From earthquakes and forest fires to hurricanes and floods, the damage that occurs during natural disasters can be catastrophic. And once the actual event is over, there may be weeks, months, even years of rebuilding homes and communities that were destroyed.
During the natural disaster, the focus is on survival and saving as many lives and homes as possible, but once the immediate danger is over, other dangers take their place. Power may be down, pumping stations may be unable to provide clean water, waste water pipes may break, and flood waters can carry many germs, spreading infections. Infections can also be spread to evacuees due to overcrowding, particularly if the situation is prolonged. All these infections can trigger sepsis among victims and emergency workers. Cuts in the skin leave an open pathway for germs to enter the body, and germs transmitted through the air may enter your lungs when you breathe in. Others may enter through your gastrointestinal tract if you put your hand to your face or if you eat or drink contaminated products. Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival.
Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.
Fungal infections during natural disasters
Normally, fungal spores stay where they are and you would not have contact with them unless you deliberately disturb them. Disasters such as earthquakes and tornadoes can push fungal spores into the air and these spores can cause lung, sinus, or skin infections. Any of these infections can trigger sepsis.
Fungal infections usually affect people with impaired or depressed immune systems, such as those undergoing chemotherapy or who are taking corticosteroids, or who have no spleen. However in a disaster situation, because of the unusual amount of fungal spores that may be in the air, seemingly healthy people could develop a fungal infection.
Bacterial infections can be spread through contaminated water, food products, or from person to person, depending on the infection. For example, leptospirosis is spread through the urine of farm animals, like pigs and cattle, or other animals, including rodents, wild animals, and even dogs.
Animal and snake bites are also a concern during a natural disaster. Many animals are displaced and disoriented after such an event and may lash out, biting humans. In a disaster situation, if someone is bitten, it may be difficult to properly clean the wound and get medical help quickly. People may also develop necrotizing fasciitis, the so-called “flesh eating” disease from bacteria in contaminated water that entered the body through a cut, scrape, or bite.
Cholera is a bacterial virus that is frequently heard about in developing countries that have contaminated water resources. It is considered to be one of the biggest infection threats when a natural disaster occurs.
Viral infections, such as hepatitis A, can spread through contaminated water, but viral infections as a whole may be more of a concern in close quarters that are housing many people, such as crowded shelters. The infections may be as common as a gastroenteritis, with vomiting and diarrhea, or others, such as influenza or rubella.
Parasitic infections such as dysentery are spread through contaminated water, and standing water in tropical climates encourages breeding of mosquitoes, which can transmit infections like malaria.
Preventing in infections during and after natural disasters
After the initial effects of a natural disaster, different levels of government, non-government organizations (NGOs), and volunteers must assess the situation and deal with the aftermath. Clean water and proper sanitation are priorities, as well as access to medical assistance should someone sustain an injury that could lead to an infection and possibly sepsis.
First responders and volunteers who enter dangerous zones, such as flooded areas, must be watchful for any wounds, no matter how slight, and be sure to clean and dress them properly, and monitor for any signs of infection. Respiratory masks must be worn by people who may enter areas that potentially have fungal spores in the air.
To reduce your risk of contamination during or after a natural disaster, keep up-to-date on your routine vaccinations and if you are traveling to a country that has different vaccination requirements, follow those as directed. Consult your local government offices to see what type of emergency supplies you should have on hand and ensure your emergency supplies are always filled.
We can’t prevent natural disasters from occurring, but we may be able to reduce our risk of injury or infection when one happens.
If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.”
Updated September 18, 2020
Read about a new Sepsis Alliance Institute training for disaster medicine professionals here.