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Mavrouli M, Mavroulis S, Lekkas E, Tsakris A. An Emerging Health Crisis in Turkey and Syria after the Earthquake Disaster on 6 February 2023: Risk Factors, Prevention and Management of Infectious Diseases. Healthcare (Basel) 2023; 11:healthcare11071022. [PMID: 37046949 PMCID: PMC10093972 DOI: 10.3390/healthcare11071022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/16/2023] [Accepted: 03/30/2023] [Indexed: 04/07/2023] Open
Abstract
On 6 February 2023, Turkey and Syria were hit by two major earthquakes that caused extremely heavy structural damage to buildings and infrastructure in one of the most densely populated areas of Anatolia. The authors visited the devastated area shortly after the earthquakes in the frame of search and rescue and scientific missions in order to check whether the newly formed conditions have the potential to further affect public health. Based on the collected disaster-related field data, it is revealed that risk factors associated with and favoring emergence of infectious diseases are present in the affected residential areas from the first hours of the emergency state. The coexistence and synergy of many collapsed health facilities, cold winter conditions, destruction of lifeline infrastructures, overcrowding in emergency shelters, poor sanitation and adverse socio-economic conditions along with evolving crises and disasters (conflicts, pandemic and epidemics) may further aggravate the already fragile public health situation and cause considerable delays in the recovery process. Efficient disease surveillance at local and regional levels is a crucial requirement for early warning and protection against emerging infectious diseases in the earthquake-affected areas among other proposed measures for prevention and management of infectious diseases.
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Affiliation(s)
- Maria Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Spyridon Mavroulis
- Department of Dynamic Tectonic Applied Geology, Faculty of Geology and Geoenvironment, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece
| | - Efthymios Lekkas
- Department of Dynamic Tectonic Applied Geology, Faculty of Geology and Geoenvironment, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece
- Earthquake Planning and Protection Organization, 15451 Athens, Greece
| | - Athanassios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Mavrouli M, Mavroulis S, Lekkas E, Tsakris A. The Impact of Earthquakes on Public Health: A Narrative Review of Infectious Diseases in the Post-Disaster Period Aiming to Disaster Risk Reduction. Microorganisms 2023; 11:microorganisms11020419. [PMID: 36838384 PMCID: PMC9968131 DOI: 10.3390/microorganisms11020419] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Earthquakes are among the most impressive natural phenomena with very high potential to set off a chain of effects that significantly affects public health through casualties and injuries. Related disasters are attributed not only to the strong ground motion and coseismic phenomena but also to secondary effects, comprising mainly landslides and tsunamis, among others. All these can create harsh conditions favorable for the emergence of infectious diseases that are capable of causing additional human and economic losses and disruption of the emergency and recovery process. The present study comprises an extensive narrative review of the existing literature on the earthquake-triggered infectious diseases recorded worldwide, along with their symptoms, causative pathogens, associated risk factors, most vulnerable population groups, and prevention strategies. Respiratory, gastrointestinal, and vector-borne diseases, as well as wound and skin infections, are mainly recorded among the earthquake-affected population. Measures for effectively preventing earthquake-triggered infectious diseases are also proposed. One of the widely proposed measures is the establishment of a proper disease surveillance system in order to immediately and effectively identify the pre- and post-disaster occurrence of infectious diseases. This approach significantly contributes to disease trends monitoring, validation of early warning, and support of the emergency response and recovery actions.
