The Impact of Earthquakes on Public Health: A Narrative Review of Infectious Diseases in the Post-Disaster Period Aiming to Disaster Risk Reduction
Abstract
:1. Introduction
2. Search Strategy
3. Spatial Distribution and Parameters of Earthquakes Associated with Infectious Diseases during Post-Disaster Period
No | Earthquake Occurrence (Date/Month/Year) | Epicentral Area | Affected Areas | Mw | I | HL | IP | TA |
---|---|---|---|---|---|---|---|---|
1 | 23/11/1980 | Irpinia, (Italy) | Campania, Naples, Salerno | 6.9 | X | 4689 | 7700 | 407,700 |
2 | 22/04/1991 | Limon, (Costa Rica) | Costa Rica, Panama | 7.7 | X | 47 | 199 | 10,419 |
3 | 17/01/1994 | Northridge (California United States) | Greater Los Angeles area, Southern California | 6.7 | IX | 60 | 7000 | 27,000 |
4 | 17/01/1995 | Kobe (Japan) | Japan | 6.9 | XI | 5297 | 34,492 | 541,636 |
5 | 25/01/1999 | Armenia (Colombia) | Armenia, Pereira | 6.2 | X | 1186 | 8563 | 1,205,933 |
6 | 17/08/1999 | Izmit (Turkey) | Marmara area, Adapazari, Gölcük, Izmit and Yalova | 7.6 | X | 17,127 | 43,953 | 1,358,953 |
7 | 21/09/1999 | Chi-Chi (Taiwan) | central Taiwan Nantou County Taichung County | 7.7 | X | 2264 | 8664 | 108,664 |
8 | 13/01/2001 | El Salvador | El Salvador, Guatemala, Honduras | 7.7 | VIII | 844 | 4723 | 1,334,529 |
9 | 26/12/2003 | Bam (Iran) | Kerman Province | 6.6 | IX | 26,796 | 22,628 | 267,628 |
10 | 26/12/2004 | Indonesia | Indian Ocean coastal countries | 9.2 | IX | 165,708 | - | 523,898 |
11 | 08/10/2005 | Kashmir (Pakistan) | Pakistan, India | 7.6 | XI | 86,000–87,351 | 69,000–75,266 | 2,800,000 |
12 | 27/05/2006 | Yogyakarta (Indonesia) | Yogyakarta, Java, Indonesia | 6.4 | IX | 5749–5778 | 38,568–137,883 | 600,000–699,295 |
13 | 02/04/2007 | Solomon Islands | Solomon Islands, Papua, New Guinea | 8.1 | VIII | 52 | 9 | 2384 |
14 | 12/05/2008 | Sichuan (China) | Sichuan Province | 7.9 | ΧΙ | 87,476 | 366,596 | 45,976,596 |
15 | 06/04/2009 | L’Aquila (Italy) | Abruzzo | 6.3 | Χ | 295 | 1000 | 56,000 |
16 | 30/09/2009 | Sumatra (Indonesia) | Sumatra | 6.3 | VII | 1195 | 1798 | 2,501,798 |
17 | 12/01/2010 | Haiti | Haiti | 7.0 | X | 222,570 | 300,000 | 3,700,000 |
18 | 23/10/2011 | Van (Turkey) | Eastern Turkey | 7.1 | VIII | 604 | 4152 | 32,938 |
19 | 09/11/2011 | Van (Turkey) | Eastern Turkey | 5.6 | VII | 40 | 30 | 105 |
20 | 11/03/2011 | Tōhoku (Japan) | Eastern Japan | 9.1 | IX | 19,759 | 6242 | 2553 |
21 | 20/04/2013 | Lushan (China) | Sichuan, Chongqing, Shaanxi | 7.0 | VIII | 198 | 14,785 | 2,198,785 |
22 | 15/10/2013 | Bohol (Philippines) | Philippines | 7.2 | IX | 230 | 976 | 3,222,224 |
23 | 26/01/2014 | Cephalonia Island (Greece) | Western Cephalonia | 6.1 | VII | 0 | 0 | - |
24 | 03/02/2014 | Cephalonia Island (Greece) | Western Cephalonia | 5.9 | VIII | 0 | 10 | - |
25 | 25/04/2015 | Gorkha (Nepal) | Kathmandu Valley, Everest | 7.8 | Χ | 8831 | 17,932 | 5,639,722 |
26 | 16/04/2016 | Ecuador | Ecuador, Colombia, Peru | 7.8 | VIII | 672 | 6274 | 389,364 |
27 | 14/04/2016 | Kumamoto (Japan) | Kumamoto Province, Kyushu, Japan | 6.2 | - | 9 | 800 | 120,800 |
28 | 16/04/2016 | Kumamoto (Japan) | Kumamoto Province, Kyushu, Japan | 7.0 | IX | 49 | 1684 | 298,432 |
4. Earthquake-Triggered Respiratory Infectious Diseases
4.1. Viral-Associated Diseases
4.2. Fungal-Associated Diseases
Coccidioidomycosis
4.3. Mycobacterial-Associated Diseases
Tuberculosis
5. Earthquake-Triggered Gastrointestinal Diseases (Water- and Food-Borne Diseases)
5.1. Bacterial-Associated Diseases
5.1.1. Shigella
5.1.2. Salmonella Enterica
5.1.3. Tularemia
5.1.4. Cholera
5.1.5. Helicobacter Pylori
