Infectious Diseases and Natural Disasters. Background Historically, infectious disease epidemics...
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Transcript of Infectious Diseases and Natural Disasters. Background Historically, infectious disease epidemics...
BackgroundBackground
Historically, infectious disease epidemics have high mortality
Disasters have potential for social disruption and death
Epidemics compounded when infrastructure breaks down
Can a natural disaster lead to an epidemic of an infectious disease?
Are there emerging infectious diseases after a natural disaster?
What is an emerging infectious disease?
In 1991, Institute of Medicine attempted to define:
– “new, re-emerging, or drug resistant infections whose incidence in humans has increased within the past 2 decades or whose incidence threatens to increase in the near future.”
Phases of Disaster Impact Phase (0-4 days)
– Extrication– Immediate soft tissue infections
Post impact Phase (4 days- 4 weeks)– Airborne, foodborne, waterborne and vector diseases
Recovery phase (after 4 weeks)– Those with long incubation and of chronic disease, vectorborne
Factors for Disease Transmission After a Disaster
Environmental considerations Endemic organisms Population characteristics Pre- event structure and public
health Type and magnitude of the disaster
Environmental Considerations Climate
– Cold- airborne– Warm- waterborne
Season (USA)– Winter- influenza– Summer- enterovirus
Rainfall– El Nino years increase malaria– Drought-malnutrition-disease
Geography– Isolation from resources
Endemic organisms(exclusively native to a place) Infectious organisms endemic to a region
will be present after the disaster Agents not endemic before the event
are UNLIKELY to be present after Rare disease may be more common Unlikely a new or changed disease will
occur Deliberate introduction could change this
factor
Population Characteristics Density
– Displaced populations– Refugee camps
Age– Increased elderly or children
Chronic Disease– Malnutrition– Heart disease– Transplantation
Population Characteristics Education
– Less responsive to disaster teams Religion Hygiene
– Underlying health education of public
Trauma– Penetrating, blunt, burns
Stress
Pre-event resources
Sanitation Primary health care and nutrition Disaster preparedness Disease surveillance Equipment and medications Transportation Roads Medical infrastructure
Type of disaster Earthquake
– Crush and penetrating injuries (Skin and soft tissue disruption, Muscle/tissue necrosis, Toxin production disease, Burns).
Hurricane (Monsoon, Typhoon) and Flooding– Water contamination(Gastroenteritis, Cholera, Non-cholera dysentery, Hepatitis)
– Vector borne diseases(Malaria, viral encephalitis, Dengue and Yellow fever,
Typhus)
Tornado– Crush (see earthquake)
Volcano– Water contamination (see Hurricane)– Airway diseases (Viral, CAP (phenomena))
Epidemics after DisastersSan Francisco, 1907 Fires; Plague San Francisco, 1907 Fires; Plague
resulting from Quarantine failure resulting from Quarantine failure
Duluth, MN, 1918 Forest Fire; Duluth, MN, 1918 Forest Fire; Influenza resulting from crowding Influenza resulting from crowding and epidemicand epidemic
Italy, 1976 Earthquake; Salmonella Italy, 1976 Earthquake; Salmonella Carriers due to sanitation Carriers due to sanitation stoppage stoppage
Summary of Factors
Many factors play a role in disease development and outbreaks
Change of disease not likely to play role– Increase in rare diseases
Change and/or closing of public health measures play a big role
General disaster reminders
Vaccinations are the mainstay of outbreak control in many situations
Dead bodies pose little to no infectious disease risk; however this is debated
Early surveillance and hygiene can prevent outbreaks
Conclusions Infectious diseases may play a role
in the post disaster period These diseases will vary depending
on many factors If the disease is not present before
the disaster, unlikely to be there after