Two cases of severe pneumonia after the 2011 Great East Japan Earthquake

Toshihide Nakadate,Yutaka Nakamura,Kohei Yamauchii,Shigeatu Endo

doi:10.5365/wpsar.2012.3.2.002

Toshihide Nakadate, Yutaka Nakamura + Show 2 more

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https://doi.org/10.5365/wpsar.2012.3.2.002

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Abstract

In 2011, during the Great East Japan Earthquake and tsunami, 90% of victims died from drowning. We report on two tsunami survivors with severe pneumonia potentially caused by Legionella pneumophila. Both victims aspirated a large quantity of contaminated water; sand, mud and a variety of microbes were thought to have entered into their lower respiratory tracts. One patient had a mycotic intracranial aneurysm; the other patient had co-infections with several organisms, including Scedosporium species. Although scedosporiosis is a relatively rare infectious disease, symptoms are progressive and prognosis is poor. These pathogens are not specific for tsunami lung, but are reported causative agents for pneumonia after near-drowning.

Highlights

Natural disasters can result in excess morbidity and mortality due to infectious diseases
In some patients with tsunami lung, sand and plant fragments are collected from bronchoalveolar lavage fluid; the patients aspirate industrial materials and various microbes that live in seawater, freshwater and soil
Cases of Legionella pneumophila pneumonia followed by invasive aspergillosis have been reported.[9]

Summary

Introduction

Natural disasters can result in excess morbidity and mortality due to infectious diseases. Acute respiratory infections (ARI) have received far less attention in humanitarian relief and preparedness programmes despite recent evidence suggesting high excess morbidity and mortality and case fatality rates due to ARI occur during such events.[1] After the initial rush of patients with injury after the Great HanshinAwaji earthquake in 1995, the number of respiratory diseases, largely pneumonia, increased about 4.5-fold.[2]. Tsunamis, which result from sudden changes in the seafloor, can occur after an earthquake and can result in large quantities of earth and sand being swept up and deposited, leaving behind sediment called tsunami deposit. This tsunami deposit, found at various places that the tsunami passes and near to shoreline, can infect the soil. We report on two cases of Legionnaires’ disease that developed after near-drowning caused by this tsunami

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