Post Disaster Public Health Challenges

Learning Objective

To discuss the major post disaster public health challenges and their preventive strategies.

Disaster Challenge

Major Public Health Issues(Post disaster)

Environmental pollutiono Water Contaminationo Poor Sanitation

Malnutritiono Protein Energy Malnutrition(PEM)o Vitamin A deficiency

Epidemicso Spread of infectitious diseases

Causes of Outbreaks of Infectious Disease in Disasters

Population displacementEnvironmental changesLoss of public utilitiesDisruption of basic health servicesImpact of food scarcity and hunger

Common Modes of Transmission

Person-to-person

o Measles, Meningitis, ARI

Feco-oral/Enteric

o Shigella, Cholera, Typhoid, Hepatitis

Vector

o Malaria

Specific Infectious Diseases After Disasters

MeaslesAcute Respiratory InfectionCholeraShigellosisMalariaTyphoidHepatitis Meningitis

Displaced Populations 80 –90% Of Deaths

5 ConditionsMalnutritionMeaslesAcute respiratory infectionDiarrheal diseases (Cholera, Shigella)

Malaria

Diagnosis and Treatment

large numbers of patients limited resources austere conditionso So Rely ono Clinical Diagnosiso Empirical Treatment

Measles -diagnosis

Fever

3 Cs Cough Coryza Conjunctivitis

Rash

Measles Vaccination

Early in the emergency situation– All children 6 months to 5 years– Long term situations children 9 months to 5 years– Any child vaccinated between 6 and 9 months -

revaccinate at 9 monthIf insufficient vaccine available, in order of

priority– undernourished children 6 month to 12 years– all other children ages 6 to 23 months– all other children 24-59 months

Concurrent vitamin A administration

Acute Respiratory Infections

A leading cause of death among effected populations

Pathogens Variety of viruses and bacteriaControl: Provide adequate space, shelter, clothing,

blankets, and ventilation

Cholera -Diagnosis

Severe dehydration

Rice water stools

Painless

Huge volumes

Vomiting

Cholera Cot

Shigellosis -Diagnosis

Bloody stools

Cramps

Fever

Malaria -Diagnosis

o Fevero Jaundiceo Cerebral symptomso Renal failureo Splenomegaly

Malaria Diagnosis

fever Pattern

Vector Control Methods

Habitat ControlReducing ContactChemical Controlo Insecticides, larvicides, rodenticideso Repellents

Biological Control

Vector Borne DiseasesDisaster environments are very conducive to the proliferation of diseases-carrying insects and rodents (vectors)

Diseases such as:Malaria, filariasis, dengue, yellow fever, encephalitis, scabies, scrub typhus, plague, endemic typhus, relapsing fever leptospirosis

Typhoid Fever Diagnosis

ROSE SPOTS

Typhoid Fever -Diagnosis

Fever, Bradycardia

Hepatitis Diagnosis

Fever

Jaundice

Malaise

Meningococcal Meningitis –Diagnosis

FeverHeadacheNeck stiffnessPurpuric rashPurulent CSF

Vector Control MeasuresPhysical screens can be used to control immediate problemFor the longer term -make environment less favourable

•Improve personal hygieneSanitationDrainageGarbage disposalFood storage and handling practicesRemove stagnate waterCamp location

Insecticide use must be monitored by professionals

Disaster Preparedness

• Pre-disaster Preparedness• Post-disaster Preparedness

• Efficient action at all levels to save lives• Reduce sufferings &• Minimize damage to property

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

SEQs1. What is a disaster? Classify natural disasters.

Enumerate the specific infectious diseases likely to spread after disaster.

2. Which of the 4 phases do you consider to be the most important? Support your answer.

3. Giving examples (from your own country) state situations where Disaster Management could have been better implemented.

4. In the case of a natural disaster, both govt and individuals are responsible for how citizens are affected. List 3 actions/activities/methods each for both govt and individuals, which can be carried out to mitigate the effects of a known natural disaster.

MCQ-1

• After the earth quake of 8th October 2005, Capital Development Authority issued a directive that in future all the buildings to be constructed in capital territory will be built on strong iron pillars so that the buildings can sustain earthquake shocks. In disaster management phases, action of CDA is included in:a. Disaster preparednessb. Disaster impact & responsec. Rehabilitation/reconstructiond. Mitigatione. Recovery

MCQ-2

• In a temporary camp, maximum distance between a dwelling and a toilet should be:

a. <6 ----->50 Metersb. <5------>45 Metersc. <4------>40 Metersd. <8------ >55 Meterse. <9------->60 Meters

MCQ-3

• In a transient camp, 3000 people are required to be settled. Minimum shelter space required for these refugees will be:

a. 11500 m2

b. 10500 m2

c. 13500 m2

d. 9500 m2

e. 6000 m2

MCQ-4

• In earth quakes:a. Injuries < deathsb. Injuries = deaths are equalc. Deaths <injuriesd. Cannot be calculatede. None of the above

MCQ-5

• Crude Mortality Rate (CDR=deaths/10000/day) is single most important indicator of serious stress in affected populations in a disaster hit area. If CDR is >2, it indicates situation is:a. Under controlb. Serious conditionc. Out of controld. Major Catastrophee. No catastrophe

MCQ-6

• More than 80 percent of all deaths in displaced populations are caused by following except:a. Acute Respiratory Infectionsb. Measlesc. Malnutritiond. Tuberculosise. Diarrhoea