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COMMUNICABLE DISEASES
AND DISASTERS
By: Doaa Habib
Under supervision of:
Dr. Mona Aboserea
ZAGAZIG UNIVERSITY
Contents
 Disaster definition
 Types
 Biological disasters
 Communicable diseases spreading after
disasters
 Disaster...
Disaster definition
 Any occurrence that causes damage,
ecological disruption, loss of human life or
deterioration of hea...
Complex emergency
 A state where the normal social order has
collapsed to the extent that national authorities
are no lon...
Types
 Atmospheric:
• Storms, hurricanes,
tornados
 Geologic:
• Earthquake,
landslides
 Hydrologic:
Flooding, tsunamis
...
Classification by time
Sudden,
acute onset
• Geological and Climatic hazards
• Epidemics of diseases
Chronic,
creeping
• d...
Communicable disease AND
disasters
Communicab
le disease
Epidemic
Disaster
Disaster
Spread of
diseases
Epidemic
Cause
Biol...
Biological disaster
Biological disaster
 Biological disasters define the devastating
effects caused by an enormous spread of a
certain kind o...
Causes
 Biological agents bacteria, virus, fungi,
parasites.
A. Already present ( antigenic shift or genetic
drift, alter...
Categories of biological hazards
(Biosafety level)
BSL1
• canine hepatitis, Escherichia coli, varicella
• Precautions are ...
Communicable diseases
spreading after disasters
Risk factors of communicable diseases
spread
Presence of pathogens
Displacement of population
Change in environment
Lack o...
Displacement: Primary
Concern
The risk for communicable disease transmission after
disasters is associated primarily with ...
Dead Bodies and Disease
 The sudden presence of large numbers of
dead bodies due to the natural disaster in the
does not ...
Common communicable
diseases
Water
borne
Air borne
Vector
borne
Contact
Water borne diseases
TreatmentDiagnosisIncubation
Period
Clinical FeaturesDisease
rehydration
therapy;
antimicrobials
dire...
Water borne diseases
TreatmentDiagnosisIncubation
Period
Clinical
Features
Disease
ampicillin;
hospitalize
seriously ill o...
Vector borne diseases
TreatmentDiagnosisIncubatio
n
Period
Clinical
Features
Disease
chloroquineparasites on
blood
smear o...
Vector borne diseases
TreatmentDiagnosisIncubation
Period
Clinical
Features
Disease
intensive
supportive
therapy
serologic...
Air borne diseases
TreatmentDiagnosisIncubatio
n
Period
Clinical FeaturesDisease
co-
trimoxazole,
chlorampheni
col
ampicil...
Contact infections
TreatmentDiagnosisIncubation
Period
Clinical
Features
Disease
immune
globulin
Antibiotic
Muscle
relaxan...
Phases of disasters
• Most of deaths, injuries
• Extrication of victims
• Immediate soft tissue infections treatment
Impac...
Diseases by disaster phases
Impact
Deaths
Injuries
Hypothermia
Dehydration
Injury site
infection
Post impact
Airborne, flu...
Disaster management
 Is more than just response and relief (i.e., it assumes
a more proactive approach)
 Is a systematic...
Disaster management cycle
Risk analysis
 Is a situation that
has the potential for
causing damage to
life, property and the
environment
 Is the pr...
Risk analysis
 Factors makes the
community more fragile
and less able to cope
with or recover from an
adverse event.
 It...
Response
 Response measures are those, which are
taken immediately, prior to and following
disasters.
 Such measures are...
Response to biological
disaster Establishment of diagnosis, epidemic
 Risk and vulnerability analysis
 enhance public h...
Response to disasters
 Search, rescue and first‐aid:
Most immediate help come from uninjured survivors.
 Field care:
1. ...
Triage
 Rapidly classify the injured on basis of Severity of
their injuries, and Likelihood of their survival with
prompt...
Relief phase
 Assistance from outside starts to reach disaster area
(6- 24hs).
Type & quantity of relief supplies depends...
Role of vaccination
 Vaccination is recommended to health
care workers but not for population in
relief phase.
Why?
 Com...
Nutrition
 Infants, children, pregnant & lactating women, sick
persons.
 Steps to ensure food relief:
1. Assessing the f...
Recovery or Rehabilitation
 Recovery is the process by which communities and
the nations are assisted in returning to the...
Recovery elements
• Survey of water sources and distribution system
• Chlorination. > 0.7ppmWater supply
• Kitchen sanitat...
Disaster prevention
 Prevention: Measures aimed at impeding and preventing the
occurrence of a disaster event.
 Items:
1...
Prevention
6. Integrated Disease Surveillance Systems
7. Immunization
8. Biosafety in the laboratories dealing with
bacter...
Mitigation
 Measures designed To lessen and reducing disaster
hazards on community.
 Vertical process in pre and post di...
Preparedness or preparation
 A program of long term development activities to strengthen the overall
capability and capac...
Disaster management
Don’t forget
 Most commonly reported disease in post-disaster
phase is Gastroenteritis ( the first killer)
 Most practic...
Thank you
Disaster and-communicable-diseases
Disaster and-communicable-diseases
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COMMUNICABLE DISEASES IN DISASTERS

