Infectious Diseases and Natural Disasters. Background ï‚§ ï‚§...
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Infectious Diseases and Natural Disasters Slide 2 Background 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? Slide 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. Slide 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 Slide 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 Slide 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 Slide 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 Slide 8 Population Characteristics Density Displaced populations Refugee camps Age Increased elderly or children Chronic Disease Malnutrition Heart disease Transplantation Slide 9 Population Characteristics Education Less responsive to disaster teams Religion Hygiene Underlying health education of public Trauma Penetrating, blunt, burns Stress Slide 10 Slide 11 Slide 12 What infections would we see today? Endemic organisms Post-impact phase Recovery Phase Slide 13 Pre-event resources Sanitation Primary health care and nutrition Disaster preparedness Disease surveillance Equipment and medications Transportation Roads Medical infrastructure Slide 14 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)) Slide 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 Slide 16 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 Slide 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 Slide 18 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 Slide 19 Conclusions Early recognition of certain diseases in disaster setting important Halting infrastructure and response has led to most increases in infectious diseases know where you are going and what is endemic