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Sawano T, Ito N, Ozaki A, Nishikawa Y, Nonaka S, Kobashi Y, Higuchi A, Tsubokura M. Evacuation of residents in a natural disaster during the COVID-19 era. QJM 2021; 114:445-446. [PMID: 33647970 PMCID: PMC7989190 DOI: 10.1093/qjmed/hcab044] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- T Sawano
- Research Center for Community Health, Minamisoma Municipal General Hospital, 54-6, 2 Choume, Takami-cho, Haramachi-ku, Minamisoma, Fukushima 975-0033, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Banchi, Hikarigaoka, Fukushima, Fukushima 960-1247, Japan
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, 57 Banchi, Jyobankamiyunaga-Yamachi, Iwaki, Fukushima 972-8322, Japan
- Address correspondence to Dr T. Sawano, Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima 975-0033, Japan.
| | - N Ito
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Banchi, Hikarigaoka, Fukushima, Fukushima 960-1247, Japan
| | - A Ozaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, 54-6, 2 Choume, Takami-cho, Haramachi-ku, Minamisoma, Fukushima 975-0033, Japan
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, 57 Banchi, Jyobankamiyunaga-Yamachi, Iwaki, Fukushima 972-8322, Japan
| | - Y Nishikawa
- Department of Internal Medicine, Soma Central Hospital, 5-18, 3 Choume, Okinouchi, Soma, Fukushima 976-0016, Japan
| | - S Nonaka
- Research Center for Community Health, Minamisoma Municipal General Hospital, 54-6, 2 Choume, Takami-cho, Haramachi-ku, Minamisoma, Fukushima 975-0033, Japan
| | - Y Kobashi
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Banchi, Hikarigaoka, Fukushima, Fukushima 960-1247, Japan
| | - A Higuchi
- Medical Governance Research Institute, 12-13, 2 Choume, Takanawa, Minato-ku, Tokyo 108-0074, Japan
| | - M Tsubokura
- Research Center for Community Health, Minamisoma Municipal General Hospital, 54-6, 2 Choume, Takami-cho, Haramachi-ku, Minamisoma, Fukushima 975-0033, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Banchi, Hikarigaoka, Fukushima, Fukushima 960-1247, Japan
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Wang K, Zhong S, Wang X, Wang Z, Yang L, Wang Q, Wang S, Sheng R, Ma R, Lin S, Liu W, Zu R, Huang C. Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101201. [PMID: 28994741 PMCID: PMC5664702 DOI: 10.3390/ijerph14101201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 09/24/2017] [Accepted: 10/08/2017] [Indexed: 11/16/2022]
Abstract
(1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing's Center for Disease Control and Prevention (CDC) and Funing People's Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3) Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33) and injury (RR = 31.80; 95% CI = 17.26, 58.61), and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29). Of the 337 injuries, 274 injuries (81%) were minor. Most deaths occurred indoors (87%) and the head (74%) was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4) Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China.
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Affiliation(s)
- Kaiwen Wang
- School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-Sen Road, Yuexiu District, Guangzhou 510080, China.
| | - Shuang Zhong
- School of Government, Sun Yat-sen University, Guangzhou 510275, China.
| | - Xiaoye Wang
- Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Zhe Wang
- Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Lianping Yang
- School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-Sen Road, Yuexiu District, Guangzhou 510080, China.
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-Sen Road, Yuexiu District, Guangzhou 510080, China.
| | - Suhan Wang
- School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-Sen Road, Yuexiu District, Guangzhou 510080, China.
| | - Rongrong Sheng
- School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-Sen Road, Yuexiu District, Guangzhou 510080, China.
| | - Rui Ma
- School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-Sen Road, Yuexiu District, Guangzhou 510080, China.
| | - Shao Lin
- School of Public Health, State University of New York at Albany, Albany, NY 12222, USA.
| | - Wenyu Liu
- Funing County's Center for Disease Control and Prevention, Yancheng 224400, China.
| | - Rongqiang Zu
- Department for Acute Infectious Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Gulou District, Nanjing 210009, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-Sen Road, Yuexiu District, Guangzhou 510080, China.
