Natural Disasters Infectious Diseases, Insect Plagues and Parasites

1
Natural DisastersInfectious Diseases, Insect
Plagues and Parasites
2
Background

• Historically, infectious disease epidemics have
  high mortality (AIDS, SPANISH FLU 1918)
• Disasters have potential for social disruption
  and death
• Epidemics are worsened when infrastructure breaks
  down (NO HOSPITALS)
• A natural disaster (Haiti hurricane) leads to an
  epidemic of an infectious disease (cholera)?

3
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.

4
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

5
Factors for Disease Transmission After a Disaster

• Environmental considerations
• Endemic organisms
• Population characteristics-pop.density, overall
  health, poverty
• Pre- event structure and public health
• Type and magnitude of the disaster

6
Environmental Considerations

• Climate
• Cold- airborne
• Warm- waterborne
• Season (USA)
• Winter- influenza YouTube - The H1N1 Swine
  Flu A Look Inside
• Rainfall
• El Nino years increase malaria (more flooding)
  in South America (Eastern Pacific) and more
  Drought (western Pacific/Asia)-malnutrition-hunger
  diseases (more detail in food unit on drought
  and famine)

7
Population Characteristics

• Density
• Displaced populations
• Refugee camps
• Age
• Increased elderly or children-more vulnerable
• Chronic Diseases
• Malnutrition
• Heart disease

8
Population Characteristics

• Education
• Less responsive to disaster teams
• Religion-some dont allow medicines
• Hygiene levels
• Underlying health education of public
• Trauma to body from disasters
• Penetrating, blunt, burns
• Stress levels post disaster

9
A REFUGEE CAMP- Infectious diseases thrive
10
SHANTYTOWN- Poor PLACES IN LDCs/ LLDCS WHERE
INFECTIONS SPREAD because of density and lack of
health care
11
Pre-disaster resources the level of these
determine the extent the diseases thrive

• Sanitation
• Primary health care and nutrition
• Disaster preparedness
• Disease surveillance
• Equipment and medications
• Transportation
• Roads
• Medical infrastructure

12
Type of disaster

• Earthquake
• Crush and penetrating injuries
• Hurricane (Monsoon, Typhoon) and Flooding
• Water contamination, vector borne diseases
• Tornado
• Crush
• Volcano
• Water contamination, airway diseases
• Magnitude
• Bigger can mean more likelihood for epidemics

13
Dominican Republic, 1979

• Hurricane David and Fredrick on Aug 31 and Sept
  5th 1979
• gt2,300 dead immediately
• Marked increase in all diseases measured
• 6 months after the hurricane
• Thyphoid fever
• Gastroenteritis
• Measles
• Viral hepatitis

14
Epidemics after Disasters

• San Francisco, 1906 Fires Plague resulting from
  Quarantine failure
• Duluth, MN, 1918 Forest Fire Influenza resulting
  from crowding and epidemic
• Italy, 1976 Earthquake Salmonella Carriers due
  to sanitation stoppage
• Haiti, 2010 Cholera after Earthquake Devastated
  the country
• U.N. says Haiti cholera protests may be
  politically motivated - CNN.com

15
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

16
Post-Impact Phase Infections

• Crush and penetrating trauma
• Skin and soft tissue disruption
• Muscle/tissue necrosis
• Toxin production disease
• Burns
• Waterborne illnesses
• Gastroenteritis (stomach diseases)
• Cholera U.N. says Haiti cholera protests may
  be politically motivated - CNN.com
• Non-cholera dysentery
• Hepatitis (affect liver function)
• Rare diseases like dengue (mosquito spread
  like malaria)
• YouTube - Thailand battles Dengue fever - 17 Oct
  08
• YouTube - The Ebola Virus Presentation

17
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

18
Classification System

• Biological Hazards
• -Infectious Disease (AIDS, H1N1)
• -Parasitic Disease (river blindness, tape worm,
  ring worm)
• -Insect Infestation (plague of locusts)
• -Plant Disease
• (Irish potato famine due to blight)

19
(No Transcript)
20
The Black Plague
The Bubonic Plague of Medieval Europe
21
The cause of the plague

• It was caused by infected rodents that were
  carrying Pasteurella pestis." Its an infectious
  disease that is transmitted when the infected
  rodent comes in contact with human beings. The
  plague was brought on usually by a rat or flea
  bite.
• The plague originated on the northern coast of
  the Black Sea where Indians had trading colonies.
  Often in the winter the plague came about because
  small rodents were looking for warm places to
  live and they chose peoples home. That whole
  family would be infected with the plague, and
  sooner or later the whole village or town would
  be infected.
• The Black Plague was responsible for millions of
  deaths. Most of the deaths recorded were in
  Europe.

