title: Post-disaster health impact of natural hazards in the Philippines in 2013.
abstract: BACKGROUND
  In 2011, the Health Emergency Management Bureau (HEMB) created the Surveillance for Post Extreme Emergencies and Disasters (SPEED), a real-time syndromic surveillance system that allows the early detection and monitoring of post-disaster disease trends. SPEED can assist health leaders in making informed decisions on health systems affected by disasters. There is a need for further validation of current concepts in post-disaster disease patterns in respect to actual field data. This study aims to evaluate the temporal post-disaster patterns of selected diseases after a flood, an earthquake, and a typhoon in the Philippines in 2013.
  
  
  METHODS
  We analyzed the 21 syndromes provided by SPEED both separately and grouped into injuries, communicable diseases, and non-communicable diseases (NCDs) by calculating daily post-disaster consultation rates for up to 150 days post-disaster. These were compared over time and juxtaposed according to the type of disaster.
  
  
  RESULTS
  Communicable diseases were found to be the predominant syndrome group in all three disaster types. The top six syndromes found were: acute respiratory infections, open wounds, bruises and burns, high blood pressure, skin disease, fever, and acute watery diarrhea.
  
  
  CONCLUSIONS
  Overall, the results aligned with the country's morbidity profile. Within 2 months, the clear gradation of increasing syndrome rates reflected the severity (flood<earthquake<typhoon) and magnitude of the disruption of the health system caused by the disasters. After 2 months, rates dropped, suggesting the beginning of the recovery phase. The most common syndromes can be addressed by measures such as providing for shelter, water, sanitation, hygiene, nutrition, and common health services.
  
  
  CONCLUSIONS
  Most post-disaster syndromes may be addressed by prevention, early diagnosis, and early treatment. Health needs differ in response and recovery phases.
authors.affiliation: Institute of Public Health, Heidelberg University, Heidelberg, Germany.
authors.forename: Miguel Antonio
authors.initials: MA
authors.lastname: Salazar
authors.affiliation: World Health Organization Office in Sri Lanka, Colombo, Sri Lanka.
authors.forename: Arturo
authors.initials: A
authors.lastname: Pesigan
authors.affiliation: Health Emergency Management Bureau, Department of Health, Republic of the Philippines, Manila, Philippines.
authors.forename: Ronald
authors.initials: R
authors.lastname: Law
authors.affiliation: Institute of Public Health, Heidelberg University, Heidelberg, Germany; v.winkler@uni-heidelberg.de.
authors.forename: Volker
authors.initials: V
authors.lastname: Winkler
keywords: disasters; infectious disease; injuries; non-communicable diseases; syndromic surveillance