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Shibata Y, Ojima T, Tomata Y, Okada E, Nakamura M, Kawado M, Hashimoto S. Characteristics of pneumonia deaths after an earthquake and tsunami: an ecological study of 5.7 million participants in 131 municipalities, Japan. BMJ Open 2016; 6:e009190. [PMID: 26908515 PMCID: PMC4769420 DOI: 10.1136/bmjopen-2015-009190] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE On 11 March 2011, the Great East Japan Earthquake struck off Japan. Although some studies showed that the earthquake increased the risk of pneumonia death, no study reported whether and how much a tsunami increased the risk. We examined the risk for pneumonia death after the earthquake/tsunami. DESIGN This is an ecological study. SETTING Data on population and pneumonia deaths obtained from the Vital Statistics 2010 and 2012, National Census 2010 and Basic Resident Register 2010 and 2012 in Japan. PARTICIPANTS About 5.7 million participants residing in Miyagi, Iwate and Fukushima Prefectures during 1 year after the disaster were targeted. All municipalities (n=131) were categorised into inland (n=93), that is, the earthquake-impacted area, and coastal types (n=38), that is, the earthquake-impacted and tsunami-impacted area. OUTCOME MEASURES The number of pneumonia deaths per week was totalled from 12 March 2010 to 9 March 2012. The number of observed pneumonia deaths (O) and the sum of the sex and age classes in the observed population multiplied by the sex and age classes of expected pneumonia mortality (E) were calculated. Expected pneumonia mortality was the pneumonia mortality during the year before. Standardised mortality ratios (SMRs) were calculated for pneumonia deaths (O/E), adjusting for sex and age using the indirect method. SMRs were then calculated by coastal and inland municipalities. RESULTS 6603 participants died of pneumonia during 1 year after the earthquake. SMRs increased significantly during the 1st-12th weeks. In the 2nd week, SMRs in coastal and inland municipalities were 2.49 (95% CI 2.02 to 7.64) and 1.48 (95% CI 1.24 to 2.61), respectively. SMRs of coastal municipalities were higher than those of inland municipalities. CONCLUSIONS An earthquake increased the risk of pneumonia death and tsunamis additionally increased the risk.
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Affiliation(s)
- Yosuke Shibata
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yasutake Tomata
- Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Eisaku Okada
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Mieko Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Miyuki Kawado
- Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Shuji Hashimoto
- Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Pourhossein B, Esmaeili S, Gyuranecz M, Mostafavi E. Tularemia and plague survey in rodents in an earthquake zone in southeastern Iran. Epidemiol Health 2015; 37:e2015050. [PMID: 26602769 PMCID: PMC4722225 DOI: 10.4178/epih/e2015050] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 11/17/2015] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Earthquakes are one the most common natural disasters that lead to increased mortality and morbidity from transmissible diseases, partially because the rodents displaced by an earthquake can lead to an increased rate of disease transmission. The aim of this study was to evaluate the prevalence of plague and tularemia in rodents in the earthquake zones in southeastern Iran. METHODS In April 2013, a research team was dispatched to explore the possible presence of diseases in rodents displaced by a recent earthquake magnitude 7.7 around the cities of Khash and Saravan in Sistan and Baluchestan Province. Rodents were trapped near and in the earthquake zone, in a location where an outbreak of tularemia was reported in 2007. Rodent serums were tested for a serological survey using an enzyme-linked immunosorbent assay. RESULTS In the 13 areas that were studied, nine rodents were caught over a total of 200 trap-days. Forty-eight fleas and 10 ticks were obtained from the rodents. The ticks were from the Hyalomma genus and the fleas were from the Xenopsylla genus. All the trapped rodents were Tatera indica. Serological results were negative for plague, but the serum agglutination test was positive for tularemia in one of the rodents. Tatera indica has never been previously documented to be involved in the transmission of tularemia. CONCLUSIONS No evidence of the plague cycle was found in the rodents of the area, but evidence was found of tularemia infection in rodents, as demonstrated by a positive serological test for tularemia in one rodent.
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Affiliation(s)
- Behzad Pourhossein
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology, Pasteur Institute of Iran, Tehran, Iran
| | | | - Miklós Gyuranecz
- Institute for Veterinary Medical Research, Centre for Agricultural Research, Hungarian Academy of Sciences, Budapest, Hungary
| | - Ehsan Mostafavi
- Department of Epidemiology, Pasteur Institute of Iran, Tehran, Iran.,National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, Kabudar Ahang, Hamadan, Iran
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Zhang W, Liu H, Jiang X, Wu D, Tian Y. A longitudinal study of posttraumatic stress disorder symptoms and its relationship with coping skill and locus of control in adolescents after an earthquake in China. PLoS One 2014; 9:e88263. [PMID: 24516622 PMCID: PMC3917873 DOI: 10.1371/journal.pone.0088263] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 01/06/2014] [Indexed: 02/05/2023] Open
Abstract
Background/Objectives Post-traumatic stress disorder is a common psychological maladaptation among adolescents after undergoing an earthquake. Knowledge about the prevalence and maintenance of post-traumatic stress disorder symptoms and the changes of its predictors over time can help medical providers assist adolescent survivors with mitigating long-term impacts. This study examined the changes in posttraumatic stress disorder symptoms and its relationship with coping skill and locus of control among adolescent earthquake survivors in China. Methodology/Findings The study used an observational longitudinal design. A total of 1420 adolescents were evaluated twice after the earthquake by using the Post-traumatic stress disorder Checklist-Civilian Version, The Internality, Powerful others and Chance scale and the Coping Styles Scale. The results indicated that the mean scores of posttraumatic stress disorder symptoms were decreased significantly and the positive rates of posttraumatic stress disorder symptoms also declined remarkably at 17 months compared to the 3 months post-earthquake. Internality locus of control and problem solving coping skill were effective resilient factors for the development and maintenance of posttraumatic stress disorder symptoms, while chance locus of control was a powerful risk factor of posttraumatic stress disorder symptoms as well as being female, being injured and property loss. Conclusions/Significance Continuous screening is recommended to identify adolescent earthquake survivors with posttraumatic stress disorder symptoms. More attention should be paid to adolescent survivors who are prone to adopt passive coping strategies responding to trauma events and who own external causal attribution.
