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Post Disaster Public Health Challenges
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Learning Objective To discuss the major post disaster public health challenges and their preventive strategies.
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Disaster Challenge
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Major Public Health Issues (Post disaster)
Environmental pollution Water Contamination Poor Sanitation Malnutrition Protein Energy Malnutrition(PEM) Vitamin A deficiency Epidemics Spread of infectitious diseases
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Causes of Outbreaks of Infectious Disease in Disasters
Population displacement Environmental changes Loss of public utilities Disruption of basic health services Impact of food scarcity and hunger
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Common Modes of Transmission
Person-to-person Measles, Meningitis, ARI Feco-oral/Enteric Shigella, Cholera, Typhoid, Hepatitis Vector Malaria
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Specific Infectious Diseases After Disasters
Measles Acute Respiratory Infection Cholera Shigellosis Malaria Typhoid Hepatitis Meningitis
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Displaced Populations 80 –90% Of Deaths 5 Conditions
Malnutrition Measles Acute respiratory infection Diarrheal diseases (Cholera, Shigella) Malaria
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Diagnosis and Treatment
large numbers of patients limited resources austere conditions So Rely on Clinical Diagnosis Empirical Treatment
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Measles -diagnosis Fever 3 Cs Cough Coryza Conjunctivitis Rash
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Measles Vaccination Early in the emergency situation
All children 6 months to 5 years Long term situations children 9 months to 5 years Any child vaccinated between 6 and 9 months -revaccinate at 9 month If insufficient vaccine available, in order of priority undernourished children 6 month to 12 years all other children ages 6 to 23 months all other children months Concurrent vitamin A administration
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Acute Respiratory Infections
A leading cause of death among effected populations Pathogens Variety of viruses and bacteria Control: Provide adequate space, shelter, clothing, blankets, and ventilation
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Cholera -Diagnosis Severe dehydration Rice water stools Painless
Huge volumes Vomiting
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Cholera Cot
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Shigellosis -Diagnosis
Bloody stools Cramps Fever
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Malaria -Diagnosis Jaundice Cerebral symptoms Renal failure
Fever Jaundice Cerebral symptoms Renal failure Splenomegaly
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Malaria Diagnosis fever Pattern
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Vector Control Methods
Habitat Control Reducing Contact Chemical Control Insecticides, larvicides, rodenticides Repellents Biological Control
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Vector Borne Diseases Diseases such as:
Disaster environments are very conducive to the proliferation of diseases-carrying insects and rodents (vectors) Diseases such as: Malaria, filariasis, dengue, yellow fever, encephalitis, scabies, scrub typhus, plague, endemic typhus, relapsing fever leptospirosis
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Typhoid Fever Diagnosis
ROSE SPOTS
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Typhoid Fever -Diagnosis
Fever, Bradycardia
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Hepatitis Diagnosis Fever Jaundice Malaise
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Meningococcal Meningitis –Diagnosis
Fever Headache Neck stiffness Purpuric rash Purulent CSF
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Vector Control Measures
Physical screens can be used to control immediate problem For the longer term -make environment less favourable Improve personal hygiene Sanitation Drainage Garbage disposal Food storage and handling practices Remove stagnate water Camp location Insecticide use must be monitored by professionals
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Disaster Preparedness
Pre-disaster Preparedness Post-disaster Preparedness Efficient action at all levels to save lives Reduce sufferings & Minimize damage to property
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Factors for Disease Transmission After a Disaster
Environmental considerations Endemic organisms Population characteristics Pre- event structure and public health Type and magnitude of the disaster
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SEQs 1. What is a disaster? Classify natural disasters Enumerate the specific infectious diseases likely to spread after disaster. 2. Which of the 4 phases do you consider to be the most important? Support your answer. 3. Giving examples (from your own country) state situations where Disaster Management could have been better implemented. 4. In the case of a natural disaster, both govt and individuals are responsible for how citizens are affected. List 3 actions/activities/methods each for both govt and individuals, which can be carried out to mitigate the effects of a known natural disaster.
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MCQ-1 After the earth quake of 8th October 2005, Capital Development Authority issued a directive that in future all the buildings to be constructed in capital territory will be built on strong iron pillars so that the buildings can sustain earthquake shocks. In disaster management phases, action of CDA is included in: Disaster preparedness Disaster impact & response Rehabilitation/reconstruction Mitigation Recovery
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MCQ-2 In a temporary camp, maximum distance between a dwelling and a toilet should be: < >50 Meters < >45 Meters < >40 Meters < >55 Meters < >60 Meters
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MCQ-3 In a transient camp, 3000 people are required to be settled. Minimum shelter space required for these refugees will be: 11500 m2 10500 m2 13500 m2 9500 m2 6000 m2
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MCQ-4 In earth quakes: Injuries < deaths
Injuries = deaths are equal Deaths <injuries Cannot be calculated None of the above
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MCQ-5 Crude Mortality Rate (CDR=deaths/10000/day) is single most important indicator of serious stress in affected populations in a disaster hit area. If CDR is >2, it indicates situation is: Under control Serious condition Out of control Major Catastrophe No catastrophe
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MCQ-6 More than 80 percent of all deaths in displaced populations are caused by following except: Acute Respiratory Infections Measles Malnutrition Tuberculosis Diarrhoea
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