Many lives and housings were lost by the March 11 Great East Japan Earthquake in 2011.   Condolence is conveyed here to the victims of this disaster and to their families, and sympathy to those who are struggling with the difficulties caused by the huge damage.

One eminent feature of the March 11 incident was that the earthquake and tsunami totally deprived the affected communities of basic public health infrastructures.   The local governments struggled to maintain residents' and refugees' health condition best possible in spite of the insufficient supply of water, foods and materials indispensable for hygienic measures.

The past experience showed us that, subsequent to an earthquake or a tsunami, infections related to injury or drowning appear first, followed by food borne and respiratory infections and then by insect vector borne infections.

Actually in the present incident, too, there were nine tetanus cases among those who had bone fracture(s) and/or other wounds (none of them were fatal) and some cases of legionellosis among those who experienced non-fatal drowning.   The infection cases that occurred in the affected regions were, however, limited to the sporadic outbreaks of acute respiratory syndromes, cases with influenza-like symptoms and cases with gastrointestinal symptoms.   The acute respiratory syndrome cases, which were more frequent among the elderly, included those of non-specific as well as pneumococcal and other common bacterial origins.   Small scale outbreaks of influenza of AH3 subtype and a large scale outbreak of norovirus gastroenteritis (exceeding 200 persons) were, however, observed in a few refugee campuses.   There was no outbreak of measles whose importation had been afraid of.   The insect vector borne infection was not observed probably due to the fact that the incident occurred in the cold season.   Generally, the disaster-associated infections that had been much afraid of were limited to a small scale owing to the hygienic activities of the local communities and those who were involved.

This supplement documents the infection surveillance and control activities that were conducted in severely damaged Iwate, Miyagi and Fukushima Prefectures and in Ibaraki Prefecture which was also affected by the incident.

Infectious Disease Surveillance Center (IDSC), National Institute of Infectious Diseases (NIID), developed a surveillance tool, “infection surveillance system for refugee camps”.   On account of different local situations, however, some local governments developed their own surveillance system and some others used their own in combination with the IDSC's system in a way more suitable for the local condition.   NIID conducted risk assessment of infectious diseases at affected areas using surveillance data provided by local government and fed back the results on the web site and by e-mail periodically.

   October 11, 2011
   National Institute of Infectious Diseases

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