5.2. Protozoa-Associated Diseases
Giardiasis
5.3. Virus-Associated Diseases
5.3.1. Rotavirus
5.3.2. Hepatitis A and E
6. Earthquake-Triggered Vector-Borne Diseases
6.1. Bacterial-Associated Diseases
Scrub Typhus
6.2. Protozoan-Associated Diseases
6.2.1. Malaria
6.2.2. Leishmaniasis
6.3. Viral-Associated Diseases
Zika Virus
7. Wound and Skin Infections
7.1. Tetanus
7.2. Gas Gangrene (Myonecrosis)
7.3. Other Skin Infections
8. Risk Factors and Preventive Measures
8.1. Risk Factors for Infectious Diseases Occurence
- Heavy structural damage to critical healthcare infrastructure, including facilities and buildings, remained unfixed during the emergency response and the subsequent recovery, causing delayed management and treatment of severe infectious diseases cases.
- Lack of awareness and provision of early or real-time warning for the upcoming and the ongoing events, resulting in little time for preparedness or evacuation.
- Severely injured earthquake and tsunami survivors highly exposed to high pathogen densities in soil and water.
- Immense changes in climate and aggravating weather conditions in the emergency response phase including dramatic temperature changes.
- Prolonged physical exposure to and inhalation of:
- ○
- airborne particulate matter due to large dust clouds formed by earthquake-triggered landslides.
- ○
- airborne particulate matter due to contaminated ejecta dust formed by earthquake-triggered liquefaction phenomena with a destructive impact on water and sewage systems.
- Prolonged physical exposure to and aspiration of contaminated water due to tsunami generation and impact on the coastal residential zones.
- Emergency shelters and evacuation camps with:
- ○
- High population density and overcrowding.
- ○
- Poor living conditions comprising small places for individuals and families and insufficient equipment for the homeless and evacuees (blankets, bed clothes, sleeping bags, etc.).
- ○
- Lack of clean running water due to damage and contamination of the water supply systems and water sources, respectively.
- ○
- Unsanitary conditions (poor hand hygiene) due to a shortage of personal hygiene items.
- ○
- Malnutrition due to insufficient food provision and shortage of long-lasting food supplies.
- ○
- Insufficient equipment comprising essentials and poor heating, ventilation and air conditioning systems among others.
- ○
- Rodent/vector infestation.
- Increased exposure to vectors and rodents due to earthquake-triggered ecological changes, leading to extensive formation of potential breeding and feeding sites of vectors and rodents.
- The weak immune system of vulnerable groups of the affected population comprising the elderly, the chronically ill individuals, and young children.
- The dependency of young children, people with disabilities, and elders of the affected communities seeking assistance with daily activities.
- Poor socio-economic conditions, including large percentage of low education level, a large part of the population living below the national poverty line leading to insufficient personal hygiene and denial of risk, disinterest, and ignorance of risk, as well as poorly constructed buildings and infrastructures.
- Poor health education and training on infectious disease prevention and control.
- Lack of emergency preparedness and training of residents and medical staff for infectious disease prevention.
- Insufficient or low vaccination coverage due to limited vaccination campaigns and short supplies.
- Close contact with cases and activities and interaction in areas where clusters of infectious disease cases have been observed.
