Disease information

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Disease surveillance

  • In disease surveillance following are important
    • a network (perhaps a hierarchy with some extra confirmation points) of trusted sources
    • case definitions (are we counting deaths, diseased, people at risk? do we count those with diarrhea? do we need to define "fever"?)
    • needed data (do we need the age of the people with that disease? or just the numbers? what do we need to know?)
    • ways to communicate the data to the people who count up the numbers
    • ways to spread the information to people who can do practical things
  • In case of Malaria
    • It is important to track weekly case numbers and provide laboratory-based diagnosis (perhaps only for a % of fever cases to track the slide/test positivity rate), to pick up the early stages of a malaria epidemic
    • Active search for fever cases may be necessary to reduce mortality in remote areas with reduced access to health care services
  • Directory of Links to Food and Water Borne Disease Information


Cholera

  • Causes
    • Cholera is an intestinal infection caused by a bacteria - and is often linked to contaminated supplies of drinking water
    • The bacterium is part of the flora of brackish water and estuaries - it is when this water gets into the drinking supply that an outbreak can start
  • Symptoms
    • It causes severe diarrhoea and vomiting, and patients, particularly children and the elderly, are vulnerable to dangerous dehydration as a result
    • Most symptomatic cases are hard to distinguish from other illnesses that cause diarrhea - it is only in one in 10 that severe symptoms such as dehydration occur.
  • Corrective Measures
    • Clean water and rehydration salts are required, but they are often in short supply in areas where they are needed most
    • Normally, rehydration salts are the only treatment given, although severely dehydrated patients may need intravenous fluids
    • Antibiotics can reduce the amount of diarrhea
    • Systems for hygienic disposal of human wastes also need to be brought in
    • Cooking practices need to be made as safe as possible - where practicable, food needs to be cooked thoroughly and eaten while hot, and raw fruit and vegetables avoided unless they are peeled first
    • Handwashing after going to the toilet is a vital measure to prevent the spread of the disease
  • Directory of Links to information about Cholera

Dengue Fever

  • Causes
    • Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. People get dengue virus infections from the bite of an infected Aedes mosquito. Mosquitoes become infected when they bite infected humans, and later transmit infection to other people they bite.
  • Symptoms
    • Symptoms of typical uncomplicated dengue usually start with fever within 5 to 6 days after a person has been bitten by an infected mosquito. Symptoms include: high fever, up to 105 degrees Fahrenheit, severe headache. retro-orbital (behind the eye) pain, severe joint and muscle pain, nausea and vomiting, and rash. The rash may appear over most of the body 3 to 4 days after the fever begins. A second rash may appear later in the disease. Most children infected with dengue virus never develop typical symptom
  • Treatment
    • There is no specific treatment for dengue fever, and most people recover completely within 2 weeks. To help with recovery, health care experts recommend getting plenty of bed rest, drinking lots of fluids, taking medicine to reduce fever. People with dengue fever should NOT take aspirin. Acetaminophen or other over-the-counter pain-reducing medicines are safe for most people.
  • Prevention
    • The best way to prevent dengue fever is to take special precautions to avoid contact with mosquitoes.
  • CDC: Dengue Fever Fact Sheet


Malaria

  • Causes
    • Malaria is caused by infection of a parasite which is carried from person to person via mosquitoes
    • Increase in the cases of Malaria recently because of development of resistance to traditional drugs, mosquitoes becoming resistant to insecticides and changes in the environmental conditions
  • Symptoms
    • The first is high fever, followed a few hours later by chills. Two to four days later, this cycle is repeated
    • The most serious forms of the disease can affect the kidneys and brain and can cause anaemia, coma and death
  • Corrective measures
    • The spread of the disease can be reduced by cutting down the mosquito population, for example by filling ditches where mosquitos breed
    • Early diagnosis can lead to successful treatment so education in spotting the symptoms of malaria is important
    • Bed nets coated in insecticide have also reduced the incidence of the disease by up to 35%, according to the World Health Organisation
    • Artemisinin-based combination therapy should be provided when a falciparum malaria epidemic is confirmed
  • Directory of links to information about Malaria

