South Asia: Tsunami & Health Situation Report #36

from World Health Organization
Published on 16 Feb 2005
Health systems are being rapidly strengthened across all tsunami-affected countries. Nutrition needs are being assessed and met. As many survivors try to return to their homes, the fluidity of internally displaced people makes the delivery of humanitarian assistance a challenge. In Indonesia, an outbreak of suspected food poisoning occurred in one camp. Environmental issues, especially sanitation improvements, remain a priority.


  • In Indonesia, 247 cases of gastroenteritis due to suspected food poisoning, occurred in a camp in Aceh Utara.
  • Cases of jaundice, dengue, typhoid fever and measles have also been reported from various sites in Aceh, but no outbreaks or new cases of tetanus have been reported.
  • 12 519 mental health services have been provided in Thailand.
  • WHO is supporting the concept of 'health and nutrition huts' that will provide all healthcare facilities in the Andaman and Nicobar Islands, India.
  • In Indonesia, more than 110 000 internally displaced people (IDP) in the east coast, and 30 000 people in the west coast, have received food from WFP.

Health Priorities

Communicable Diseases

Indonesia: An outbreak of gastroenteritis due to suspected food poisoning has occurred in a camp in Blang Nebung, Tanah Pasir, Aceh Utara. A total of 247 cases have been reported, with 138 cases hospitalized. Symptoms included severe vomiting and dizziness. All age groups have been affected. Field investigations are currently ongoing.

A fatal case of acute jaundice from a village near Suak Beukah, Aceh Jaya, was identified as a 13-year-old girl. Field investigations identified a further 4 household members with fever and jaundice, ranging in ages from 5 to 50 years. Laboratory test results are pending. Surveillance for similar illnesses has been heightened. Health education on sanitation and hygiene has also been imparted.

The previously reported case of hepatitis E in Lam Lhom, Aceh Besar, was an adult male who also tested positive for hepatitis A. Both diagnoses were made by rapid (screening) tests, with confirmatory antibody testing (ELISA) pending. The case was likely to have been infected after ingesting water from the tsunami. No new cases have been observed, although surveillance for acute jaundice has been heightened. The community has been improving sanitation and hygiene practices, such as boiling water and washing hands with soap, and hygiene kits that have been provided.

The previously hospitalized case of dengue hemorrhagic fever in Aceh Utara has been discharged and is recovering at home. Two more suspected cases of dengue have been reported from the General Hospital in Banda Aceh. Preliminary laboratory results were negative, with confirmatory test results pending.

Two suspect cases of typhoid fever from Meulaboh hospital both tested positive for Salmonella typhi by rapid (but not validated) testing. Blood culture from one of the cases grew S. typhi, sensitive to ceftriaxone and ciprofloxacin, among other antibiotics. Blood cultures from the other case were negative, although the patient was treated with ceftriaxone prior to testing. Results of stool cultures of both cases are pending.

Two additional cases of measles have been reported in Seunudon, Aceh Utara, and one of them has tested positive in the laboratory. As of 14 February 2005, a total of 29 cumulative cases of measles have been identified in Aceh Utara. Case management guidelines have been translated into Bahasa Indonesian by WHO and will be disseminated to ministries of health and NGOs in the area. Accelerated vaccination campaigns are planned for the entire district. As of 11February 2005, approximately 144 000 children have been immunized against measles in Aceh province. Furthermore, discussions with provincial ministries of health on measles vaccination have resulted in a plan to accelerate vaccination in urban areas where coverage has been poor, due to high mobility of the population, lack of social mobilization, and lack of participation of health practitioners.

The tetanus outbreak in Aceh province appears to be resolving.

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