Epidemics after Natural Disasters

 The relationship between natural disasters and communicable diseases is frequently misconstrued. The risk for outbreaks is often presumed to be very high in the chaos that follows natural disasters, a fear likely derived from a perceived association between dead bodies and epidemics. However, the risk factors for outbreaks after disasters are associated primarily with population displacement. The availability of safe water and sanitation facilities, the degree of crowding, the underlying health status of the population, and the availability of healthcare services all interact within the context of the local disease ecology to influence the risk for communicable diseases and death in the affected population. We outline the risk factors for outbreaks after a disaster, review the communicable diseases likely to be important, and establish priorities to address communicable diseases in disaster settings.

Natural disasters are catastrophic events with atmospheric, geologic, and hydrologic origins. Disasters include earthquakes, volcanic eruptions, landslides, tsunamis, floods, and drought. Natural disasters can have rapid or slow onset, with serious health, social, and economic consequences. During the past 2 decades, natural disasters have killed millions of people, adversely affected the lives of at least 1 billion more people, and resulted in substantial economic damages (1). Developing countries are disproportionately affected because they lack resources, infrastructure, and disaster-preparedness systems.

Deaths associated with natural disasters, particularly rapid-onset disasters, are overwhelmingly due to blunt trauma, crush-related injuries, or drowning. Deaths from communicable diseases after natural disasters are less common.