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Affiliation(s)
- Weiqing Zhang
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Liu
- West China Second Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaolian Jiang
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- * E-mail:
| | - Dongmei Wu
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yali Tian
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Bianchini V, Roncone R, Tomassini A, Necozione S, Cifone MG, Casacchia M, Pollice R. Cognitive behavioral therapy for young people after l'aquila earthquake. Clin Pract Epidemiol Ment Health 2013; 9:238-42. [PMID: 24358053 PMCID: PMC3866707 DOI: 10.2174/1745017901309010238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 10/01/2013] [Accepted: 10/02/2013] [Indexed: 02/01/2023]
Abstract
Objective: Cognitive behavior therapy (CBT) emerges as the best validated therapeutic approach for children and adolescents who experienced trauma-related symptoms, particularly associated with anxiety or mood disorders. The aim of this study was to evaluate the CBT efficacy among young people exposed to L’Aquila earthquake, in 2009. Methods: one year after the disaster, 39 young subjects as a case group (CBT treated) and 24 as a comparison group (no CBT treated) were evaluated with the Impact of Event Scale Revised (IES-R), the General Health Questionnaire-12 items (GHQ-12) and the Brief Cope. CBT was conducted in 12 sessions (once per week for 3 months). After CBT intervention, both groups were evaluated again with the same psychometric instruments. Results: our results show a significantly decrease in post traumatic symptoms and psychological distress severity in CBT group. It was attributable to an improvement in each of three PTSD dimensions (intrusion, avoidance, and arousal) and in the total score of IES-R (p< 0.04). Among CBT treated group, subjects that adopted “planning/problem solving” coping strategies (p < .02) and “religiosity” (p < .045) show higher improvement in psychological distress. Conclusions: our findings show the efficacy of CBT and the influence of individual coping strategies in the improvement of posttraumatic stress symptoms and psychological distress among young people seeking help from an outpatients service for young people with psychiatric problems (the SMILE) after the catastrophic disaster in L’Aquila.
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Affiliation(s)
- Valeria Bianchini
- Service for Monitoring and early Intervention against psychoLogical and mental suffering in young people" (SMILE), L'Aquila University, Italy ; Department of Clinical Medicine, Public Health and Sciences of Life and Enviroment, University of L'Aquila, Italy
| | - Rita Roncone
- Service for Monitoring and early Intervention against psychoLogical and mental suffering in young people" (SMILE), L'Aquila University, Italy ; Psychiatric Unit, San Salvatore Hospital, L'Aquila, Italy ; Department of Clinical Medicine, Public Health and Sciences of Life and Enviroment, University of L'Aquila, Italy
| | - Annarita Tomassini
- Service for Monitoring and early Intervention against psychoLogical and mental suffering in young people" (SMILE), L'Aquila University, Italy ; Department of Clinical Medicine, Public Health and Sciences of Life and Enviroment, University of L'Aquila, Italy
| | - Stefano Necozione
- Department of Clinical Medicine, Public Health and Sciences of Life and Enviroment, University of L'Aquila, Italy
| | - Maria Grazia Cifone
- Department of Clinical Medicine, Public Health and Sciences of Life and Enviroment, University of L'Aquila, Italy
| | - Massimo Casacchia
- Service for Monitoring and early Intervention against psychoLogical and mental suffering in young people" (SMILE), L'Aquila University, Italy ; Psychiatric Unit, San Salvatore Hospital, L'Aquila, Italy ; Department of Clinical Medicine, Public Health and Sciences of Life and Enviroment, University of L'Aquila, Italy
| | - Rocco Pollice
- Service for Monitoring and early Intervention against psychoLogical and mental suffering in young people" (SMILE), L'Aquila University, Italy ; Psychiatric Unit, San Salvatore Hospital, L'Aquila, Italy ; Department of Clinical Medicine, Public Health and Sciences of Life and Enviroment, University of L'Aquila, Italy
