Upload
ursula-griffith
View
214
Download
0
Tags:
Embed Size (px)
Citation preview
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