North East
Preventive health in Sikkim
Altitude, landslides and scrub typhus define a small state's outsized acute risks.
What matters most in Sikkim
Scrub typhus
Why here: A significant cause of severe post-monsoon fever in the hills.
What to look for: Fever with a painless black scab, headache, swollen glands.
What to do: Ask for an eschar search; treatment is cheap and effective.
Altitude illness
Why here: Rapid ascent to high passes causes sickness that can progress to fatal fluid on the lungs or brain.
What to look for: Headache with nausea on ascent; breathlessness at rest or unsteady walking means descend now.
What to do: Ascend gradually, sleep low, and descend immediately if symptoms worsen — no summit is worth it.
Waterborne disease
Why here: Monsoon landslides disrupt spring-fed supply.
What to look for: Watery diarrhoea with vomiting or sunken eyes; yellow eyes; fever that persists beyond a week.
What to do: Boil or chlorinate drinking water, especially after landslides disturb the supply. Start ORS at the first loose stool rather than waiting for dehydration.
And everywhere in India
These are not specific to Sikkim, but they cause more illness nationally than anything above, and every one of them is covered free by a national programme.
Tuberculosis
Why here: Still India's deadliest infectious disease, in every state and every income group.
What to look for: A cough lasting more than two weeks, evening fever, night sweats, losing weight without trying.
What to do: Diagnosis and the full drug course are free under the NTEP at any government facility. Stopping early is what creates drug-resistant TB — finish the course.
Snakebite
Why here: One of India's largest causes of accidental death, and heavily rural. Most deaths are delays, not venom.
What to look for: Any bite from an unidentified snake. Drooping eyelids, difficulty swallowing or breathing, or bleeding that will not stop are emergencies.
What to do: Go straight to a government hospital with antivenom. Do not cut, suck, or apply a tourniquet, and do not go to a traditional healer first — that detour is what kills.
Rabies
Why here: Effectively always fatal once symptoms begin, and effectively always preventable before they do.
What to look for: Any bite, scratch or lick on broken skin from a dog, cat, monkey or bat. There is no safe wait-and-see.
What to do: Wash the wound with soap under running water for 15 minutes, then get the vaccine the same day. Free under the NRCP. A wound that looks trivial still counts.
Dengue
Why here: Present in every state and rising with urbanisation; the danger is the crash after the fever breaks.
What to look for: High fever with severe body ache, then — around day 3–7 — belly pain, vomiting, bleeding gums, or sudden exhaustion. That phase is the dangerous one.
What to do: Fluids and paracetamol only. Avoid ibuprofen and aspirin, which worsen bleeding. Empty standing water weekly — the mosquito breeds in clean water at home, not in drains.
The programmes named on this page
- NCVBDC — National Center for Vector Borne Diseases Control
- NTEP — National TB Elimination Programme
- UIP — Universal Immunisation Programme
- IDSP — Integrated Disease Surveillance Programme
- NRCP — National Rabies Control Programme
- NSCAEM — National Sickle Cell Anaemia Elimination Mission
Each is a real government programme, and the testing or treatment described is free at a government facility.
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