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Yamauchi H, Yoshihisa A, Iwaya S, Owada T, Sato T, Suzuki S, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh SI, Takeishi Y. Clinical features of patients with decompensated heart failure after the Great East Japan Earthquake. Am J Cardiol 2013; 112:94-9. [PMID: 23561586 DOI: 10.1016/j.amjcard.2013.02.057] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 02/26/2013] [Accepted: 02/26/2013] [Indexed: 01/17/2023]
Abstract
The occurrence of heart failure (HF) and its clinical features after a great disaster have not been rigorously examined. We retrospectively examined the effect of the Great East Japan Earthquake on the occurrence of decompensated HF. The number of patients admitted for treatment of decompensated HF and their clinical features were compared between 2 periods, March 11, 2011 to September 10, 2011 (after the earthquake) and the same period in the previous year. The number of admissions increased from 55 in 2010 to 84 in 2011. A comparison of the clinical features showed that the patients admitted after the earthquake had (1) older age (p = 0.031), (2) greater systolic blood pressure (p = 0.039), (3) a greater incidence of new-onset HF due to valvular heart disease (p = 0.040), (4) interruption of drugs (p = 0.001), (5) a greater incidence of infection (p = 0.019), (6) greater B-type natriuretic peptide (p = 0.005) and C-reactive protein (p = 0.003) levels, (7) a lower estimated glomerular filtration rate (p = 0.048) and lower albumin levels (p = 0.021), and (8) a larger diameter of the inferior vena cava (p = 0.008). In conclusion, these results suggest that the earthquake increased the incidence of HF in association with high blood pressure, interruption of drugs, inflammation, malnutrition, and fluid retention. Taking appropriate measures to control blood pressure, nutritional status, and hygiene environment might decrease the occurrence of HF in future disasters.
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Large-scale disaster and gastrointestinal diseases. Clin J Gastroenterol 2013; 6:99-104. [DOI: 10.1007/s12328-013-0369-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 02/07/2013] [Indexed: 10/27/2022]
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Omote S, Kato M, Kido T, Okamoto R, Ichimori A, Sakakibara C, Tsukasaki K. Relationship between the degree of property damage and changes in red blood cells, hematocrit, and hemoglobin among victims of the Noto Peninsula Earthquake. Environ Health Prev Med 2013; 18:151-64. [PMID: 23132633 PMCID: PMC3590323 DOI: 10.1007/s12199-012-0305-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 08/31/2012] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the impact of the Noto Peninsula Earthquake on various hematologic parameters. We studied the relationships between the degree of property damage and changes in red blood cells (RBCs), hemoglobin (Hb), and hematocrit (Ht) among residents before and after the March 2007 Noto Peninsula Earthquake. METHODS A total of 5,563 residents of Wajima City who were not receiving oral treatment for anemia and who had received basic health screenings for fiscal years (FYs) 2006 and 2007, before and after the earthquake. We analyzed changes in their RBCs, Hb, and Ht levels by gender, age, body mass index (BMI), level of property damage, and evaluation standards. RESULTS RBCs, Hb, and Ht for FY2007 showed a trend of decreasing values compared to FY2006 in both male and female subjects. RBCs and Hb significantly decreased in females aged between 65 and 74 years who experienced total property damage, and Ht significantly increased for those younger than 65 years who experienced the same level of damage. In addition, significant differences by degree of property damage and FY2007/FY2006 ratio were seen only among subjects with a BMI ratio <1. Furthermore, we found a significant relationship between reduction of RBCs or Hb and increasing age in females; however, no significant relationship to property damage was found. No significant relationships were found for males. CONCLUSIONS A significant association between property damage and changes in RBCs, Hb, and Ht was not found in this population of residents who experienced the Noto Peninsula Earthquake.
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Affiliation(s)
- Shizuko Omote
- Division of Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan.