8.2. Prevention Strategies and Actions for Mitigating the Risk of Earthquake-Triggered Infectious Diseases
8.2.1. Establishment of a Proper Disease Surveillance System
8.2.2. Prevention of Infectious Diseases in Emergency Shelters
8.2.3. Prevention of Infectious Diseases among First Responders and Affected Population
- Ensuring the safety of drinking water and sewerage systems not only in either temporary or permanent relief camps but also in areas characterized by high risk
- Compliance with the existing safety and hygiene measures
- Where existing measures are not sufficient, educational activities for hygiene and sanitation awareness raising should be conducted, aiming for the integration of safe water and hand hygiene best practices into households, communities, and countries
- Large-scale preventive vaccination and medicine programs for several infectious diseases should be implemented, along with the establishment of a proper disease surveillance program and a long–term empowering and strengthening of the public-sector health system.
8.2.4. Measures for Mitigating the Risk of Respiratory Infectious Diseases
8.2.5. Measures for Mitigating the Risk of Waterborne Diseases
8.2.6. Measures for Mitigating the Risk of Vector- and Rodent-Borne Diseases
8.2.7. Education, Training, and Awareness-Raising Actions
9. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Earthquake Occurrence (DD/MM/YYYY) | Earthquake Affected Area | Infectious Diseases (Causative Factors–Cases, Outbreaks, Epidemics) | References |
---|---|---|---|
17/01/1994 | Northridge California, United States | Outbreak of coccidioidomycosis (Coccidiodes immitis), 203 cases (including 3 deaths) | [68] |
Outbreak of coccidioidomycosis (C. immitis) | [69] | ||
17/01/1995 | Kobe, Japan | Increase in the number of patients with respiratory diseases by 4.5 times | [80] |
21/09/1999 | Chi-Chi, Taiwan | Acute respiratory infections | [81] |
Upper respiratory tract infection | [82] | ||
13/01/2001 | El Salvador | Upper respiratory infections (30%) | [70] |
Respiratory infections | [71] | ||
26/12/2003 | Bam, Iran | Respiratory infections (6.86% of the total population within 1 month) | [84] |
Respiratory tract infections | [83] | ||
08/10/2005 | Kashmir, Pakistan | Viral upper respiratory tract infection (23%) | [87] |
12/05/2008 | Sichuan, China | Increase of tuberculosis cases in hospitals of the affected area | [101] |
30/09/2009 | Sumatra, Indonesia | Respiratory infections | [88] |
12/01/2010 | Haiti | Acute respiratory infection (16.3%) | [72] |
Increase in tuberculosis in the affected population: 3-fold in a camp for internally displaced persons (693/100,000) and 5-fold in an urban slum (1165/100,000) | [75] | ||
Tuberculosis | [76] | ||
11/03/2011 | Tōhoku, Japan | 43% of cases-community pneumonia (Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae) | [89] |
20/04/2013 | Lushan, China | Respiratory tract infections | [90] |
Respiratory infection (45.7%) | [91] | ||
15/10/2013 | Bohol, Philippines | Acute respiratory infections | [92] |
476/3555 children: positive to tuberculin skin reaction–TST, 16 with active tuberculosis | [93] | ||
26/01/2014 03/02/2014 | Cephalonia, Greece | Increase of respiratory infection cases | [79] |
25/04/2015 | Gorkha, Nepal | Pneumonia and post-streptococcal glomerulonephritis: high incidence among children from affected areas | [98] |
Upper respiratory tract infections | [95] | ||
Infections of the respiratory tract (42.3%) | [96] | ||
1 case of tuberculous peritonitis (1 girl 14 years old with fever, abdominal pain and vomiting) | [99] | ||
14/04/2016, 16/04/2016 | Kumamoto, Japan | Upper respiratory infections | [100] |
Earthquake Occurrence (DD/MM/YYYY) | Earthquake Affected Area | Infectious Diseases (Causative Factors–Cases, Outbreaks, Epidemics) | References |
---|---|---|---|
23/11/1980 | Irpinia, Italy | 1 outbreak of gastroenteritis (39 cases, firefighters) 1 outbreak of viral hepatitis (6 cases, city of Potenza) | [102] |
