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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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Açma A, Williams A, Repetto E, Cabral S, Sunyoto T, Woolley SC, Mahama G. Prevalence of MDR bacteria in an acute trauma hospital in Port-au-Prince, Haiti: a retrospective analysis from 2012 to 2018. JAC Antimicrob Resist 2021; 3:dlab140. [PMID: 34514410 PMCID: PMC8419367 DOI: 10.1093/jacamr/dlab140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/13/2021] [Indexed: 11/22/2022] Open
Abstract
Background Antibiotic resistance (ABR) is recognized as an increasing threat to global health. Haiti declared ABR an emerging public health threat in 2018, however, the current surveillance system is limited. We described the microbiological data from a Médecins Sans Frontières trauma hospital, to increase knowledge on ABR in Haiti for similar facilities. Methods A retrospective cross-sectional analysis of routine microbiological data of samples taken from patients admitted to the inpatient ward or followed up in the outpatient clinic of the trauma hospital from March 2012 to December 2018. Resistance trends were analysed per isolate and compared over the 7 year period. Results Among 1742 isolates, the most common samples were pus (53.4%), wound swabs (30.5%) and blood (6.9%). The most frequently detected bacteria from these sample types were Staphylococcus aureus (21.9%), Pseudomonas aeruginosa (20.9%) and Klebsiella pneumoniae (16.7%). MDR bacteria (32.0%), ESBL-producing bacteria (39.1%), MRSA (24.1%) and carbapenem-resistant Enterobacteriaceae (CRE) species (2.6%) were all detected. Between 2012 and 2018 the number of ESBL isolates significantly increased from 3.2% to 42.9% (P = 0.0001), and resistance to clindamycin in MSSA isolates rose from 3.7% to 29.6% (P = 0.003). Two critical WHO priority pathogens (ESBL-producing CRE and carbapenem-resistant P. aeruginosa) were also detected. Conclusions Over a 7 year period, a high prevalence of MDR bacteria was observed, while ESBL-producing bacteria showed a significantly increasing trend. ABR surveillance is important to inform clinical decisions, treatment guidelines and infection prevention and control practices.
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Affiliation(s)
- Ayşe Açma
- Médecins Sans Frontières-Operational Centre Brussels (MSFOCB), Haiti Mission, Port-au-Prince, Haiti
| | - Anita Williams
- MSFOCB Luxembourg Operational Research (LuxOR) Unit, Luxembourg.,MSFOCB, Middle East Medical Unit (MEMU), Beirut, Lebanon
| | - Ernestina Repetto
- Medecins Sans Frontieres -Operational Centre Geneva (MSFOCG), Medical Department, Geneva, Switzerland
| | - Sèrgio Cabral
- MSFOCB Nap Kembe Acute Trauma Hospital, Tabarre, Haiti
| | - Temmy Sunyoto
- MSFOCB Luxembourg Operational Research (LuxOR) Unit, Luxembourg
| | - Sophie Cherestal Woolley
- Médecins Sans Frontières-Operational Centre Brussels (MSFOCB), Haiti Mission, Port-au-Prince, Haiti
| | - Gabane Mahama
- MSFOCB Operations Department Cell 3, Brussels, Belgium
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The spectrum of bacteria and mechanisms of resistance identified from the casualties treated in the Israeli field hospital after the earthquake in Nepal, 2015: A retrospective analysis. Travel Med Infect Dis 2020; 37:101707. [PMID: 32353631 DOI: 10.1016/j.tmaid.2020.101707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 04/04/2020] [Accepted: 04/24/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND On the April 25, 2015, a 7.8 magnitude earthquake struck Nepal. Soon-after, the Israel Defense Force (IDF) dispatched a tertiary field-hospital to Kathmandu. The field-hospital was equipped with a clinical laboratory with microbiology capabilities. Limited data exists regarding the spectrum of bacteria isolated from earthquake casualties. We aimed to identify the spectrum of bacteria and their mechanisms of resistance in-order to allow preparedness of antibiotic treatment protocols for future disaster scenarios. METHODS - The field-laboratory phenotypically processed cultures from sterile and non-sterile sites as needed clinically. Later-on, the isolates were brought to Israel for quality control, definite identification and molecular characterization including mechanisms of resistance. RESULTS A total of 82 clinical pathogens were isolated from 56 patients; 68% of them were Gram negative bacilli. The most common isolates were Enterobacteriaceae (55%) -36% carried bla-NDM and 33% produced Extended-spectrum beta-lactamase (ESBL), mostly blaCTX-M-15. Enterococcus spp were the main Gram positive bacteria isolated (22 isolates), yet, none were vancomycin resistant. The overall level of resistance was 27% MDR and 23% extensively drug resistant (XDR) bacteria. CONCLUSIONS - Gram negative bacteria were the predominant organism cultured from the casualties, of them 77% were MDR or XDR. NDM was the most common resistance mechanism. The Antibiotic inventory of a field-hospital should be set to cover a wide and unexpected spectrum of bacteria, including resistant organisms. This report adds important information to the scarce reports of bacterial resistance in Nepal.
