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Old 08-13-2010, 11:40 AM
NetDep NetDep is offline
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Default Post-Disaster Disease Management



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Mods - feel free to move this if appropriate.

I was reading through the threads and also the disease management in Pakistan with the recent floods and thought I would find a short and readable piece on that topic. I found the following, printed and will laminate it to put with my other first-aid topics I keep in my first-aid/meds bin...(the bin is for overflow and meds I want to keep centralized - not to take the place of IFAK's or BOB/EDC FAK's)...

http://www.cbc.ca/health/story/2008/...-diseases.html

It might be a good idea to highlight those diseases you know little about - or want to know more about - or think they apply to your most likely scenario and do some additional research on www.cdc.gov - a good source of information as well.

Last edited by NetDep; 08-13-2010 at 11:42 AM.. Reason: Add information...
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Old 08-13-2010, 01:52 PM
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This topic never gets the attention it needs.

In a major or total SHTF situation disease has a good chance to run loose. Poor water, massive die off, bodies weaken by starvation, refuee camps, poor sanitation..... In a total SHTF regular vaccinations will end for most people.

If there is a shot for it, I'd get it (even if its only good for a year or two)
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Old 08-13-2010, 04:29 PM
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Old 08-13-2010, 04:47 PM
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read ONE SECOND AFTER... a pleathura of diseases from blood borne to sexual, etc... face masks help. staying away from crowds helps too. most importantly as adults UPDATE YOUR IMMUNIZATIONS! yes adults need to update their shots too. i just got the Dtap, diptheria, pertussis, and tetanus. i'm good for the next ten years. update your MMR as well.
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Old 08-13-2010, 08:21 PM
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Two of the most critical factors of infection control:

Clean hands

Clean drinking water

As for the video - 5 diseases that will explode - she list Tuberculosis (TB ) as #1. Whooping cough is a lot more deadly to infants the TB. A healthy adult can usually hold off a TB infection. People can have TB for years, never show any signs, not be contagious,,,, nothing. The immune system holds the infection in check. When they develop cancer, or some other disease, that is when they develop and active TB infection.

If your going to list TB, you really need to list whooping cough right there next to it.
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Old 08-13-2010, 08:44 PM
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GET THE DTAP VACCINE! diptheria, tetanus and pertussis (whooping cough). i don't know about a vaccine for tb. only the test to see if you were exposed.
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Old 08-13-2010, 08:47 PM
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shots are good for ten years!
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Old 08-13-2010, 09:39 PM
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Originally Posted by kev View Post
As for the video - 5 diseases that will explode - she list Tuberculosis (TB ) as #1. Whooping cough is a lot more deadly to infants the TB. A healthy adult can usually hold off a TB infection. People can have TB for years, never show any signs, not be contagious,,,, nothing. The immune system holds the infection in check. When they develop cancer, or some other disease, that is when they develop and active TB infection.

If your going to list TB, you really need to list whooping cough right there next to it.


93% of cases of pertussis infection involve children under 10 years old.

While it does infect a lot of children, it is usually not fatal.

From what I gather, there are around 10 deaths in the US every year from pertussis and almost all of them are in infants under one year old. From CDC data it looks like there are currently around 3100 cases per year in the US.

Compared to the diseases she did mention, the fatality rates for pertussis, even with absolutely no more immunizations, would not compare to the number of deaths from the other diseases.


Tuberculosis is one of the most communicable diseases, and if SHTF, living conditions would rapidly deteriorate to the point where it would spread like wildfire.

90% of TB cases have no symptoms and many of these never get sick, but of the 10% that do show symptoms, half will die, so it kills 5% of people infected with it, and with a general lack of hygiene and poor living conditions associated with surviving SHTF, TB could very easily kill millions of Americans.


I think if you look at 1) the communicability of the diseases, 2) the infection rates of the diseases, and 3) the mortality rates of those diseases, you will see why she said TB and not pertussis.
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Old 08-13-2010, 09:52 PM
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I think if you look at 1) the communicability of the diseases, 2) the infection rates of the diseases, and 3) the mortality rates of those diseases, you will see why she said TB and not pertussis.
I understand why she listed TB - I just think that if you list TB, you need to list whooping cough.

And if you think that whooping cough is not that big of an issue,

http://articles.latimes.com/2010/jul...cough-20100720

Quote:
California declares whooping cough epidemic
Officials are concerned about a rise in reported cases and five infant deaths so far. Vaccinations are urged for elderly adults, pregnant women, children and those who may have contact with infants.......................