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Daito H, Suzuki M, Shiihara J, Kilgore PE, Ohtomo H, Morimoto K, Ishida M, Kamigaki T, Oshitani H, Hashizume M, Endo W, Hagiwara K, Ariyoshi K, Okinaga S. Impact of the Tohoku earthquake and tsunami on pneumonia hospitalisations and mortality among adults in northern Miyagi, Japan: a multicentre observational study. Thorax 2013; 68:544-50. [PMID: 23422213 PMCID: PMC3664371 DOI: 10.1136/thoraxjnl-2012-202658] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background On 11 March 2011, the Tohoku earthquake and tsunami struck off the coast of northeastern Japan. Within 3 weeks, an increased number of pneumonia admissions and deaths occurred in local hospitals. Methods A multicentre survey was conducted at three hospitals in Kesennuma City (population 74 000), northern Miyagi Prefecture. All adults aged ≥18 years hospitalised between March 2010 and June 2011 with community-acquired pneumonia were identified using hospital databases and medical records. Segmented regression analyses were used to quantify changes in the incidence of pneumonia. Results A total of 550 pneumonia hospitalisations were identified, including 325 during the pre-disaster period and 225 cases during the post-disaster period. The majority (90%) of the post-disaster pneumonia patients were aged ≥65 years, and only eight cases (3.6%) were associated with near-drowning in the tsunami waters. The clinical pattern and causative pathogens were almost identical among the pre-disaster and post-disaster pneumonia patients. A marked increase in the incidence of pneumonia was observed during the 3-month period following the disaster; the weekly incidence rates of pneumonia hospitalisations and pneumonia-associated deaths increased by 5.7 times (95% CI 3.9 to 8.4) and 8.9 times (95% CI 4.4 to 17.8), respectively. The increases were largest among residents in nursing homes followed by those in evacuation shelters. Conclusions A substantial increase in the pneumonia burden was observed among adults after the Tohoku earthquake and tsunami. Although the exact cause remains unresolved, multiple factors including population aging and stressful living conditions likely contributed to this pneumonia outbreak.
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Jia Z, Shi L, Duan G, Liu W, Pan X, Chen Y, Tian W. Traumatic experiences and mental health consequences among child survivors of the 2008 Sichuan earthquake: a community-based follow-up study. BMC Public Health 2013; 13:104. [PMID: 23379511 PMCID: PMC3573920 DOI: 10.1186/1471-2458-13-104] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 01/24/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study was implemented to examine the relationship between traumatic experiences and longitudinal development of mental health for children and adolescents who survived the 2008 Sichuan earthquake. METHODS Using the method of multistage systematic sampling, 596 children aged between 8 and 16 years were randomly selected from severely affected areas of the earthquake. These children were interviewed with standardized instruments of posttraumatic stress disorder (PTSD) and depression at the 15th month after the earthquake, and re-interviewed at the 36th month. RESULTS From the initial to the follow-up assessments, there were no significant changes in both PTSD and depression scores. In addition, no significant change was found on the overall prevalence rates of the symptoms: from 12.4% to 10.7% for PTSD, from 13.9% to 13.5% for depression, and from 4.2% to 4.7% for their co-occurrence. The study also indicated that the earthquake might have a delayed impact on the psychosocial functioning of children and adolescents who were not directly affected by the disaster. CONCLUSIONS For child and adolescent survivors of the earthquake, symptoms of PTSD and depression seemed to persist over time. The finding that children reduced their use of mental health services raised great concerns over how to fulfill the unmet psychological needs of these children. More mental health interventions should be allocated to children who had elevated risk for developing persistent course of the symptoms.
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Affiliation(s)
- Zhaobao Jia
- Department of Health Service Management, Second Military Medical University, Shanghai, 200433, China
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12
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Yamanda S, Hanagama M, Kobayashi S, Satou H, Tokuda S, Niu K, Yanai M. The impact of the 2011 Great East Japan Earthquake on hospitalisation for respiratory disease in a rapidly aging society: a retrospective descriptive and cross-sectional study at the disaster base hospital in Ishinomaki. BMJ Open 2013; 3:bmjopen-2012-000865. [PMID: 23293238 PMCID: PMC3549258 DOI: 10.1136/bmjopen-2012-000865] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate the impact in an aging society of the 2011 Great East Japan earthquake on hospitalisation for respiratory disease at the disaster base hospital. DESIGN Descriptive and cross-sectional study. SETTING Emergency care in Japanese Red Cross Ishinomaki Hospital, a regional disaster base hospital in Miyagi, Japan. PARTICIPANTS 322 emergency patients who were hospitalised for respiratory disease from 11 March to 9 May 2011, and 99 and 105 emergency patients who were hospitalised in the corresponding periods in 2009 and 2010, respectively. MAIN OUTCOME MEASURES Description and comparison of patient characteristics and disease distribution in terms of age, time after the disaster and activities of daily living (ADL). RESULTS 1769 patients were admitted to our hospital during the study period (compared to 850 in 2009 and 1030 in 2010), among whom 322 were hospitalised for respiratory disease (compared to 99 in 2009 and 105 in 2010). Pneumonia (n=190, 59.0%) was the most frequent cause of admission for pulmonary disease, followed by acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) (n=53, 16.5%), asthma attacks (n=27, 8.4%) and progression of lung cancer (n=22, 6.8%). Compared with the corresponding periods in 2009 and 2010, the increase in the absolute numbers of admissions was highest for pneumonia, followed by AE-COPD and asthma attacks. At hospitalisation, 195 patients were 'dependent' and 54 patients were 'partially dependent'. Respiratory admissions accompanied by deterioration of ADL after the disaster were more frequent in elderly and female patients. CONCLUSIONS After the Great East Japan Earthquake, admissions for pneumonia and exacerbation of chronic respiratory disease in the elderly increased at the disaster base hospital.