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Bekçibaşı M, Hoşoğlu S, Deveci Ö, Dayan S. Therapy for wound infections after earthquakes requires inclusion of drugs targeting Gram-negative bacteria. Infect Dis (Lond) 2017; 49:862-864. [DOI: 10.1080/23744235.2017.1337276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Muhammed Bekçibaşı
- Department of Infectious Diseases and Clinical Microbiology, Bismil State Hospital, Diyarbakır, Turkey
| | - Salih Hoşoğlu
- Department of Infectious Diseases and Clinical Microbiology, Fatih University School of Medicine, İstanbul, Turkey
| | - Özcan Deveci
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Saim Dayan
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakır, Turkey
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Zhang L, Zhao M, Fu W, Gao X, Shen J, Zhang Z, Xian M, Jiao Y, Jiang J, Wang J, Gao G, Tang B, Chen L, Li W, Zhou C, Deng S, Gu J, Zhang D, Zheng Y, Chen X. Epidemiological analysis of trauma patients following the Lushan earthquake. PLoS One 2014; 9:e97416. [PMID: 24846207 PMCID: PMC4028270 DOI: 10.1371/journal.pone.0097416] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 04/18/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A 7.0-magnitude earthquake hit Lushan County in China's Sichuan province on April 20, 2013, resulting in 196 deaths and 11,470 injured. This study was designed to analyze the characteristics of the injuries and the treatment of the seismic victims. METHODS After the earthquake, an epidemiological survey of injured patients was conducted by the Health Department of Sichuan Province. Epidemiological survey tools included paper-and-pencil questionnaires and a data management system based on the Access Database. Questionnaires were completed based on the medical records of inpatients with earthquake-related injuries. Outpatients or non-seismic injured inpatients were excluded. A total of 2010 patients from 140 hospitals were included. RESULTS The most common type of injuries involved bone fractures (58.3%). Children younger than 10 years of age suffered fewer fractures and chest injuries, but more skin and soft -tissue injuries. Patients older than 80 years were more likely to suffer hip and thigh fractures, pelvis fractures, and chest injuries, whereas adult patients suffered more ankle and foot fractures. A total of 207 cases of calcaneal fracture were due to high falling injuries related to extreme panic. The most common type of infection in hospitalized patients was pulmonary infections. A total of 70.5% patients had limb dysfunction, and 60.1% of this group received rehabilitation. Most patients received rehabilitation within 1 week, and the median duration of rehabilitation was 3 weeks. The cause of death of all seven hospitalized patients who died was severe traumatic brain injuries; five of this group died within 24 h after the earthquake. CONCLUSIONS Injuries varied as a function of the age of the victim. As more injuries were indirectly caused by the Lushan earthquake, disaster education is urgently needed to avoid secondary injuries.
