RESUMO
In the aftermath of disasters in areas where populations live in close proximity and where sanitation and water supplies are compromised, an environment is created which is conducive to epidemics of vaccine-preventable diseases.<br>A strong earthquake occurred in Haiti in January 2010, severely affecting Port au Prince, the capital of the country, and the Government was functionally damaged. Over 220,000 people lost their lives and over 300,000 were injured.<br>Around 1.3 million people are living in temporary shelters in the Port-au-Prince metropolitan area and over 500,000 people have left the disaster areas to seek refuge in the rest of the country.<br>In Haiti, one of the world's most impoverished countries, the weak routine vaccination coverage was noted and the vaccination campaign was concerned as one of the first priorities.<br>The Japanese Red Cross (JRC) sent a medical team, called an ERU (Emergency Response Unit) right after the earthquake and provided medical services such as clinics in affected areas.<br>At the same time, we were involved in the vaccination campaign as one of the key players in the International Federation of the Red Cross and Red Crescent Societies (IFRC) in responding to the mass vaccination campaign by the Ministry of Health supported by WHO (World Health Organization) and UNICEF.<br>More than 150,000 people were vaccinated in 1 month by all Red Cross members. 35,217 of them were by JRC and the coverage was 75.5% according to the random survey. Including all the activities, it took more than 3 months and 62% of initially estimated population was vaccinated until the end.<br>After disasters, people typically move to other places seeking a better environment so mass vaccination campaign has to be carried out immediately, once it is decided upon. The selection of target populations, vaccines and good cooperation with other organizations is the key to success.
RESUMO
The purpose of this investigation is to study the frequency and penetrance of BRCA1 and BRCA2 germline mutations in Japanese familial breast cancer patients. Mutation analysis of BRCA1 and BRCA2 by protein truncation test was conducted on the 120 breast cancer patients (probands) with at least one breast cancer (site-specific breast cancer families, n=105) or one ovarian cancer (breast/ovarian cancer families, n=15) patient in their first-degree relatives. Eight BRCA1 (7.6%) and ten BRCA2 (9.5%) mutations were found in site-specific breast cancer families (n=105), and seven BRCA1 (46.7%) but no BRCA2 (0%) mutations were found in breast/ovarian cancer families (n=15). In site-specific breast cancer families, mutation frequency of BRCA1 and BRCA2 was high in families with more than three breast cancer patients (30%, 6/20), early onset (40< or = years old) breast cancer patients (41.1%, 14/34), or bilateral breast cancer patients (40%, 6/15). Cumulative incidence of breast cancer by age 70 was estimated to be 78% and 80% for BRCA1 and BRCA2 mutation carriers, respectively, and that of ovarian cancer was 40% and 0% for BRCA1 and BRCA2 mutation carriers, respectively. Family profiles are important determinants of risk for carrying a BRCA1 or BRCA2 mutation. Japanese women with BRCA1 mutation have a high risk of breast and ovarian cancer and those with BRCA2 mutation have a high risk of breast cancer but not ovarian cancer.