WHO SITREP NO 10 SITUATION SUMMARY

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WHO SITREP NO 10 Japan earthquake and tsunami Situation Report No. 10 19 March 2011 As of 14:30 hrs Manila Time All times stated below are in Tokyo time. SITUATION SUMMARY A 9.0 magnitude earthquake occurred on 11 March 2011 in Japan at 5:46:23 GMT, hitting the northeast coast of Honshu, Japan. Based on official Japanese government figures, 6 548 persons are confirmed dead, 2 516 injured with more than 10 354 missing. At least 131 persons remain to be evacuated and 376 907 have been evacuated. A small number of influenza-like illness and gastroenteritis cases have been reported from several evacuation centres. Fukushima Daiichi nuclear power plant: o Cooling operations continue. o The power cable from an external power supply was installed on 18 March to aid cooling operations. o White smoke continues to rise from Units 2, 3 and 4. o Levels of radiation fluctuate at the west gate of the plant. o Levels of radiation within 60 km of the Plant range from 0.5-150 micro Sv/hr Levels of radiation measured at Saitama, Chiba and Tokyo prefectures are at background levels. We continue to monitor the situation closely.

EVENT INFORMATION Weather The three prefectures most affected in the eastern Tohoku region (Iwate, Miyagi, Fukushima) are expecting temperatures from -5C to 19C today. Weather conditions are expected to improve with temperatures warming. Wind is blowing mostly from the west toward the Pacific Ocean, blowing at 1-2 m/sec. Conditions of Central and western Tohoku prefectures (Aomori, Akita and Yamagata), where evacuation centres are located, are also expected to improve to cloudy today; expected temperatures today are from -4C to 8C. POPULATION STATUS Death counts continue to rise. The majority of deaths are from Iwate, Fukushima and Miyagi prefectures. Deaths 6548 * Expecting more than 15,000 deaths in Tohoku region according to various media sources Injured 2516 Missing 10 354 HEALTH STATUS, LIFELINE SERVICES AND RESPONSE A large number of people are reporting dizziness and light-headedness due to the continuing aftershocks. Health care facilities Of the disaster designated hospitals in the Kanto area, 20 are at capacity and 130 are still accepting additional patients. 2

Table 1: Disaster designated hospitals by prefecture in the Kanto area Prefecture Disaster designated hospital not able to accept additional patients Total disaster designated Hospitals Aomori 0 8 Iwate 2 12 Miyagi 8 14 Akita 1 12 Yamagata 0 7 Fukishima 4 8 Ibaragi 2 11 Tochigi 3 9 Tokyo 0 69 TOTAL 20 150 Displaced people There are more than 2 398 evacuation shelters for displaced persons. Relief efforts are being hampered by a shortage of gasoline for delivery vehicles (media). People are facing cold temperatures with insufficient heating. Many elderly persons have lost their daily medications. There are approximately 5-6 nurses available at each evacuation centre. Basic supplies (oil/gas, blankets, diapers, toilet paper) and medications are running low. The Japanese population by age group is as follows: 13.1% are 0-14 years, 64% are 15-64 years and 22.9% are 65 years and older. This group breakdown was used to estimate the number of people by age group in evacuation centres. However this should be interpreted with precaution as the age groups at the evacuation centre may not reflect the population age distribution. At least 27 people are reported to have died at the evacuation sites. A large proportion of these patients were in hospital before being evacuated (media). 3

