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SASTM Newsflash - Philippines: typhoon aftermath update

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Philippines: Typhoon Aftermath Update

New information for November 18, 2013: WHO categorizes this emergency as a Grade 3, their highest category. Almost half of the health facilities in the affected areas are non-functioning. Approximately 4,000 casualties, 1,200 missing, and more than 4 million displaced persons have been reported. Forty-four provinces are affected; the most severely affected areas are Leyte, northern Iliolo, and Eastern Samar provinces, and Tacloban City. Health services are absent or severely limited in the most affected areas (48 of 103 health facilities in MIMAROPA, Western, Central, and Eastern Visayas are non-functioning), and medical supplies are extremely limited.

Typhoon Aftermath: Typhoon Haiyan struck the central Philippines (Eastern and Western Visayas and Northern Mindanao) on November 8, 2013, with damage and flooding that have caused approximately 4,000 casualties, 1,200 missing, and more than 4 million displaced persons. Forty-four provinces are affected; the most severely affected areas are Leyte, northern Iliolo, and Eastern Samar provinces, and Tacloban City. Health services are absent or severely limited in the most affected areas (48 of 103 health facilities in MIMAROPA, Western, Central, and Eastern Visayas are non-functioning), and medical supplies are extremely limited. WHO categorizes this emergency as a Grade 3, their highest category.

Recommendations for short-term rescue and relief workers align with the normal travel health indications for the Philippines and include vaccination against hepatitis A, typhoid, hepatitis B, influenza, cholera (not available in the United States), and rabies, plus all routine vaccines. (Tetanus vaccination must be up-to-date, and measles vaccination is indicated for all unvaccinated health care workers without other evidence of immunity.) Hepatitis B, rabies, and Japanese encephalitis (JE) vaccines require that a series be completed; a single dose is not protective. Injectable typhoid vaccine is preferable as the oral vaccine requires a series. Increased disease risk in the ongoing aftermath of the typhoon is possible, though, historically, the risk is low unless there is prolonged compromise of the availability of potable water.

·       Travelers should carry oral rehydration solution, loperamide, and a quinolone antibiotic for presumptive self-treatment of traveler's diarrhea.

·       Malaria risk is none to low in most of the affected areas, though northern Palawan Province, a high risk area, in the west was struck by this storm. See the Travax malaria map for protective recommendations.

·       Sentinel surveillance indicates the presence of JE in rural areas of all islands and occurs throughout the year. As the natural host (pig) has likely been decimated due to the flooding, and Culex vectors do not tolerate salination, JE likely does not present increased risk to travelers in the immediate term.

·       Chikungunya risk and significant dengue fever risk exists year-round throughout the country, but Aedes vectors do not tolerate salination.

·       Tuberculin skin testing is recommended prior to travel and 6–8 weeks after return. If exposure to known TB patients will occur, use of personal respiratory protective devices (e.g., N-95 respirators) is recommended.

·       The major health risks resulting from contaminated water include skin infections, leptospirosis, and gastrointestinal disease, including cholera. There is no evidence that corpses pose an epidemic disease risk after a natural disaster; however, workers who routinely handle corpses as part of the relief effort should take precautions and use personal protective equipment.

·       Disaster relief workers should avoid exposure to or consumption of non-potable water, practice good personal hygiene, and consider anti-leptospirosis prophylaxis with 200 mg of doxycycline once weekly. Adequate first aid supplies should be carried for treatment of skin infections. Insect precautions are essential at all times.

Communicated By: Shoreland's Travax News Alert Service

 

 


 

South African Society of Travel Medicine (SASTM)

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The content and opinions are neither pre-screened nor endorsed by the SASTM. The content should neither be interpreted nor quoted as inherently accurate or authoritative.

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The information provided in SASTM Newsflashes is collected from various news sources, health agencies and government agencies. Although the information is believed to be accurate, any express or implied warranty as to its suitability for any purpose is categorically disclaimed. In particular, this information should not be construed to serve as medical advice for any individual. The health information provided is general in nature, and may not be appropriate for all persons. Medical advice may vary because of individual differences in such factors as health risks, current medical conditions and treatment, allergies, pregnancy and breast feeding, etc. In addition, global health risks are constantly evolving and changing. International travelers should consult a qualified physician for medical advice prior to departure.

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