Global & Disaster Medicine

Archive for September, 2017

September 19, 1985: An 8.1M earthquake strikes Mexico City and leaves 10,000 people dead, 30,000 injured and thousands more homeless.

History Channel


7.1M Earthquake Strikes Mexico, Killing Over 100

ShakeMap Intensity image

https://www.youtube.com/watch?v=8Hx5zAzm1OU

Population Exposure Map

Tectonic Summary

The September 19, 2017, M 7.1 earthquake in Central Mexico occurred as the result of normal faulting at a depth of approximately 50 km. Focal mechanism solutions indicate that the earthquake occurred on a moderately dipping fault, striking either to the southeast, or to the northwest. The event is near, but not directly on, the plate boundary between the Cocos and North America plates in the region. At the location of this event, the Cocos plate converges with North America at a rate of approximately 76 mm/yr, in a northeast direction. The Cocos plate begins its subduction beneath Central America at the Middle America Trench, about 300 km to the southwest of this earthquake. The location, depth, and normal-faulting mechanism of this earthquake indicate that it is likely an intraplate event, within the subducting Cocos slab, rather than on the shallower megathrust plate boundary interface.

While commonly plotted as points on maps, earthquakes of this size are more appropriately described as slip over a larger fault area. Normal-faulting events of the size of the September 19th, 2017 earthquake are typically about 50×20 km (length x width).

Over the preceding century, the region within 250 km of the hypocenter of the September 19th, 2017 earthquake has experienced 19 other M 6.5+ earthquakes. Most occurred near the subduction zone interface at the Pacific coast, to the south of the September 19 event. The largest was a M 7.6 earthquake in July 1957, in the Guerrero region, which caused between to 50-160 fatalities, and many more injuries. In June 1999, a M 7.0 at 70 km depth, just to the southeast of the September 19, 2017 earthquake, caused 14 fatalities, around 200 injuries, and considerable damage in the city of Puebla (MMI VIII).

Today is the anniversary of the devastating 1985 M 8.0 Michoacan earthquake, which caused extensive damage to Mexico City and the surrounding region. That event occurred as the result of thrust faulting on the plate interface between the Cocos and North America plates, about 450 km to the west of the September 19, 2017 earthquake. Today’s earthquake also occurs 12 days after a M 8.1 earthquake offshore of Chiapas, in southern Mexico. The epicenter of the M 8.1 event is located about 650 km to the southeast of today’s quake. That earthquake also occurred as the result of normal faulting within the subducting Cocos Plate, at a depth of 50-70 km.


Aung San Suu Kyi condemns human rights violations in Rakhine state but nothing on ethnic cleansing complaints of the role of the Burmese military

Reuters

“…Human rights group Amnesty International described her speech as “little more than a mix of untruths and victim-blaming”, saying she and her government were “burying their heads in the sand” for ignoring the army’s role in the violence.

“We condemn all human rights violations and unlawful violence. We are committed to the restoration of peace and stability and rule of law throughout the state,” Suu Kyi said in her address in the capital, Naypyitaw.

“Action will be taken against all people, regardless of their religion, race and political position, who go against the law of the land and violate human rights,” she said….”

 

 


NWS: Dominica devastated

Hurricane Maria Raised to Major Status

https://www.youtube.com/watch?v=cI6Bc7bWG-s

 

cone graphic

 

ZCZC MIATCPAT5 ALL
TTAA00 KNHC DDHHMM

BULLETIN
Hurricane Maria Advisory Number  13
NWS National Hurricane Center Miami FL       AL152017
500 AM AST Tue Sep 19 2017

…EXTREMELY DANGEROUS HURRICANE MARIA HEADED FOR THE VIRGIN
ISLANDS AND PUERTO RICO…

 

SUMMARY OF 500 AM AST…0900 UTC…INFORMATION
———————————————-
LOCATION…16.0N 62.3W
ABOUT 65 MI…100 KM WSW OF GUADELOUPE
ABOUT 205 MI…325 KM SE OF ST. CROIX
MAXIMUM SUSTAINED WINDS…155 MPH…250 KM/H
PRESENT MOVEMENT…WNW OR 300 DEGREES AT 9 MPH…15 KM/H
MINIMUM CENTRAL PRESSURE…934 MB…27.58 INCHES

