In the Handbook on Control of Communicable Diseases in Man (2) there is a summary of currently recommended quarantine and isolation procedures for use with patients and their contacts. The Centers for Disease Control's guide, Isolation Techniques for Use in Hospitals (58), is directed toward limiting the spread of disease in acute care facilities. Unfortunately, the infection control programs which can, under normal circumstances, approach the standards in this guide are few in Latin America and the Caribbean. After disaster, conditions in the established hospital often include the lack of water and electricity essential for handwashing, disinfection and microbiological identification.
Infection rates in teaching hospitals in Latin America and the Caribbean approach fifty percent under normal circumstances. In studies of pediatric wards, prevalence of gastroenteritis has exceeded one hundred percent. Thus, if a child entered without diarrhea, he had it at least once before he was discharged. The nonexistence of effective and appropriate hospital infection control programs in developing countries must be taken into account by relief authorities charged with caring for casualties of disaster in existing institutions. A regional program is currently being developed at the Pan American Health Organization (59)