Medical effects of the tsunami
Death and disease from the Asian tsunami will be headline news for
years. This natural disaster will have both direct and indirect effects
on the Australian community; and many people, especially police officers,
will become directly involved in helping the devastated.
Infectious diseases have affected people because of the disruption
to sanitation, and food and water supplies. They include typhoid,
cholera, melioidosis, amoebiasis, malaria, dengue fever, hepatitis
A, hepatitis E and leptospirosis.
Typhoid
Typhoid has an incubation period between one day and a month. It
is associated with diarrhoea, abdominal pain and fever. It has a mortality
rate of about one in five – if untreated. Transmission occurs only
from human to human. This is usually from contaminated food, because
some people become chronic carriers, especially if they are older
when they contract the disease. Vaccine is available and reliable.
Cholera
Cholera causes severe watery diarrhoea that one can catch within
hours or up to five days after contact, causing death by dehydration.
Half of the severe cases will be fatal without treatment. Any contacts
have to be watched closely, as the disease is extremely contagious.
Vaccines are not always effective. Prevention of exposure is the best
protection. This makes the disease a high risk without clean water.
Melioidosis
The bacteria that cause melioidosis are found in contaminated water
and soil, and spread to humans and animals through direct contact
with the contaminated source. An infection causing fever, pneumonia,
bone and skin infection/ulcers, it is sometimes hard to treat and
can reactivate after months or years.
It has an incubation period of one to 21 days, and is unpredictable
in its presentation. Most cases of melioidosis can be treated with
an appropriate antibiotic. No vaccination is available, so protection
relies on good hygiene.
Amoebiasis
Amoebiasis is a bowel infection caught from infected people. It might
not show up for years, but sometimes causes typical dysentery, fever
and abdominal pain in just days. No vaccine is available and the disease
can sometimes invade internally, causing chronic abscesses and ongoing
disease. Protection comes from good hygiene and early treatment.
Malaria
Malaria is a mosquito-borne disease which shows itself in seven to
30 days. One can reduce the risk of contracting it through physical
avoidance of the mosquito bite, and anti-malaria tablets. No effective
vaccines exist, despite the expenditure of millions of dollars on
developing them. Treatment of infection, however, is reasonably successful.
Dengue fever
Dengue fever is an infectious disease carried by mosquitoes. Fever,
intense headache and rash characterize a disease that will show up
within three to 14 days of exposure. No vaccine is available, and
most sufferers recover completely within two weeks with symptomatic
treatment only.
Hepatitis A and E
Both hepatitis A and E are passed from human to human through faecal
contamination and have an incubation period from two weeks up to two
months. These diseases cause fever and jaundice (skin turning yellow
from the build up of bilirubin).
Common and rarely fatal, hep A has an effective vaccine that can
provide lifelong cover. For hep E – which is extremely uncommon –
no vaccine or treatment is available. Good hygiene is the only protection
against it.
Leptospirosis
Leptospirosis is a bacterial disease that affects humans and animals.
One usually catches it through exposure to water contaminated by the
urine of infected animals. No vaccine exists for the disease, which
becomes obvious from four to 19 days of exposure, usually with fever,
chills, and confusion.
Stress
Non-infectious disease will probably have the most effects on Australia.
These include the post traumatic stress reaction (PTSD) that comes
from helping those affected – directly or indirectly – by the disaster.
The typical post traumatic stress occurs because of the severity
of the disaster, and the sense of hopelessness and lack of control
it brings to those affected. No amount of reasoning will explain why
some lost their lives while others survived.
As a police officer, you might be involved in the relief effort and
therefore know people who are reacting in an abnormal way. A sympathetic
ear and time to reflect on what has happened might be the best help
for them. This is expected to apply to children, too – those who read
of, or see on television, the disaster’s effects but do not understand
them.
Even years after the event, some people will still need to talk about
what happened, while most people will seem to have moved on with their
lives. Any response to those affected should be made with care. Do
not expect that the effects will all have faded away after three months.
