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守望相助，2008，挺起中国的脊梁！
综合阅读以下文献综述，可以得出初步估计高发疫情主要是
1。由于空气污染导致的细菌病毒引起的呼吸道疾病暴发，特别是针对免疫力低下的伤者集中的避难所；
2。水源污染，没有清洁饮用水导致的肠道疾病，如痢疾，霍乱，诺如病毒性肠炎，钩端螺旋体病；
3。蚊虫传播的疾病，如疟疾
4。尸体没有得到妥善处理，腐烂后污染水源。
5。血源性传播疾病，因灾区用血量迅速增加，检测手段滞后，如HIV ,HBV,HCV等
6。机会性感染。受外伤后免疫力低下患者极易感染机会性病原体，如白念，隐球菌，由于灾区伤者多且集中，容易形成爆发感染。
7。寄生虫疾病，卫生设施不够，食物被污染等感染寄生虫的机会大大增加，如溶组织内阿米巴，环孢子虫病，贾弟虫病等。
8。大家再补充，呵呵。
JAMA. 1997 Mar 19;277(11):904-8.Links
A coccidioidomycosis outbreak following the Northridge, Calif, earthquake.
美国加州地震后球孢子菌病暴发
Schneider E, Hajjeh RA, Spiegel RA, Jibson RW, Harp EL, Marshall GA, Gunn RA, McNeil MM, Pinner RW, Baron RC, Burger RC, Hutwagner LC, Crump C, Kaufman L, Reef SE, Feldman GM, Pappagianis D, Werner SB.
Epidemic Intelligence Service (EIS), Community Disease Control, County of San Diego Department of Health Services, CA, USA.
OBJECTIVE: To describe a coccidioidomycosis outbreak in Ventura County following the January 1994 earthquake, centered in Northridge, Calif, and to identify factors that increased the risk for acquiring acute coccidioidomycosis infection. DESIGN: Epidemic investigation, population-based skin test survey, and case-control study. SETTING: Ventura County, California. RESULTS: In Ventura County, between January 24 and March 15, 1994, 203 outbreak-associated coccidioidomycosis cases, including 3 fatalities, were identified (attack rate [AR], 30 cases per 100,000 population). The majority of cases (56%) and the highest AR (114 per 100,000 population) occurred in the town of Simi Valley, a community located at the base of a mountain range that experienced numerous landslides associated with the earthquake. Disease onset for cases peaked 2 weeks after the earthquake. The AR was 2.8 times greater for persons 40 years of age and older than for younger persons (relative risk, 2.8; 95% confidence interval [CI], 2.1-3.7; P<.001). Environmental data indicated that large dust clouds, generated by landslides following the earthquake and strong aftershocks in the Santa Susana Mountains north of Simi Valley, were dispersed into nearby valleys by northeast winds. Simi Valley case-control study data indicated that physically being in a dust cloud (odds ratio, 3.0; 95% CI, 1.6-5.4; P<.001) and time spent in a dust cloud (P<.001) significantly increased the risk for being diagnosed with acute coccidioidomycosis. CONCLUSIONS: Both the location and timing of cases strongly suggest that the coccidioidomycosis outbreak in Ventura County was caused when arthrospores were spread in dust clouds generated by the earthquake. This is the first report of a coccidioidomycosis outbreak following an earthquake. Public and physician awareness, especially in endemic areas following similar dust cloud-generating events, may result in prevention and early recognition of acute coccidioidomycosis.
BMJ. 2001 Feb 10;322(7282):317. Links
Pneumonia, cholera, and dysentery feared after earthquake.
地震后的肺炎，霍乱和痢疾
Sharma R.
Mumbai.
Public Health. 2004 Sep;118(6):403-8. Links
The devastation of Bam: an overview of health issues 1 month after the earthquake.
地震后一个月灾区健康状况回顾
Akbari ME, Farshad AA, Asadi-Lari M.
