(organisms) for prolonged periods and those become virulant when the host loses its immunitty/resistance due to some other diseases like aids/hiv or due to debility.

Upper respiratory tract diseases form 75 % of of all respiratory diseases and man power wastage is the main loss due to respiratory infections.Common cold is the is the most common of all other upper respiratotry diseases continued closed by tonsilitis,nasopharyngitis and laryngitis.

Prevention and control; Prevention of over crowding,ventilation,protection from cold and immunisation against diseases like diphtheria and tuberclosis etc, and health education to public are the methods of prevention and control measures of air borne diseases and droplet inetions.Health education mailly aiming at inhibitting spitting around and promotting use of handkerchief and mottivating people to get immunised when necessary and when facilities are available.
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RODENT CONTROL AND PREVENTION OF DISEASES

               Rodents are the source and reservoir of more than 15 percent of animal borne diseases known up to till now.Rodents act as hosts to several parasites causing human and animal diseases.The flea is the most important parasite from the medical point of view.Rats are great destroyers of food grains and standing crops.They destroy more than 10 times they consume.They are nuisance to eggs and poultry which they eat and destroy more than other wild mammals.They cause damage to buildings,dams and structures.They destroy articles of clothing,furniture,leather,electric wires,etc.

They serve as international conveyers of epidemic diseases like plague,and it is noticed that the great plague epidemics in the past were due to migration of infected rats on ships from China to India,Middle east,Europe and South America.

2.Rodent control is obtained by denying them nesting,breeding and hiding places and also denying them food and destroying them.To achieve these measures are anti rodent hygiene,anti rodent engineering,anti rodent house keeping and active and combined destruction measures.Trapping and poisoning are the two main proceedures are normally used for the destruction of rats.Rats enter houses through drain pipes left open,through doors and windows and out side,fittings,through the lower parts of the doors,ventilators,unused chimney flues and so on.The doors and windows must be tight fitting and reinforced with metal sheets to keep the rats from destroying through the basement and upper windows.All water and drain pipes should be surrounded by concrete where they pierce the walls.The main sanctuaries for rats are the provisional stores,markets,slaughter houses,diary farms,restaurents,bakery,shops and human dwellings,etc in cities,and corn godowns,cattle sheds,piggeries etc are in rural areas.which afford them nesting,breeding and feeding for rats.In rural areas the field rats can not be controlled by rat proofing of houses and godowns,for there is a continual sufficiency of food.Rat burrows can be closed with mixture of cement,sand and broken glass.Provision stores should be protected by wire screens.In rural and urban areas the access of rats to places where they can secure nesting facilities and food should be barred.Garbage and offal must be disposed of by burning.A very high standard of sanitation and general cleanliness in and around houses,godowns,factories,provision stores,market places and slaughter houses avoids the rat of places for nesting,breeding and resting.Trapping can reduce the population of rats soon,if the the traps are properly set and baited.For destruction of rats poisoning campaign should be carried out.The main natural enemies of rats are the cats,eagles,vultures,owls,foxes,mangoose and dogs etc.Some of these may help to reduce the rat population to some extent,none of them is practicable value in the rat control programmes.Diseases mainly conveyed to human beings are Rat fever/Weil's disease,(Leptrospirosis),Rat bite fever,Plague,Murine Typhus,etc.

3.Leptospirosis/Weils disease(Rat fever).This is commonly known as Weils disease.This a sudden infection characterised in human beings by fever,albumen present in urine,bleedings,head ache and pains in the body,skin rashes,enlargement of liver and excretion of bile in urine and loose motions and abdominal pains.The natural reservoir and source are rats and field mice.These rodents are tolerant to this disease and do not suffer.The organism is excreted in their urine and faeces.The immediate source of infection to man is through contact with soil contaminated with infective excreta,specially urine.The entry in man is through microscopic cuts and abrasions sustained during works in soil,drains,sewers or bathing in contaminated water  also may give rise to out breakes.The out breaks may occur among farmers,miners and fishermen,etc.The incubation period is a week rarely up to 13 days.The patient's urine may be infective from the end of first week onwards from ten to 25 th day,but may extend upto 60 days in some rare cases.Rats are infective throughout their life.Man possess no natural immunity.the disease can be severe or mild course depending on the type of infecting organism.This disease is prevalent Japan and most countries in Europe and Asia.