22
Who or what was effected by the plague?

• The plague affected people on the northern coast
  of the Black sea. In 1346 it had reached Crimea
  near Turkey. Once the disease had reached Turkey
  and the Mediterranean it then went into the rest
  of Europe, but it had taken on a more aggressive
  form.
• It reached Sicily in 1346, Italy in early 1347,
  and towards the end of 1347 was in Marseilles,
  France. In 1348 it attacked Spain and spread
  throughout Germany and France. Early that same
  year the disease came to London, by 1349 was in
  Oxford and spread throughout England where it was
  present until 1359. Scotland was affected
  somewhat later. It was carried by rats on ships.
• It is estimated the roughly about 25 million
  people died from the Black plague.

23
Symptoms of the plague

• The symptoms were described as convulsions
  followed by a rise of temperature, with vomiting,
  headache, giddiness, intolerance to light, pain
  in the lower abdomen, back and limbs,
  sleeplessness, apathy and delirium. The body
  temperature varied greatly from 101º-107º but
  fell two or three degrees on the second or third
  day.
• The headache was described as splitting and the
  deliriousness similar to the DTs (delirium
  tremens), resulting from extreme drunkenness. The
  eyes became red the tongue swelled and became
  covered with a white fur except on the tip. Later
  the tongue became dry and the fur turned yellow
  or brown.
• Constipation was the rule but there might be
  diarrhea an even worse sign. A characteristic
  symptom in severe cases was that the patient
  appeared dazed and stupid, staggered and had
  slurred speech.
• The patient might die within 24 hours, but more
  commonly death occurred on the second or third
  day. Recovery was very rare.

24
The effects

• In Europe is plague was known as the black
  death", because of the discoloration of the skin,
  and the black tumors that occurred on the second
  day of the plague. The tumors were mostly in the
  groin area, in most cases the person would die
  with in 24 hours.
• The plague was also know as the poor plague
  because the first ones occurred in poorer parts
  of the towns.

25
Ring around the rosy connected to the plague?

• The childs song Ring around the rosy is said
  to have a connection to the plague
• Ring around the rosy Rose-colored areas of
  skin.
• Pocket full of posies- Sweet-smelling flowers
  that those tending the sick would carry to ward
  off the stench of disease.
• Ashes ashes- Impending death (or the sneezing
  and coughing of the plague).
• All fall down- Death.

26
What was done to help stop it?

• Efforts were made to stop the plague from
  spreading towns blockaded themselves, turning
  away travelers and refugees, but all it took for
  it to spread was one person to slip by.
• In the countryside it tended to work in pockets,
  missing some villages altogether and wiping out
  most of the population of others.
• In the towns the death rate ran at about 30,
  whilst some villages were abandoned, the
  survivors fleeing, creating "deserted villages".

27
Outlandish cures

• 1. Sit next to a blazing hot fire (as the Pope
  did) right through the hot summer of 1348.
• 2. Live in a house sheltered from the wind, and
  close all the doors and windows.
• 3. "The swellings should be softened with figs
  and cooked onions mixed with yeast and butter."
  Guy de Chaulliac
• 4. "Toads should be thoroughly dried in the sun,
  then laid on the boil. The toad will swell and
  draw the poison into its own body. When it is
  full, it should be thrown away and a new one
  applied." (A doctor's advice)5. "All human
  excrement and other filth lying in the city is to
  be removed." Letter from Edward III to the Lord
  Mayor of London, 1349.6. "Consume a medicine
  made from boiled onions and the gall bladder of a
  hare." (Another doctor's advice)

28
What could have been done to prevent this?

• If the countries that were effected had any idea
  that the Black Plague would be moving their way,
  and how it was contracted the could have been a
  few things they could of done to prevent it. They
  couldve tried to keep the rodent population
  down, have tighter security from the effected
  places not letting the people effected into other
  places that had yet to experience the plague.
• Even today there is no real cure for the black
  plague.

29
Who could help those who were effected?

• For the people who were struck by this disease
  there really wasnt much that could be done for
  them, since there was no real cure for it.
• For the family and friends that had a loved one
  that had been stricken with the plague all they
  could do is wait, and pray that their loved one
  would hopefully pull through it.

30
Conclusions

• Infectious diseases play a role in the post
  natural disaster period
• These diseases will vary depending on many
  factors like wealth, climate, geography, etc.

31
Conclusions

• Early recognition of certain diseases in disaster
  setting is important to nip it in the bud
• Travellers should know where they are going and
  what is endemic in that area. Make sure you get
  all proper medical needles before travel to areas
  with these diseases.
• http//www.powershow.com/view/5646a-NGVlM/Insects_
  as_Disease_Vectors_powerpoint_ppt_presentation
• HowStuffWorks Videos "Superswarm Locust Plagues"