Surveillance of morbidity during wildfires--Central Florida, 1998.
Several large wildfires occurred in Florida during June-July 1998, many involving both rural and urban areas in Brevard, Flagler, Orange, Putnam, Seminole, and Volusia counties. By July 22, a total of 2277 fires had burned 499,477 acres throughout the state (Florida Department of Community Affairs, unpublished data, 1998). On June 22, after receiving numerous phone calls from persons complaining of respiratory problems attributable to smoke, the Volusia County Health Department issued a public health alert advising persons with pre-existing pulmonary or cardiovascular conditions to avoid outdoor air in the vicinity of the fires. To determine whether certain medical conditions increased in frequency during the wildfires, the Volusia County Health Department and the Florida Department of Health initiated surveillance of selected conditions. This report summarizes the results of this investigation. (+info
Canada's "disasters-R-us" medical platoon a hit in Honduras.
The Canadian Forces Disaster Assistance Response Team did not take long to adapt to the medical needs of 90,000 survivors of Hurricane Mitch last November. (+info
Needs assessment following hurricane Georges--Dominican Republic, 1998.
Hurricane Georges struck the Carribean Islands in September 1998, causing numerous deaths and extensive damage throughout the region. The Dominican Republic was hardest hit, with approximately 300 deaths; extensive infrastructure damage; and severe agricultural losses, including staple crops of rice, plantain, and cassava. Two months after the hurricane, the American Red Cross (ARC) was asked to provide food to an estimated 170,000 families affected by the storm throughout the country. To assist in directing relief efforts, CDC performed a needs assessment to estimate the food and water availability, sanitation, and medical needs of the hurricane-affected population. This report summarizes the results of that assessment, which indicate that, 2 months after the disaster, 40% of selected families had insufficient food > or =5 days per and 28% of families reported someone in need of medical attention. (+info
Juvenile hypothyroidism among two populations exposed to radioiodine.
We found an epidemic of juvenile hypothyroidism among a population of self-defined "downwinders" living near the Hanford nuclear facility located in southeast Washington State. The episode followed massive releases of 131I. Self-reported data on 60 cases of juvenile hypothyroidism (<20 years of age) among a group of 801 Hanford downwinders are presented, as well as data concerning the thyroid status of approximately 160,000 children exposed to radioiodine before 10 years of age as a result of the 26 April 1986 Chernobyl explosion in the former Soviet Union. These children were residents of five regions near Chernobyl. They were examined by standardized screening protocols over a period of 5 years from 1991 to 1996. They are a well-defined group of 10 samples. Fifty-six cases of hypothyroidism were found among boys and 92 among girls. Body burdens of 137Cs have been correlated with hypothyroidism prevalence rates. On the other hand, the group of juvenile (<20 years of age) Hanford downwinders is not a representative sample. Most of the 77 cases of juvenile hypothyroidism in the Hanford group were diagnosed from 1945 to 1970. However, the ratio of reported cases to the county population under 20 years of age is roughly correlated with officially estimated mean levels of cumulative thyroid 131I uptake in these counties, providing evidence that juvenile hypothyroidism was associated with radioiodine exposures. Because even subtle hypothyroidism may be of clinical significance in childhood and can be treated, it may be useful to screen for the condition in populations exposed to radioiodine fallout. Although radiation exposure is associated with hypothyroidism, its excess among fallout-exposed children has not been previously quantified. (+info
Persistent respiratory effects in survivors of the Bhopal disaster.
OBJECTIVE: To examine the role of exposure to the 1984 Bhopal gas leak in the development of persistent obstructive airways disease. DESIGN: Cross sectional survey. SETTING: Bhopal, India. SUBJECTS: Random sample of 454 adults stratified by distance of residence from the Union Carbide plant. MAIN OUTCOME MEASURES: Self reported respiratory symptoms; indices of lung function measured by simple spirometry and adjusted for age, sex, and height according to Indian derived regression equations. RESULTS: Respiratory symptoms were significantly more common and lung function (percentage predicted forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), and FEV1/FEV ratio) was reduced among those reporting exposure to the gas leak. The frequency of symptoms fell as exposure decreased (as estimated by distance lived from the plant), and lung function measurements displayed similar trends. These findings were not wholly accounted for by confounding by smoking or literacy, a measure of socioeconomic status. Lung function measurements were consistently lower in those reporting symptoms. CONCLUSION: Our results suggest that persistent small airways obstruction among survivors of the 1984 disaster may be attributed to gas exposure. (+info
Y2K: the moment of truth.
It remains to be seen whether the world will move in time to fix the Y2K bug, or whether computers around the world will shut down when the clock strikes midnight on 31 December 1999. Y2K could have a serious impact on environmental facilities, particularly given the extent to which computer software and microchips are now involved in pollution control and environmental monitoring and protection systems. (+info
Great earthquakes and medical information systems, with special reference to telecommunications.
The Hanshin-Awaji earthquake in January 1995 caused the greatest number of deaths and injuries in Japan since World War II. Various weaknesses of modern information systems were exposed during and after the earthquake. The authors carried out a questionnaire survey to investigate the current state of hospital information and to examine the kinds of information needed immediately after an earthquake. The survey results show that information about the ability to admit new patients and the availability of medical supplies is necessary immediately after such a disaster. These results will be useful for planning countermeasures against this kind of disaster. (+info
Preventive effect of artemether on schistosome infection.
OBJECTIVE: To study the preventive effect of artemether (Art) in protecting the people from schistosome infection during flood fighting in schistosomiasis endemic area of Poyang Lake, Jiangxi Province. METHODS: From mid July to mid August in 1996, the water level in Poyang Lake rose due to torrential rains and 2 embankments, Zhedi and Jiangtongdi, which appeared in dangerous situation and were selected as the pilot spots. After those who went to fight against flood arrived at the pilots their sera were collected within 48 hours and were examined with indirect hemagglutination test (IHA), enzyme-linked immunosorbent assay (ELISA) and McAb-ELISA. Individuals with negative outcome in the 3 tests were then selected as the study subjects and were allocated randomly to the Art or the control group. The first dose of Art given to the individuals contacted with the infested water within 11-15 days was 6 mg/kg. If the individual continually contacted the infested water, the same dose of Art was given once every 15 days. After the individuals withdrew from the pilot, one more dose of Art was administered 7-15 days later. Placebo (starch) was given to individuals in the control group at the same period as in artemether group. Stool examinations were made in both groups 40-50 days after the last medication for evaluation of the preventive effect of artemether. Double blind method was used in the administration of both artemether and placebo. RESULTS: In Zhedi pilot, the individuals fought against flood for about 1 month. In Art group, 99 individuals receiving 3 doses of the drug completed the stool examination with egg-positive rate of 4% and no acute schistosomiasis was seen. In the control group, among 110 people who completed the observation, 44 were egg-positive with an infection rate of 40%, and 29 were identified as having acute schistosomiasis. In Jiangtondi, the studied individuals contacted the infested water for only about 4 hours. But in the control group 4 out of 102 individuals were egg-positive, while none of the 103 individuals in Art group receiving 2 doses of the drug showed schistosome infection. No apparent side effect was seen in the people treated with artemether. CONCLUSION: After oral Art was given to the people fighting against flood in schistosomiasis endemic area of Poyang Lake, it was shown that the oral Art has a promising effect on controlling acute schistosomiasis and reducing the infection rate. (+info