How diagnostics pave the way for disease control

Heartbreaking scenes fill our TV screens and social media feeds, showing all too clearly how extreme events like earthquakes, tsunamis, hurricanes, floods and fires severely impact people, economies and infrastructure.^{1, 2} But what about the disease outbreaks that follow in the wake of these events – often after the TV cameras have left – which may kill hundreds of thousands more than the disaster itself?^{2, 3} 

In light of recent natural disasters such as the Turkey-Syria earthquake, Medix Biochemica asks: How can diagnostics providers rise to the challenge and play a role in curbing these deadly outbreaks?

Approximately 45 000 lives are lost every year due to natural disasters around the world² and, while many people are killed in the short term due to structural collapse, those who survive the immediate effects of the disaster face the life-threatening problem of infectious and vector-borne disease outbreaks.^{2, 3} It’s estimated that annually over 700 000 post-disaster deaths are caused by infectious diseases.²

It’s statistics like these that inspire us at Medix Biochemica and our clients to work to make a difference. 

Why do diseases spread more rapidly after a natural disaster?

Overcrowding, poor sanitation and exposure to disease-carrying organisms are a few of the biggest risk factors:^{2, 3}

• Displacement: People who lose their housing often have to live together in relief shelters or temporary housing, where overcrowding and unsanitary conditions cause diseases to spread among large groups of people (and then to new areas once these people return to their homes).^{2, 3}
• Water, sanitation and hygiene: Poor sanitation, poor hygiene and a lack of access to safe drinking water and food can cause serious illness.^{2, 3}
• Lack of healthcare access: Poor or overcrowded healthcare services can contribute to disease outbreaks.³ Poor vaccine coverage is also a risk factor.³
• Infrastructure damage: Overflow of or damage to sanitation systems can cause water-borne diseases to spread.³
• Exposure to disease-carrying animals: Mosquitos and other pests may breed in flooded or waterlogged areas, causing outbreaks of parasitic diseases like malaria.³ Displaced people are also at risk of being exposed to animals (both wildlife and livestock), which may further contribute to the spread of diseases.³
• Assisting in clean-up activities: Exposure to floodwater while helping with post-disaster clean-up increases the risk of exposure to a  water-borne disease³ (this could affect both survivors and rescue teams).

How soon after a natural disaster does disease break out?

Infectious diseases can cause problems days, weeks or even months after the initial natural disaster takes place.⁴  In one widely-known tragic example, Haiti experienced an outbreak of cholera in October 2010, a full 10 months after a devastating earthquake hit the country in January of that year.⁵ This was a resurgence of the disease, after more than 3 years with no reported cases in the country.⁵ The earthquake itself killed over 200 000 people and displaced over 1 million. The outbreak caused over 820 000 cases of cholera and killed nearly 10 000 people.⁵

A post-disaster outbreak has 3 distinct phases:

• Phase 1 (impact phase, usually up to 4 days): Survivors are extricated and injured people are given initial medical treatment.⁴  
• Phase 2 (post-impact phase, 4 days to 4 weeks): The first waves of infectious diseases start to emerge – these could be waterborne, droplet-/airborne, vector-borne or food-borne.⁴
• Phase 3 (recovery phase, after 4 weeks): Diseases with longer incubation periods start to emerge.⁴ Areas may be affected by a combination of endemic and new ‘imported’ diseases,⁴ one or more of which may grow into an epidemic.⁴

Companies involved in providing post-disaster aid need to consider these timelines as they plan how best to assist.

Which diseases should we expect after a natural disaster?

These are a few of the most common diseases that can affect an area after a natural disaster takes place:

   Water-borne diseases:⁴  

• Cholera

• Leptospirosis

• Hepatitis A and E

Droplet-/airborne diseases:^{4, 6} 

• Measles

• Influenza

• Pneumonia

• Meningococcal meningitis 

• Tuberculosis (TB)

• Respiratory fungal infections

Vector-borne diseases:⁴  

• Dengue fever
• Malaria

How can effective diagnostic testing help in the aftermath of natural disasters?