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Affiliation(s)
- Maria Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
| | - Spyridon Mavroulis
- Department of Dynamic Tectonic Applied Geology, Faculty of Geology and Geoenvironment, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece
| | - Efthymios Lekkas
- Department of Dynamic Tectonic Applied Geology, Faculty of Geology and Geoenvironment, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece
| | - Athanassios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Mavrouli M, Mavroulis S, Lekkas E, Tsakris A. Respiratory Infections Following Earthquake-Induced Tsunamis: Transmission Risk Factors and Lessons Learned for Disaster Risk Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094952. [PMID: 34066563 PMCID: PMC8125353 DOI: 10.3390/ijerph18094952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/29/2021] [Accepted: 05/02/2021] [Indexed: 11/26/2022]
Abstract
Earthquake-induced tsunamis have the potential to cause extensive damage to natural and built environments and are often associated with fatalities, injuries, and infectious disease outbreaks. This review aims to examine the occurrence of respiratory infections (RIs) and to elucidate the risk factors of RI transmission following tsunamis which were induced by earthquakes in the last 20 years. Forty-seven articles were included in this review and referred to the RIs emergence following the 2004 Sumatra-Andaman, the 2009 Samoa, and the 2011 Japan earthquakes. Polymicrobial RIs were commonly detected among near-drowned tsunami survivors. Influenza outbreaks were commonly detected during the influenza transmission period. Overcrowded conditions in evacuation centers contributed to increased acute RI incidence rate, measles transmission, and tuberculosis detection. Destruction of health care infrastructures, overcrowded evacuation shelters, exposure to high pathogen densities, aggravating weather conditions, regional disease endemicity, and low vaccination coverage were the major triggering factors of RI occurrence in post-tsunami disaster settings. Knowledge of risk factors underlying RIs emergence following earthquake-induced tsunami can contribute to the implementation of appropriate disaster prevention and preparedness plans characterized by sufficient environmental planning, resistant infrastructures, resilient health care facilities, and well-established evacuation centers. Global and local disease surveillance is a key prerequisite for early warning and protection against RIs’ emergence and transmission in tsunami-prone areas.
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Affiliation(s)
- Maria Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- Correspondence:
| | - Spyridon Mavroulis
- Department of Dynamic Tectonic Applied Geology, Faculty of Geology and Geoenvironment, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece; (S.M.); (E.L.)
| | - Efthymios Lekkas
- Department of Dynamic Tectonic Applied Geology, Faculty of Geology and Geoenvironment, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece; (S.M.); (E.L.)
| | - Athanassios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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Charnley GEC, Kelman I, Gaythorpe KAM, Murray KA. Traits and risk factors of post-disaster infectious disease outbreaks: a systematic review. Sci Rep 2021; 11:5616. [PMID: 33692451 PMCID: PMC7970931 DOI: 10.1038/s41598-021-85146-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/23/2021] [Indexed: 01/31/2023] Open
Abstract
Infectious disease outbreaks are increasingly recognised as events that exacerbate impacts or prolong recovery following disasters. Yet, our understanding of the frequency, geography, characteristics and risk factors of post-disaster disease outbreaks globally is lacking. This limits the extent to which disease outbreak risks can be prepared for, monitored and responded to following disasters. Here, we conducted a global systematic review of post-disaster outbreaks and found that outbreaks linked to conflicts and hydrological events were most frequently reported, and most often caused by bacterial and water-borne agents. Lack of adequate WASH facilities and poor housing were commonly reported risk factors. Displacement, through infrastructure damage, can lead to risk cascades for disease outbreaks; however, displacement can also be an opportunity to remove people from danger and ultimately protect health. The results shed new light on post-disaster disease outbreaks and their risks. Understanding these risk factors and cascades, could help improve future region-specific disaster risk reduction.
