The Great East-Japan Earthquake and devastating tsunami: an update and lessons from the past Great Earthquakes in Japan since 1923.

Japan has a long history of fighting against great earthquakes that cause structural damage/collapses, fires and/or tsunami. On March 11, 2011 at 14:46 (Friday), the Great East-Japan Earthquake (magnitude 9.0) attacked the Tohoku region (northeastern Japan), which includes Sendai City. The earthquake generated a devastating tsunami, leading to unprecedented disasters (~18,500 victims) in coastal areas of Iwate, Miyagi and Fukushima prefectures, despite the fact that people living in the Tohoku region are well trained for tsunami-evacuation procedures, with the mindset of "Tsunami, ten-den-ko." This code means that each person should evacuate individually upon an earthquake. Sharing this rule, children and parents can escape separately from schools, houses or workplaces, without worrying about each other. The concept of ten-den-ko (individual evacuation) is helpful for people living in coastal areas of earthquake-prone zones around the world. It is also important to construct safe evacuation centers, because the March 11(th) tsunami killed people who had evacuated to evacuation sites. We summarize the current conditions of people living in the disaster-stricken areas, including the consequences of the Fukushima nuclear accident. We also describe the disaster responses as the publisher of the Tohoku Journal of Experimental Medicine (TJEM), located in Sendai, with online support from Tokyo. In 1923, the Great Kanto Earthquake (magnitude 7.9) evoked a massive fire that destroyed large areas of Tokyo (~105,000 victims), including the print company for TJEM, but the Wistar Institute printed three TJEM issues in 1923 in Philadelphia. Mutual aid relationships should be established between distant cities to survive future disasters.