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Affiliation(s)
- Li Zhang
- State Key Laboratory of Kidney Disease, Department of Nephrology, Chinese PLA General Hospital and Military Medical College, Beijing, China
| | - Minggang Zhao
- National Health and Family Planning Commission of the People’s Republic of China, Beijing, China
| | - Wenhao Fu
- National Health and Family Planning Commission of the People’s Republic of China, Beijing, China
| | - Xinqiang Gao
- National Health and Family Planning Commission of the People’s Republic of China, Beijing, China
| | - Ji Shen
- Health and Family Planning Commission of Sichuan Province, Chengdu, China
| | - Zuyun Zhang
- Health and Family Planning Commission of Sichuan Province, Chengdu, China
| | - Ming Xian
- Health and Family Planning Commission of Sichuan Province, Chengdu, China
| | - Yunzhi Jiao
- Health and Family Planning Commission of Sichuan Province, Chengdu, China
| | - Jian Jiang
- Health and Family Planning Commission of Sichuan Province, Chengdu, China
| | - Jinqian Wang
- Health and Family Planning Commission of Sichuan Province, Chengdu, China
| | - Guomin Gao
- Department of Health, United Logistic Ministry, Chengdu Military Region, Chengdu, China
| | - Bin Tang
- Department of Health, United Logistic Ministry, Chengdu Military Region, Chengdu, China
| | - Liang Chen
- Department of Health, United Logistic Ministry, Chengdu Military Region, Chengdu, China
| | - Weimin Li
- West China Hospital, Sichuan University, Chengdu, China
| | | | - Shaoping Deng
- Sichuan Provincial People’s Hospital, Chengdu, China
| | - Jianwen Gu
- General Hospital of Chengdu Military Command, Chengdu, China
| | - Dong Zhang
- State Key Laboratory of Kidney Disease, Department of Nephrology, Chinese PLA General Hospital and Military Medical College, Beijing, China
| | - Ying Zheng
- State Key Laboratory of Kidney Disease, Department of Nephrology, Chinese PLA General Hospital and Military Medical College, Beijing, China
| | - Xiangmei Chen
- State Key Laboratory of Kidney Disease, Department of Nephrology, Chinese PLA General Hospital and Military Medical College, Beijing, China
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Clinical and microbiologic characteristics of children treated at the Fort de France university hospital after the 2010 Haiti earthquake. Pediatr Infect Dis J 2013; 32:568-9. [PMID: 23340552 DOI: 10.1097/inf.0b013e3182863c53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Few data related to the care of children injured in an earthquake are available. The objective of our study was to analyze the results of clinical and microbiologic characteristics of children treated in a Fort de France hospital after the Haiti earthquake. Bacteria were mainly Gram-negative bacteria. Some of these infections seemed to be environmental; a significant portion was related to acquisition during hospitalization.
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Amount of Usage and Involvement in Explosions Not Associated with Increased Contamination of Prehospital Vehicles with Multi-drug-resistant Organisms. Prehosp Disaster Med 2013; 28:107-9. [DOI: 10.1017/s1049023x12001781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractIntroductionThe role of explosions and patient transport vehicles as sources and vectors of Gram-negative, multidrug-resistant organisms (MDROs) that predominate infections following lengthy evacuations after disasters due to natural hazards and in current war-trauma patients is unknown.Hypothesis/ProblemDamaged or heavily-used vehicles could be sources of the MDROs subsequently linked to nosocomial infections.MethodsFrom January through May 2008 in Iraq, inside surfaces of heavily-used, tactical vehicles (Experimental Group) were sampled with sterile, pre-moistened swabs. Swabs, along with positive and negative controls, were shipped to the reference laboratory in Washington, DC, where they underwent culture, identification and susceptibility testing, and pulsed-field gel electrophoresis. Multidrug-resistant organisms were defined according to the standard Centers for Disease Control and Prevention definitions. High risk organisms (HROs) were defined as susceptible E. coli, A. baumannii, P. aeruginosa, Enterobacter spp, or Klebsiella spp. Concurrently, new counterparts (Control Group) were similarly surveyed in a storage lot in Georgia, USA. Groups were compared using the Chi-squared test.ResultsOne hundred thirty-nine consecutive vehicles including all available ambulances were sampled, yielding 153 swabs. Nineteen were lost or damaged during shipping. Seventy-nine swabs yielded growth of one or more Gram-negative bacteria. The amount and genotype of MDROs in heavily-used vehicles, including those involved in roadside bombings, were compared to control vehicles and to strains isolated from wounds and environmental surfaces at the base hospital. Predominant organisms included P. agglomerans (34%), S. flexneri (8%), E. vulneris (6%), Pseudomonas sp. (6%), and K. pneumonia (6%). No MDROs were isolated. Thirteen vehicles (eight of 94 experimental and five of 45 control) yielded HRO. There was no difference in contamination rates (P = .63). No HROs were isolated from ambulances. No clonal association existed between vehicle and hospital strains.ConclusionGiven the implications that this knowledge gap has on military and civilian prehospital reservoirs of infection, further study is warranted to confirm these findings and identify targets for preventive intervention throughout civilian disaster and military casualty evacuation chains.LeshoE, AkeJ, HuangX, CashDM, NikolichM, BarberM, RobensK, GarnettE, LindlerL, ScottP. Amount of usage and involvement in explosions not associated with increased contamination of prehospital vehicles with multi-drug-resistant organisms. Prehosp Disaster Med. 2013;28(2):1-3..
