title: Epidemic activity after natural disasters without high mortality in developing settings.
abstract: Natural disasters with minimal human mortality rarely capture headlines but occur frequently and result in significant morbidity and economic loss. We compared the epidemic activity observed after a flood, an earthquake, and volcanic activity in Peru. Following post-disaster guidelines, healthcare facilities and evacuation centers surveyed 10-12 significant health conditions for ~45 days and compared disease frequency with Poisson regression. The disasters affected 20,709 individuals and 15% were placed in evacuation centers. Seven deaths and 6,056 health conditions were reported (mean: 0.29 per person). Health facilities reported fewer events than evacuation centers (0.06-0.24 vs. 0.65-2.02,P< 0.001) and disease notification increased 1.6 times after the disasters (95% CI: 1.5-1.6). Acute respiratory infections were the most frequent event (41-57%) and psychological distress was second/third (7.6% to 14.3%). Morbidity increased after disasters without substantial casualties, particularly at evacuation centers, with frequent respiratory infections and psychological distress. Post-disaster surveillance is valuable even after low-mortality events.
authors.affiliation: Dirección General de Epidemiología; Peruvian Ministry of Health; Lima, Peru.
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Loayza-Alarico
authors.affiliation: Emerging Infections and Parasitology Departments; US Naval Medical Research Unit No. 6 (NAMRU-6); Lima, Peru; Universidad Peruana Cayetano Heredia; Lima, Peru.
authors.forename: Andres G
authors.initials: AG
authors.lastname: Lescano
authors.affiliation: Dirección General de Epidemiología; Peruvian Ministry of Health; Lima, Peru.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Suarez-Ognio
authors.affiliation: Dirección General de Epidemiología; Peruvian Ministry of Health; Lima, Peru.
authors.forename: Gladys M
authors.initials: GM
authors.lastname: Ramirez-Prada
authors.affiliation: Emerging Infections and Parasitology Departments; US Naval Medical Research Unit No. 6 (NAMRU-6); Lima, Peru.
authors.forename: David L
authors.initials: DL
authors.lastname: Blazes
keywords: acute respiratory infections; disease surveillance; epidemiology; evacuation centers; natural disasters; psychological stress