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Infection control campaign at evacuation centers in Miyagi prefecture after the Great East Japan Earthquake.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Kanamori, Hajime Kunishima, Hiroyuki Tokuda, Koichi Kaku, Mitsuo |
| Copyright Year | 2011 |
| Abstract | To the Editor—Japan is now experiencing a crisis as a result of the Great East Japan Earthquake (magnitude, 9.0) that occurred on March 11, 20ll. The most devastated area was Miyagi prefecture in the Tohoku region, especially the coastal area, which experienced a great deal of damage as a result of the tsunami. The Fukushima nuclear power plant is dispersing radioactive substances as a result of the seismic damage to the plant. As of April 1, 2011, the death toll associated with the earthquake and the subsequent tsunami exceeded 6,700, with more than 7,000 individuals missing in Miyagi prefecture. Approximately 71,000 people are living at 550 evacuation shelters. Many survivors are obliged to reside in the shelters under harsh and unsanitary conditions. Health care is likely to be insufficient for evacuees because there are few healthcare workers, including medical doctors, registered nurses, and public health nurses. There is a public health concern about the increased risk of infectious diseases, including acute respiratory infections, influenza, tuberculosis, and measles, under crowded living conditions and about diarrheal diseases and waterborne diseases that are typically seen after natural disasters. In Japan, an increase in the morbidity rate associated with pneumonia was reported after the 1995 Hanshin-Awaji earthquake. Therefore, the Tohoku Regional Infection Control Network has begun infection control activities to support evacuation centers in their fight against infectious diseases. People who have lost their homes are crowded into each evacuation center (Figure 1). In most cases, there is no housing available for evacuees to live in, and the distance between families is less than 1 m, which suggests the difficulty of conducting droplet precautions. Influenza was epidemic from February through March in Japan, and continuous monitoring of influenza at evacuation centers is needed. We found that some individuals could not wear masks properly, even if the mask supply were sufficient to provide masks for all residents. Room ventilation in evacuation centers also tends to be poor, because it remains cold in Miyagi prefecture until late spring. If small rooms in which to isolate patients with influenza-like illnesses are unavailable in evacuation centers, partitioning family units by using corrugated cardboard may be acceptable. Running water is unavailable or insufficient as a result of damage to the water supply system. Hand hygiene depends on the use of alcohol-based hand sanitizers, despite the limited supply of such sanitizers. In addition, many residents have little understanding of hand hygiene because they are not healthcare professionals. Poor compliance with hand hygiene increases the risk of cross infection, particularly when cooking and eating, using temporary lavatories, and processing garbage and infectious waste. Education regarding the importance of hand hygiene before food preparation and after using toilets is needed, and alcohol-based hand sanitizers need to be installed in the most visible spots. Many evacuation centers still experience unsanitary conditions as a result of poor environmental maintenance. Floors and toilets remain dirty unless no outdoor shoes are allowed and regular cleaning is done. Inappropriate disposal of infectious waste, including vomitus, feces, and diapers, can lead to the transmission of infectious pathogens. It is essential to disseminate basic knowledge and skills for cleaning and disinfecting the shelter environment. To achieve effective infection control measures in Miyagi prefecture, we require the cooperation and contribution of many hospitals in the region. The Tohoku Regional Infection Control Network was established in 1999 to fight against infectious diseases and to promote infection control activities. The operation center is located in the infection control unit of Tohoku University Hospital and is connected with more than 100 regional healthcare facilities. The network works functionally and collaboratively on infection control activities at evacuation centers and hospitals in disasterstricken areas, including activities such as (1) infectious diseases consultation, (2) infection control educational programs and training, (3) infection control interventions, and (4) regional cooperation with local government against infectious diseases. The network enables us to rapidly respond to infection control issues in efficient ways, especially in terms of information dissemination and resource allocation. Thus, the network has an important role in solving infection control issues and improving infection control practices in the Tohoku region. We will continue our infection control activities at evacuation centers after the most disastrous earthquake on record. |
| File Format | PDF HTM / HTML |
| DOI | 10.1086/661224 |
| PubMed reference number | 21768770 |
| Journal | Medline |
| Volume Number | 32 |
| Issue Number | 8 |
| Alternate Webpage(s) | https://www.cambridge.org/core/services/aop-cambridge-core/content/view/156B416C45B59E088C220E44D04C1548/S0195941700050165a.pdf/infection_control_campaign_at_evacuation_centers_in_miyagi_prefecture_after_the_great_east_japan_earthquake.pdf |
| Alternate Webpage(s) | https://doi.org/10.1086/661224 |
| Journal | Infection control and hospital epidemiology |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