Table 2: Estimated age groups of people at the evacuation centres* Prefecture Number of evacuation centres Number of evacuees Estimated: Age 0<14 Estimated: Age>15, <65 Estimated: Age >65 Prefecture total population Households Aomori 32 367 48 235 84 1 400 050 575 128 Iwate 386 48 413 6 342 30 984 11 087 1 330 657 505 719 Miyagi 1063 177946 23311 113885 40750 2347300 915196 Yamagata 28 2712 355 1736 621 1166309 388829 Fukushima 556 131 665 17 248 84 266 30 151 2 041 051 749 760 Ibaragi 185 7 126 934 4 561 1 632 2 966 892 1 091 108 Tochigi 148 1 028 135 658 235 2 013 414 712 692 Niigata 51 7 650 1 002 4 896 1 752 2 371 574 854 073 Total >2 398 376 907 49 375 241 220 86 812 15 637 247 5 792 505 * These figures should be interpreted with caution as the population at the evacuation centre may not reflect the population age distribution. Table 3: Number of stranded and evacuated persons by prefecture, 18 March Prefecture Stranded Evacuees Total Population Aomori - 367 1 373 164 Iwate 0 48 413 1 330 530 Miyagi 1 177 946 2 359 991 Yamagata* - 2 712 1 168 789 Fukushima 130 131 665 2 091 223 Ibaragi* - 7 126 2 968 865 Tochigi - 1 028 2 007 014 Niigata* - 7 650 2 374 922 Total 131 376 907 15 674 498 *These numbers include evacuees from Fukushima and/or Miyagi 4

Communicable diseases Cases of influenza-like illness (ILI) and gastrointestinal infection have been reported at various evacuation shelters (see table below). Control measures include encouraging the use of face masks for persons with respiratory illness, the use of alcohol disinfectants, and increasing fluid intake. The availability of masks and alcohol disinfectants are limited. Table 4: ILI and gastroenteritis cases in evacuation centres Location of evacuation centre ILI cases Gastroenteritis cases Kamaishi city, Iwate 1 10 Wakabayash-ku, Sendai city, Miyagi 7 - Shichigahama town, Miyagi 2 - Otsuchi town, Iwate - 8 Response to health and lifeline services The National Emergency Management Committee, led by the Prime Minister, has been established to oversee and coordinate all response activities. A state of emergency has been declared. All prefectures have also activated the local government response. There is a steady improvement in the supply of power, gas, and water throughout the Tohoku region. Provision and transportation of food and water are challenging due to road access and petrol availability. Rescue/health activities Activities coordinated through DMAT (Disaster Medical Assistance Team), MHLW Responding - 12 teams Mobilizing - 8 teams Standby - 103 teams Active deployment of DMAT rescue operations has been stepped down as it is no longer in active rescue phase. Public health nurse teams are being deployed to evacuation centres: Responding - 60 teams Mobilizing - 9 teams Standby - 31 teams Four mental health care teams were deployed to Miyagi prefecture. Food/water/essentials 938 425 households from 12 prefectures are without running water; the most affected prefectures: Miyagi, Fukushima, Yamagata, Iwate (limited information), Ibaraki, Tochigi, Chiba, Akita, Aomori. 5

Distribution centres: Miyagi (5), Fukushima (11) and Iwate (1) Rice, food and water are being provided. Items also distributed include blankets, radios, gasoline, flashlights, dry ice and other essentials. 2 895 394 food items were delivered to evacuation centres and 1 811 100 food items are en route. 2 134 997 bottles of water arrived. 785 000 bottles are on the way. Sewage: Mobile latrines continue to be distributed. Management of bodies: MHLW is supporting the local government for disposal of dead bodies. Food safety: Communication: Electricity: Gas: Petrol: Roads/transport: Individual local health authorities are responsible for advising on health and hygiene control for affected persons. The MHLW has provided general information and guidance to local governments. Please see the guidance: http://www.mhlw.go.jp/stf/houdou/2r9852000001558e.html 799 736 telephone lines remain out of service. A reported 5 498 base stations of NTT, Soft Bank, KDDI, emobile and wilcom mobile companies are not working. Disaster messaging service in operation through mobile phone providers. 319 268 households remain without power across Kanto and Tohoku regions. 443 825 households are without gas supply. Petrol is being provided to evacuation centres by freight train and tankers. Damaged roads have been reported from Aomori, Miyagi, Yamagata, Akita, Tokyo, Ibaraki, Tochigi, Saitama, Gunma, Chiba, Iwate. Assessments from Fukushima are not yet completed. East Japan Railway's bullet train and train services in the Tohoku region remain halted. Sendai airport has commenced operations for 24-hour rescue helicopters only. Yamagata, Hanamaki and Fukushima airports are open 24 hours for rescue operations. Several seaports have reopened. JR established a new route for freight train transportation of relief items (fuel tank). This freight train is from Kanagawa and Hokkaido and goes to Morioka via Aomori. 6