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Affiliation(s)
- Gina E. C. Charnley
- grid.7445.20000 0001 2113 8111Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK ,grid.7445.20000 0001 2113 8111MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Ilan Kelman
- grid.83440.3b0000000121901201Institute for Risk and Disaster Reduction, Faculty of Mathematical and Physical Sciences, University College London, London, UK ,grid.83440.3b0000000121901201Institute for Global Health, Faculty of Population Health, University College London, London, UK ,grid.23048.3d0000 0004 0417 6230University of Agder, Kristiansand, Norway
| | - Katy A. M. Gaythorpe
- grid.7445.20000 0001 2113 8111Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK ,grid.7445.20000 0001 2113 8111MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Kris A. Murray
- grid.7445.20000 0001 2113 8111Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK ,grid.7445.20000 0001 2113 8111MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK ,grid.415063.50000 0004 0606 294XMRC Unit The Gambia At London, School of Hygiene and Tropical Medicine, Fajara, The Gambia
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Takahashi S, Murata K, Ozawa K, Yamada H, Kawakami H, Nakayama A, Asano Y, Mochizuki K, Mikamo H. Moraxella species: infectious microbes identified by use of time-of-flight mass spectrometry. Jpn J Ophthalmol 2019; 63:328-336. [PMID: 31273564 DOI: 10.1007/s10384-019-00669-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 04/02/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To report the clinical manifestations, identification, antimicrobial susceptibilities, and treatment outcomes of ocular infections caused by Moraxella species. STUDY DESIGN Retrospective study. PATIENTS AND METHODS The medical records of all patients treated at the Departments of Ophthalmology of the Ogaki Municipal Hospital and the Gifu University Graduate School of Medicine for ocular infections caused by Moraxella species between January 2011 and June 2017 were examined. The stored Moraxella species isolated from ocular samples were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), molecular identification, and the biochemical properties. RESULTS Sixteen eyes of 16 patients were treated for Moraxella ocular infections. The patients' median age was 72 years. A predisposing systemic or ocular condition was identified in 15 of the patients. Nine of the patients developed keratitis; four, conjunctivitis; and three, blebitis. M lacunata (6 eyes), M catarrhalis (6), M nonliquefaciens (3), and M osloensis (1) were identified by MALDI-TOF MS. All isolates were sensitive to levofloxacin, tobramycin, ceftazidime, ceftriaxone, and cefazolin. Twelve patients with keratitis or blebitis were treated with various topical antimicrobial combinations, and systemic antibiotics were used in 10 of the 12 patients. The mean time for the complete closure of the epithelial defects with keratitis was 24 days. The visual outcomes after treatment were favorable except in 1 keratitis patient who underwent enucleation. CONCLUSIONS The use of duo-therapy with a combination of fluoroquinolone and cefmenoxime should be considered in cases nonresponsive to monotherapy, such as keratitis and bleb-associated infections. MALDI-TOF MS is useful for the identification of Moraxella to the species level.
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Affiliation(s)
- Shunsuke Takahashi
- Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiro Murata
- Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kenji Ozawa
- Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroki Yamada
- Department of Ophthalmology, Ogaki Municipal Hospital, Gifu, Japan
| | - Hideaki Kawakami
- Department of Ophthalmology, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu-shi, Gifu, 500-8513, Japan.
| | - Asami Nakayama
- Department of Clinical Laboratory, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuko Asano
- Department of Clinical Laboratory, Ogaki Municipal Hospital, Gifu, Japan
| | - Kiyofumi Mochizuki
- Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
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Nagashima H, Fujimura I, Nakamura Y, Utsumi Y, Yamauchi K, Takikawa Y, Yokoyama Y, Sakata K, Kobayashi S, Ogawa A. Changes in pulmonary function of residents in Sanriku Seacoast following the tsunami disaster from the Great East Japan Earthquake. Respir Investig 2018; 56:184-188. [PMID: 29548658 DOI: 10.1016/j.resinv.2017.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Residents in the district struck by the Great East Japan Earthquake Tsunami (GEJET) suffered from adverse living conditions and various pulmonary diseases. OBJECTIVES To evaluate the influence of GEJET, we performed serial assessment of pulmonary function of approximately 10,000 residents in the district struck by GEJET. METHODS Using a spirometer, we assessed the pulmonary function of approximately 10,000 residents older than 18 years in the Sanriku seacoast, which was struck by the tsunami. Measurements were performed in 2011 and 2012. RESULTS We compared FVC (forced vital capacity) % pred. and FEV1 (forced expiratory volume in 1second) % pred. of subjects between 2011 and 2012, by serial spirometry. Of the 7053 subjects studied, including 2611 men and 4442 women, FVC% pred. and FEV1% pred. were significantly higher in 2012 than in 2011. Physical indices including height, body weight and the body mass index (BMI) did not change significantly during this period. Smoking prevalence changed significantly between 2010, 2011, and 2012. Both FVC% pred. and FEV1% pred. of subjects who had quit smoking increased significantly on spirometry carried out in 2012, compared with those in 2011. CONCLUSIONS The pulmonary function expressed as FVC% pred. and FEV1% pred. were significantly higher in 2012 than in 2011 among the subjects studied. The changes in the smoking status may be one of the reasons for the increase in values observed. However, other undetermined factors during recovery from a disaster might have resulted in improved pulmonary function.
