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Infection control after and during natural disaster.

ABSTRACT: We encounter many natural disasters in Japan and various infectious diseases could occur during and after natural disasters. Two recent major natural disasters, the Great East Japan Earthquake and the Kumamoto Earthquake in 2011 and 2016, respectively, killed tremendous numbers of people and many were affected with infectious diseases in evacuation centers as well as shelters for long period. Infection control teams of medical facilities inside or outside of affected areas were dispatched, supported evacuees, and made great contributions to: (i) control epidemic infectious diseases such as influenza and norovirus infection, (ii) educate and encourage people, (iii) improve environments. According to the experiences and evidence accumulated from these two disasters, it is apparent that infection control activities will definitely reduce infection during and after disasters. However, unlike the Disaster Medical Assistance Team and Japan Medical Association Team, there is no organization specialized for infection control in disaster-affected areas. A disaster infection control team should be established by leads of either of government and/or societies related to infectious diseases and infection control.

SUBMITTER: Izumikawa K

PROVIDER: S-EPMC6328906 | biostudies-other | 2019 Jan

REPOSITORIES: biostudies-other

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Infection control after and during natural disaster.

Izumikawa Koichi K

Acute medicine & surgery 20180923 1

We encounter many natural disasters in Japan and various infectious diseases could occur during and after natural disasters. Two recent major natural disasters, the Great East Japan Earthquake and the Kumamoto Earthquake in 2011 and 2016, respectively, killed tremendous numbers of people and many were affected with infectious diseases in evacuation centers as well as shelters for long period. Infection control teams of medical facilities inside or outside of affected areas were dispatched, suppo ...[more]

PMID: 30651992

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Project description:Targeted HIV cure strategies require definition of the mechanisms that maintain the virus. Here, we tracked HIV replication and the persistence of infected CD4 T cells in individuals with natural virologic control by sequencing viruses, T cell receptor genes, HIV integration sites and cellular transcriptomes. Our results revealed three mechanisms of HIV persistence operating within distinct anatomic and functional compartments. In lymph node, we detected viruses with genetic and transcriptional attributes of active replication in both T follicular helper (TFH) cells and non-TFH memory cells. In blood, we detected inducible proviruses of archival origin among highly differentiated, clonally expanded cells. Linking the lymph node and blood was a small population of circulating cells harboring inducible proviruses of recent origin. Thus, HIV replication in lymphoid tissue, clonal expansion of infected cells, and recirculation of recently infected cells act together to maintain the virus in HIV controllers despite effective antiviral immunity. Fluorescence-activated cell sorting (FACS) was used to sort subsets of CD4 T cells from blood (peripheral blood mononuclear cells; PBMC) and lymph node from a cohort of HIV-infected people with natural control of the virus (termed HIV controllers). Subsets of CD4 T cells that were sorted are as follows: from blood, (1) naÃ¯ve (N), (2) central memory (CM), (3) transitional memory (TM), and (4) effector memory (EM); from lymph node, (1) naÃ¯ve (N), (2) non-germinal center T-follicular helpers (nGC), (3) germinal center T-follicular helpers (Tfh), (4) effector memory (EM), and (5) other central memory-like subsets (CMPD1lo57lo, CMPD1lo57hi, and/or CMPD1lo). Total RNA and total DNA were extracted from these sorted subsets in separate fractions using RNAzol RT and DNAzol. Total cellular DNA was used for HIV quantification and sequence analysis as describe in the publication. Total RNA used for mRNA library construction by oligo-dT purification (Dynabeads), random fragmentation by heating in the presence of Magnesium (in form of 5x first-strand buffer, LifeTech), reverse transcription (SuperScript III), and then second-strand synthesis, end repair, a-tailing, and adaptor ligation using NEBNext enzyme master mixes and oligonucleotides. Libraries were sequenced on an Illumina HiSeq2000. Please note that each 'source name' value represent individual who havs HIV infection with natural control of the virus.

Project description:Objectives To study short- and long-term effects of experiencing a disaster in repatriated injured survivors and the differential effect of injury, need for medical treatment, loss of loved ones and danger to life on both physical and mental health. Design Prospective online study. Setting Open online survey among Dutch survivors of the 2004 Asian tsunami. Participants Of the estimated total of 464 Dutch survivors, the authors recruited 144 unique respondents (59 men and 85 women) with a total of 175 assessments made in various time periods. Main outcome measures Health outcomes were Symptom Checklist 90 (SCL-90), Impact of Event Scale (original version, in Dutch) and Beck Depression Inventory II. Correlations were calculated with socio-demographic as well as disaster-related factors: physical injury, medical care, loss of loved ones and duration of threat to life. Assessments were clustered in four post-disaster time periods (0-3, 4-6, 7-30 and 31-48 months). Results Across these periods, SCL-90 scores were significantly higher than the reference population (p<0.001), with a significant linear downward trend between the groups over time (p=0.001). The same pattern occurred for the Impact of Event Scale (p<0.001) and the Beck Depression Inventory II (p=0.002). Physical injury, medical care or loss of loved ones was not associated with higher total SCL-90 scores or somatic subscores. Both duration of threat to life and female sex were correlated with all measured outcome parameters. Conclusions Exposure to the 2004 Asian tsunami had significant short- and long-term impacts on health complaints in a group of repatriated Dutch tsunami victims. Cross-sectionally, there was a trend towards recovery over 4 years, although 22% still reported high psychological and physical distress 4 years post-disaster. Duration of danger to life and female sex were associated with more physical and mental health complaints. In this study, neither disaster-related injury nor loss of loved ones resulted in negative health outcomes.

Dataset Information

Infection control after and during natural disaster.

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Infection control after and during natural disaster.

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