1635. Clinical Characteristics of Active Pulmonary Tuberculosis after the 2011 Great East Japan Earthquake
Session: Poster Abstract Session: Mycobacterial Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: The occurrence and outbreaks of infectious diseases were reported after the Great East Japan Earthquake and subsequent tsunami that occurred on March 11, 2011. Pneumonia in-patients increased after the earthquake, and the clinical features were described by several authors. Displaced people after natural disasters are vulnerable to tuberculosis (TB). In this study, we investigated clinical characteristics of active pulmonary TB patients who were hospitalized after the earthquake.

Methods: TB patients were referred to Miyagi Cardiovascular and Respiratory Center (a designated hospital with 50 beds in TB ward) throughout Miyagi prefecture after the earthquake. A total of 47 active pulmonary TB in-patients at the hospital during a period of six months after the earthquake were analyzed by using hospital databases and medical records. Laboratory examination and chest X-ray on admission were also evaluated. Activity of daily living was classified into three categories “independent”, “partially dependent”, or “dependent”.

Results: The mean age of TB patients was 72.5 ± 17.7. Before admission, seven (14.9%) were forced to live in shelters, public or temporary housing. Comorbidities included 11 cases with malignancy, 10 cases with diabetes, and 4 cases with heart failure. Twenty-three patients (48.9%) were classified into “partially dependent” or “dependent”. Oxygenation was required for 12 (25.5%) patients on admission. Chest X-ray showed bilateral infiltration in 38 (80.9%) cases and cavitation in 17 (36.2%) cases. Serum albumin in patients from tsunami affected areas was significantly lower than those in patients from non-tsunami affected areas. Moreover, BUN to creatinine ratio in patients from tsunami affected areas was significantly higher than that in patients from non-tsunami affected areas. Four patients died despite appropriate treatment.

Conclusion: We experienced severe elderly TB cases after the earthquake. Our data suggested that TB patients from tsunami affected areas had undernutrition and dehydration. Assessment and improvement of nutritional status for elderly TB patients after natural disasters are necessary as well as appropriate use of antituberculous drugs and supportive care.

Hajime Kanamori, MD, PhD, MPH1,2, Noboru Aso, MD, PhD1, Bine Uchiyama, MD, PhD1, Hiroo Saito1, Yoichi Hirakata, MD, PhD1 and Mitsuo Kaku, MD, PhD2, (1)Miyagi Cardiovascular and Respiratory Center, Kurihara, Japan, (2)Department of Infection Control and Laboratory Diagnostics, Tohoku University Graduate School of Medicine, Sendai, Japan

Disclosures:

H. Kanamori, None

N. Aso, None

B. Uchiyama, None

H. Saito, None

Y. Hirakata, None

M. Kaku, None

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