Infectious Disease and Natural Disaster
The earthquake that struck Haiti in 2010 was one of the worst natural disasters in history. According to Peranteau et al. (2010):
Immediately after the earthquake the need so vastly outstripped the resources that patients generally lacked basic identifiers and medical records […] Treatment plans were reduced to word of mouth. At first we used scraps of paper or cardboard taped to the patient … (p. 127)
Nearly a quarter of a million people were killed with another quarter of a million injured, and millions of people were displaced from their homes (World Health Organization, 2010). In the ensuing months, a cholera epidemic ravaged the already traumatized country. The destruction of infrastructure, contamination of water supply, and increased human vulnerability from displacement create favorable conditions for the spread of infectious diseases following natural disasters. Respiratory infections and diarrheal diseases are also commonly found encountered after floods, tsunamis, and other types of meteorological and geophysical disasters.
In the aftermath of such tragedies, priority is placed on implementing control measures to re-establish basic healthcare and prevent epidemics. Nurses often play important leadership roles in both domestic and international disaster response. For this Discussion, you consider disasters from an epidemiologic perspective and how nurses can address health outcomes following them.
References:
Peranteau, W. H., Havens, J. M., Harrington, S., & Gates, J. D. (2010). Re-establishing surgical care at Port-au-Prince General Hospital, Haiti.
Journal of the American College of Surgeons,
211(1), 126–130.
World Health Organization. (2010, September). Letter from the editor.
Focus: Emergency and Humanitarian Action,
5.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
· Curley, A. L. C. (Ed.). (2024).
Population-based nursing: Concepts and competencies for advanced practice (4th ed.). Springer.
· Chapter 12, “Implications of Global Health in Population-Based Nursing” (pp. 303-335)
· Maness, L. R. (2019). The effect of hurricanes on pathogenic diseases.
Journal of Environmental Health,
81(6), 16–20.
· Mavrouli, M., Mavroulis, S., Lekkas, E., & Tsakris, A. (2021).
Respiratory infections following earthquake-induced tsunamis: Transmission risk factors and lessons learned for disaster risk management.Links to an external site.
International Journal of Environmental Research and Public Health,
18(9), Article 4952.
· Nuzzo, J. B., Meyer, D., Snyder, M., Ravi, S. J., Lapascu, A., Souleles, J., Andrada, C. I., & Bishai, D. (2019).
What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping reviewLinks to an external site..
BMC Public Health,
19(1), Article 1310.
· World Health Organization. (2018, February 22).
Health inequities and their causes [Multimedia]Links to an external site.
.
· Global Epidemiology and Population Health
·
Time Estimate: 2 minutes
· Walden University, LLC. (2021).
Monitoring and controlling pandemicsLinks to an external site.[Interactive media]. Walden University Blackboard.
· Walden University. (2021, October 26).
Talks for good: Racial inequalities in healthcare [Video]Links to an external site.
. YouTube.
Note: The approximate length of this media piece 60 minutes.
To prepare:
· Consider the role of epidemiologic methods in preparing for or responding to natural disasters.
· Focus on global health initiatives, effects of natural disasters on health outcomes, and global health inequities and how they are magnified by natural disasters.
· Select a recent (within past 10 years) natural disaster. You may choose an event that occurred in the U.S. or internationally.
· Explore the current literature and identify the specific leadership roles that nurses have in mitigating negative health outcomes following disasters.
By Day 3 of Week 11
· Briefly describe your selected recent natural disaster.
· Discuss the health consequences of the disaster at the population level.
· Explain how the concepts of population health and epidemiology discussed in this course were or could have been used to assess the preparation and health outcomes after this disaster.
· Explain how the concepts of population health and epidemiology discussed in this course were or could have been used to mitigate negative health effects following this disaster.
· Describe the specific leadership roles that nurses have in mitigating negative health outcomes following disasters.
By Day 6 of Week 11
Respond to
at least two colleagues
on two different days in one or more of the following ways:
· Ask a probing question, substantiated with additional background information, evidence, or research.
· Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
· Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
· Validate an idea with your own experience and additional research.
· Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
· Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
· RESPOND TO THIS DISCUSION POST
Kristie
In September of 2022 I sat in my living room with my daughter and our dog not knowing what the night would bring, we had hurricane shutters up and everything was as secure as we could get it, Hurricane Ian was heading right for us, and neither of us had ever experienced a hurricane before, yet alone one of this magnitude. At the time my boyfriend, a paramedic was on shift, and we did not know when he would be able to come home. Working in healthcare I was scared for us, but petrified for those in my community that had no shelter, or resources to secure their own homes and protect themselves from the devastation that was coming. The purpose of this post is to discuss a recent natural disaster, the consequences and concepts of health and epidemiology that have been used to assess future preparation of hurricanes and mitigating health outcomes.
Hurricane Ian was a powerful and very destructive Category 5 Hurricane coming in from the Atlantic, striking the southeastern United States in late September 2022. It made landfall in southeastern Florida on September 28th with catastrophic winds, heavy rainfall, and a massive storm surge, particularly devastating in Fort Myers, Cape Coral, and Naples. The storm caused widespread flooding, infrastructure damage and power outages, resulting in over 150 fatalities and billions of dollars in damages. Hurricane Ian is one of the costliest hurricanes in U.S. history and highlighted the increasing risks posed by intense tropical storms (Bucci et al., 2022).