17/08/1999 | Izmit, Turkey | Giardia lamblia and Enterobius vermicularis infections in children still living and studying in temporary settlements and schools even years after the earthquakes | [105] |
Hepatitis A and E | [108] | ||
Hepatitis A and E | [106] | ||
Tularemia outbreak (Francisella tularensis, 5 cases) | [107] | ||
A mild gastroenteritis outbreak among SAR personnel (two to three loose or watery stools accompanied by abdominal pain) | [103] | ||
Current increase in diarrheal infections (Shigella) | [104] | ||
21/09/1999 | Chi-Chi, Taiwan | Acute gastroenteritis (15 shigellosis cases) | [81] |
Acute gastroenteritis | [82] | ||
25/01/1999 | Armenia, Colombia | Giardiasis (Giardia lamblia) | [109] |
13/01/2001 | El Salvador | Gastrointestinal infections | [71] |
26/12/2003 | Bam, Iran | Gastrointestinal infections (0.81% of the total population within 1 month) | [84] |
Diarrheal diseases | [83] | ||
26/12/2004 | Indonesia | Tsunami survivors: waterborne infections (85% of children under 5 years old: diarrhea, 100% of the population had no access to clean drinking water and sanitation systems). | [110] |
08/10/2005 | Kashmir, Pakistan | Rotavirus outbreak | [111] |
Acute digestive disease (14.3%) | [87] | ||
06/04/2009 | L’Aquila, Italy | Salmonella enterica epidemic in children | [112] |
12/01/2010 | Haiti | Cholera and cholera-like disease | [77] |
Cholera outbreak | [113] | ||
23/10/2011 09/11/2011 | Van, Turkey | Significantly higher prevalence of Helicobacter pylori in dyspeptic patients-disaster survivors compared to dyspeptic patients in the pre-disaster period | [114] |
26/01/2014 03/02/2014 | Cephalonia, Greece | Gastroenteritis outbreak (22 gastroenteritis cases among soldiers) | [79] |
25/04/2015 | Gorkha, Nepal | Gastrointestinal infections | [94,97] |
Acute gastroenteritis: high incidence among children from affected areas | [98] | ||
Cholera (Vibrio cholerae serogroup 01 Ogawa serotype) | [115] | ||
Acute watery diarrhea (Vibrio cholerae): 169 cases, of which 150 were in the Kathmandu Valley | [116] | ||
14/04/2016, 16/04/2016 | Kumamoto, Japan | Gastrointestinal infections | [100] |
Εarthquake Occurrence (DD/MM/YYYY) | Earthquake Affected Area | Infectious Diseases (Causative Factors–Cases, Outbreaks, Epidemics) | References |
---|---|---|---|
22/04/1991 | Limon, Costa Rica | Malaria (Plasmodium falciparum) | [132] |
26/12/2003 | Bam, Iran | Cutaneous leishmaniasis (20,999 cases (1993–2012): 6731 before and 14,268 after the earthquake | [138] |
Anthroponic cutaneous leishmaniasis: increase in annual incidence from 58.6 cases/100,000 in the 12 months before the earthquakes to 864 cases/100,000 in the following 12 months | [133] | ||
Cutaneous leishmaniasis | [134,135,136,137] | ||
12/05/2008 | Sichuan, China | Visceral leishmaniasis | [139] |
12/01/2010 | Haiti | Suspected malaria (10.3%) | [72] |
11 laboratory-confirmed cases of P. falciparum malaria (7 US residents-emergency responders, 2 Haitians, 1 US traveler) | [73] | ||
Malaria | [77] | ||
P. falciparum malaria (76/255 patients) | [74] | ||
25/04/2015 | Gorkha, Nepal | Outbreak of scrub typhus (Orientia tsutsugamushi) | [140,141] |
16/04/2016 | Ecuador | Zika virus outbreak | [142,144,145] |
Zika virus outbreak (89 cases in the pre-earthquake period-2103 in the post-earthquake period) | [143] |
Εarthquake Occurrence (DD/MM/YYYY) | Earthquake-Affected Area | Infectious Diseases (Causative Factors/Cases, Outbreaks, Epidemics) | References |
---|---|---|---|
17/08/1999 | Izmit, Turkey | Infections/infestations, cutaneous superficial fungal infections (Tinea pedis), cases of viral skin diseases, insect bites | [151] |
Ιnfectious complications (wound infections): gram-negative bacteria (mainly Acinetobacter spp.), Staphylococcus spp. | [152] | ||
Wound infections: Gram-negative bacteria (Acinetobacter baumanii, P. aeruginosa, Escherichia coli, Klebsiella pneumoniae, Stenotrophomonas maltophilia) and Staphylococcus spp. (630 injured) | [153] | ||
