3. Disaster definition
Any occurrence that causes damage,
ecological disruption, loss of human life or
deterioration of health and health services on
a scale sufficient to warrant an extraordinary
response from outside the affected community
or area.
Emergency:
Any occurrence which requires immediate
response
(community is capable of coping)
4. Complex emergency
A state where the normal social order has
collapsed to the extent that national authorities
are no longer able to cope with the
administration of their country.
Examples
wars and civil strife
Armed aggression
Other actions resulting in displaced persons
and refugees
5. Types
Atmospheric:
• Storms, hurricanes,
tornados
Geologic:
• Earthquake,
landslides
Hydrologic:
Flooding, tsunamis
Biological:
• Epidemics of
communicable
Accidents:
• Transportation accidents
• Collapse of buildings, dams
and other structures,
• Mine disasters
Technological failures
• nuclear power station or
leak at a chemical plant
Civil disturbances, terrorism:
War and refugee
Natural Man made
6.
7. Classification by time
Sudden,
acute onset
• Geological and Climatic hazards
• Epidemics of diseases
Chronic,
creeping
• drought, famine
• environmental degradation, deforestation
• chronic exposure to toxic substances
10. Biological disaster
Biological disasters define the devastating
effects caused by an enormous spread of a
certain kind of living organism-that may spread
a disease or infestations in human, plant,
animal or insect life on an epidemic or
pandemic level.
Communit
y
Country
World wide
11. Causes
Biological agents bacteria, virus, fungi,
parasites.
A. Already present ( antigenic shift or genetic
drift, altered immunity)
B. new emerging
Biological toxins
Bioterrorism
12. Categories of biological hazards
(Biosafety level)
BSL1
• canine hepatitis, Escherichia coli, varicella
• Precautions are minimal, most likely involving gloves and some
sort of facial protection
BSL 2
• hepatitis A, B and C, some influenza A strains, Lyme disease, salmonella,
mumps, measles, dengue fever, HIV.
• cause only mild disease to humans, Require more extreme precautions,
the use of autoclaves for sterilizing.
BSL 3
• anthrax, West Nile virus, , SARS, MERS, yellow fever, and malaria
• It requires much more safety protocols including the use of respirators to
prevent airborne infection. Biological hazards in this group generally
have known vaccines or treatments.
BSL 4
• Marburg virus, Ebola virus, Lassa fever virus, small pox
• fatal to humans for which there is no known treatment or vaccine
• Drastic measures
14. Risk factors of communicable diseases
spread
Presence of pathogens
Displacement of population
Change in environment
Lack of basic health services
Disruption of basic public facilities
Food shortage
Altered individual resistance to diseases
15. Displacement: Primary
Concern
The risk for communicable disease transmission after
disasters is associated primarily with the size and characteristics of
the population displaced, specifically
the proximity of safe water and functioning latrines
the nutritional status of the displaced population
the level of immunity to vaccine- preventable diseases such
as measles
the access to healthcare services
The breakdown in living conditions following disasters may
increase the exposure to vectors and transmission of
plague, louse borne typhus and relapsing fever other vector
borne like malaria and dengue.
The incidence of dog bite and risk of rabies may increase
as neglected strays come in close contact with persons
living in temporary shelters
16. Dead Bodies and Disease
The sudden presence of large numbers of
dead bodies due to the natural disaster in the
does not a risk for epidemics.