Nearly 1,500 cases of whooping cough have been reported statewide this year, nearly five times the number of cases last year, according to Dr. Gil Chavez, the state's epidemiologist.

Some of the children that came up positive were fully immunized.

Here we are, dealing with a vaccine preventable disease, and its still being spread. What do you think is going to happen when there is no vaccine?

TB, there is a vaccine, but its not used very much. I dont even think clinics offer the TB vaccine unless your going to some third world country.
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Old 08-13-2010, 10:01 PM
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I understand why she listed TB - I just think that if you list TB, you need to list whooping cough.

I understand that whooping cough is nothing to sneeze at (no pun intended).

However she called it "5 diseases that will explode WSHTF", and she chose in her opinion, the five most dangerous diseases, based on her experience as a health care professional in SE Asia and elsewhere.

The 5 deaths in Los Angeles, while a tragedy, represent almost 30% of all deaths from pertussis in the US this year.

Worldwide, pertussis kills 295,000 people, mostly children every year. 295,000 people is a lot of people, but it pales in comparison to the 1.8 million deaths every year from TB.


In addition, most Americans as of right now have antibodies to pertussis, and it would take around 10 years for every American to lose all immunity to pertussis. Therefore, WSHTF, pertussis infection rates would not explode in the same way TB rates would.
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Old 08-13-2010, 10:04 PM
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TB is also exploding here in the US. Anti-biotic resistant strains that are much more aggressive are showing up in all parts of the US. Anyone who works in primary care can tell you TB is cropping up infrequently now, and is usually difficult to treat. Hardly the epidemic it was 150 years ago, but any bacterial strains resistance to antibiotics is cause for serious concern. Increase the propagation by poor hygiene and sanitation and there could be an epidemic in short order.
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Old 08-13-2010, 10:11 PM
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TB is also exploding here in the US. Anti-biotic resistant strains that are much more aggressive are showing up in all parts of the US. Anyone who works in primary care can tell you TB is cropping up infrequently now, and is usually difficult to treat. Hardly the epidemic it was 150 years ago, but any bacterial strains resistance to antibiotics is cause for serious concern. Increase the propagation by poor hygiene and sanitation and there could be an epidemic in short order.

Precisely.

The same conditions would affect pertussis the same way, but because of immunizations, and the way pertussis kills only a segment of the population, and you can see why TB would be much worse much faster that pertussis.
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Old 08-13-2010, 10:56 PM
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For Tuberculosis, there is Bacillus Calmette-Guérin (BCG) vaccine, but it is pretty much just just for children...with limited effectiveness. There are some experimental vaccines being tested for adults, but don't know when those will ever be available.
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Old 08-13-2010, 11:17 PM
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Any bug that causes gastroenteritis, especially in children, is a big concern for me; dehydration = death in a matter of days. Another concern of mine are "simple" bacterial infections, especially those caused by the ubiquitous staph, strep, and E. coli. Add to that list any myriad of acute respiratory bugs, both viral and bacterial, as well as water-born bugs like microsporidia, crypto, giardia, and cholera. Don't forget the fungal pathogens that will really set-in as malnutrition takes hold.
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Old 08-14-2010, 08:20 AM
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Quote:
Originally Posted by countryboy123 View Post
Worldwide, pertussis kills 295,000 people, mostly children every year. 295,000 people is a lot of people, but it pales in comparison to the 1.8 million deaths every year from TB.

That is pretty big difference, 295,000 compared to 1.8 million.

But, that is comparing a vaccine preventable disease, to a long term chronic disease. If you take out the vaccine factor, what would the numbers be?

How many of that 1.8 million TB patients also had HIV/AIDS? I would imagine that 1.8 million also includes TB/HIV deathes.

I can appreciate how deadly TB is. Working in the medial field, I have had the job of doing Directly Observed Therapy (DOT) on newly diagnosed TB patients. That means I have gone out to peoples houses, and watched them take their meds, and recorded it into a log book.

With doing DOT, I noticed something - all of the TB patients (PT) had some kind of underlying health condition and were heavy smokers. Most of the PTs had bronchitis, 1 had Hepatitis C and Diabetes, were poor - which means their diet might not have been very good. One person refused to take the meds, so the sheriffs department arrested that person and shipped him/her off to a special hospital in Austin, Texas.

Treatments for TB usually require a handful of anti-biotics daily for 6 months. So even with modern medicine, TB is very difficult to treat. Some PTs do not tolerate their meds very well. In some kind of post SHTF situation, TB is going to be almost impossible to treat.

As for spreading TB - I have seen active TB PTs living in the same house with people that tested negative. Why does TB infect one person, and not another, I do not know.

