The public health response to the Chi-Chi earthquake in Taiwan, 1999

Objective. On September 21, 1999, at 1:47 a.m., an earthquake measuring 7.3 on the Richter scale struck the middle Chi-Chi region of Taiwan. The present study examines the response of the public health sector to the earthquake. Methods. A community needs assessment using modified cluster sampling was performed in shelters of Nantou and Taichung Counties five days after the earthquake struck. Twenty-five temporary medical service systems (TMSSs) conducted surveillance for selected diseases and mortality within one week post-earthquake aided by a buddy system that allowed unaffected counties to provide support to affected counties. Results. The number of cases of acute respiratory infections and acute gastroenteritis in the affected area was higher than that of neighboring unaffected counties in the post-earthquake phase (p<0.001). Earthquake-related deaths were estimated at 2,347 deaths (death rate 116 per 100,000 population); the mean age of the decedents was 49.7 years. No significant difference was observed between males (120/100,000) and females (110/100,000) (risk ratio [RR]=1.09; 95% confidence interval [CI] 0.84, 1.42; p>0.05). The age-adjusted mortality rate was significantly higher in 1999 (odds ratio [OR]= 2.11; 95% CI 1.99, 2.24) than in a comparable period in 1998. Conclusion. Emergency preparedness must be based on carefully conceived priorities, information, and communications, and improved capabilities must be developed to rapidly implement an emergency public health network. The emergency response to this event-consisting of TMSSs, a buddy system, and a communication system-should be considered in planning for future disaster events in Taiwan.