Dead bodies only pose health risks in a few
situations that require specific precautions,
such as deaths from cholera, anthrax or
hemorrhagic fevers
18. Water borne diseases
TreatmentDiagnosisIncubation
Period
Clinical FeaturesDisease
rehydration
therapy;
antimicrobials
direct
microscopic
observation of
V. cholera in
stool
2 hrs - 5 daysprofuse watery
diarrhea, vomiting
Cholera
penicillin,
doxyxycline,
erythromycin,
cephalosporins
leptospira-
specific IgM
serological
assay
2 - 28 dayssudden onset fever,
headache, chills,
vomiting, severe
myalgia
Leptospiro
sis
supportive care;
hospitalize/
barrier nursing
for severe
cases;
monitoring of
detecting
anti- HAV of
anti-HEV IgM
Antibodies
15 - 50 daysjaundice, abdominal
pain, nausea,
diarrhea,
fever, fatigue and
loss of Appetite
Hepatitis
19. Water borne diseases
TreatmentDiagnosisIncubation
Period
Clinical
Features
Disease
ampicillin;
hospitalize
seriously ill or
malnourished;
rehydration
suspect if
bloody
diarrhea,
confirm by
isolation of
organism
12 - 96 hrsmalaise, fever,
vomiting,
blood and
mucous in
stool
Bacillary
dysentery
ampicillin,
trimethoprim
sulfate,
ciprofloxacin
culture from
blood, bone
marrow, bowel
fluids; rapid
antibody tests
3 - 14 dayssustained
fever,
headache,
constipation
Typhoid fever
ORSclinical1- 4 daysDiarrhea,
vomiting
Viral
Gastroenteritis
20. Vector borne diseases
TreatmentDiagnosisIncubatio
n
Period
Clinical
Features
Disease
chloroquineparasites on
blood
smear observed
using a
microscope; rapid
diagnostic
assays
7 - 30
days
fever, chills,
sweats, head
and body aches,
nausea
and vomiting
Malaria
intensive
supportive
therapy
Serum antibody
testing with
ELISA or rapid
dot-blot
technique
4 - 7 dayssudden onset
severe flu- like
illness, high
fever,
severe
headache, retro
orbital pain
Dengue
22. Air borne diseases
TreatmentDiagnosisIncubatio
n
Period
Clinical FeaturesDisease
co-
trimoxazole,
chlorampheni
col
ampicillin
Clinical, culture
respiratory
secretions
1 - 3 dayscough, difficulty breathing,
fast breathing, chest
indrawing
Pneumon
ia
supportive
care; vitamin
A; antibiotics
in
complicated
cases
generally made
by clinical
observation
10 - 12
days
rash, high fever, cough,
runny nose, red eyes;
serious post measles
complications (5-
10% of cases) - diarrhea,
pneumonia
Measles
Penicillin,
chlorampheni
col,
ceftriaxone,
Examination of
CSF, elevated
WCC, protein;
gram negative
5 - 15
days
Sudden onset fever, rash,
neck stiffness; altered
consciousness; bulging
fontanel in <1 yrs of age
Bacterial
meningiti
s
24. Phases of disasters
• Most of deaths, injuries
• Extrication of victims
• Immediate soft tissue infections treatment
Impact Phase (0-4 days)
• Airborne, foodborne, waterborne and vector diseases
• Prevent more spread of infection, stabilization
Post impact phase (4 days – 4 weeks)
• Infections with long incubation (TB) and of chronic disease, vector
borne
• Reconstruction
Recovery phase ( after 4 weeks)
25. Diseases by disaster phases
Impact
Deaths
Injuries
Hypothermia
Dehydration
Injury site
infection
Post impact
Airborne, flu
Waterborne, GE
vector diseases
Tetanus
Recovery
TB
Schistosomiasis
Lieshmaniasis
Leptospirosis
Nosocomial
infections of
chronic disease
26. Disaster management
Is more than just response and relief (i.e., it assumes
a more proactive approach)
Is a systematic process is based on the key
management principles (planning, organizing,
coordinating and controlling)
Aims to reduce the negative impact or consequences
of adverse events (i.e., disasters cannot always be
prevented, but the adverse effects can be minimized)
28. Risk analysis
Is a situation that
has the potential for
causing damage to
life, property and the
environment
Is the probability
that an injury or
damage will occur.
Hazard Risk
29. Risk analysis
Factors makes the
community more fragile
and less able to cope
with or recover from an
adverse event.
It comprises poverty,
social exclusion, and
inequity, illiteracy,
inadequate or
inequitable access to
basic health and
development services.
Is the susceptibility
of damage to life,
property and the
environment if a
hazard reaches its
full potential
Susceptibility Vulnerability
30. Response
Response measures are those, which are
taken immediately, prior to and following
disasters.
Such measures are directed towards saving
life and protecting property and dealing
with the immediate damage caused by the
disaster.
Its success depends vitally on good
preparedness.
31. Response to biological
disaster Establishment of diagnosis, epidemic
Risk and vulnerability analysis
enhance public health surveillance
seek national assistance/guidance to Set case definition, put
guidelines
Control of epidemic
1. alert hospitals and healthcare providers of the threat
2. prepare alternative care facilities
3. prepare to distribute medications
4. triage, tagging, dealing with dead bodies
Prevent spread:
1. Pharmacological: immunization, chemoprophylaxis
2. Non pharmacological: isolation, quarantine
3. Infection control precautions
32. Response to disasters
Search, rescue and first‐aid:
Most immediate help come from uninjured survivors.