 

WATCHES AND WARNINGS
——————–
CHANGES WITH THIS ADVISORY:

None

SUMMARY OF WATCHES AND WARNINGS IN EFFECT:

A Hurricane Warning is in effect for…
* Guadeloupe
* Dominica
* St. Kitts, Nevis, and Montserrat
* U.S. Virgin Islands
* British Virgin Islands
* Puerto Rico, Culebra, and Vieques

A Tropical Storm Warning is in effect for…
* Antigua and Barbuda
* Saba and St. Eustatius
* St. Maarten
* Anguilla
* St. Lucia
* Martinique

A Hurricane Watch is in effect for…
* Saba and St. Eustatius
* St. Maarten
* St. Martin and St. Barthelemy
* Anguilla
* Isla Saona to Puerto Plata

A Tropical Storm Watch is in effect for…
* St. Vincent and the Grenadines
* West of Puerto Plata to the northern Dominican Republic-Haiti
border

A Hurricane Warning means that hurricane conditions are expected
somewhere within the warning area.  Preparations to protect life and
property should be rushed to completion.

A Tropical Storm Warning means that tropical storm conditions are
expected somewhere within the warning area.

A Hurricane Watch means that hurricane conditions are possible
within the watch area.  A watch is typically issued 48 hours
before the anticipated first occurrence of tropical-storm-force
winds, conditions that make outside preparations difficult or
dangerous.

A Tropical Storm Watch means that tropical storm conditions are
possible within the watch area, generally within 48 hours.

Interests elsewhere in Hispaniola, the southeastern Bahamas, and
the Turks and Caicos Islands should monitor the progress of Maria.
Additional watches and warnings may be required today.

For storm information specific to your area in the United
States, including possible inland watches and warnings, please
monitor products issued by your local National Weather Service
forecast office.  For storm information specific to your area
outside the United States, please monitor products issued by your
national meteorological service.

 

DISCUSSION AND 48-HOUR OUTLOOK
——————————
At 500 AM AST (0900 UTC), the center of Hurricane Maria was located
near latitude 16.0 North, longitude 62.3 West.  Maria is moving
toward the west-northwest near 9 mph (15 km/h), and this general
motion is expected to continue through Wednesday.  On the forecast
track, the eye of Maria will move over the northeastern Caribbean
Sea today, and approach the Virgin Islands and Puerto Rico tonight
and Wednesday.

Maximum sustained winds are near 155 mph (250 km/h) with higher
gusts.  Maria is a category 4 hurricane on the Saffir-Simpson
Hurricane Wind Scale.  Some fluctuations in intensity are likely
during the next day or two, but Maria is forecast to remain an
extremely dangerous category 4 or 5 hurricane while it approaches
the Virgin Islands and Puerto Rico.  An Air Force Hurricane Hunter
aircraft is currently investigating Maria.

Hurricane-force winds extend outward up to 30 miles (45 km) from the
center and tropical-storm-force winds extend outward up to 125 miles
(205 km).

The estimated minimum central pressure is 934 mb (27.58 inches).

 

HAZARDS AFFECTING LAND
———————-
WIND:  Hurricane conditions will continue to spread throughout
portions of the hurricane warning area in the Leeward Islands this
morning.  Hurricane conditions should spread through the remainder
of the Hurricane Warning area later today and Wednesday.  Hurricane
conditions are possible within the Hurricane Watch area in the
Dominican Republic late Wednesday, with tropical storm conditions
possible by early Wednesday.  Tropical storm conditions are possible
in the Tropical Storm Watch area in St. Vincent and the Grenadines
this morning, and are possible in the Tropical Storm Watch area in
the Dominican Republic on Wednesday.

Wind speeds atop and on the windward sides of hills and mountains
could be much stronger than the near-surface winds indicated in this
advisory.