21/09/1999 | Chi-Chi, Taiwan | Wound infections—Crush syndrome | [154] |
26/12/2004 | Indonesia | Wound infections: tetanus (106 cases), Clostridium tetani | [162] |
Ιnfections—infestations, traumatic skin lesions, and contact dermatitis | [157] | ||
Wound infections (Aeromonas spp., E. coli, K. pneumoniae, P. aeruginosa, and Proteus spp.) | [156] | ||
Skin and soft tissue infections | [158] | ||
Ιnfected superficial wounds on the limbs and face (recurrence: necrosis of underlying tissues, need for repeated cleaning, and dressing of wounds) | [159] | ||
Tetanus outbreak | [160,161] | ||
08/10/2005 | Kashmir, Pakistan | Gas gangrene of the limbs and tetanus requiring respiratory support (51 patients with tetanus, of whom 22 died) | [86] |
Wound infections: P. aeruginosa, Enterobacter spp. and Acinetobacter spp. (multi-resistant strains) | [155] | ||
27/05/2006 | Yogyakarta, Indonesia | Wound infections: tetanus (71 cases) | [162] |
Wound infections: tetanus (26 cases) | [163] | ||
12/05/2008 | Sichuan, China | Wound infections (E. coli, S. aureus, S. haemolyticus, A. baumanii, A. cloacae, P. aeruginosa, C-type chain coccus, and Bacillus aerogenes capsulatus), gas gangrene (Clostridium perfringens) | [164] |
67 probable cases (2.41%) of gas gangrene of which 5 were confirmed by culture (C. perfringens) | [171] | ||
Crush syndrome–wound infections: A. baumanii, P. aeruginosa, E. cloacae, and E.coli | [170] | ||
Wound infections: Gram-negative bacilli, Gram-positive bacteria, Candida spp., Gram-negative cocci, Clostridium sordelli | [165] | ||
Skull wound infections: Gram-positive bacteria (S. aureus, S. epidermidis), Gram-negative bacteria (E. cloacae, K. pneumoniae, Serratia rubidaea) | [172] | ||
Wound infections in 50 children: Gram-positive bacteria (16%), Gram-negative bacteria (82%) (A. baumannii, E. cloacae, P. aeruginosa), 1 month after the earthquake | [167] | ||
Wound infections (24.4% Gram-positive bacteria: Staphylococcus aureus, −73.2% Gram-negative bacteria: Escherichia coli, Acinetobacter baumannii, Enterobacter cloacae, and P. aeruginosa) | [166] | ||
Crush syndrome—wound infections: A. baumannii, E. coli, S. aureus, gas gangrene | [169] | ||
Wound infections: Gram-negative bacteria | [168] | ||
Wound infections: A. baumannii, Burkholderia cepacia, S. aureus, and Enterococcus spp. | [173] | ||
Crush syndrome | [174] | ||
12/01/2010 | Haiti | Wound/skin infections | [77] |
Wound infections (polymicrobial, 89% Gram-negative bacteria, antimicrobial resistant) | [175] | ||
Wound infections: tetanus (2 cases) | [176] | ||
23/10/2011 09/11/2011 | Van, Turkey | Wound infections: Gram-negative aerobic bacteria and A. baumannii, P. aeruginosa, E. coli, and E. faecium | [177] |
20/04/2013 | Lushan, China | Intracranial infection (initial stage of hospitalization: S. aureus and E. coli—prolonged stay in ICU: A. baumannii and K. pneumoniae | [91] |
25/04/2015 | Gorkha, Nepal | 56 human losses: 68% Gram-negative bacilli (55%, Enterobacteriaceae) | [178] |
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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, 419. https://doi.org/10.3390/microorganisms11020419
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(2):419. https://doi.org/10.3390/microorganisms11020419
Chicago/Turabian StyleMavrouli, Maria, Spyridon Mavroulis, Efthymios Lekkas, and Athanassios Tsakris. 2023. "The Impact of Earthquakes on Public Health: A Narrative Review of Infectious Diseases in the Post-Disaster Period Aiming to Disaster Risk Reduction" Microorganisms 11, no. 2: 419. https://doi.org/10.3390/microorganisms11020419
APA StyleMavrouli, M., Mavroulis, S., Lekkas, E., & Tsakris, A. (2023). The Impact of Earthquakes on Public Health: A Narrative Review of Infectious Diseases in the Post-Disaster Period Aiming to Disaster Risk Reduction. Microorganisms, 11(2), 419. https://doi.org/10.3390/microorganisms11020419