Field care:
1. Availability of ambulatory health facilities
2. Bed availability in nearby hospitals
3. Medical & surgical services
Triage
tagging
name, age, place of origin, triage category, diagnosis & initial
treatment
Dealing with dead bodies
Removal of the dead from the disaster scene, use of body bags if
badly damaged
Identification
Reception by relatives
New burial areas sited at least 250 meters away from drinking
water sources
33. Triage
Rapidly classify the injured on basis of Severity of
their injuries, and Likelihood of their survival with
prompt treatment
At the site of disaster
Four color code system:
34.
35. Relief phase
Assistance from outside starts to reach disaster area
(6- 24hs).
Type & quantity of relief supplies depends upon:
Type of disaster
Type and quantity of supplies available locally.
Rapid damage assessment
Surveillance and disease control
1. Implement as soon as possible all public health
measures to reduce the risk of disease transmission
2. Organize a reliable disease reporting system to
identify outbreaks and to promptly initiate control
measures
36. Role of vaccination
Vaccination is recommended to health
care workers but not for population in
relief phase.
Why?
Compliance, Sterilization, Human
workforce
Cold‐chain should be maintained
vaccination for general population have
role in recovery phase
37. Nutrition
Infants, children, pregnant & lactating women, sick
persons.
Steps to ensure food relief:
1. Assessing the food supplies after the disaster
2. Assessing the nutritional needs of the affected
population.
3. Calculating the daily food rations and need for large
population groups.
4. Monitoring the nutritional status of the affected
population.
38. Recovery or Rehabilitation
Recovery is the process by which communities and
the nations are assisted in returning to their proper
level of functioning following a disaster ( >4 days)
‘’Restoration of the pre‐disaster conditions’’.
Priorities shift from health care needs towards
environmental measures.
Long term recovery: reconstruction of damage after
disaster.
39. Recovery elements
• Survey of water sources and distribution system
• Chlorination. > 0.7ppmWater supply
• Kitchen sanitation
• Personal hygiene of individuals involved in food
preparation
Food safety
• Washing, cleaning and bathing facility
• Emergency latrines
Basic sanitation
and hygiene
• Intensified vector control programs.Vector control
• Reconstruction
• Reintegrate disaster survivors into the society
Long term
recovery
40. Disaster prevention
Prevention: Measures aimed at impeding and preventing the
occurrence of a disaster event.
Items:
1. Vulnerability Analysis and Risk Assessment
2. Environmental Management
Safe Water supply and proper maintenance of sewage pipeline
3. Personal hygiene awareness, provision of washing, cleaning and
bathing facilities, and avoiding overcrowding.
4. Vector control
Elimination of breeding places by water management, draining
of stagnant pools and not allowing water to collect.
Outdoor fogging and control of vectors by regular spraying of
insecticides.
Keeping a watch on the rodent population
5. Burial/disposal of the Dead bodies
41. Prevention
6. Integrated Disease Surveillance Systems
7. Immunization
8. Biosafety in the laboratories dealing with
bacteria, viruses or toxins
9. Prevention of Post-disaster Epidemics
10. Non-pharmaceutical Interventions for
Disease Containment by Isolation and
Quarantine
42. Mitigation
Measures designed To lessen and reducing disaster
hazards on community.
Vertical process in pre and post disaster.
Include:
1- Structural mitigation – construction projects which
reduce economic and social impacts
Flood mitigation works
Appropriate land use planning, ventilation
Improved building codes
Safety of health facilities and public health services
2- Non-structural activities – policies and practices which
raise
awareness of hazards or encourage developments to
43. Preparedness or preparation
A program of long term development activities to strengthen the overall
capability and capacity of a country to manage efficiently all types of
emergencies.
It require inter sectorial cooperation
Elements:
1. Evaluate the risk of the country or particular region to the disaster
2. Adopt standards and regulations
3. Organize communication, information and warning systems
4. Ensure coordination and response mechanisms
5. Adopt measure to ensure that financial and other resources are
available for increased readiness and can be mobilized in disaster
situation
6. Develop public education program, vaccinations
7. Coordinate information session with news media
8. Organize disaster simulation exercises that test response mechanisms.
45. Don’t forget
Most commonly reported disease in post-disaster
phase is Gastroenteritis ( the first killer)
Most practical and effective strategy of disease
prevention and control in post-disaster phase is
‘supplying safe drinking water and proper disposal
of excreta’
Foremost step for disease prevention and control in
post-disaster phase is chlorination of all water bodies.
Level of residual chlorine to be maintained in all water
bodies in post-disaster phase is (> 0.7 ppm)
A common micronutrient deficiency in disasters is
Vitamin A deficiency: It occurs due to deficient relief
diets, measles and diarrhea (gastroenteritis)
Other common deficiencies include scurvy (Vitamin