STORM SURGE:  A dangerous storm surge accompanied by large and
destructive waves will raise water levels by as much as 7 to 11
feet above normal tide levels in the hurricane warning area near
where the center of Maria moves across the Leeward Islands and the
British Virgin Islands.

The combination of a dangerous storm surge and the tide will cause
normally dry areas near the coast to be flooded by rising waters
moving inland from the shoreline.  The water is expected to reach
the following heights above ground if the peak surge occurs at the
time of high tide…

Puerto Rico and the U.S. Virgin Islands…6 to 9 ft

The deepest water will occur along the immediate coast near and to
the north and east of the landfall location, where the surge will be
accompanied by large and destructive waves.  Surge-related
flooding depends on the relative timing of the surge and the tidal
cycle, and can vary greatly over short distances.  For information
specific to your area, please see products issued by your local
National Weather Service forecast office.

RAINFALL: Maria is expected to produce the following rain
accumulations through Thursday:

Central and southern Leeward Islands…10 to 15 inches, isolated 20
inches.
U.S. and British Virgin Islands…10 to 15 inches, isolated 20
inches.
Puerto Rico…12 to 18 inches, isolated 25 inches.
Northern Leeward Islands from Barbuda to Anguilla…4 to 8 inches,
isolated 10 inches.
Windward Islands and Barbados…2 to 4 inches, isolated 6 inches.
Eastern Dominican Republic…4 to 8 inches, isolated 12 inches.

Rainfall on all of these islands will cause life-threatening flash
floods and mudslides.

SURF:  Swells generated by Maria are affecting the Lesser Antilles.
These swells are likely to cause life-threatening surf and rip
current conditions.  Please consult products from your local
weather office.


Gauging the threat of Jose……

[Image of probabilities of 34-kt winds]

cone graphic


CDC: Disaster Preparedness for Expectant and New Parents as Maria storms in…….

CDC 

Preparedness for Expectant and New Parents

Illustration of pregnant woman with various preparation iconsDisasters, such as wildfires(https://www.cdc.gov/reproductivehealth/emergency/wildfires.htm), hurricanes(https://www.cdc.gov/disasters/hurricanes/index.html), and floods(https://www.cdc.gov/disasters/floods/index.html), can be unpredictable and devastating. In honor of National Preparedness Month, learn general tips to get prepared before a disaster and what to do in case of a disaster to help keep you and your family safe and healthy.

Get Prepared for an Emergency or Disaster

Disasters can be scary and stressful, especially if you’re expecting or have a baby. You can take the following steps now to help you prepare for an emergency and better cope if an emergency happens.

  • Talk to your doctor or other healthcare provider about—
    • What steps you should take in any emergency.
    • Where you will get prenatal care if your doctor’s office is closed.
    • Where you will deliver your baby if your hospital is closed.
  • Learn the signs of signs of preterm labor(https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm#warning_signs) (labor before 37 weeks of pregnancy) and prepare emergency birth kit supplies.
  • Learn about your community’s warning signals (such as tornado sirens) and check with your state emergency management agency to find out how to get emergency alerts and about the best places to take shelter during different types of emergencies.
  • Make a family communication plan for how you and your family will contact one another and what steps you will take in different types of situations.
  • Prepare an emergency kit that includes a 3-day supply of food and water, health supplies (including any medicines you may be taking), personal and baby care items, safety supplies, electronics (flashlight, radio, cell phone with charger, and extra batteries), and important documents, such as emergency telephone numbers.
  • Plan ahead for where your baby will sleep if you have to evacuate your home. Your baby is safest sleeping on his or her back on a surface that is separate from others and does not have pillows, blankets, or toys. Learn more about these and other actions at Parents and Caregivers(https://www.cdc.gov/sids/Parents-Caregivers.htm#prevention) .

Illustration of doctor talking to pregnant woman about an emergency kitOnce you are out of immediate danger, continue your prenatal care even if it is not with your primary doctor.