Tetanus


Post-traumatic stress prevention

  • Survivior Fact Sheet
    • Most disaster survivors only experience mild, normal stress reactions, and disaster experiences may even promote personal growth and strengthen relationships. However, as many as one out of every three disaster survivors experience some or all of the following severe stress symptoms, which may lead to lasting Posttraumatic Stress Disorder (PTSD), anxiety disorders, or depression:
      • Dissociation (feeling completely unreal or outside yourself, like in a dream; having "blank" periods of time you cannot remember); Intrusive reexperiencing (terrifying memories, nightmares, or flashbacks); Extreme attempts to avoid disturbing memories (such as through substance use; Extreme emotional numbing (completely unable to feel emotion, as if empty); Hyper-arousal (panic attacks, rage, extreme irritability, intense agitation); Severe anxiety (paralyzing worry, extreme helplessness, compulsions or obsessions); Severe depression (complete loss of hope, self-worth, motivation, or purpose in life)
      • Most child and adult survivors experience one or more of these normal stress reactions for several days: Emotional reactions: temporary (i.e., for several days or a couple of weeks) feelings of shock, fear, grief, anger, resentment, guilt, shame, helplessness, hopelessness, or emotional numbness (difficulty feeling love and intimacy or difficulty taking interest and pleasure in day-to-day activities); Cognitive reactions: confusion, disorientation, indecisiveness, worry, shortened attention span, difficulty concentrating, memory loss, unwanted memories, self-blame; Physical reactions: tension, fatigue, edginess, difficulty sleeping, bodily aches or pain, startling easily, racing heartbeat, nausea, change in appetite, change in sex drive; Interpersonal reactions in relationships at school, work, in friendships, in marriage, or as a parent: distrust; irritability; conflict; withdrawal; isolation; feeling rejected or abandoned; being distant, judgmental, or over-controlling
  • Helping Children and Adolescents Cope with Violence and Disasters, NIH Publication No. 01-3518, dated 2001 (http://www.nimh.nih.gov/publicat/violence.cfm)
    • Youngsters who have experienced a catastrophic event often need support from parents and teachers to avoid long-term emotional harm. Most will recover in a short time, but the few who develop PTSD or other persistent problems need treatment.
    • For children 5 years of age and younger, typical reactions can include a fear of being separated from the parent, crying, whimpering, screaming, immobility and/or aimless motion, trembling, frightened facial expressions and excessive clinging. Parents may also notice children returning to behaviors exhibited at earlier ages (these are called regressive behaviors), such as thumb-sucking, bedwetting, and fear of darkness. Children in this age bracket tend to be strongly affected by the parents' reactions to the traumatic event.
  • Center for Treatment of Psychotrauma
    • The symptoms that characterize Post-Traumatic Stress Disorder (PTSD) can be divided into three main categories: Re-experiencing; Avoidance; Hyper-arousal
    • Natural Recovery Process - What can be done immediately after the traumatic event? Return to routine: Try to get back to normal, as much as this is possible. Take care to get enough sleep: At this stage the body expends an enormous amount of energy and sleep is the way to restore this energy. Stay in touch: Keep in touch with those near to you, family and friends, and share your feelings with them. Limit media exposure: Try to control the amount of news and disturbing pictures you are exposed to via television, radio and newspapers. Postpone judgment to a later time: At this stage many people blame themselves for their behavior during the event. In many cases this is unjustified, but they have trouble seeing that on account of the emotional turmoil they are currently experiencing.
    • Theraputic Resources (http://www.swin.edu.au/bioscieleceng/neuropsych/ptsd/) world-wide listing from Australia.

Acute Kidney Failure

A frequent problem in land-based earthquakes is kidney failure from crush injuries and/or dehydration. The disruption of drinking water supplies, will also cause acute kidney failure due to dehydration.

  • Acute kidney failure normally requires kidney dialysis. Machines for blood-based dialysis ("hemodialysis"), or supplies for peritoneal dialysis can be quite scarce in devastated areas.
  • A new treatment which has been successful in pilot clinical trials in both adults and infants involves the use of an already existing medicine infused intravenously into the survivor's arm. For details: dwmoskowitz@genomed-dot-com

Local, State and Federal Advisories

CONDITIONS IN THE RECOVERY AREA CHANGE RAPIDLY. MANY NEW DISEASE AND HEALTH ADVISORIES ARE BEING POSTED BY THE C.D.C. and STATE HEALTH AUTHORITIES AS RECOVERY EFFORTS PROGRESS.

NEW ADVISORIES WILL BE POSTED REGULARLY. PLEASE REFER BACK OFTEN.


Environmental Health & Toxicology Links


Environmental Concerns - Water Safety - Chemical Exposure - Toxic Gases - Mold

See also

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