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Disease Outbreaks in Tsunami Hit Areas
January 6, 2005
>>Regarding post-disaster surveillance and monitoring of diseases that are likely to occur, WHO noted that the Ministry of Public Health has strengthened surveillance for epidemic-prone diseases in affected areas, and has established additional surveillance response teams.
There was no evidence of disease outbreaks resulting from the tsunami disaster, said WHO.
The WHO has set up a 24-hour Tsunami Operation Centre at its Thailand office.
The centre is responsible for coordinating WHO's relief and restoration efforts with the government of Thailand, the UN agencies and other government and non-government counterparts.<<
Although there may not be evidence of disease outbreaks in Thailand, several other tsunami hit areas are reporting outbreaks. In India there are at least 13 cases of measles in Cuddalore and 4 cases of chicken pox in Port Blair. In Sri Lanka there have been 3 reported case of fatal flu in. In Indonesia there has been an outbreak of fatal tetanus. There are also concerns about potential outbreaks of cholera and Dengue Fever.
The above infections tax medical staff at relief camps and the millions of displaced people create overcrowded facilities that can lead to unsanitary conditions.
In Thailand there have been outbreaks of H5N1 bird flu in pigeons and wild birds. Documented human to human transmission has been rare, but it seems that under the right conditions, such as close care given by a relative, H5N1 has passed from brother to sister in Vietnam and daughter to mother and aunt in Thailand. Similarly, many of the 147 tiger deaths at the Sri Racha Tiger Zoo in Thailand were probably due to tiger to tiger transmission since the deaths occurred over an extended time period and rose from a few to many new cases per day.
Thus, the potential for human to human transmission in crowded relief camps is a real possibility. New fatal bird flu cases have been reported in Vietnam. Such infections may initially go undiagnosed. In the 1918 flu pandemic, many cases were mistakenly diagnosed as cholera or Dengue Fever. Since Dengue Fever is not passed from human to human, appropriate isolation procedure may not be employed. Indeed the daughter in the Thailand cluster described above was initially diagnosed as Dengue Fever, which led to close contact between the daughter and mother.
Establishing surveillance response teams should help reduce the likelihood of spread of any H5N1 bird flu that might devlop in the tsunami hit countries in south Asia,