Shaken to the Core

Written Assignment Unit 1

HS 2212: INFECTIOUS DISEASES

Instructor Mukesh Saran

University of the People

September 2023
 Scenario: A severe earthquake just occurred in your area. Homes, public services (such as

power, water, and trash removal), and many lives have been lost. Full evacuation is not likely.

Living conditions in local shelters have become crowded and unhygienic. The hospital

generators have failed and the morgue is full. At this rate, communicable disease begins to

threaten the health of the residents. Luckily, you are a healthcare professional specializing in

epidemiology and can help the community make plans to survive until they can rebuild.

1. Imagine and describe the living conditions or other characteristics of the disaster situation

in your locale.

A recent devastating inland earthquake has caused widespread destruction in our area. While

there was no tsunami, the powerful shocks led to building collapses, infrastructure damage, and

fires due to gas leaks and electrical issues. This catastrophe disrupted essential services, leaving

us without water, electricity, or proper waste disposal. The local hospital is overwhelmed, and

community shelters are overcrowded with poor sanitation, posing infectious disease risks. Lack

of power threatens food safety, and clean water access is limited. In this dire situation, expertise

in epidemiology is crucial for disease prevention, makeshift medical facilities, and collaboration

for vital supplies, prioritizing community well-being during the lengthy rebuilding process.

2. After conducting research into the threat of disease in a disaster situation, describe which

specific communicable diseases pose the greatest threat to your area.

In the wake of a devastating earthquake in our region, the population faces significant threats

from various communicable diseases due to damaged infrastructure, overcrowded living

conditions, and disruptions in essential services. A pressing concern is the potential outbreak of

waterborne diseases such as cholera and dysentery. The earthquake's damage to water supply

systems may have led to contamination of water sources with sewage and other pollutants. This

contaminated water, when used for consumption or personal hygiene, can easily transmit these

diseases, especially in densely populated shelters lacking proper sanitation facilities.

Vector-borne diseases like West Nile virus and dengue fever are also of great concern.

Stagnant water in the debris left by the earthquake can become breeding grounds for disease-

carrying mosquitoes, facilitating the spread of diseases like malaria (World Health Organization,

2020). Disrupted waste management and the accumulation of trash can attract disease-spreading

animals, increasing the risk of illnesses such as leptospirosis and hantavirus (Mavrouli et al.,

2022).

Respiratory infections, including influenza and tuberculosis, are a threat in crowded and

poorly ventilated shelters. Proximity and poor air quality in such conditions can facilitate the

transmission of respiratory illnesses (Loaiza-Ceballos et al., 2021). Additionally, the physical and

emotional stress experienced by survivors can weaken their immune systems, making them more

susceptible to these diseases.

Furthermore, the failure of backup generators at hospitals in the aftermath of the earthquake

can exacerbate wound infections, raising the risk of deadly bacterial infections like methicillin-

resistant Staphylococcus aureus (MRSA), which is resistant to many antibiotics (Šiširak et al.,

2010).

To mitigate these threats, immediate attention must be given to restoring access to clean

water, establishing adequate sanitation facilities, and implementing measures to control disease
vectors. Prioritizing public health education can empower residents to practice proper hygiene,

disease prevention, and symptom recognition. Establishing a surveillance system to monitor

disease outbreaks and ensuring prompt medical care for affected individuals will be crucial in

minimizing the spread of infectious diseases and safeguarding our community's health as we

begin the process of rebuilding and restoring essential services.

3. Prepare a brief report to be delivered to local authorities including specific actions that

should be taken to prevent disease.

I reach out to the local authorities in order to address the critical issue of disease prevention

in the aftermath of the recent severe earthquake that has devastated our community. The situation

is dire, with homes, public services, and many lives lost. Evacuation is not currently feasible, and

living conditions in local shelters have become overcrowded and unhygienic. Furthermore, the

failure of hospital generators and a full morgue have compounded our challenges. The risk of

communicable diseases spreading among the affected population is imminent. As a healthcare

professional specializing in epidemiology, I would like to propose a set of priorities, actions, and

requirements to prevent further loss of lives and protect the health of our residents.

Primarily, we must ensure clean water supply. Immediate action must be taken to ensure a

clean and safe water supply. This includes repairing or setting up temporary water treatment

facilities to provide access to clean drinking water for all residents. We must also establish

proper waste disposal and sanitation facilities in the shelters to prevent the accumulation of

waste and the proliferation of disease vectors. This way, we can proceed with promoting

rigorous infection control measures within shelters, including the provision of hand sanitizers,
masks, and education on proper hygiene practices. Isolate individuals showing symptoms of

illness to prevent further transmission. Medical care must also be prioritized for the injured

and vulnerable populations. Reinforce our medical facilities with additional personnel, medical

supplies, and equipment, and address the failure of hospital generators promptly.

Another priority is implementing vector control measures, especially in areas with stagnant

water or debris, to prevent the spread of diseases like malaria and dengue fever. Mobilize trained

emergency response teams, including healthcare professionals, epidemiologists, and sanitation

experts, to coordinate relief efforts and prevent disease outbreaks. We shall establish a robust

communication system to disseminate critical information about disease prevention, medical

services, and safety measures to the affected population.

I also request that we collaborate with local organizations, NGOs, and neighboring

communities to pool resources, personnel, and expertise for a coordinated response in order to

implement a disease surveillance system to monitor the health status of shelter residents and

detect outbreaks early. Finally, we must recognize the psychological impact of the disaster and

provide psychosocial support to residents to reduce stress and anxiety, which can weaken the

immune system.

In these challenging times, it is imperative that we prioritize disease prevention to protect the

lives and well-being of our community. By focusing on clean water, sanitation, infection control,

medical care, and collaboration, we can mitigate the risk of communicable diseases spreading

among our vulnerable population. Immediate action is essential to ensure that our community

can survive and rebuild in the wake of this devastating earthquake. I urge the local authorities to

implement these measures promptly to safeguard the health of our residents.

References

Loaiza-Ceballos, M. C., Marin-Palma, D., Zapata, W., & Hernandez, J. C. (2021). Viral

respiratory infections and air pollutants. Air Quality, Atmosphere & Health, 15(1), 105–

114. https://doi.org/10.1007/s11869-021-01088-6

Mavrouli, M., Mavroulis, S., Lekkas, E., & Tsakris, A. (2022). Infectious Diseases Associated

with Hydrometeorological Hazards in Europe: Disaster Risk Reduction in the Context of

the Climate Crisis and the Ongoing COVID-19 Pandemic. International Journal of

Environmental Research and Public Health, 19(16), 10206.

https://doi.org/10.3390/ijerph191610206

Šiširak, M., Zvizdić, A., & Hukić, M. (2010). Methicillin-Resistant Staphylococcus Aureus

(mrsa) as a Cause of Nosocomial Wound Infections. Bosnian Journal of Basic Medical

Sciences, 10(1), 32–37. https://doi.org/10.17305/bjbms.2010.2733

World Health Organization. (2020). Vector-borne Diseases. Who.int; World Health

Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/vector-borne-

diseases