RADIATION AND NUCLEAR FACILITIES Among the three nuclear power plants in the affected area [Onagawa (Miyagi), Daiichi and Daini (Fukushima)], Daiichi (approximately 250 km from Tokyo) continues to experience cooling problems with reports of higher than normal radiation levels on site. Cooling operations via helicopter water spraying, water injection via fire trucks, and connection to extra power supplies have been ongoing since 18 March. Radiation monitoring in Tohoku and Kanto regions continue to record low absolute levels. Fukushima Daiichi ("No. 1"; Fukushima) A total of six reactors are present. Three reactors initially shut down automatically and three reactors were shut down manually after investigation. However, there have been at least two explosions and increased radiation levels have been detected at the facility. Radiation levels continue to be monitored on site and are presented in the below figure, showing overall low levels compared to the past few days. On 17 March, additional Self Defence Force (SDF) members and others have joined to assist with the cooling operations. These operations have included spraying of water from helicopters around 9:48 am (~7.5 tons each spray; due to radiation levels, helicopter operations are limited to 40 minutes per operation) and at ground level using fire engines from both SDF and police. On 18 March, supplying power through external sources was initiated. This operation is expected to supply power to reactors 1-4 (with reactor 2, the least damaged reactor targeted first) to enhance cooling capacity. The cooling operations via fire trucks are expected to continue later in the afternoon after completing this electric operation. The government has announced that spraying of water via helicopters did not occur on 18 March. Based on the Japanese Chief Cabinet Secretary, the following human injuries/contaminations have been reported as of 17 March related to Daiichi plant/radiation evacuation. 2 - non-severe injuries 1 - broken legs 1 - unknown condition 2 - severely ill 17 workers suffered due to radiation exposure on their faces, but were not taken to hospital due to low levels 1 worker suffered significant exposure during vent work 2 policemen were exposed and subsequently decontaminated 1 (?) fireman was exposed and is currently being investigated Of the 190 persons suspected of being exposed to radiation following Daiichi Reactor No. 1's explosion, 22 persons have been confirmed with detectable radiation levels. 3 hospital patients from evacuation zone with confirmed detectable radiation levels 7

Of 60 persons with potential radiation exposure during helicopter relief operations, 3 confirmed with detectable radiation levels Of 35 evacuees with potential radiation exposure, 0 determined they were not exposed to radiation Of 100 evacuees with potential exposure, 9 confirmed with detectable radiation levels 6 persons inside a helicopter that was operating at the time of the reactor 3 explosion received decontamination treatment Ronald Reagan, a US battleship, detected low levels of radiation, but stated that it is less than the amount naturally exposed in 1 month It was reported that 10 000 people have been tested for detectable radiation and only a small minority tested positive. Table 5: Fukushima Daiichi Nuclear Reactor Plant Situation as of 18 March 2011 Coolant System Expose / Fire temperature of pool Response Unit 1 Unit 2 Unit 3 Unit 4 Down Down Down Down Hydrogen explosion 12 March Explosion 15 March; white smoke continues to be generated. Hydrogen explosion 14 March; white smoke continues Fire 15 and 16 March; white smoke continues to be generated. NA NA NA ~84 C Unit 5 Down No 67.6 C Unit 6 Down No 65 C Sea water pumping Sea water pumping Water inject using fire engine Emergency diesel generator of Unit 6 is supplying electricity to Units 5 and 6; but a pump at Unit 5 is now in operation for cooling (NHK) Emergency diesel generator operating; a second power source is now in operation (NHK). The Government of Japan raised the event in Fukushima Daiichi Units 1, 2 and 3 to Level 5 on the International Nuclear and Radiological Event Scale (INES). 8