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Affiliation(s)
- Shinsuke Yamanda
- Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
| | - Masakazu Hanagama
- Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
| | - Seiichi Kobayashi
- Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
| | - Hikari Satou
- Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
| | - Shinsaku Tokuda
- Division of Cell Biology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kaijun Niu
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Miyagi, Japan
| | - Masaru Yanai
- Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
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Shiga H, Miyazawa T, Kinouchi Y, Takahashi S, Tominaga G, Takahashi H, Takagi S, Obana N, Kikuchi T, Oomori S, Nomura E, Shiraki M, Sato Y, Takahashi S, Umemura K, Yokoyama H, Endo K, Kakuta Y, Aizawa H, Matsuura M, Kimura T, Kuroha M, Shimosegawa T. Life-event stress induced by the Great East Japan Earthquake was associated with relapse in ulcerative colitis but not Crohn's disease: a retrospective cohort study. BMJ Open 2013; 3:bmjopen-2012-002294. [PMID: 23396562 PMCID: PMC3586105 DOI: 10.1136/bmjopen-2012-002294] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Stress is thought to be one of the triggers of relapses in patients with inflammatory bowel disease (IBD). We examined the rate of relapse in IBD patients before and after the Great East Japan Earthquake. DESIGN A retrospective cohort study. SETTINGS 13 hospitals in Japan. PARTICIPANTS 546 ulcerative colitis (UC) and 357 Crohn's disease (CD) patients who received outpatient and inpatient care at 13 hospitals located in the area that were seriously damaged by the earthquake. Data on patient's clinical characteristics, disease activity and deleterious effects of the earthquake were obtained from questionnaires and hospital records. PRIMARY OUTCOME We evaluated the relapse rate (from inactive to active) across two consecutive months before and two consecutive months after the earthquake. In this study, we defined 'active' as conditions with a partial Mayo score=2 or more (UC) or a Harvey-Bradshaw index=6 or more (CD). RESULTS Among the UC patients, disease was active in 167 patients and inactive in 379 patients before the earthquake. After the earthquake, the activity scores increased significantly (p<0.0001). A total of 86 patients relapsed (relapse rate=15.8%). The relapse rate was about twice that of the corresponding period in the previous year. Among the CD patients, 86 patients had active disease and 271 had inactive disease before the earthquake. After the earthquake, the activity indices changed little. A total of 25 patients experienced a relapse (relapse rate=7%). The relapse rate did not differ from that of the corresponding period in the previous year. Multivariate analyses revealed that UC, changes in dietary oral intake and anxiety about family finances were associated with the relapse. CONCLUSIONS Life-event stress induced by the Great East Japan Earthquake was associated with relapse in UC but not CD.
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Affiliation(s)
- Hisashi Shiga
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Teruko Miyazawa
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshitaka Kinouchi
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Seiichi Takahashi
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Gen Tominaga
- Department of Gastroenterology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Hiroki Takahashi
- Department of Gastroenterology, Sendai Medical Center, Sendai, Japan
| | | | - Nobuya Obana
- Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
| | - Tatsuya Kikuchi
- Department of Gastroenterology, Sendai City Hospital, Sendai, Japan
| | - Shinya Oomori
- Department of Gastroenterology, Japanese Red Cross Sendai Hospital, Sendai, Japan
| | - Eiki Nomura
- Department of Gastroenterology, Miyagi Cancer Center, Natori, Japan
| | - Manabu Shiraki
- Department of Gastroenterology, Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Yuichirou Sato
- Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
| | - Shuichiro Takahashi
- Department of Gastroenterology, Iwate Prefectural Chubu Hospital, Kitakami, Japan
| | - Ken Umemura
- Department of Gastroenterology, South Miyagi Medical Center, Ogawara, Japan
| | - Hiroshi Yokoyama
- Department of Gastroenterology, Iwate Prefectural Iwai Hospital, Ichinoseki, Japan
| | - Katsuya Endo
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoichi Kakuta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroki Aizawa
- Department of Internal Medicine, Kesennuma City Hospital, Kesennuma, Japan
| | - Masaki Matsuura
- Department of Gastroenterology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Tomoya Kimura
- Department of Gastroenterology, Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Masatake Kuroha
- Department of Gastroenterology, Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Tooru Shimosegawa
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Zhang L, Liu X, Li Y, Liu Y, Liu Z, Lin J, Shen J, Tang X, Zhang Y, Liang W. Emergency medical rescue efforts after a major earthquake: lessons from the 2008 Wenchuan earthquake. Lancet 2012; 379:853-61. [PMID: 22386038 DOI: 10.1016/s0140-6736(11)61876-x] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Major earthquakes often result in incalculable environmental damage, loss of life, and threats to health. Tremendous progress has been made in response to many medical challenges resulting from earthquakes. However, emergency medical rescue is complicated, and great emphasis should be placed on its organisation to achieve the best results. The 2008 Wenchuan earthquake was one of the most devastating disasters in the past 10 years and caused more than 370,000 casualties. The lessons learnt from the medical disaster relief effort and the subsequent knowledge gained about the regulation and capabilities of medical and military back-up teams should be widely disseminated. In this Review we summarise and analyse the emergency medical rescue efforts after the Wenchuan earthquake. Establishment of a national disaster medical response system, an active and effective commanding system, successful coordination between rescue forces and government agencies, effective treatment, a moderate, timely and correct public health response, and long-term psychological support are all crucial to reduce mortality and morbidity and promote overall effectiveness of rescue efforts after a major earthquake.
