HTH -- Haiti Earthquake

March 17, 2011. CDC Issues Health Information for Humanitarian Aid Workers in Japan

SOURCE: Centers for Disease Control and Prevention

The U.S. Nuclear Regulatory Commission recommends that all Americans within 50 miles of the Fukushima reactors should evacuate the area.

On March 11, a 9.0 magnitude earthquake occurred off the east coast of Japan. A subsequent tsunami struck the coast, killing thousands of people and causing serious, widespread damage to buildings, roads, and power lines, particularly along the east coast of the Tohoku region. If you are traveling to Japan to assist with the recovery, CDC recommends that you take precautions to protect your health. First and foremost, schedule a visit with a travel medicine provider, ideally 4–6 weeks before you leave, to discuss individualized recommendations that can keep you healthy.

Vaccinations

Your provider should ensure that you are up-to-date on routine vaccines, especially tetanus, and you should also receive a hepatitis B vaccination series. Northern Japan has long winters, and insect-borne diseases are not believed to be a problem while the weather stays cold. However, Japanese encephalitis is endemic, and flooding from the tsunami may expand the mosquito breeding range, so workers who plan to be in Japan during the summer should consider vaccination against Japanese encephalitis.

Radiation

Damage to the Fukushima nuclear power plant following the earthquake and tsunami has resulted in an ongoing leak of radiation from this facility. The Japanese government has evacuated hundreds of thousands of residents of Fukushima Prefecture living within 20 kilometers of the nuclear power plant. The U.S. Nuclear Regulatory Commission currently recommends that all Americans evacuate to a distance of 80 kilometers (50 miles). At this time, the risk of exposure to radiation and the risk of contamination from radioactive materials are believed to be low, especially for anyone outside of a 50 mile radius of the nuclear power plant. Humanitarian aid workers traveling to Japan should follow guidance from appropriate authorities to ensure their safety. Aid workers who believe they have been exposed to radiation should seek immediate medical care.

Injury

Flood waters, downed power lines, wet electrical outlets, interrupted gas lines, and debris all pose health risks. Any wound or rash can become infected, so clean any wound thoroughly with soap and water and have it evaluated as soon as possible by a health care professional. Wear sturdy, thick-soled shoes to protect your feet in tsunami-affected areas. Avoid downed power lines.

Mental Health

Because of the tremendous devastation and loss of life and worry about radiation, you may find the situation extremely stressful. Keeping items of comfort, such as family photos, favorite music, or materials that provide spiritual support nearby can offer comfort in such situations. Checking in with family members and close friends from time to time can also be a source of support.

Food and Water Precautions

Although travelers' diarrhea is generally considered to be a low risk in Japan, disruptions caused by the tsunami could have contaminated water sources. You should follow basic food and water precautions in affected areas: drink only bottled beverages, eat only food that is cooked and served hot, and eat raw fruits and vegetables only if you have washed and peeled them yourself. You should also bring loperamide and, possibly, an antibiotic for presumptive self-treatment of diarrhea, should it develop.

Cold Weather

Winters in northern Japan are long and cold, and you should be prepared for snow and low temperatures. Pack warm clothing and dress in layers. Be familiar with the signs and symptoms of hypothermia and frostbite, and seek medical attention as soon as possible in the event of a cold injury.

Seeking Care Abroad and Evacuation Planning

Health care resources in affected areas may be nonexistent or may be strained treating patients injured in the earthquake or tsunami. You can avoid straining these resources further by following the precautions above; however, in the event that you need care, locate a local health care provider before you leave the United States, and confirm that the facility is operational.

After You Return

Illness in returned aid workers is rare, but in the event that you become ill, especially with a fever, seek health care immediately, and make sure your provider knows you have recently returned from Japan.

If you believe that you have been exposed to radiation, seek medical care right away. If you have already returned to the United States, explain that you have traveled to Japan and might have been exposed to radiation.

Items to Bring With You

Plan for limited or no services, including electricity, safe water, and food distribution systems. Pack to be as self-sufficient as possible but bring only those items necessary for the trip. Make sure that you pack a basic travel health kit in your carry-on luggage.