Radiation levels Higher than expected radiation levels continue to be detected at the plant facility, but there appears to be no large increase. As measurement at the main gate has been suspended during cooling operations, measurements have not been conducted since late 16 March. Radiation levels (gamma rays; micro Sv/hr) detected from 15 18 March at Daiichi plant Due to cooling operations by water injection, radiation measurements at the main gate have not occurred regularly since 17 March. On 18 March at 5:00 am, the level at west gate was 279.4micro Sv/hr while at 4:00 pm, the level was 2285 micro Sv/hr. On 19 March at 8.10 am the level was 838 micro Sv/hr at a distance of 1.1km from Unit 3. This figure dropped to 364.5 micro Sv/hr at 9.00am (NHK). Around 10 am on 17 March, based on measurements from the SDF helicopters involved in the cooling operations: 4.13 milli Sv/h at 1000ft (300m); 87.7 milli Sv/h at 300ft (90m). The Japanese government requested the USA to dispatch an unmanned inspector airplane "Global Hawk" to monitor radioactivity near the Daiichi plant. In the Fukushima area, measurements from areas within ~60 km have ranged from 0.5 to 150 micro Sv/hour, 18 March. The areas with the highest detection measure were detected ~30km northwest of the Daiichi facility. The reason this particular area detected the highest measures is unknown. Various media are reporting detection of abnormal levels of radiation on passengers travelling from Japan to other countries and areas (Republic of Korea, Taiwan, Province of China, United States of America). Levels of radiation measured at Saitama, Chiba and Tokyo prefectures are at background levels. We continue to monitor the situation closely. 9

LOCATION Source of Information RADIATION LEVEL REPORTED 15-Mar 16-Mar 17-Mar 18-Mar Background levels for each area IBARAKI PREFECTURE Mito TOCHIGI PREFECTURE Utunomiya city GUNMA PRERECTURE Maebashi city SAITAMA PREFECTURE Saitama City CHIBA PREFECTURE Ichihara City TOKYO PREFECTURE Shingyuku JPN Ministry of Education Time (JST) 19:00-20:00 Level (usv/h) Time (JST) Level (usv/h) Time (JST) Level (usv/h) Time (JST) Level 0.239 0.241 0.21 0.189 0.321 0.212 0.189 0.167 0.389 0.109 0.096 0.086 19:00-15:00-14.00-20:00 16:00 15.00 0.169 0.067 0.063 0.058 0.055 0.04 0.038 0.034 0.361 0.053 0.05 0.05 0.036~0.05 6 0.030~0.06 7 0.017~0.04 5 0.031~0.06 0 0.022~0.04 4 0.028~0.07 9 COMMENTS: Yellow means higher than standard level milli = 10-3 micro = 10-6 nano = 10-9 National response to radiation/nuclear facility issues Due to potential radiation exposure all people within a 20 km radius have been evacuated from the towns of Okuma, Tomioka, Naraha, Futaba. People residing between 20 to 30 km of the Daiichi plant like people from Kawauchi village, Tamura city, Hirono town, Iwaki city, Iitate village, Minamisoma city, Katsurao village, and Namie town, have been advised to stay indoors and avoid the use of ventilator systems, close windows and not to bring laundry hanging outside indoors. The Director General of the International Atomic Energy Agency (IAEA) is presently in Japan. MHLW has advised local governments not to sell foods/liquids that are over the set threshold levels and provided advice on how to minimize exposure to radiation. 10