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Disaster and-communicable-diseases

  1. 1. COMMUNICABLE DISEASES AND DISASTERS By: Doaa Habib Under supervision of: Dr. Mona Aboserea ZAGAZIG UNIVERSITY
  2. 2. Contents  Disaster definition  Types  Biological disasters  Communicable diseases spreading after disasters  Disaster management
  3. 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. 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. 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. 6. 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
  7. 7. Communicable disease AND disasters Communicab le disease Epidemic Disaster Disaster Spread of diseases Epidemic Cause Biological disaster Result Epidemic after disaster
  8. 8. Biological disaster
  9. 9. 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
  10. 10. Causes  Biological agents bacteria, virus, fungi, parasites. A. Already present ( antigenic shift or genetic drift, altered immunity) B. new emerging  Biological toxins  Bioterrorism
  11. 11. 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
  12. 12. Communicable diseases spreading after disasters
  13. 13. 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
  14. 14. 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
  15. 15. 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
  16. 16. Common communicable diseases Water borne Air borne Vector borne Contact
  17. 17. 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
  18. 18. 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
  19. 19. 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
  20. 20. Vector borne diseases TreatmentDiagnosisIncubation Period Clinical Features Disease intensive supportive therapy serological assay for JE virus IgM specific antibodies in CSF or blood (acute phase) 5 - 15 daysQuick onset, headache, high fever, neck stiffness, stupor, disorientation, tremors Japanese encephalitis intensive supportive therapy serological assay for yellow fever virus antibodies 3 - 6 daysfever, backache, headache, nausea, vomiting; toxic phase jaundice, abdominal pain, kidney failure Yellow fever
  21. 21. 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
  22. 22. Contact infections TreatmentDiagnosisIncubation Period Clinical Features Disease immune globulin Antibiotic Muscle relaxants entirely clinical3 - 21 daysdifficulty swallowing, lockjaw, muscle rigidity, spasms Tetanus Penicillin in massive doses Sero therapy in proper dose Clinical, culture of discharge 3 - 21 daysFever, toxicity, wound infection, tissue necrosis Gas gangrene Post exposure immunization, serotherapy History of biteAccording to bite site Hydrophobia, aerophobia, seizures Rabies
  23. 23. 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)
  24. 24. 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
  25. 25. 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)
  26. 26. Disaster management cycle
  27. 27. 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
  28. 28. 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
  29. 29. 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.
  30. 30. 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
  31. 31. 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
  32. 32. 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:
  33. 33. 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
  34. 34. 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
  35. 35. 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.
  36. 36. 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.
  37. 37. 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
  38. 38. 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
  39. 39. 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
  40. 40. 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
  41. 41. 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.
  42. 42. Disaster management
  43. 43. 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
  44. 44. Thank you
  • KailashSinha2

    Jun. 7, 2021

COMMUNICABLE DISEASES IN DISASTERS

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