In America when you hear people talk about diarrhea it’s usually in a whisper. It’s not something like to talk about in “polite company”. When they do talk about it they usually speculate about how they “got a bad piece of [insert food here] at the restaurant I went to last night”. If they are very forthcoming – and we all have those friends who seem intent on sharing TMI (too much information!) – they’ll tell you how they were up and back to the bathroom all night. Any self-serving comedy film targeted at US teenagers will include at least one scene where diarrhea compromises someone (who can forget these scene in the Ben Stiller/Jennifer Aniston flick “Along Came Polly”).
But the one thing that stands out about diarrhea in America is that you’re almost always talking to the person the next day because it rarely kills people in the United States.
Not so in the rest of the world where diarrhea claims the lives of nearly 1.5 million children every year. And yet, as a new joint report from UNICEF and WHO shows us, these deaths are easily preventable with full implementation of a seven-point plan. The cornerstones of this global plan are simple: improved nutrition, water, and sanitation; provision of life-saving treatments like zinc and rehydration solutions and expanded access to new rotavirus vaccines. In short, providing to children and communities around the world the basics that we take for granted here in the USA. Recently, more than 100 organizations worldwide issued a Call to Action encouraging decision-makers to commit the resources necessary to reduce diarrheal disease deaths.
Growing up in my household, talking about diarrhea was not unusual, it was the norm. My father has spent his professional life working on vaccines and treatments for cholera, typhoid fever, diarrhea and dysentery. So in our house it was typical for leading diarrhea researchers like Robert Black, Mary Lou Clements, Claudio Lanata, Roger Glass, Raj Bhan, and John Clemens to sit around our dinner table and discuss the latest in control of watery diarrhea or dysentery.
While dinner time discussions of diarrhea were often distasteful for my teenage ears, I did learn the truths behind some common myths around diarrhea that I will share here. First, improved water and sanitation are important for controlling diarrhea but they are not enough on their own. Rotavirus – the leading cause of fatal pneumonia worldwide – infects every child in the world regardless of how good their sanitation situation so vaccination is critical. Second, diarrhea is not always a mild disease. Even left unchecked, especially in very young infants, it can lead to serious dehydration. When dehydrated other systems start to shut down or malfunction and it can lead to death. Third, the best treatments of most cases of diarrhea are a simple solution of sugar and salts, often with zinc added, and not antibiotics. (No, Gatorade is not the right combination of sugars and salts.)
Diarrhea has unnecessarily taken the lives of too many children for too long. Perhaps one way to begin taking action against it is to start having a few more dinner time conversations about it. The teenagers at the table might be prone to making jokes initially. But who knows, maybe they’ll also learn that for millions of children and families around the world, diarrhea is no laughing matter.