Vectorborne diseases

Water pools and disrupted vector control are the contributing factors to vector-borne diseases, and the most common consequences are diseases transmitted by Aedes mosquitoes in endemic areas. These include malaria, dengue, and scrub typhus.

Malaria is perhaps the greatest threat by precedent (Connolly et al., 2004; Orellana, 2005; Wilder-Smith, 2005). An example is the malaria epidemic of

Table 13.2 Most common infectious diseases in disaster camp settings

Condition

Comment

Food-borne and water-borne, primarily diarrheal disease, cholera, shigella, salmonella, hepatitis A, hepatitis E

Contributing factors: polluted water and food.

Vector-borne, region-specific - malaria, dengue, scrub typhus, Japanese B encephalitis Measles

Acute respiratory tract infections Meningococcal meningitis Tetanus

Account for > 40% of deaths and > 80% children < 2 years

Contributing factors: inadequate vector control, crowding; flooded areas to promote mosquito breeding Contributing factors: crowding, populations with low measles vaccination rates

Often most common cause of morbidity

(Diaz and Achi, 1989)

Most common in the "meningitis belt" of

Africa

Contributing factors: wounding

Adapted from Wilder-Smith (2005); Connelly et al., 2004.

Burundi in 2001, which included 2.8 million cases in a country of 7 million (Connnolly et al., 2004). This was a reflection of overcrowding, use of temporary shelters, inadequate access to health-care services, a lapse in vector control and high levels of chloroquine-resistant P. falciparum.

With regard to the tsunami, most of the affected areas are endemic for malaria, with an incidence prior to the disaster of about 1 per 1000 population (Briet et al., 2005; Wilder-Smith, 2005). The malaria risk was not magnified by flooding from salt water, since this does not support the lifecycle of mosquitoes, but the salt water was turned brackish by monsoon rains in Indonesia and Sri Lanka (VanRooyen and Leaning, 2005). Dengue is also endemic in this area, particularly in Indonesia, where there was an ongoing epidemic prior to the disaster (Wilder-Smith, 2005).

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