Kim Mihyun, Kamigaki Taro, Mimura Satoshi, Oshitani Hitoshi
Department of Virology, Tohoku University Graduate School of Medicine.
Nihon Koshu Eisei Zasshi. 2013 Oct;60(10):659-64.
The Great East Japan Earthquake, which occurred on March 11, 2011, damaged many health facilities and compelled many inhabitants to live in evacuation centers. For the purpose of monitoring infectious disease outbreaks, infectious disease surveillance targeted at evacuation centers was established in Miyagi Prefecture. In this study, we summarized the monitoring activities of infectious diseases through this surveillance after the earthquake.
Infectious disease surveillance was implemented from March 18 to November 6, 2011. The surveillance consisted of two phases (hereafter, surveillance 1 and 2) reflecting the difference in frequencies of reporting as well as the number of targeted diseases. Surveillance 1 operated between March 18 and May 13, 2011, and Surveillance 2 operated between May 10 and November 6, 2011. We reviewed the number of cases reported, the number of evacuation centers, and demographic information of evacuees with the surveillance.
In Surveillance 1, there were 8,737 reported cases; 84% of them were acute respiratory symptoms, and 16% were acute digestive symptoms. Only 4.4% of evacuation centers were covered by the surveillance one week after the earthquake. In Surveillance 2, 1,339 cases were reported; 82% of them were acute respiratory symptoms, and 13% were acute digestive symptoms. Surveillance 2 revealed that the proportion of children aged 5 years and younger was lower than that of other age groups in all targeted diseases. No particular outbreaks were detected through those surveillances.
Infectious disease surveillance operated from one week after the earthquake to the closure of all evacuation centers in Miyagi Prefecture. No outbreaks were detected in that period. However, low coverage of evacuation centers just after the earthquake as well as skewed frequencies of reported syndromes draw attention to the improvement of the early warning system. It is important to coordinate with the medical aid team that visits the evacuation centers on a regular basis and to obtain information about the characteristics of evacuees. It is necessary to establish a surveillance system that can monitor infectious disease efficiently from an early phase.
2011年3月11日发生的东日本大地震损毁了许多医疗设施,并迫使许多居民居住在疏散中心。为监测传染病暴发情况,宫城县针对疏散中心建立了传染病监测体系。在本研究中,我们总结了地震后通过该监测体系开展的传染病监测活动。
传染病监测于2011年3月18日至11月6日实施。该监测体系分为两个阶段(以下简称监测1和监测2),反映了报告频率以及目标疾病数量的差异。监测1于2011年3月18日至5月13日运行,监测2于2011年5月10日至11月6日运行。我们通过该监测体系审查了报告的病例数、疏散中心数量以及疏散人员的人口统计学信息。
在监测1中,报告病例8737例;其中84%为急性呼吸道症状,16%为急性消化道症状。地震一周后,仅有4.4%的疏散中心纳入监测范围。在监测2中,报告病例1339例;其中82%为急性呼吸道症状,13%为急性消化道症状。监测2显示,在所有目标疾病中,5岁及以下儿童的比例低于其他年龄组。通过这些监测未发现特定的暴发情况。
传染病监测自地震一周后开始,直至宫城县所有疏散中心关闭。在此期间未检测到暴发情况。然而,地震后疏散中心的低覆盖率以及报告综合征频率的偏差,促使人们关注预警系统的改进。与定期访问疏散中心的医疗援助团队进行协调并获取疏散人员特征信息非常重要。有必要建立一个能够从早期阶段有效监测传染病的监测系统。