Impact of the Tohoku earthquake and tsunami on pneumonia hospitalisations and mortality among adults in northern Miyagi, Japan: a multicentre observational study

Abstract

BackgroundOn 11 March 2011, the Tohoku earthquake and tsunami struck off the coast of northeastern Japan. Within 3 weeks, an increased number of pneumonia admissions and deaths occurred in local hospitals.MethodsA multicentre survey was conducted at three hospitals in Kesennuma City (population 74 000), northern Miyagi Prefecture. All adults aged ≥18 years hospitalised between March 2010 and June 2011 with community-acquired pneumonia were identified using hospital databases and medical records. Segmented regression analyses were used to quantify changes in the incidence of pneumonia.ResultsA total of 550 pneumonia hospitalisations were identified, including 325 during the pre-disaster period and 225 cases during the post-disaster period. The majority (90%) of the post-disaster pneumonia patients were aged ≥65 years, and only eight cases (3.6%) were associated with near-drowning in the tsunami waters. The clinical pattern and causative pathogens were almost identical among the pre-disaster and post-disaster pneumonia patients. A marked increase in the incidence of pneumonia was observed during the 3-month period following the disaster; the weekly incidence rates of pneumonia hospitalisations and pneumonia-associated deaths increased by 5.7 times (95% CI 3.9 to 8.4) and 8.9 times (95% CI 4.4 to 17.8), respectively. The increases were largest among residents in nursing homes followed by those in evacuation shelters.ConclusionsA substantial increase in the pneumonia burden was observed among adults after the Tohoku earthquake and tsunami. Although the exact cause remains unresolved, multiple factors including population aging and stressful living conditions likely contributed to this pneumonia outbreak.

Urban disaster preparedness of Hong Kong residents: A territory-wide survey

“…The elderly population is vulnerable to disasters with a disproportionally high morbidity and mortality rate. [44][45][46] A decline in physical and cognitive functions, and chronic disease burden limit their mobility and accessibility to resources for emergency preparedness and recovery.…”

The Great East-Japan Earthquake and Devastating Tsunami: An Update and Lessons from the Past Great Earthquakes in Japan since 1923

“…In addition, many of those people are elderly (aged 65 years or over) and have large amounts of financial burden as well as psychological stress. In fact, after the Great East-Japan Earthquake, there have been reports showing the increased prevalence or worsening of various diseases, including influenza infection (Hatta et al 2012;Tohma et al 2012), chronic obstructive pulmonary disease (Yamanda et al 2013), pneumonia (Suzuki et al 2011;Aoyagi et al 2012;Takahashi et al 2012;Daito et al 2013), near drowningassociated fungal infection (Nakamura et al 2011;Igusa et al 2012;Kawakami et al 2012), diabetes mellitus (Fujihara et al 2012), hypertension (Ogawa et al 2012, cardiovascular diseases (Aoki et al 2012), heart failure (Nakano et al 2012), deep vein thrombosis (Ueda et al 2012;Shibata et al 2013), peptic ulcers (Kanno et al 2012), dementia (Furukawa et al 2012), and seizure (Shibahara et al 2013). The increased onset or worsening of these diseases may be related to life-threatening stress, depressive situations without future prospects, or unhealthy conditions in the evacuation centers and/or subsequent temporary housing.…”

“…Many papers have reported increases in respiratory diseases, which may be related to the high population of elderly people in the tsunami-stricken areas (Suzuki et al 2011;Daito et al 2013;Yamanda et al 2013). It is of particular importance to take care of elderly evacuees, because they may not complain of problems, as observed in the 1995 Great Hanshin-Awaji Earthquake (Morimoto et al 2011).…”

Impact of the 2011 Great East Japan Earthquake on community health: ecological time series on transient increase in indirect mortality and recovery of health and long-term-care system

“…The number of pneumonia hospitalisations increased 2 weeks after the earthquake in select hospitals in Miyagi Prefecture 4 5. Frequency of ambulance transports and number of admissions to hospitals of cardiovascular disease cases increased within 2 months of the earthquake in Miyagi Prefecture 6 7.…”