4.Prevention and control:Rodent control in costal areas and sewers in urban areas.Swimming in infected pools should be avoided.Attendants should wear protective clothing.Disinfection of articles used by patient daily and also terminal should be ensured.Protective clothing for workers,speacially in trenches,sewers,divers.
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EFFECTS OF EXTREME HOT CLIMATE AND PREVENTION

1.Now a days progressively increasing the sorrounding temperature,evaporative regulation some times, causes some sorts of weakness,sleeplessness and cramps and also severe imbalance leads to heat stroke,or dehydration causing heat exaustion and both syndromes are distigushable and require different treatment measures.Heat stroke condition happens  a result of an excessive raise in body temperature.When sweating  and its evoporation are sufficient the thermal loss maintain the body temperature and continue to do,so until to fill up again the water level is maintained.The thermoregulatory mechanism may fail if the internal conditions are adverse,such as relative deficiency of water in the body or if the external conditions may unbearable under intense solar radiation,high temperature or very hot winds.Heat exhaustion occurs more commonly than heat stroke.In heat exhaustion the main effects are not due to the rise of body temperature as in the case of heat stroke and not so much due to excessive sorrounding temperature,but are the result of water and salt exhaust due to excessive sweating.The reasons are:-

2.Very high temperature causes excessive sweating. High temperature and very high atmospheric humidity or stagnant air retard efficient evaportion of sweat which drips off the body as useless perspiration with out causing body cooling.
3.Water requirement in hot weather is higher than in cold weather or a temperate climate.If water intake is also reduced,its excretion also is reduced.But normal water loss necessary to remove the toxic metabolic products has to continue in concenterated urine.
iii.Excessive sweating also causes salt excretion.Normally 15 grammes of salt intake is required daily.Any salt taken over this daily necessary is excreted in the urine.If the intake is reduced or excretion in sweat is increased,salt is conserved by diminishing its excretion in the urine.
4.Water constitutes about 70% of the body weight or about 50 litres.Out of which 30% or 15 litres is extracellular  and 70% or about 35 litres is in intracellular comparments,75% of extracellular fluid or about 11 litres exists as tissue fluid and 25 % or about 3 litres as circulating plasma.Maintainance of the fluid balance and its relative distribution in the 3 compartments of the body is important for the health of the cells and tissues and is kept constant.

5.Other effects of heat are Heat cramps and Prickly heat which occur due to intracellular over dehydration and hyperactivity of acrine sweat glands respectivily.It is due to non adaptation to hot climate and fatigue,more in the cases of Heat cramps.Any muscle may go into cramp,but fatigued muscle is more susceptible.

6.The effects of heat are widespread in the subtropics in the hot season.They occur less commonly in the tropics than generally expected or supposed,especially heat stroke.The centres of heat are the shores of Persian Gulf and the central and north western plains of India.The great majority of cases occur in Punjab.Most cases occur during the week or two prior to the onset of the mansoons and during breaks of the mansoons when atmospheric temperature and humidity is very high.In the north
and west the dangerous period is towards the end of June or later.In central India it is in mid-June.While in south and eastern India it is in May and early June are critical periods.During the hot weather it can happen any part of India.Onset of heat strock is sudden and heat exhaustion is gradual.High atmospheric temperature is the most important primary cause.Adapted men can withstand temperatures of even 43 digree centigrade in a dry atmosphere.when the temperature rises to 46 or so in the presence of wind vilocity of more than 35 km per hour,the danger point approaches and  the heat stroke may occur.Constant exposure to the sun glare is irritating to the point of causing distress,headaches,mental irritablity and actual exhaustion.High atmospheric humidity is an important factor in the causation of heat effects.Air movement is also an important atmospheric factor which decides the human thermal comfort.The combination contributes a greater heat load to the body and produces discomfort with a temperature of 43 digree centigrade and relative humidity of 20% as obtained in the punjab.Fluid loss in excessive sweating affects cooling capacity of the body.In the plains of India in hot weather,the minimum water loss in sweat and urine by an individual doing moderate work is 8 litres a day.Prolonged work in close places is more harmfull than in the open areas.Overcrowding increases the temperature and humidity of the room and bad ventilation aggravates these conditions.lack of sleep and rest are predisponding factors.Food requirement of persons in hot weather is the same to which they are accustomed.Rapid consumption of alcohol in large quantities may increase the attack.
7.Prevention of effects of heat:-The fluid intake must be enough to produce sweat and compensate for loss of water in it.The salt intake should compensate for its excessive loss in sweating.Rest and sleep must be adequate as the recovery must compensate for the work.Adaptation is the most important and valuable preventive measure against the effect of heat.The ability to do hard work in a hot climate can be achieved in about 2 -3 weeks by gradual habitation procedure.Bathing must be ensured every day,where it is possible arrangemade should be made on the banks of a running stream as it is benificial.Improved shower baths also are of great value.An active,healthy,clean skin is an important agent for dissipation of heat through radiation,convection and evaporation.Clothing must be normally light and loose and permeable to water and air.Houses must be spacious,well ventilated and cool.Health education to all in preventive measures is important by giving simple talks on the causes and prevention of the effects of heat and simple precautions to avoid the risk of developing them.People should be educated to recognise the early symptoms of effects of heat such as weakness,headache,giddiness,absence of thirst and feeling of vomiting.
8.First aid and early treatment:- This is important and necessary to arrest the progress of the illness and avoid permanent neurological injury and save life.All must be prepared to act soon in case of emergency.Temperature must be rapidly reduced by spraying cool water(not ice cold) and fanning,thirst is put out by giving enough cool water,but not too much.When cooling is reduced it falls to 39 digree centigrade the patient is removed to heat stroke centre.Dehydration is treated by the administration of fluids and elecrtolytes.Cases of pure water loss hould be given water only.In serious cases with anorexia,nausea and vomiting with hypertension/hypotension should be transfered to nearest hospital for further management.

