Chapter 6 Post-disaster epidemic analysis and prevention-6

For a long time, the expectation that "a major disaster will be followed by a major epidemic" has had a profound impact on the judgments of the public and policymakers.Such misguided expectations (often due to the association of disease with dead bodies) can lead to worry and panic among affected populations, as well as confusion in the media and other relevant institutions. In fact, outbreaks are less likely after natural disasters, especially when the disaster does not result in large-scale population movements.And when the basic survival supplies (such as clean drinking water and sanitation facilities, adequate temporary shelter and basic medical services) are insufficient for temporary migrant populations, infectious diseases are likely to spread among the population.

Those unfavorable conditions that easily lead to the spread of disease should be improved by quickly restoring basic services in the first place.Ensuring access to clean drinking water and basic medical services is critical, as is surveillance and early warning of disease-prone diseases in the affected areas. A comprehensive communicable disease risk assessment can help us identify which diseases should be prioritized for surveillance and prioritize immunization and disease vector control efforts.Five basic steps to slow the spread of infectious diseases after a disaster are summarized in Table 2 in the Appendix.The vast majority of disaster-related deaths are caused by exacerbated trauma.Disaster emergency plans should naturally focus on trauma care and casualty management, but they should also take into account the health care needs of disaster survivors.

We must be prepared, both for treatment and prevention, for the large gatherings of survivors without access to clean drinking water and sanitation that often follow disasters.For example, the rapid delivery of clean drinking water, the sufficient supply of medicines to treat dehydration, antibiotics, and vaccines, etc.The monitoring of disaster-affected areas is crucial to grasp the relative impact of natural disasters on the morbidity and mortality of local infectious diseases.However, in a post-disaster environment, obtaining relevant monitoring data is often not easy.In disasters, the damage to public basic medical facilities makes the already fragile monitoring and response system worse, or even completely destroyed.As in the 2004 disaster in Aceh, Indonesia, surveillance officials and public health workers themselves may die or go missing.Population migration can also distort census data, making calculations of comparative figures more difficult.

Health services in emergencies are often provided by multiple countries and international organizations, which poses a challenge for multi-stakeholder coordination.At the same time, the lack of pre-disaster baseline monitoring data makes it difficult to accurately judge the impact of natural disasters on disease transmission. Although the post-disaster monitoring system is mainly aimed at the rapid detection of current (post-disaster) epidemic diseases, the lack of baseline monitoring data and accurate reference values ​​as the denominator will hinder the interpretation of the detection data.Detected cases of endemic diseases may be interpreted (due to lack of background data) as trends in post-disaster epidemics.In this case, however, when cases of infectious disease are detected, the priority should be the rapid implementation of control measures.Despite these challenges and difficulties, continuous surveillance and rapid response to infectious diseases; are central to monitoring the occurrence of diseases, documenting their impact, implementing necessary emergency control measures, and better assessing the risk of disease outbreaks after disasters role.