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5 Feb 2013

Infectious Diseases After the Earthquake: Pneumonia as a Significant Reason for Hospital Care (Chest, abstract, edited)

[Source: Chest, full page: (LINK). Abstract, edited.]

Infectious Diseases After the Earthquake: Pneumonia as a Significant Reason for Hospital Care

Tetsuji Aoyagi, MD, PhD; Mitsuhiro Yamada, MD, PhD; Hiroyuki Kunishima, MD, PhD; Koichi Tokuda, MD, PhD; Hisakazu Yano, MD, PhD; Noriomi Ishibashi, MD; Masumitsu Hatta, MD, PhD; Shiro Endo, MD, PhD; Kazuaki Arai, PhD; Shinya Inomata, MD; Yoshiaki Gu, MD; Hajime Kanamori, MD, PhD; Miho Kitagawa; Yoichi Hirakata, MD, PhD; Mitsuo Kaku, MD, PhD

Author and Funding Information: From the Department of Infection Control and Laboratory Diagnostics (Drs Aoyagi, Tokuda, Ishibashi, Hatta, Endo, Inomata, Kanamori, and Kaku and Ms Kitagawa), Internal Medicine; Department of Regional Cooperation for Infectious Diseases (Drs Yamada, Kunishima, Gu, and Kaku); and Department of Clinical Microbiology With Epidemiological Research and Management and Analysis of Infectious Diseases (Drs Yano, Arai, and Hirakata), Tohoku University Graduate School of Medicine, Sendai, Japan.

Correspondence to: Mitsuo Kaku, MD, PhD, Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryoumachi, Aobaku, Sendai, 980-8574, Japan; e-mail:

For editorial comment see page 287

Drs Aoyagi and Yamada contributed equally to this work.

Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

CHEST. February 2013;143(2):349-356. doi:10.1378/chest.11-3298 - Published online




Natural catastrophes increase infectious disease morbidity rates. On March 11, 2011, a 9.0-magnitude earthquake and associated Pacific coast tsunami struck East Japan. The aim of this study was to investigate the characteristics of patients with infectious diseases who needed hospitalization after this disaster.


We searched the medical records of 1,577 patients admitted to Tohoku University Hospital in the Sendai area within 1 month (March 11, 2011-April 11, 2011) after the disaster. We examined (1) changes in the rates of hospitalizations for infectious diseases over time and (2) the variety of infectious diseases.


The number of hospitalized patients with infectious diseases increased after the first week to double that during the same period in 2010. Pneumonia comprised 43% of cases, and 12% consisted of skin and subcutaneous tissue infection, including tetanus. Pneumonia was prevalent in elderly patients (median age, 78 years) with low levels of serum albumin and comorbid conditions, including brain and nervous system disorders. Sputum cultures contained Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae, known pathogens of community-acquired pneumonia in Japan. In addition, 20.5% of patients had positive results for urinary pneumococcal antigen.


Among hospitalized patients, infectious diseases were significantly increased after the disaster compared with the same period in 2010, with pneumonia being prominent. The analyses suggest that taking appropriate measures for infectious diseases, including pneumonia, may be useful for disaster preparedness and medical response in the future.