What to Do During and Just After Disaster

Expectant Parents

Pregnant women have special medical needs. If you’re pregnant or think you may be pregnant, you and your partner can take the following steps to help you stay safe and healthy in the event of a disaster.

  • If you have any signs of preterm labor(https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm#warning_signs) (labor before 37 weeks of pregnancy), call your healthcare provider or 911, or go to the hospital immediately if it is safe to leave.
  • If you have to evacuate, be prepared to leave quickly and have your emergency kit ready to go.
  • If staying at a shelter or in temporary housing, tell the staff as soon as possible that you are pregnant and if you have any health problems.
  • Once you are out of immediate danger, continue your prenatal care, even if it is not with your primary doctor. Tell the doctor or other healthcare provider if you have any health problems and if you take any medications (both over-the-counter and prescription).
  • If you have your prenatal vitamins or prescription medicines with you, take them as directed. If you don’t have your prenatal vitamins or prescription medicines with you, ask staff at the shelter for help getting them.
  • Protect yourself from infections by washing your hands often and staying away from people who are sick.
  • During disasters, harmful chemicals(https://www.cdc.gov/disasters/chemicals.html) from businesses and other places may be released into the environment. Listen to announcements from emergency officials about chemical safety and actions you may need to take to protect yourself. If you have questions about exposure to harmful chemicals during pregnancy, call MotherToBaby at 1-866-626-6847. To reach the nationwide poison control center, call 1-800-222-1222.
  • To help with physical stress, drink plenty of water and rest as often as you can. To help relieve emotional stress, talk to a healthcare provider, friend, or family member about your concerns and feelings.

Illustration of woman tucking baby into crib with words safe sleepYour baby is safest sleeping on his or her back on a surface that is separate from others and does not have pillows, blankets, or toys.

Parents of Infants

A disaster can make it difficult to access necessary supplies and health care. Parents and caregivers of infants can take the following steps to help keep their families safe and healthy in the event of a disaster.

  • If you have to evacuate, be prepared to leave quickly and have your emergency kit that includes infant care supplies, such as baby food and a portable crib, ready to go.
  • If you breastfeed your baby, continue to do so. Clean water may not be available for mixing formula or washing bottles. If you have questions about exposure to harmful chemicals while breastfeeding, call MotherToBaby at 1-866-626-6847. To reach the nationwide poison control center, call 1-800-222-1222.
  • If you are away from your home during a disaster, take these actions to help your baby sleep safely(https://www.cdc.gov/sids/Parents-Caregivers.htm#prevention) .
  • As soon as it is safe to do so, get a postpartum checkup if you are due for a visit, even if it is not with your usual doctor. If you’re not ready to get pregnant, you can ask for several months’ supply of the pill, patch, or ring or consider using a birth control method(https://www.cdc.gov/reproductivehealth/contraception/index.htm) that will prevent pregnancy for several months.
  • As soon as it is safe to do so, see a doctor or other healthcare provider for well-baby checkups or if you’re concerned about a health problem, even if it is not with your baby’s usual doctor.
  • If you have your prescription medicines with you, take them as directed. If you don’t have your medicines with you, ask staff at the shelter for help getting them.
  • If your baby is currently taking prescription or over-the-counter medicines, and you have them, continue giving them as directed.
  • To help relieve emotional stress, talk to a healthcare provider, friend, or family member about your concerns and feelings.

MCI at a nursing home in Florida

NY Times

“….Judy Frum, the chief nursing officer at the air conditioned hospital just across the street from the rehabilitation center, was working in the Irma command center when the emergency room notified her that three patients had been brought in from the nursing home.

“It set off a red flag that something might be going on,” said Frum, who grabbed a colleague and hurried across the street.

When they arrived, paramedics were treating a critically ill patient near the entrance. She saw harried staff members trying to get patients into a room where fans were blowing.

The center had some electricity, but not enough to power the air conditioning.

Frum called her facility, Memorial Regional Hospital, to issue a mass casualty alert. As many as 100 hospital employees rushed over to help….”

