While awaiting rescue, swimming or treading water should be limited to conserve energy, and the person should attempt to remove as much of the body from the water as possible; attaching oneself to a buoyant object can improve the chance of survival should unconsciousness occur.Hypothermia (and cardiac arrest) presents a risk for survivors of immersion. This risk increases if the survivor—feeling well again—tries to get up and move, not realizing their core body temperature is still very low and will take a long time to recover.Most people who experience cold-water drowning do not develop hypothermia quickly enough to decrease cerebral metabolism before ischemia and irreversible hypoxia occur. The neuroprotective effects appear to require water temperatures below about 5 °C (41 °F). Diagnosis
The World Health Organization in 2005 defined drowning as "the process of experiencing respiratory impairment from submersion/immersion in liquid." This definition does not imply death or even the necessity for medical treatment after removing the cause, nor that any fluid enters the lungs. The WHO further recommended that outcomes should be classified as death, morbidity, and no morbidity. There was also consensus that the terms wet, dry, active, passive, silent, and secondary drowning should no longer be used.Experts differentiate between distress and drowning. Distress – people in trouble, but who can still float, signal for help, and take action. Drowning – people suffocating and in imminent danger of death within seconds. Forensics
Forensic diagnosis of drowning is considered one of the most difficult in forensic medicine.
The first virus isolates were obtained during this outbreak from mosquitoes and human blood samples collected from Gulu in northern Uganda in 1959.The second epidemic in 1996–1997 was confined to Uganda. The 35-year hiatus between the two outbreaks and evidence of an outbreak in 1904–1906 in Uganda indicate a 30–50 year cycle for epidemics.In 2013, ONNV was confirmed as the cause of disease in a 60-year-old German woman who became infected while traveling in East Africa. In 2015–2016 there was a minor outbreak in Uganda with 51 suspected cases.There has been a minor outbreak in Mombasa (Kenya) and the County Government of Mombasa issued a warning. A 2015 study indicated that ONNV is endemic in coastal East Africa, along with chikungunya virus. References


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