Children and Disasters

Issue #9: June 3, 2014

NEWS

  • WORLD HEALTH ORGANIZATION DECLARES INTERNATIONAL POLIO EMERGENCY – The spread of wild poliovirus has recently begun crossing international boundaries, originating in Pakistan, Syria, and Cameroon. The WHO calls for an international coordinated response. The risk is especially great in regions currently free of polio, but whose immunization practices have been disrupted by violent conflict. Immunizations are crucial for travelers crossing designated international boundaries. This is only the second time since regulations were adopted in 2005 that the WHO has declared such an emergency. The H1N1 outbreak led to the previous declaration in 2009.

TOOLS

  • PEDIATRIC ANTHRAX CLINICAL MANAGEMENTThe American Academy of Pediatrics has released new guidelines for the clinical management of children after a bioterror exposure to B anthracis. The extent of suspected exposure will influence recommendations on duration of antibiotic prophylaxis. An anthrax vaccine is available for use under an Investigational New Drug protocol since data for its use in children are not available. Treatment of disease depends on clinical manifestations and diagnostic guidance is provided. In severe cases, Anthrax Immune Globulin or raxibacumab antitoxin is indicated. In the event of a potential exposure, real-time updates on the basis of new empirical experience will be important in optimizing management.
  • ONLINE COURSE: RESILIENCE IN CHILDREN EXPOSED TO TRAUMA, DISASTER AND WAR – Ann S. Masten, PhD, University of Minnesota, presents a free online course in July considering resilience in human development, research methods, and controversies in child resilience.
  • PEDIATRIC DISASTER PREPAREDNESS COALITIONS – Coalitions are important in integrating pediatric specific interventions into regional systems of care. The King County Healthcare Coalition in Washington reports efforts to maintain proficiency in pediatric triage skills for mass casualty incidents.
  • CHILD ABUSE IN DISRUPTED COMMUNITIES AFTER DISASTERS – A review of traumatic brain injury epidemiology after natural disasters reminds us that severe consequences of child abuse often accompany the community disruption of disasters. Another opportunity for injury prevention.

SCIENCE

  • PUBLIC HEALTH INSURANCE CLAIMS TO IDENTIFY INDIVIDUALS DEPENDENT ON ELECTRICITY FOR SPECIAL HEALTH CARE NEEDS – Medicare claims data were evaluated for their ability to identify adults dependent on electricity to power oxygen concentrators or ventilators, who might need urgent assistance in a regional emergency. The investigators found that such data were 93% accurate. Providing local health departments with such data in a secure fashion might enable timely responses. Would Medicaid data serve to identify children needing the same assistance?
  • COLLEGE AND UNIVERSITY EMERGENCY PREPAREDNESS – A survey of security personnel at 223 American colleges and universities regarding disaster and emergency preparedness revealed that 96% had emergency plans, but 10% do not practice the plan, 27% do not perform table top exercises, and 20% do not perform after action analysis or provide reports. Major gaps include the need to improve planning interactions with local fire, police, EMS, and hospital services, and planning for evacuations.
  • ANALYSIS OF MASS CASUALTY INCIDENTS AT MASS GATHERINGS – Of 290 MCIs occurring at mass gatherings, 56% were directly attributed to conditions of crowding, 20% involved event specific violent accidents, 13% were due to structural failures, 9% were deliberately caused, and 2% involved toxins. Epidemiologic patterns suggest approaches to prevention and mitigation.

Edited byDr. Bob Kanter

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