 


9/18/1987: Cesium-137 is removed from an abandoned cancer-therapy machine in Goiana, Brazil leading to the radiation poisoning of hundreds of people

History Channel

 

 


As of 14 September, fourteen autochthonous confirmed cases of chikungunya have been diagnosed in Italy, six in Rome and eight in the coastal area of Anzio .

WHO

Chikungunya – Italy

Disease outbreak news
15 September 2017

As of 14 September, fourteen autochthonous confirmed cases of chikungunya have been diagnosed in Italy, six in Rome and eight in the coastal area of Anzio (Lazio Region). There are additional cases being investigated.

Collegamento al siti tematico Vaccinazioni. Apre una nuova pagina.

The date of onset of symptoms of the first case was on 5 August 2017. The dates of onset of the latest cases are between 25 August and 7 September 2017.

Public health response

The following public health measures described in the Italian National Chikungunya Surveillance and Response Plan are implemented:

  • Disinfestation and vector control measures in the Anzio and Rome areas;
  • Communication to the population about chikungunya and information on protection against mosquito bites. Ministry of Health’s website has pages about chikungunya which can be found here;
  • Measures to prevent transmission through blood transfusion;
  • Information and guidelines for health care practitioners to manage patients.

The National Health Institute (Istituto Superiore di Sanità) issued a public statement on 8 September 2017 concerning the outbreak.

WHO risk assessment

There is a risk for further transmission. This is due to:

  • Aedes albopictus being established throughout the Mediterranean basin;
  • this vector having demonstrated the capacity to sustain outbreaks of chikungunya in the past; and
  • the area of the current case being highly populated and touristic particularly in summer months.

The disease mostly occurs in Africa, Asia, Americas and the Indian subcontinent. In 2007, transmission was reported for the first time in Europe, in the Emilia Romagna region of north-eastern Italy. There were 217 laboratory confirmed cases during this outbreak and it demonstrated that mosquito-borne outbreaks by Aedes albopictus are possible in Europe. Currently, there is another ongoing autochthonous outbreak in Var Department that started in early August 2017.

WHO advice

Personal protection

Basic precautions should be taken by people within and travelling to this area of Italy. These include wearing long sleeves and pants, use of repellents, and ensuring rooms are fitted with screens to prevent mosquitoes from entering.

Clothing which minimizes skin exposure to the day-biting vectors is advised. Repellents can be applied to exposed skin or to clothing in strict accordance with product label instructions. Repellents should contain DEET, IR3535, or Icaridin. People should sleep under a mosquito bed net and use air conditioning or window screens to prevent mosquito bites. Mosquito coils or other insecticide vaporizers may also reduce indoor biting.

Vector control

The Aedes albopictus species thrives in a wide range of water-filled containers, including tree-holes and rock pools, in addition to artificial containers such as unused vehicle tires, saucers beneath plant pots, rain water barrels and cisterns, and catch basins.

Prevention and control relies heavily on reducing the number of these natural and artificial water-filled container habitats that support breeding of the mosquitoes. This requires mobilization of affected communities, and strengthening monitoring of the vector mosquito. During outbreaks, indoor space spraying with insecticides may be performed to kill flying mosquitoes along with killing the immature larvae in water-filled containers through source reduction.

About chikungunya

Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash. Joint pain is often debilitating and can vary in duration. Hence the virus can cause acute, subacute or chronic disease. There is no cure for the disease and treatment is focused on relieving the symptoms. The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.


Nestlé’s direct-sales army in Brazil is part of a broader transformation of the food system that is delivering Western-style processed food and sugary drinks to the most isolated pockets of Latin America, Africa and Asia.

NY Times

 

“…..A New York Times examination of corporate records, epidemiological studies and government reports — as well as interviews with scores of nutritionists and health experts around the world — reveals a sea change in the way food is produced, distributed and advertised across much of the globe. The shift, many public health experts say, is contributing to a new epidemic of diabetes and heart disease, chronic illnesses that are fed by soaring rates of obesity in places that struggled with hunger and malnutrition just a generation ago….”


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