Rapidly diagnosing an infectious disease is critical to:¹⁰

• Providing appropriate treatment for patients
• The surveillance of infectious diseases 
• Detecting outbreaks
• Controlling the spread of infectious diseases

However, diagnostic testing can be challenging in the wake of a natural disaster – hospitals and healthcare facilities quickly become overwhelmed by the influx of patients, and many people can’t get to a healthcare facility for testing because of infrastructure damage.¹¹

In cases like these, reliable point-of-care (PoC) diagnostic testing is essential.^{10, 11}

How point-of-care testing helps in post-disaster scenarios

PoC testing is medical testing that can be done at or near the site of patient care, using mobile equipment.¹¹ It can be used to quickly detect a range of infectious diseases under challenging conditions, with limited time and resources.^{10, 12}

PoC testing makes accurate diagnoses and monitoring more accessible in resource-limited situations.¹³ In these devastating scenarios, the quality of PoC tests – including sensitivity and specificity – is critical.¹³

Quality diagnostics materials: How Medix Biochemica can help you to make a difference

If you’re in the diagnostics space and looking to improve your disaster-preparedness and PoC testing accuracy, partnering with Medix Biochemica can help.¹²

We provide antigens, antibodies and other critical raw materials for use in in vitro diagnostic (IVD) tests.^{12, 14} This includes testing for common infectious diseases, such as measles and mumps, hepatitis, rotavirus, COVID-19 and influenza.¹⁵ Our reagents are also used in the detection of tropical vector-borne diseases like dengue, zika and West Nile virus.¹⁶ 

All Medix Biochemica products are created according to stringent quality standards, allowing our clients to produce PoC tests that are highly accurate and reliable.^{12, 14}

Read more about what sets our reagents apart.

With a broad product portfolio and 5 decades of experience, we’re able to provide a highly versatile and knowledgeable service offering,^{12, 14} so that your team is empowered to make a difference and help save lives.

References:

1. Hidalgo J, Baez AA. Natural disasters. Crit Care Clin. 2019;35(4):591-607. doi:10.1016/j.ccc.2019.05.001. 
2. Quintanilla N. Outbreaks of vector-borne infectious disease following a natural disaster. Georgetown Medical Review. 2022. doi:10.52504/001c.38768. 
3. Charnley GEC, Kelman I, Gaythorpe KAM, et al. Traits and risk factors of post-disaster infectious disease outbreaks: a systematic review. Sci Rep. 2021;11(1):5616. doi:10.1038/s41598-021-85146-0. 
4. Preventing and controlling infectious diseases after natural disasters. United Nations University. Accessed February 19, 2023. https://unu.edu/publications/articles/preventing-and-controlling-infectious-diseases-after-natural-disasters.html. 
5. Cholera in Haiti. Centers for Disease Control and Prevention. Accessed February 17, 2023. https://www.cdc.gov/cholera/haiti/index.html.
6. Benedict K, Park BJ. Invasive fungal infections after natural disasters. Emerg Infect Dis. 2014;20(3):349-355. doi:10.3201/eid2003.131230. 
7. Climate change: fires, floods, and infectious diseases. Lancet Microbe. 2021;2(9):e415. doi:10.1016/S2666-5247(21)00220-2. 
8. Anderson J, Bausch C. Climate change and natural disasters: scientific evidence of a possible relation between recent natural disasters and climate change. Policy brief for the EP Environment Committee IP/A/ENVI/FWC/2005-35. 
9. Interim immunization recommendations for individuals displaced by a disaster. Centers for Disease Control and Prevention. Accessed February 17, 2023. https://www.cdc.gov/disasters/disease/vaccrecdisplaced.html.
10. A scoping review of point-of-care testing devices for infectious disease surveillance, prevention and control. ECDC technical report. Accessed February 19, 2023. https://www.ecdc.europa.eu/en/publications-data/scoping-review-point-care-testing-devices-infectious-disease-surveillance.
11. Tran NK, Godwin Z, Bockhold J. Point-of-care testing at the disaster-emergency-critical care interface. Point Care. 2012;11(4):180. doi:10.1097/POC.0b013e318265f7d9.
12. Expert opinion. Interview with Amy Moore, Product Manager, and Anthony Austin, Global Marketing Manager, Medix Biochemica. February 16, 2023. 
13. Chen H, Liu K, Li Z, et al. Point of care testing for infectious diseases. Clin Chim Acta. 2019;493:138-147. doi:10.1016/j.cca.2019.03.008.
14. Antibodies/antigens/enzymes. Medix Biochemica. Accessed February 20, 2023. https://www.medixbiochemica.com/antibodies-antigens-enzymes. 
15. Our products - infectious diseases. Medix Biochemica. Accessed February 21, 2023. https://www.medixbiochemica.com/our-products/by-clinical-area/infectious-diseases.html
16. Tropical diseases. Medix Biochemica. Accessed February 20, 2023. https://info.medixbiochemica.com/tropical-diseases.