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FUNGAL INFECTION - RING WORM-CONTROL AND PREVENTION

1.Fungal infections like Ring worm are common in hot-damp areas and some people escape from those infections completely.There is always an improvement in  dry season when less cases occur and they are not severe.Person always sweat more, suffer more.Mild cases normaly becoming severe by friction and sweating,rendering the sufferer unable to do work.The main areas like sweaty areas of the body which are liable to be exposed to friction such as armpit,groin and in between the toes.

2.Ring worm causes by Dermatomycosis,a group of fungi,large number present in nature,infects skin,nails and hair in which are only few pathegenic to human beings with out giving rise to the diseases of  internal organs.The main manifstation of the fungal infection of the skin is a ring like a lesion ,so it is called ring worm and also called Teania.The manifestations vary according to the site infected and the species of fungus affected.Infections of armpits ,scalp and nails are less locally,but in children any part of the body may be affected and they are susceptible which subsides as they grow.In adult men the feet are commonly affected and known as 'Athelet'foot,In women certain varieties of fungus are uncommon.The ring worm of certain type affecting the skin between underneath the toes and producing sogginess,peeling and fissuring etc,accompanied with foul odour.

3.The resorvoir and source of infection in local areas is a person suffering from an infection.Other main source of infection is the animal reservoir.It causes more inflamatory resistant lessions than human beings.Direct contact is an important mode of transmission.The roll played by toilet seats,bath places and boards,towels,etc,in transmission of fungal infection from one to another may be possible.Undergarments may play some roll but still it has been not proved.The combs and barber's shears and clipers are a factor in trasmission of certain fungal infection.The shoe of an infected person will transmit the lesions  in him.After getting infection,friction and increased temperature allow to grow the disease.In fact the liability of growth of the skin diseases of fungal infection is dependant chiefly upon these factors rather than the contraction of infection alone.Personal hygiene and health education are very important roll in controling and preventing skin diseases.

4.Clothing should be loose and not irritating with special care in drying and keeping dry.Areas between the toes and armpits and etc,should be more carefully dried after a bath,sports men or excessive sweating due to any cause.Application of dusting powder before wearing socks and shoes and under garments for the day,helps in maintaining the skin dry in these areas.Men should not exchange each others towels,foot wear and items of underclothing.General cleanliness in ablution rooms and swimming baths have helped in preventing infection up to certain extent,Floors and duckboards must be scrubbed and washed with cresol or bleaching powder.Coconut coir matting should not be usd in bathing places as it remains always wet.

5.The control of spread of infection of ring worm in a community is bound with early detection and proper treatment of all cases suffering from ring worm infection.Dryness of skin is the most important factor in curing infection.Proper drying of the toes after bathing or removing the shoes must be carried out,All dead skin should be removed by a washcloth daily.Aeration of feet by wearing sandal or chappal may be helpful.Through mechanical drying and protection may be helped by inserting absorbent cottan wool into the interspaces.Dusting of the toes with foot powder may also be done once or twice a day but not in acute cases,as a preventive measure.socks must be changed washed and dried in all days.Rest is necessary in severe ring worm infections.Treatment measures should be carried out under the supervision of dermatologist's advice in Severe cases and may require admission in hospitals.It is always better to refer to a dermatologist for his investigation and treatment in complicated cases to find out the correct diseases and treatment and follow up.

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