title: Deterioration in regional health status after the acute phase of a great disaster: respiratory physicians' experiences of the Great East Japan Earthquake.
abstract: BACKGROUND
  The Great East Japan Earthquake occurred on March 11, 2011. The source of the ensuing devastation was not the tremors, but the subsequent tsunami. Responding emergency medical teams could not provide sufficient assistance, which led to many people dying before the rescue teams arrived. Thus, the main objective of healthcare professionals became to prevent deterioration in people's health statuses in the disaster area.
  
  
  METHODS
  One month after the earthquake, the Health-Promoting Association of Respiratory Medicine of Tohoku conducted a survey regarding changing disease prevalence among inpatients in respiratory medicine departments of regional core hospitals in Miyagi Prefecture, the area that suffered the most damage.
  
  
  RESULTS
  The number of patients from March 11 to April 10, 2011 was 2.7 times greater than that during the same period in 2010 (1223 vs. 443, respectively). The prevalence of asthma, exacerbations of chronic obstructive pulmonary disease, and community-acquired pneumonia were also 2-3 times greater in 2011 than in 2010 (98 vs. 32, 117 vs. 46, and 443 vs. 202, respectively) among all ages. Half of the community-acquired pneumonia cases originated in evacuation shelters. The number of inpatients with other diseases, including those who drowned, was relatively small, and mortality did not increase significantly at these hospitals.
  
  
  CONCLUSIONS
  The findings may result from poor shelter or dwelling conditions, as well as overpopulation and lack of basic resources. Adequate shelters, supply systems, and protection from infection, including vaccinations, are needed to prevent deteriorations in health status after the acute phase of a natural disaster.
authors.affiliation: Health-Promoting Association of Respiratory Medicine of Tohoku, Japan. ohkouchi@idac.tohoku.ac.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Ohkouchi
authors.forename: Risa
authors.initials: R
authors.lastname: Shibuya
authors.forename: Masaru
authors.initials: M
authors.lastname: Yanai
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ichinose
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nukiwa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D055866:Earthquakes; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D015272:Pulmonary Medicine; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D057192:Tsunamis