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Affiliation(s)
- Hiromi Nagashima
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Itaru Fujimura
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Yutaka Nakamura
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Yu Utsumi
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Kohei Yamauchi
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan.
| | - Yasuhiro Takikawa
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Yukari Yokoyama
- Faculty of Social Welfare, Department of Social Welfare, Nihon Fukushi University, Mihama-cho, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine, Japan
| | | | - Akira Ogawa
- Iwate Medical University School of Medicine, Morioka, Japan
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Okinaga S, Furukawa K, Ishiki A, Tomita N, Arai H. Disaster medicine for the elderlies -chronological aspects of the Great East Japan Earthquake and Tsunami and future issues. Nihon Ronen Igakkai Zasshi 2017; 54:136-142. [PMID: 28592733 DOI: 10.3143/geriatrics.54.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Naito T, Matsuda N, Tanei M, Watanabe Y, Watanabe A. Relationship between public subsidies and vaccination rates with the 23-valent pneumococcal vaccine in elderly persons, including the influence of the free vaccination campaign after the Great East Japan Earthquake. J Infect Chemother 2014; 20:450-3. [DOI: 10.1016/j.jiac.2014.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 03/01/2014] [Accepted: 03/14/2014] [Indexed: 10/25/2022]
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Uchimura M, Kizuki M, Takano T, Morita A, Seino K. Impact of the 2011 Great East Japan Earthquake on community health: ecological time series on transient increase in indirect mortality and recovery of health and long-term-care system. J Epidemiol Community Health 2014; 68:874-82. [PMID: 24847089 DOI: 10.1136/jech-2014-204063] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The objectives were to clarify the trend in the cause-specific mortality rate and changes in health and long-term-care use after the Great East Japan Earthquake in 2011. METHODS We obtained the following data from national sources: the number of deaths by cause, age and month; the amount of healthcare insurance expenditures by type of services, age and month; the amount of long-term-care insurance expenditures by type of services, age, care need and month. We estimated increase in standardised mortality rate postearthquake compared with pre-earthquake, and change in the standardised amount of health and long-term-care insurance expenditures post-earthquake compared with pre-earthquake in three severely affected prefectures, Iwate, Miyagi and Fukushima, by the adjustment for trends in the other prefectures. RESULTS The risk of indirect mortality increased in the month of the earthquake (relative risk (RR) with 95% CI 1.20 (1.13 to 1.28) for those 60-69 years of age, 1.25 (1.17 to 1.32) for 70-79 years, and 1.33 (1.27 to 1.38) for 80 years and older). The amount of health and long-term-care insurance expenditures decreased among elderly persons in the month of the earthquake, and recovered to 95% of usual level within 1-5 months. Among cities and towns hit by tsunami, higher percentage of households flooded was associated with higher risk of indirect mortality (p<0.001), lower expenditures for outpatient medical care (p<0.001), and lower expenditures for home-care services (p<0.001). CONCLUSIONS This study showed transient increase in indirect mortality and recovery of health and long-term-care system after the earthquake.
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Affiliation(s)
- Mari Uchimura
- Department of Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masashi Kizuki
- Department of Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takehito Takano
- Department of Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayako Morita
- Department of Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kaoruko Seino
- Department of International Health and Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Abstract
This month, on November 12, the world will recognize the fourth annual World Pneumonia Day. First launched in 2009 by a coalition of global health leaders (1), World Pneumonia Day aims to raise awareness about pneumonia's toll on the world's children and to promote interventions to protect against, treat, and prevent the disease. Pneumonia continues to be the leading killer of young children around the world, causing ≈14% of all deaths in children 1 month to 5 years of age (2). It is a critical disease for countries to conquer in order to reach Millennium Development Goal 4: reducing the child mortality rate by two thirds from 1990 to 2015 (3). Most children who die from pneumonia live in developing countries, where such factors as malnutrition, crowding, and lack of access to quality health care increase the risk for death. Pneumonia kills few children in industrialized countries, although it remains among the top 10 causes of deaths in the United States, for example, because of deaths in older adults (4).
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Affiliation(s)
- Rana Hajjeh
- Centers for Disease Control and Prevention, Atlanta,GA 30333, USA.
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