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Affiliation(s)
- Lulu Zhang
- Institute of Military Health Management, Second Military Medical University, Shanghai, China.
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Jia Z, Tian W, Liu W, Cao Y, Yan J, Shun Z. Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the 2008 Sichuan earthquake. BMC Public Health 2010; 10:172. [PMID: 20353554 PMCID: PMC2867995 DOI: 10.1186/1471-2458-10-172] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Accepted: 03/30/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association between ages and psychological impact of natural disasters has not been well characterized. A population-based study was conducted 15 months after the 2008 Sichuan earthquake to assess whether elderly survivors were more likely to develop posttraumatic stress disorder (PTSD) and general psychiatric morbidity. METHODS A population-based survey of 327 survivors (152 elders, 175 younger adults) was conducted in severely affected areas by the earthquake, using a multi-stage systematic sampling design. RESULTS Compared with the younger adult survivors, the elderly were more likely to have symptoms of PTSD (22.5% vs. 8.0%, p = 0.001) and general psychiatric morbidity (42.0% vs. 25.4%, p = 0.003). Risk factors, such as being elderly, having been in serious danger, having lost family members, and having felt guilt concerning one's death or injury were significantly associated with developing PTSD; being elderly, having family members or friends seriously injured, and having felt guilt concerning one's death or injury were significantly associated with developing general psychiatric morbidity. Utilization of mental health services is strongly associated with the decreased risk for developing both of the symptoms. CONCLUSION Compared with the younger adults, the elderly survivors were more likely to develop PTSD and general psychiatric morbidity. More mental health services should be distributed to the elderly and groups at particular risk, to ensure their smooth mental health reconstruction after the earthquake.
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Affiliation(s)
- Zhaobao Jia
- Faculty of Health Service, Second Military Medical University, Shanghai, China
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17
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Affiliation(s)
- Emily Y Y Chan
- School of Public Health, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, SAR, China.
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Abstract
Internists are well-positioned to play significant roles in recognizing and responding to epidemics, outbreaks, and bioterrorist attacks. They see large numbers of patients with various health problems and may be the patients' only interaction with the medical community for symptoms resulting from infectious diseases and injuries from radiation, chemicals, and/or burns. Therefore, Internists must understand early warning signs of different bioterrorist and infectious agents, proper reporting channels and measures, various ways that they can assist the public health response, and roles of different local, state, and federal agencies. In addition, it is important to understand effects of a public health disaster on clinic operations and relevant legal consequences.
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Affiliation(s)
- Bruce Y Lee
- Section of Decision Sciences and Clinical Systems Modeling, Core Faculty, Center for Research in Health Care, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Floret N, Viel JF, Mauny F, Hoen B, Piarroux R. Negligible risk for epidemics after geophysical disasters. Emerg Infect Dis 2006; 12:543-8. [PMID: 16704799 PMCID: PMC3294713 DOI: 10.3201/eid1204.051569] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
After geophysical disasters (i.e., earthquakes, volcanic eruptions, tsunamis), media reports almost always stress the risk for epidemics; whether this risk is genuine has been debated. We analyzed the medical literature and data from humanitarian agencies and the World Health Organization from 1985 to 2004. Of >600 geophysical disasters recorded, we found only 3 reported outbreaks related to these disasters: 1 of measles after the eruption of Pinatubo in Philippines, 1 of coccidioidomycosis after an earthquake in California, and 1 of Plasmodium vivax malaria in Costa Rica related to an earthquake and heavy rainfall. Even though the humanitarian response may play a role in preventing epidemics, our results lend support to the epidemiologic evidence that short-term risk for epidemics after a geophysical disaster is very low.
