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DISASTER
RECOVERY

Conclusions
There are short, medium, and long-term disaster-related infec- Lessons learned from recent episodes highlight the need for com-
tious disease concerns. In early response phases, triage, prescription munity-based, local physicians to participate in first response and
renewals, identification and management of immunocompromised recovery efforts, disease reporting, and patient advocacy. In addi-
or contagious hosts is critical. The latter requires sensitive profes- tion, future efforts will benefit from better record-keeping for dis-
sionalism and cultural competency due to the stigmatizing nature placed populations, innovative approaches for directly observed
of HIV and tuberculosis. Outbreaks of gastrointestinal disease are therapy, more rapid re-staffing of mental health clinics; provision
seen after floods before the re-introduction of sanitation and hy- of funding for patient transportation needs and health care/screen-
giene interventions. Skin and soft tissue infections abound after ing for guest workers. Above all, medical professionals should know
trauma in contaminated environments, and are problematic for res- about and advocate for sustaining the nation’s public health infra-
cue workers as well as disaster victims. Respiratory infections are structure, so that successes such as the thwarting of wide-spread
associated with crowds and lack of handwashing facilities, present- Zika-virus outbreaks after Hurricane Harvey can be replicated.
ing challenges in distinguishing between self-limited versus serious
disease such as pneumonia. Vector born disease prevention can be Dr. Ruth Berggren is the Director of Center for Medical
successful; both rescue workers and victims are vulnerable, and vac- Humanities & Ethics, Marvin Forland, MD, Distin-
cination guidelines should be followed for prevention of influenza, guished Professor in Medical Ethics, James J. Young Chair
pneumonia and measles outbreaks. In the long term, residents and for Excellence In Medical Education, and Professor of
health professionals in disaster zones can expect prolonged waiting Medicine, Division of Infectious Diseases, at UT Health
times for rebuilding the infrastructure needed for diagnostic capac- Science Center San Antonio.
ity, subspecialty consultation and mental health care.

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