Ministry of Health and Medical Education, Iran.
The appalling earthquake in the ancient city of Bam on December 27th 2003 was one of the worst disasters since the last century in Iran. Further to the chilling statistics of human loss, essential services including water supply, power, telephone, health care services, main roads, and the city's only airport were crippled. From the 'public health' and 'health emergency' perspectives, the initial priorities were to minimise avoidable further mortality and morbidity. This required prompt evacuation of the injured, defining catchment areas, establishment of efficient systems for disease control, organising a disaster management plan, out patient management, co-ordination of international aid, and re-organising the current PHC network in the district. The second stage, each department planning health delivery for the subsequent year, was rapidly initiated. This paper discusses these strategies, which were designed specifically for Bam but are likely useful in similar situations.
Semin Pediatr Infect Dis. 2006 Jan;17(1):36-45. Links
Infectious diseases that pose specific challenges after natural disasters: a review.
自然灾害后传染病的挑战
Ligon BL.
Baylor College of Medicine, Department of Pediatrics, Houston, Texas 77030, USA. bligon@bmc.tmc.edu
In a time span of less than one year, December 2004 to October 2005, several natural disasters of extreme proportions struck different areas of the world, causing unparalleled destruction and loss of lives and property. In each of these instances, the potential existed for acquisition of infectious diseases caused by bacteria, viruses, mold, and mildew and demonstrated that such disasters represent a public health concern, which is exacerbated by the fact that many factors may work synergistically to increase the risk of morbidity and mortality caused by communicable diseases. This article reviews causes, symptoms, and treatments of various infectious diseases that pose a threat in the event of a natural disaster.
Clin Infect Dis. 2007 Apr 15;44(8):1032-9. Epub 2007 Mar 2. Links
Widespread outbreak of norovirus gastroenteritis among evacuees of Hurricane Katrina residing in a large "megashelter" in Houston, Texas: lessons learned for prevention.
休斯敦飓风后诺如病毒肠炎爆发
Yee EL, Palacio H, Atmar RL, Shah U, Kilborn C, Faul M, Gavagan TE, Feigin RD, Versalovic J, Neill FH, Panlilio AL, Miller M, Spahr J, Glass RI.
Centers for Disease Control and Prevention, Coordinating Center for Infectious Diseases, Div. of Viral Diseases, Atlanta, GA 30333, USA. bwd3@cdc.gov
BACKGROUND: After Hurricane Katrina, an estimated 200,000 persons were evacuated to the Houston metropolitan area, >27,000 of whom were housed in 1 large "megashelter," the Reliant Park Complex. We investigated an outbreak of gastroenteritis reported among the evacuees who resided in the Reliant Park Complex to assess the spread of the infectious agent, norovirus, and to implement and evaluate the effectiveness of interventions used for control. METHODS: Public health authorities conducted surveillance of gastroenteritis among evacuees treated at the Reliant Park Medical Clinic during 2-12 September 2005. Basic demographic and clinical data were recorded. Specimens of stool and vomitus were collected and tested for bacteria, parasites, and viruses. Shelter census data were used to estimate the daily incidence of disease. RESULTS: During a period of 11 days, >1000 patients were treated at the clinic for gastroenteritis, which accounted for 17% of all clinic visits. Norovirus was the sole enteric pathogen identified, but multiple different strains were involved. Among the evacuees residing in the Reliant Park Complex, the incidence of gastroenteritis was estimated to be 4.6 visits per 1000 persons per day, and among the evacuees who resided there for 9 days, 1 (4%) of 24 persons would have been ill. Intensive public health measures were promptly instituted but did not definitively slow the progression of the outbreak of norovirus gastroenteritis. CONCLUSIONS: Our investigation underscores the difficulties in managing such outbreaks in crowded settings and the need for rapid, sensitive laboratory assays to detect norovirus. Additional research is needed to establish more effective measures to control and prevent this highly contagious gastrointestinal illness.
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