Is TB a serious condition - yes. There is no doubt about that.

As for respiratory infections, the big ones on my list are - The Flu, Pneumonia, TB

An interesting read at the world health organization - http://www.who.int/infectious-diseas...t.html#Anchor1

Quote:
Most deaths from infectious diseases - almost 90% - are caused by only a handful of diseases. And most of them have plagued mankind throughout history, often ravaging populations more effectively than wars................
From the WHO site:

Pneumonia
HIV/AIDS
Diarrhoea
Tuberculosis (TB)
Malaria
Measles
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Old 08-14-2010, 10:06 AM
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The common thread I see here that ties all the nasty together is - contaminated water. Now, not having much medical training other than Red Cross generic 101, Will the big three purification methods work at eliminating this risk? (Filtration, boiling, bleach)

I have read one second after, and seeing threads like this seem to really put the true threats of living through a major disaster in perspective. I think keeping clean water and hygiene / sanitation a priority, along with a good diet that promotes a healthy immune system, and taking an approach that tries to limit/ avoid exposure to the nasty will go a long way to staying on this side of the dirt. Good post.
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Old 08-14-2010, 01:24 PM
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But, that is comparing a vaccine preventable disease, to a long term chronic disease. If you take out the vaccine factor, what would the numbers be?

How many of that 1.8 million TB patients also had HIV/AIDS? I would imagine that 1.8 million also includes TB/HIV deathes.

You make a very good point.

I would imagine that without a vaccine, the numbers for pertussis would be quite a bit higher.

Think about it like this.

If SHTF has happened, there wont be any more immunizations, but most Americans will still hold some immunity to pertussis for several more years until it wears off. Because of this, pertussis outbreaks will immediately post SHTF start rising, but they will not explode, because most Americans have some immunity to the disease.

Eventually, approximately 10 years post SHTF, the full effects of pertussis on the American people would be felt. This is because the pertussis vaccine generally protects you for 10 years.

Conditions that make transmission of disease will include poor sanitary conditions, cramped living conditions, exposure to the elements, other disease processes, etc. Both diseases would benefit from these conditions but TB would have the opportunity to wreak major havoc before pertussis just because pertussis cannot infect everybody just yet.
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Old 08-14-2010, 03:14 PM
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I'm going to throw a wrench in the whole debate here by stating upfront that we don't do vaccinations. Any.

I did allow one of my children to participate in a study of un-vaccinated children's immunity to specific diseases. In the study he underwent tests once a month for 4 months in which they tested for immunity of vaccine-preventable illnesses as well as some typical illnesses that we don't have vaccines for.

I won't go into great detail but suffice it to say he has better immunity for most of them than your average vaccinated child. We do now what others will have to begin doing after shtf. Take all possible precautions, use safe sanitation methods, cook foods and purify water properly, and DON'T kill the good stuff along with the bad. Your body has to learn to fight off illnesses. It needs practice with the minor germs and help from the good ones.

Vaccines have their place and time. But I don't believe all of them are exactly what they seem. Or as beneficial ALL the time as they are during key times.

Whooping cough is a nasty illness. Natural immunity lasts at least 30 years up to 70 years and is boosted by every contact after the initial illness. Vaccines immunity wears off at a maximum of 25-30 years. Why would you take a chance on having your children immune during good times when medicine is available and having it wear off when it's most needed? My kids have had whooping cough and I'm very grateful that it was minor cases with medical care available if needed. I'm also very grateful that I was able to take precautions to prevent it while they were too small to fight it and young enough to recover fully.

Same with some of the other things... like chicken pox. While less deadly and terrifying than whooping cough it's still important. Why would I immunize a child with something that wears off just as they reach an age where the 'childhood disease' is now an adult version that's known to be much more virulent in adults with longer lasting effects?

Mine have had it. We dealt with it. No additional medical care was needed that we couldn't provide at home and they are immune for life now. My youngest one is the only one who hasn't had it. And I only hope she gets it before she grows up. With all the immunized people it's getting harder for them to get it naturally as children so they get it as adults when they integrate into the workforce.
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Old 08-14-2010, 04:12 PM
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I agree that simple sanitation is the most important component of keeping disease at bay post SHTF, though, I would think Antibiotics would be worth their weight in Gold.
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Old 08-16-2010, 12:42 AM
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TB keeps coming up, and while it's probably going to hit epidemic proportions after TSHTF, I would be more concerned with acute diseases. Respiratory tract infections, raging bacterial infections, and unrelenting diarrhea.
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