Transcript Infectious Diseases and Natural Disasters

Natural Disasters
Infectious Diseases,
Insect Plagues and
Parasites
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)?
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
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
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)
Population Characteristics
 Density
– Displaced populations
– Refugee camps
 Age
– Increased elderly or children-more
vulnerable
 Chronic Diseases
– Malnutrition
– Heart disease
Population Characteristics
 Education
– Less responsive to disaster teams
 Religion-some don’t allow medicines
 Hygiene levels
– Underlying health education of public
 Trauma to body from disasters
– Penetrating, blunt, burns
 Stress levels post disaster
A REFUGEE CAMP- Infectious diseases thrive
SHANTYTOWN- Poor PLACES IN LDC’s/ LLDC’S WHERE
INFECTIONS SPREAD because of density and lack of health care
Pre-disaster resources: the
level of these determine the
extent the diseases thrive
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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
 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
Dominican Republic, 1979
 Hurricane David and Fredrick on Aug 31 and
Sept 5th 1979
 >2,300 dead immediately
 Marked increase in all diseases measured
6 months after the hurricane
– Thyphoid fever
– Gastroenteritis
– Measles
– Viral hepatitis
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
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
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
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
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)
The Black Plague
The Bubonic Plague of Medieval Europe
The cause of the plague
 It was caused by infected rodents that were carrying
“Pasteurella pestis." It’s 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.
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.
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.
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.
Ring around the rosy
connected to the plague?
 The child’s 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.
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".
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)
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 could’ve 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.
Who could help those who
were effected?
 For the people who were struck by this disease there
really wasn’t 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.
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.
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/5646aNGVlM/Insects_as_Disease_Vectors_powerpoint_ppt_
presentation
 HowStuffWorks Videos "Superswarm: Locust Plagues"