Causes of hospitalisation before and after the 2009 L'Aquila earthquake

Abstract

On 6 April 2009, an earthquake struck L'Aquila. The San Salvatore Hospital was evacuated, and a field hospital was built. The study aimed to assess the epidemiologic impact of the earthquake through the analysis of patient population admitted to the field hospital during a 2-month period following the disaster. We retrospectively evaluated causes of hospitalisation and demographic data of patients admitted to (i) the Division of Internal Medicine and (ii) the Division of Emergency Medicine of the field hospital from 6 April, 2009 to 29 May, 2009. All data were compared with the admissions made at the same divisions of the San Salvatore Hospital during the same period of previous year. (i) Patient group (n = 102) and comparison group (n = 108). Mean patient age was higher, patients living in L'Aquila were more numerous, while mean length of stay was lower after than before the earthquake. Infectious diseases increased, while 'other' diseases decreased after the disaster both in admission and in discharge diagnoses. Gastroenterological diseases decreased with the earthquake but only in admission diagnoses. (ii) Patient group (n = 5255) and comparison group (n = 6564). Triage codes changed with the earthquake. Cardiovascular, psychiatric, gynaecological, infectious and chronic diseases increased, while pneumologic, gastroenterological, traumatic and 'other' diseases decreased after the quake. The number of hospitalised patients decreased with the tremor, while those discharged transferred to other hospitals and those who rejected hospitalisation increased. A natural disaster completely changes causes of hospitalisation in the Divisions of Internal and Emergency Medicine. These findings can be useful for the design of specific intervention programmes and for softening the detrimental effects of quakes.

Natural disasters and infectious disease in Europe: a literature review to identify cascading risk pathways

“…Eight studies related to food- and water-borne diseases and zoonoses and one to vaccine-preventable diseases; 25 two did not specify the pathogen or disease. 26 No deaths were reported in any of the outbreaks.…”

“…Another study looked at the incidence of infectious diseases in general following the L’Aquila earthquake. 26 This found that admission rates for infectious diseases rose from 7.41% before the earthquake to 27.18% in the 2 months following the earthquake. Rates of people diagnosed with an infectious disease but not requiring hospitalization also rose, from 12.04 to 27.29%.…”

“…Reports were identified from the following countries: Austria; 22 , 31 Bosnia and Herzegovina, Croatia and Serbia; 16 Bulgaria; 27 Czech Republic; 21 Denmark; 30 , 34 France; 32 Germany; 20 , 29 Italy; 24 , 26 Poland; 33 , 35 Spain; 25 The Netherlands; 28 Turkey. 23 …”

“…16 , 21 One related to HIV, STI and viral hepatitis, specifically hepatitis A and E, 23 and one related to vaccine-preventable diseases, specifically, chickenpox. 25 One report examined infectious diseases as a whole, 26 one investigated gastrointestinal, influenza-like illness and dermatological complaints 28 and one did not report on the pathogen or disease, 33 so these could not be classified according to type. As the definition of outbreak was inconsistent across studies, an external standardized definition was not used in order to make the study as inclusive as possible.…”

“… 25 In Italy, where hygiene conditions were poor following the L’Aquila earthquake, older people were reported to be more vulnerable to infectious diseases, because of the effect of ageing on immunity. 26 People working and living in agricultural settings may be particularly vulnerable to ‘leptospirosis’ following flooding or heavy rainfall. For example, in Bulgaria, men of working age were more likely to be infected with ‘leptospirosis’ than younger men or women, with cattle and pig farmers at the highest risk due to potential occupational exposure.…”