Smog over Mumbai: More kids on nebulisers, inhalers

MUMBAI: The air in Mumbai has been smog-ridden for close to a month now, and the effects on the populace are visible. Hospitals are seeing a surge in patients with wheezing, prolonged cough, upper respiratory infections, runny nose and fever, symptoms that indicate that viral activity and polluted air are causing massive morbidity.
Air quality has been swinging between 'poor' and 'very poor', leaving both adults and children with a host of symptoms which occasionally require hospitalisation. Dr NT Awad, professor emeritus of respiratory medicine at Sion Hospital, says the chest and fever outpatient departments have seen a 30% jump in cases since mid-December. Children and elders are among the worst affected, with those with pre-existing lung problems facing the brunt.
At Mahalaxmi's SRCC Children's Hospital, six of the nine ICU hospitalized children have a lung condition. "There is a definite rise in respiratory ailments, and it is sending even otherwise healthy kids to intensive care," said Dr Soonu Udani, medical director. The hospital has isolated an unprecedented number of respiratory syncytial viruses this season, which infect lungs and breathing passages.
Children particularly are experiencing prolonged wheezing episodes. Some with blocked noses and chest congestion are going on multiple rounds of hospitals. Pediatrician Dr Bijal Srivastava recalled a 14-month-old baby who was rushed to Hiranandani Hospital last week with blocked nose and laboured breathing. "The child was wheezing to the extent that he needed inhalational support (drugs directly pumped to lungs). Fortunately, we could prevent the child from going on oxygen support," she said. According to her, the season and pollution is leading to multi-trigger and viral-induced wheezing in children. "It is not asthma, but in these conditions, lungs and breathing tubes go into spasms," she said. Dr Udani cautioned that prolonged exposure could predispose children to small airway disease.
According to Dr Rakesh Kumar, former director of National Environmental Engineering Research Institute, the real burden of respiratory illnesses due to environmental factors is hidden. An informal study by medical interns had found almost 50% of residents in a housing society grappling with respiratory symptoms. "But many were taking home remedies or ayurveda, so your typical hospital statistics wouldn't even reflect them," he said.
Doctors have few solutions when parents seek advice. "We can't ask children to be kept at home, away from schools and daycare," said Dr Srivastava. One way, Kumar says, is to check construction activity. Monitoring how many trucks enter or leave a site through the night can be revealing. "A single massive site can affect pollution levels of an entire zone," he said.