Effects of Disaster and Public Health Challenges

The effects of disasters may be divided into health effects and other effects.

Health Effects

• Injuries & Deaths
• Emotional Stress and Psychological Reactions
• Epidemics
• Increase in indigenous diseases

Other Effects

• Food Shortage
• Disruption of Services / Infrastructure Damage
• Property Damage
• Environmental Damage

 

Post Disaster Public Health Challenges

Major Public Health Issues (Post disaster)

Environmental pollution

• Water Contamination
• Poor Sanitation

Malnutrition

• Protein Energy Malnutrition (PEM)
• Vitamin A deficiency

Epidemics

• Spread of infectious diseases

Causes of Outbreaks of Infectious Disease in Disasters

• Population displacement
• Environmental changes
• Loss of public utilities
• Disruption of basic health services
• Impact of food scarcity and hunger

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

Common Modes of Transmission

Person-to-person

• Measles, Meningitis, ARI

Feco-oral/Enteric

• Shigella, Cholera, Typhoid, Hepatitis

Vectors

• Malaria

Specific Infectious Diseases after Disasters

1. Measles
2. Acute Respiratory Infection
3. Cholera
4. Shigellosis
5. Malaria
6. Typhoid
7. Hepatitis
8. Meningitis

In displaced populations  80 –90% of deaths occur due to 5 conditions:

• Malnutrition
• Measles
• Acute respiratory infection
• Diarrheal diseases (Cholera, Shigella)
• Malaria

Diagnosis and Treatment

As there are large numbers of patients, limited resources and austere conditions, one has to rely on

• Clinical Diagnosis
• Empirical Treatment

Measles –diagnosis

a. Fever

b. 3 Cs

• Cough
• Coryza
• Conjunctivitis

c. Rash

Measles Vaccination

Early in the emergency situation

–      All children 6 months to 5 years

–      Long term situations children 9 months to 5 years

–      Any child vaccinated between 6 and 9 months -revaccinate at 9 month

If insufficient vaccine available, in order of priority

–      undernourished children 6 month to 12 years

–      all other children ages 6 to 23 months

–      all other children 24-59 months

Concurrent vitamin A administration

Acute Respiratory Infections

Acute respiratory infections are a leading cause of death among effected populations. Pathogens involved are a variety of viruses and bacteria.

Control:

Provide adequate space, shelter, clothing, blankets, and ventilation

Cholera –Diagnosis

• Severe dehydration
• Rice water stools
• Painless
• Huge volumes
• Vomiting

Shigellosis –Diagnosis

• Bloody stools
• Cramps
• Fever

Malaria –Diagnosis

• Fever
• Jaundice
• Cerebral symptoms
• Renal failure
• Splenomegaly

Vector Control Methods

1. Habitat Control
2. Reducing Contact
3. Chemical Control

• Insecticides, larvicides, rodenticides
• Repellents

Insecticide use must be monitored by professionals

4. Biological Control

Physical screens can be used to control immediate problem. For the longer term -make environment less favorable for the vectors.

Following steps can be taken as well:

Improve personal hygiene through:

• Sanitation
• Drainage
• Garbage disposal
• Food storage and handling practices
• Remove stagnate water
• Camp location

Vector Borne Diseases

Disaster environments are very conducive to the proliferation of diseases-carrying insects and rodents (vectors).

Diseases such as malaria, filariasis, dengue, yellow fever, encephalitis, scabies,   scrub typhus, plague, endemic typhus, relapsing fever, leptospirosis are vector borne.

Typhoid Fever –diagnosis

• Rose spots
• Fever
• Bradycardia

Hepatitis Diagnosis

• Fever
• Jaundice
• Malaise

Meningococcal Meningitis –Diagnosis

• Fever
• Headache
• Neck stiffness
• Purpuric rash
• Purulent CSF