It's May already, and Thailand's summer heat is getting more intense. Excruciating outdoor temperatures, and electricity demands, keep hitting record highs. Three provinces -- Sukhothai, Lampang and Kanchanaburi -- were recently ranked among the 15 hottest places in the world by El Dorado Weather, with temperatures of up to 44C. The country's scorching weather this year has also set a record for the longest heatwave in at least 65 years.
The Ministry of Public Health has warned Thai people of the risk of falling victim to heatstroke. Yearly figures reveal an increasing number of deaths from between March and May, from 2013 to 2015 -- with 25, 28 and 56 people dying of heatstroke each year respectively. In March of this year alone, 11 heatstroke deaths were reported countrywide. According to the Bureau of Epidemiology, the majority of heatstroke-related deaths was found among people over 60 years of age.
As preventive protocol, the ministry has implored provincial health offices across the country to closely monitor people in their neighbourhoods, especially the seven high-risk groups, which includes those who work directly under the sun, such as farmers, soldiers and athletes; kids aged below five; the elderly; people with underlying illnesses such as heart disease and stroke; the obese; those with inadequate rest; and regular alcohol drinkers.
To help us understand heatstroke, neurologist Asst Prof Dr Phinit Limsukhon answers some of the most frequently asked questions about this heat-related medical complaint.
Does heatstroke mean too much exposure to strong sunlight?
Not necessarily, says Dr Phinit. Heatstroke occurs when the body temperature gets higher than 42C. And this can be the consequence of activities other than just standing in the sun.
"Heatstroke mostly attacks people who work in hot places with poor air ventilation, such as those whose job involves the use of burners and melting furnaces," he explained.
"This means these people can fall prey to heatstroke even when they do not work under the sun. Chefs who work in front of hot stoves all day might not develop heatstroke if their workplace is well-ventilated."
Are heatstroke and heat exhaustion the same?
Heat exhaustion is more common -- also a result of your body overheating. It's milder than heatstroke and involves symptoms like fatigue and dehydration. Heat exhaustion, when worsened, can become heatstroke. They're part of the spectrum of heat-related illnesses, but they're not really the same thing.
In normal circumstances, the body gets rid of excessive heat through sweating. But if the body becomes dehydrated, the mechanism to sweat cannot work properly, which means the body's cooling system begins to fail, allowing heat to build up to dangerous levels.
"The body's rising temperatures lead to enzymes in several organs not being able to work as they're supposed to," the neurologist added. "And brain cells are more vulnerable than any other parts of the body, so brain-related symptoms are among the first to appear."
"In serious cases, heatstroke is likely to lead to brain damage, organ failure, coma and death."
Is everyone at risk of suffering heatstroke?
Not everybody is at risk, said Dr Phinit. And it depends on several factors.
People with difficulties sweating, such as those with sweat-gland dysfunction, the elderly and small children are at higher risk of developing symptoms. People who are not physically fit or who drink a lot of alcohol are also more susceptible to heatstroke.
"People who take certain types of medication that play a role in the body's ability to sweat, such as allergy and antidepressant drugs, must also be more careful," he added. "Those who feel extremely thirsty but refuse to drink water for whatever reason are also at risk, if they stay amid the heat for long periods."
How do we know we are about to suffer heatstroke?
The prominent signs of heatstroke include facial redness, lack of sweat despite the heat, dry lips, intense thirst, decreased urination frequency and volume, extreme tiredness, rapid pulse and breathing, and eventually unconsciousness.
"The severity of heatstroke varies according to the body's temperature, how dehydrated the body is and how easily it can be rehydrated. It may take hours for the symptoms to progress to a coma. It's life-threatening, but only a minority actually die from heatstroke."
If heatstroke has something to do with extremely high body temperature, can we then take fever-relief medication to alleviate the condition?
Giving fever medicine to heatstroke sufferers is a must-not, says Dr Phinit. "Take people suffering from influenza, for example. Their body's mechanism to sweat and cool off works properly; as a result, chances are low that their fever will become fatal. Heatstroke occurs when the body fails to cool off. Fever relief will not help with that."
What are the standard treatments for heatstroke?
When it comes to heatstroke remedies, there are only two important things to note, says the neurologist. First, rehydration. Second, reducing risk factors. "If patients are still conscious, give them plenty of water," he advises. "If they can shower, then do it. Basically, treatments for heatstroke are similar to when a person passes out. Get patients to lie down in a cool, well-ventilated place as well as cooling or fanning their skin.
"In cases where symptoms are so severe the patient is in a coma, they need to be referred to a hospital immediately. They might require intravenous fluid-replacement therapy."
How much water is considered enough to reduce the risk of dehydration?
One simple indicator is urine colour throughout the day, says Dr Phinit. Hay-coloured urine is ideal. If it turns to something more like tea, then it's time to start drinking more water. When urine is so clear it looks like rainwater, then maybe there's been too much water intake, overworking the kidneys.
"The type of drink must also be taken into consideration when it comes to tackling dehydration," says the specialist.
"When the body falls short of water, the blood thickens and plain water is the best thing to treat such a condition. Drinking sugary beverages is not the right thing to do. Also, if you're suffering or recovering from heatstroke, avoid caffeinated and alcoholic beverages. The body needs rest, so soft diets are the way to go."
A mist fan at Somdech Phra Pinklao Hospital cools people off from the heat.
