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close this bookEpidemiologic Surveillance after Natural Disaster (PAHO - OPS; 1982; 105 pages) [FR] [ES]
close this folderPart 1 : Epidemiologic surveillance and disease control after natural disaster
close this folderChapter 2 : Postdisaster potential of communicable disease epidemics
View the documentExposure of susceptibles to endemic communicable disease
View the documentIncreases in levels of endemic communicable disease in local populations
View the documentSpecial problems with communicable disease in encamped populations
View the documentCommunicable diseases after disasters

Communicable diseases after disasters

Even in very poor developing countries, serious outbreaks of communicable disease very rarely occur after natural disasters which do not involve the encampment of populations (21). Known exceptions to this include cases of leptospirosis, which increased in Brazil after flooding (23), the aggravation of an ongoing typhoid fever problem following hurricanes in Mauritius (24), and cases of food poisoning in both Dominica and the Dominican Republic (25). It is probably more likely that the diversion of scarce resources from normal public health activities to disaster relief, or subsequent economic problems aggravated by a disaster, will lead to epidemic long after the acute event, such as in the resurgence and subsequent failure to eradicate malaria from Haiti (26).

With this in mind, in the thirteenth (1981) edition of the American Public Health Association handbook entitled Control of Communicable Diseases in Man (27) there is a consensus described that was reached by specialists in communicable disease, liaison representatives, and Pan American Health Organization/World Health Organization officials about the relative risk of individual communicable disease after disaster. This information is presented in a simplified form in Table 2. For a further discussion of each disease, the reader should consult the thirteenth edition or a tropical medicine text (28).

Table 2. Epidemic Potential of Selected Communicable Diseases Following Disaster in Latin America and the Caribbean (27, 28)

Disease

Disaster Potential

Geographic Areas at Risk


Qualitative/Quantitative*


Amebiasis

contamination water/food

?

cosmopolitan

Chickenpox- Herpes Zoster

overcrowding in emergency situations

3 +

worldwide (infection nearly universal)

Cholera

contamination water/food, crowding in primitive conditions

1 +

none

Diarrhea, nonspecific

contamination water/food, crowding

4 +

universal

Diphtheria

crowding of susceptible groups

2 +

universal

Ebola/Marburg Virus

direct contact with infected blood secretions, organs or semen. Possible by vector-borne/aerosol routes

?

Rhodesia, Kenya, Sudan, Zaire

Food Poisoning—Staphylococcal

mass feeding and inadequate refrigeration/cooking facilities

4+

universal

—Bacillus cereus

mass feeding and inadequate refrigeration/cooking facilities

3+

universal

Gastroenteritis

—Epidemic Viral Gastroenteritis

contamination water/food crowding

?

universal

—Rotavirus Gastroenteritis

contamination of water/food, crowding

?

universal

Hemorrhagic Fevers of Argentinian and Bolivian Types

contamination of food

?

Argentina, Bolivia

Hepatitides Viral

—Viral Hepatitis A

contamination of water/food, inadequate sanitary facilities

4+

universal

—Viral Hepatitis B

improper sterilization procedures

4+

universal

—Viral Hepatitis, Non-A, Non-B

?

?

universal

Influenza

crowding

4+

universal (pandemics, epidemics, localized and sporadic outbreaks)

Leprosy

interruption of case detection and therapy

?

endemic

Leptospirosis

contamination of water/food, flooding of areas with high water table

?

worldwide

Malaria

availability of water for mosquito breeding

?

Tropical South America, Panama, and Haiti

Measles

introduction of measles to susceptible isolated population

?

universal

Meningitis, Meningococcal

crowding

?

endemic

Pediculosis

crowding, clothing

?

endemic worldwide

Plague

crowding, inappropriate rodent control, unhygienic conditions

?

endemic in certain areas of North and South America

Poliomyelitis

crowding nonimmune groups, contaminated food, inadequate sewage disposal

?

worldwide

Rabies

stray dogs

2+

worldwide

Relapsing Fever

overcrowding. malnournishment, poor personal hygiene

2+

endemic

Salmonellosis

overcrowding, contamination of food in mass feeding, poor sanitation

3 +

worldwide

Scabies

overcrowding

2 +

endemic

Shigellosis

crowding, poor sanitation, malnournishment

4 +

worldwide

Streptococcal Diseases caused by Group A (Beta Hemolytic streptococci)

contamination of food

2+

common in temperate zones and semitropical areas

Tetanus

flood, hurricanes, earthquakes

3 +

worldwide

Tuberculosis

crowding

1 +

worldwide

Typhoid Fever

disruption of usual sanitary control of food and water

2+

worldwide

Typhus Fever (Endemic Louse- Borne)

unhygienic conditions , crowding

2+

endemic foci

Yellow Fever

availability of infected mosquitoes

?

enzootic in Northern South America and parts of Africa

Whooping Cough

crowding

2+

worldwide

*? Potential
1 + rare
2 + occasional
3 + frequent
4 + usual

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