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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

Cascading Causes and Emergencies

 

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

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