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Affiliation(s)
- Nathalie Floret
- University Hospital of Besançon¸ Besançon, France
- University of Franche-Comté, Besançon, France
| | - Jean-François Viel
- University Hospital of Besançon¸ Besançon, France
- University of Franche-Comté, Besançon, France
| | - Frédéric Mauny
- University Hospital of Besançon¸ Besançon, France
- University of Franche-Comté, Besançon, France
| | - Bruno Hoen
- University Hospital of Besançon¸ Besançon, France
- University of Franche-Comté, Besançon, France
| | - Renaud Piarroux
- University Hospital of Besançon¸ Besançon, France
- University of Franche-Comté, Besançon, France
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Lai SL, Hsu MT, Chen SS. The impact of SARS on epilepsy: the experience of drug withdrawal in epileptic patients. Seizure 2005; 14:557-61. [PMID: 16188463 PMCID: PMC7111166 DOI: 10.1016/j.seizure.2005.08.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2005] [Indexed: 11/26/2022] Open
Abstract
Background During the 2003 severe acute respiratory syndrome (SARS) outbreak, many patients avoided hospital visit because of fear of infection. Antiepileptic drug (AED) withdrawal is a risk factor for seizure recurrence. Therefore, seizure control during the SARS outbreak is a good model for examining the impact of drug withdrawal in seizure control. Methods All seizures experienced by each patient before, during, and after the SARS outbreak periods were registered in each patient's seizure diary. The patients were divided into four groups according to the presence of drug withdrawal as well as seizure attack. In each group, seizures occurring during three different periods were compared. Risk factors for seizure recurrence were also examined. Results Of 227 cases, 49 stopped taking medication during the outbreak. Among them, 28 suffered seizure attacks during AED withdrawal. Four cases developed cluster attacks and two cases had status epilepticus after AED withdrawal. AED withdrawal produced a significant increase in seizure frequency. The major risk factors for withdrawal seizures were symptomatic etiologies, polytherapy and non-seizure free before AED withdrawal. Conclusions The SARS outbreak adversely affected seizure control because of AED withdrawal. Patients with polytherapy, non-seizure free and symptomatic etiologies were more susceptible to recurrence of seizures after AED withdrawal.
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Affiliation(s)
- Shung-Lon Lai
- Department of Neurology, Kaohsiung Chang-Gung Memorial Hospital, 123 Ta-Pei Rd. Niao-Sung Hsiang, Kaohsiung, Taiwan.
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Chen KT, Chen WJ, Malilay J, Twu SJ. The public health response to the Chi-Chi earthquake in Taiwan, 1999. PUBLIC HEALTH REPORTS (WASHINGTON, D.C. : 1974) 2003; 118:493-9. [PMID: 14563906 PMCID: PMC1497595 DOI: 10.1093/phr/118.6.493] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE On September 21, 1999, at 1:47 a.m., an earthquake measuring 7.3 on the Richter scale struck the middle Chi-Chi region of Taiwan. The present study examines the response of the public health sector to the earthquake. METHODS A community needs assessment using modified cluster sampling was performed in shelters of Nantou and Taichung Counties five days after the earthquake struck. Twenty-five temporary medical service systems (TMSSs) conducted surveillance for selected diseases and mortality within one week post-earthquake aided by a buddy system that allowed unaffected counties to provide support to affected counties. RESULTS The number of cases of acute respiratory infections and acute gastroenteritis in the affected area was higher than that of neighboring unaffected counties in the post-earthquake phase (p<0.001). Earthquake-related deaths were estimated at 2,347 deaths (death rate 116 per 100,000 population); the mean age of the decedents was 49.7 years. No significant difference was observed between males (120/100,000) and females (110/100,000) (risk ratio [RR]=1.09; 95% confidence interval [CI] 0.84, 1.42; p>0.05). The age-adjusted mortality rate was significantly higher in 1999 (odds ratio [OR]=2.11; 95% CI 1.99, 2.24) than in a comparable period in 1998. CONCLUSION Emergency preparedness must be based on carefully conceived priorities, information, and communications, and improved capabilities must be developed to rapidly implement an emergency public health network. The emergency response to this event-consisting of TMSSs, a buddy system, and a communication system-should be considered in planning for future disaster events in Taiwan.
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Affiliation(s)
- Kow-Tong Chen
- Field Epidemiology Training Program, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China
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22
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Chen KT, Chen WJ, Malilay J, Twu SJ. The public health response to the Chi-Chi earthquake in Taiwan, 1999. Public Health Rep 2003. [DOI: 10.1016/s0033-3549(04)50285-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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