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Iwata K, Ohji G, Oka H, Takayama Y, Aoyagi T, Gu Y, Hatta M, Tokuda K, Kaku M. Communicable Diseases After the Disasters: with the Special Reference to the Great East Japan Earthquake. JOURNAL OF DISASTER RESEARCH 2012; 7:746-753. [DOI: 10.20965/jdr.2012.p0746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
On March 11, 2011, the Great East Japan Earthquake – a massive temblor followed by a gigantic tsunami was associated with significant morbidity and mortality. Among many health problems such as trauma, drowning, and mental illnesses, infectious diseases may place significant burden on survivors of such disasters. Wound infections including tetanus, leptospirosis, legionellosis, rickettsiosis, respiratory infections, and diarrheal illness among other infections had been considered to be associated with earthquake and tsunami. Overall, the impact of infectious diseases after the Great East Japan Earthquake was relatively small, with only sporadic outbreaks observed. The incidence of serious infections such as tetanus, legionellosis, and tsunami lung, was also low, considering the overall impact of the earthquake and tsunamiper se. This review discusses the impact of infectious diseases after the Great East Japan Earthquake, and reviews past disaster-related infections as reference.
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Benjamin E, Bassily-Marcus AM, Babu E, Silver L, Martin ML. Principles and practice of disaster relief: lessons from Haiti. ACTA ACUST UNITED AC 2011; 78:306-18. [PMID: 21598258 DOI: 10.1002/msj.20251] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Disaster relief is an interdisciplinary field dealing with the organizational processes that help prepare for and carry out all emergency functions necessary to prevent, prepare for, respond to, and recover from emergencies and disasters caused by all hazards, whether natural, technological, or human-made. Although it is an important function of local and national governing in the developed countries, it is often wanting in resource-poor, developing countries where, increasingly, catastrophic disasters tend to occur and have the greatest adverse consequences. The devastating January 12, 2010, Haiti earthquake is a case study of the impact of an extreme cataclysm in one of the poorest and most unprepared settings imaginable. As such, it offers useful lessons that are applicable elsewhere in the developing world. Emergency preparedness includes 4 phases: mitigation or prevention, preparedness, response, and recovery. Periods of normalcy are the best times to develop disaster preparedness plans. In resource-poor countries, where dealing with the expenses of daily living is already a burden, such planning is often neglected; and, when disasters strike, it is often with great delay that the assistance from international community can be deployed. In this increasingly interconnected world, the Haiti earthquake and the important international response to it make a strong case for a more proactive intervention of the international community in all phases of emergency management in developing countries, including in mitigation and preparedness, and not just in response and recovery. Predisaster planning can maximize the results of the international assistance and decrease the human and material tolls of inevitable disasters. There should be a minimum standard of preparedness that every country has to maintain and the international assistance to achieve that. International academic medical centers interested in global health could strengthen their programs by prospectively including in them contingency planning for international relief operations. Healthcare professionals of these institutions who travel to disaster zones should rigorously prepare themselves and make provisions for collecting and reporting data, which will enrich the knowledge of this growing activity.
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