An example of the adverse effects of an earthquake on medical conditions was observed in 1981 after a magnitude 6.7 earthquake in Athens, Greece. A 50% increase in deaths due to myocardial infarction was documented during the first 3 days after the earthquake, with the death rate peaking on the third day (41,42). There may be a plausible biological mechanism for increased risk of cardiac problems after a natural disaster: emotional stress and physical activity cause increased levels of catecholamines, vasoconstriction, and increased coagulability (43). If stress has such an acute physiological effect, then the proportion of sudden deaths might be expected to increase. On the day of the 1985 Mexico City earthquake, the number of abortions, premature births, and normal deliveries in chronic care facilities rose and together constituted the primary cause of all admissions seen on that day (44,45). Even more admissions for these causes occurred 4 days later, again probably because of the effects of stress related to the disaster (44).