Food safety and water quality (Food safety Information from INFOSAN Japan) Monitoring of food in terms of radionuclide contaminations The Food Safety Department of the Ministry of Health, Labour and Welfare has issued a notice dated 17 March 2011, addressed to all local food safety inspection authorities that they must monitor/investigate radionuclide levels in foods for identification/prevention of potential food safety risks associated with radioactive nuclide contaminations. The notice indicates guideline levels for radionuclide in different types of foods. These levels are set taking into account scientific evidence and data, including those available in ICRP. The monitoring/investigation should be in line with the Manual for Radionuclide Testing in Foods developed in 2002, which is supplemental to the "National Guideline for Monitoring Radionuclide in Environment, used in Situations Related to Nuclear Accidents and Radiological Events, developed in 2000. If the level detected in foods exceeds the guideline levels indicated in the notice above, the concerned foods are withdrawn for precaution. So far no incident has been reported, no identification on high levels of radionuclide contaminations in foods. For overall radionuclide contamination monitoring The Government has taken necessary action as a whole, by following the above mentioned National Guideline for Monitoring Radionuclide in Environment, to monitor actual radionuclide levels in different areas. Test results in different samples from environments, including waters are available at the following sites (available only in Japanese). http://www.pref.fukushima.jp/j/ http://www.mext.go.jp/a_menu/saigaijohou/syousai/1303723.htm Drinking water quality On 18 March, Fukushima-ken Environmental Radioactivity Monitoring Centre Fukushima Branch Office reported results of measurements of iodine-131, cesium-134, and cesium-137 for 15 samples of drinking water collected over a 48-hour period from 08:00 am on 16 March to 08:00 am on 18 March. Samples were collected in Fukushima, apparently from drinking water taps within the Centre itself although this was not specifically stated. Values of cesium-134 and cesium-137 were at non-detectable levels in all samples except the first where values of 25 and 33 Bq/kg, respectively were reported. Reported values of iodine-131 ranged from non-detectable to 180 Bq/kg. All reported values were below the internationally agreed Operational Intervention Levels (OIL's) for I-131 (3,000 Bq/kg), Cs-134 (1,000 Bq/kg) and Cs-137 (2,000 Bq/kg). Iodine-131 is not a significant source of radiation because of its low specific activity (ref. IAEA General Safety Guide No. 2: http://www-pub.iaea.org/mtcd/publications/pdf/pub1467_web.pdf) 11

INTERNATIONAL RESPONSE Rescue teams are being coordinated by UNDAC. Rescue teams from Australia, USA, Republic of Korea, Mexico, New Zealand, China, United Kingdom, France, Singapore Germany, Switzerland, Russia, Mongolia, Italy, Turkey, South Africa, and Indonesia have been deployed. Japan Red Cross is offering mental and social care for numerous survivors. WHO-WPRO RESPONSE WHO/WPRO is coordinating with WHO Kobe Centre, jointly monitoring the situation Dr H. Ogawa, Team Leader Environmental Health of WHO/WPRO, arrived in Tokyo, 18 March to support the WHO Kobe Centre and to coordinate with the UNDAC team. Forward planning for assessment of status, risk and planning for response for potential nuclear and human health needs are being conducted. Funds have been made available for initiating training and planning for the mental health and psycho-social issues. Frequently asked questions developed on the food safety aspects have been published at: http://www.who.int/hac/crises/jpn/faqs/en/index6.html. These will be updated as new information is available. RISK COMMUNICATION Actions Updated Frequently Asked Questions on WPRO web page Media Centre, with specific FAQs on food safety issues Media monitoring CONTACTS FOR MORE INFORMATION WPRO Situation Room: For further information: GPN: 89250; SITROOM@wpro.who.int + 63 528 9035 + 63 528 9650 + 63 528 9249 + 63 528 9341 Mr Peter Cordingley Public Information Officer Mobile: +63 918 963 0224 12

Dr Art Pesigan Emergency and Humanitarian Action Tel: +63 918 917 8053 13