Hurricane Ian’s impact on public health in Florida was profound, leading to widespread illness, healthcare system strain, and long-term mental health challenges. The storm’s extensive flooding created ideal conditions for Vibrio vulnificus, a flesh-eating bacteria resulting in thirty-eight confirmed cases and eleven deaths across the states. Most of these infections occurred within six days of the hurricane’s land fall, primarily affecting individuals with open wounds that were exposed to contaminated waters (Centers for Disease Control and Prevention, 2023). The healthcare infrastructure was severely disrupted, with numerous hospitals in southwest Florida losing access to portable water and power, my organization included. This led to the evacuation of over 1,200 patients, including those in intensive care units, and the closure of several facilities (Southwick, 2022). Hospitals that remained operational faced overwhelming demands, treating a surge of storm-related injuries, and managing the complexities of a disaster response (Advisory Board, 2022). The mental health repercussions have also been significant, with many residents experiencing acute stress, anxiety, and grief due to displacement and loss. I myself experienced survival guilt for many weeks, although I had no power or water for weeks, I still had a house and my family, others did not. Vulnerable patients, such as the elderly and those with chronic health conditions faced heightened risks due to limited access to care and support services. My organization opened “oxygen lounges” where the public could come in and receive oxygen if they had lost it at home. The cumulative effects of all these factors underscores the critical need for robust disaster preparedness and resilient healthcare systems to mitigate the public health impacts in the future.
Together, population health and epidemiology provide essential frameworks for assessing preparation for and health outcomes after disasters such as Hurricane Ian. From a population health perspective, the focus would be on understanding how social determinants of health, like income, housing quality, assess to healthcare and transportation affect the different community’s ability to prepare for and recover from hurricane Ian. Health equity metrics could help identify which of the populations were most at risk and the least supported, therefore guiding future policies and resource allocations. Epidemiology provides tools needed to study health outcomes post hurricane, such as tracking incidence rates if injuries, infectious diseases, and mental health conditions. Surveillance systems could have monitored real-time emergency department and shelters to detect emerging health threats.
Concepts from population health and epidemiology could have significantly mitigated the negative health effects of Hurricane Ian by enhancing preparedness, targeted interventions, and risk communication. From a population health perspective, pre-disaster planning addresses social determinants of health, such as housing, access to care, and transportation could have better protected vulnerable groups (elderly, low-income individuals, homeless and those with chronic conditions) who suffered disproportionality during and after the hurricane. This includes the development of community-based resilience plans, improved evacuation strategies, and continuity of care systems to ensure access to medications and medical care (Raker et al., 2020). In terms of epidemiology, real time surveillance systems could have been more robustly applied to detect and respond to Vibrio Vulnificus infections from floodwaters. Risk assessments and geographic mapping of vulnerable areas (flood-prone neighborhoods) would have informed targeted public health messaging and resource allocation, such as pre-distributing clean water, wound care supplies, or emergency power sources for medical devices (Centers for Disease Control and Prevention, 2023).
Nursing leaders play a vital role in mitigating negative health outcomes following disasters by acting as frontline responders, educators, coordinators, and advocates. They provide public health education to affected communities, offering guidance on hygiene, infection prevention, and managing health needs in disrupted environments. Nurse leaders also coordinate care for displaced individuals by ensuring continuity of medications and follow-up care. In addition, they advocate for disaster preparedness funding, equitable healthcare access, and policy reforms that address the needs of vulnerable populations. Mental health support is another critical area, as nurses trained in trauma-informed care deliver immediate psychological aid and long-term support for those impacted by trauma and loss. Through these multifaceted roles, nurses are central to both the immediate and long-term health recovery of disaster-stricken communities (Sciences, N. A. of, Engineering, & and Medicine; National Academy of Medicine; Committee on the Future of Nursing 2020–2030, 2021).
In conclusion, Hurricane Ian underscored the critical importance of applying population health and epidemiological principles in disaster preparedness and response. Assessing risk factors, identifying vulnerable populations, and implementing targeted interventions are essential to reducing preventable illness and death during and after such events. Nurses, as frontline health professionals and leaders, play a pivotal role in delivering care, educating communities, and advocating for health equity in times of crisis. By strengthening surveillance systems, improving access to care, and supporting nurse-led initiatives, public health systems can become more resilient and responsive to future disasters. Integrating these approaches ensures a more coordinated, equitable, and effective response that protects the health and well-being of populations.
References
Advisory Board (2022).
Incredible Strain: How Hurricane Ian Wreaked Havoc at Florida Hospitals.
Bucci, L., Alaka, L., Hagen, A., Delgado, S. & Bevan, J. (2022). Hurricane Ian.
National Hurricane Center.
Centers for Disease Control and Prevention. (2023).
Notes from the field: Vibriosis cases associated with flood waters during and after Hurricane Ian – Florida, September–October 2022. Centers for Disease Control and Prevention.
Raker, E. J., Arcaya, M. C., Lowe, S. R., Zacher, M., Rhodes, J., & Waters, M. C. (2020). Mitigating health disparities after natural disasters: Lessons from the RISK Project.
Health Affairs,
39(12), 2128–2135.
Sciences, N. A. of, Engineering, & and Medicine; National Academy of Medicine; Committee on the Future of Nursing 2020–2030. (2021).
Nurses in disaster preparedness and Public Health Emergency response. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.
Southwick, R. (2022).
Hurricane Ian Forces Florida Hospitals to Evacuate Patients.
