| Sumario: | Sustaining health amidst the chaos following environmental catastrophes is a fundamental challenge in disaster medicine. Although historically rare in the immediate post-disaster aftermath, communicable disease outbreaks have recently occurred among displaced disaster survivors. Disaster responders are instrumental in preventing, recognizing, and containing outbreaks. Implementation of preventive public health measures for evacuees from outset through the entire resettlement process is essential. When expertly coordinated, disaster response teams have the potential to dramatically influence the unusually high mortality rates in refugee camps. The early surveillance systems following the January 2010 earthquake in Haiti reported high rates of respiratory, gastrointestinal, and febrile illness, but no outbreaks occurred. Then, with thunderous emergence, a cholera epidemic nine months later raised alarms for relief experts and public health professionals. Haiti, already plagued by high rates of HIV, tuberculosis, and malaria, is now threatened by adding cholera to its list of endemic infectious diseases. With large portions of the population still displaced, conditions are favorable for respiratory, vector-borne disease, and other diarrheal outbreaks as well. Tragically, the cholera epidemic recapitulates the threat of natural disaster-driven pestilence, a modern struggle of impoverished societies worldwide. That the cholera outbreak occurred under watchful eyes of expert disaster responders and thousands of humanitarian relief workers, underscores the necessity of a proactive global response to poverty, the greatest harbinger of disease transmission, even before disaster strikes.
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