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Infectious Diseases and Natural Disasters

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Infectious Diseases and Natural Disasters Background Historically, infectious disease epidemics have high mortality Disasters have potential for social disruption and ... – PowerPoint PPT presentation

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Title: Infectious Diseases and Natural Disasters


1
Infectious Diseases and Natural Disasters
2
Background
  • Historically, infectious disease epidemics have
    high mortality
  • Disasters have potential for social disruption
    and death
  • Epidemics are 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?

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, vectorborne

5
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

6
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

7
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

8
Population Characteristics
  • Density
  • Displaced populations
  • Refugee camps
  • Age
  • Increased elderly or children
  • Chronic Disease
  • Malnutrition
  • Heart disease
  • Transplantation

9
Population Characteristics
  • Education
  • Less responsive to disaster teams
  • Religion
  • Hygiene
  • Underlying health education of public
  • Trauma
  • Penetrating, blunt, burns
  • Stress

10
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11
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12
Pre-event resources
  • Sanitation
  • Primary health care and nutrition
  • Disaster preparedness
  • Disease surveillance
  • Equipment and medications
  • Transportation
  • Roads
  • Medical infrastructure

13
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

14
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

15
Epidemics after Disasters
  • San Francisco, 1907 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

16
Summary of Factors
  • Many factors play a role in disease development
    and outbreaks
  • Change and/or closing of public health measures
    play a big role

17
What infections would we see today?
  • Endemic organisms
  • Post-impact phase
  • Recovery Phase

18
Post-Impact Phase Infections
  • Crush and penetrating trauma
  • Skin and soft tissue disruption (MRSA)
  • Muscle/tissue necrosis
  • Toxin production disease
  • Burns
  • Waterborne
  • Gastroenteritis
  • Cholera
  • Non-cholera dysentery
  • Hepatitis
  • Rare diseases

19
Post-Impact Phase Infections
  • Vector borne
  • Malaria
  • WNV, other viral encephalitis
  • Dengue and Yellow fever
  • Typhus
  • Respiratory
  • Viral
  • CAP
  • Rare disease
  • Other
  • Blood transfusions

20
Recovery Phase Infections
  • These agents need a longer incubation period
  • TB
  • Schistosomiasis
  • Lieshmaniasis
  • Leptospirosis
  • Nosocomial infections of chronic disease

21
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

22
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

23
Conclusions
  • Early recognition of certain diseases in disaster
    setting important
  • Poor infrastructure and response has led to most
    increases in infectious diseases
  • know where you are going and what is endemic
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