Fear of Epidemics Among Earthquake Survivors

World Health Organization (WHO) released a FAQ on March 18 regarding health concerns in Japan following the devastating earthquake, tsunami, aftershocks, and nuclear accidents still on-going.

I see some possible inaccuracies in this FAQ, based on what we have learned in Haiti, but it is an excellent start.

The immediate health concerns after a natural disaster such as a tsunami are clean drinking water, food, shelter, and medical care for the injured and those with long-term medical problems. Winter weather conditions with snow and rain, in addition to a lack of shelter and limited power supplies, put people at increased risk of conditions caused by exposure to the cold weather.

Traumatic injuries are a primary concern. Injuries such as broken limbs and head injuries are caused by the physical impact of being washed along in the wave. As the water recedes, the strong suction of debris being pulled back out to sea through populated areas can further cause injuries.

Also, as I have posted elsewhere, what's in the debris can include all kinds of chemical and other contaminents, like dead bodies.  You don't want to be consuming food which may have been exposed to the debris, should be refrigerated but probably lost that for a while.

The risk of an outbreak of a communicable disease is associated with the size, health status and living conditions of the population displaced by the tsunami. Crowding, inadequate water and sanitation, poor access to health services, and sudden population displacement increase the risk of communicable disease transmission.

Think many people in a crowded shelter, some of them are sick.  Many of them without their daily medicine, such as the elderly.  Based on estimates of 2004, in the Tohoku region alone, there are 526,000 persons of above 80 years of age, with the largest age group between 50 and 54 years of age.

The risk assessment conducted by the Japan Infectious Disease Surveillance Centre (IDSC) and the National Institute of Infectious Diseases (NIID) on the current situation identified the following diseases with a high risk of outbreaks.

Acute respiratory infections and influenza-like illnesses are a major cause of illness and deaths among displaced populations. Lack of access to medical services can further increase the risk of deaths from acute respiratory infection.

Acute diarrheal diseases can occur when the drinking water or food is contaminated.

Vaccine-preventable diseases such as tetanus and measles.

People in the debris could easily have got cut by objects traveling along with them in the wave.

To prevent transmission of influenza in evacuation centres, the following measures can be done:

• Encourage hand hygiene with an adequate number of hand washing facilities and/or alcohol-based disinfectants
• Educate evacuees on proper cough/sneeze etiquette
• Ensure that evacuees with symptoms wear masks
• Keep room temperature/moisture at comfortable levels, if possible.
• Conduct proper diagnosis of suspected cases using a rapid test kit
• Consider Oseltamivir (Tamiflu) prophylaxis for high-risk contacts of confirmed cases.
• Consider isolating confirmed/suspected cases within the evacuation centre depending on the condition of evacuation centers.