Chapter 7 Post-disaster epidemic analysis and prevention-7

The centralization of corpses is often based on a misconception that if these corpses are not buried or cremated immediately, outbreaks of infectious diseases may result. Burial is preferable to cremation when mass casualties occur. Every effort should be made to identify the dead body.Every effort should be made to avoid mass burials. Families should have the opportunity (and the conditions) to have an appropriate funeral according to their own customs. If cemeteries or crematoria are not currently available, other temporary alternative sites and facilities should be provided. For staff handling dead bodies, ensure that:

* General precautions for contact with blood and body fluids; * Use gloves and dispose of used gloves properly; * Body bags should be used if possible; * Wash hands with soap after handling dead bodies and before eating; * Disinfection of means of transport and equipment; * Disinfection of corpses is not required before disposal (except for diseases such as cholera, Shigella dysentery, and hemorrhagic fever); * The bottom of all cemeteries should be at least 1.5 meters above the groundwater table, with a 0.7-meter impermeable barrier. The continuous provision of safe drinking water is the most important disease prevention measure after a major disaster.Chlorides are widely available, inexpensive and easy-to-use pharmaceuticals.It can effectively inhibit most pathogenic bacteria in water.The staffing plan must provide adequate water, sanitation, and minimum space for each person meeting international standards.

The most basic medical care conditions are crucial for disease prevention, early diagnosis and treatment of common diseases.Equally important is providing access to secondary and tertiary care facilities.Here are some steps you can take to lessen the impact of infectious disease: * Early diagnosis and treatment of diarrhea and acute respiratory infections, especially in children under 5 years of age. * Diagnose and treat malaria as early as possible in areas with high malaria incidence, and treat falciparum malaria with artemisinin-based comprehensive therapy within 24 hours of fever. * Medical care and prevention measures for major infectious diseases.

* Proper wound cleaning and care.For post-disaster wound treatment, tetanus vaccine should be injected (appropriately choose a vaccine with tetanus immune globulin or a vaccine without tetanus immune globulin). * Provide necessary medicines and set up a medical emergency kit, such as providing oral rehydration salts for diarrheal diseases, antibiotics for acute respiratory infections, etc. * To disseminate health knowledge, the missionary focus is on: * Good hand hygiene * Safe food preparation methods * Boiled water or chlorinated water * Early diagnosis and treatment of fever

* In areas with high malaria prevalence, use of insecticide-treated bed nets * Vector control adapted to local disease prevalence Early detection of cases with epidemic tendency is the key to ensure rapid control of the epidemic.Surveillance/early warning systems should be established early to detect disease outbreaks and monitor locally important epidemics. * Whether a priority disease should be included in the surveillance system should be based on a systematic assessment of the risk of the infectious disease. * Healthcare workers should be trained to identify priority diseases and report them promptly to higher health authorities.

* Response to disease outbreaks requires rapid assay sampling, storage and transport of samples for further surveillance studies.For example, if a cholera outbreak is considered to be at risk, kits for cholera-related assays should be prepared. Mass measles immunization and vitamin A supplementation are very important in areas where widespread vaccination has not been done before.Mass measles vaccination should be implemented as soon as possible in areas where vaccination coverage is less than 90% among persons <15 years of age.The priority age group for vaccination should be 6 months to 5 years, up to 15 years if resources are available.

Typhoid fever vaccine is not currently recommended for large-scale prevention of typhoid fever.According to local conditions, vaccination can be combined with other preventive measures to prevent typhoid outbreaks in disaster areas. In general, the hepatitis A vaccine is not recommended to prevent outbreaks of the disease in affected areas. The cost of the cholera vaccine, and the logistical complexities associated with processing and administering the vaccine, have limited its widespread use.Although the cholera vaccine can be helpful in certain situations, it is no substitute for adequate water and good sanitation.The effectiveness of cholera vaccines has not been evaluated in disaster-affected areas relative to its importance in other public health conditions.

Targeted preventive measures against malaria are needed.This should be based on a broad assessment of local conditions, including parasite types and pathogen carriers. Post-disaster flooding may delay mosquito population growth, giving us time to implement preventive measures such as spraying indoors with insecticides, or reprocessing and relocating insecticide-treated mosquito nets, especially before those Areas already using long-lasting insecticides. In areas where falciparum malaria occurs, artemisinin-based comprehensive treatment should be provided free of charge.It is also necessary to detect cases of fever as soon as possible to reduce the number of deaths.

For dengue fever, the main preventive measures should focus on the control of pathogen carrier sources.In the community, the focus should be on mobilizing the public to eliminate mosquito breeding sites and conduct hygiene education, specifically: * Ensure that all water storage containers are closed with lids at all times. * Remove and destroy containers or debris that may hold water, such as bottles, tires, cans, etc.