Earthquakes

Abstract number: S14

Korten V.

Infectious consequences of an earthquake mainly involve several types of communicable diseases and crush related infections. Water-borne and food-borne illnesses often result from the disruption of the public water and sewage systems and contamination of water supply. Overcrowding, poor hygiene and sanitation in temporary shelters also may be factors. The type of infectious diseases are associated with the epidemiology of communicable diseases in the area where the earthquake occurred. The most common outbreaks associated with earthquakes are gastroenteritis, infectious hepatitis and pulmonary infections. In unvaccinated populations, there are reports of increased measles. Tetanus can be seen in populations where vaccination coverage levels are low. The risk for diarrhoeal disease outbreaks following earthquakes is higher in developing countries than in industrialised countries. An outbreak of acute watery diarrhoea involved >750 cases occurred in a camp after the 2005 earthquake in Pakistan. Acute respiratory infections, hepatitis E clusters and measles (>400 clinical cases in the 6 months) also occurred among the displaced victims after the same earthquake. Contamination of drinking water led to an outbreak of rotavirus after the 2005 earthquake in Kashmir, India. An unusual outbreak of coccidiomycosis associated with exposure to increased levels of airborne dust occurred after the 1994 Southern California earthquake.

Persons who have been trapped by rubble for several hours or days may develop compartment syndromes requiring fasciotomy or amputation. Infectious complications were common in renal victims of the1999 Marmara Earthquake in Turkey and were associated with increased mortality when complicated by sepsis. Of 639 renal victims, 223 (34.9%) had infectious complications, mainly sepsis and wound infections. Most of the infections were nosocomial in origin and caused by Gram-negative aerobic bacteria and Staphylococcus spp. Multivariate analysis of the risk-factors for nosocomial infections revealed a significant association with fasciotomy and length of hospital stay in a back up university hospital. The most frequent pathogens isolated from pus and/or wounds culture in 2008 Wenchuan earthquake survivors were S. aureus, E. coli, A. baumannii, E. cloacae, and P. aeruginosa.

Disaster-preparedness plans, focused on trauma and mass casualty management and also on health needs of the surviving affected populations may decrease the health impact of earthquakes.