Headlines
As reported by The Hartford Courant, September 2, 2005.
Survivors Face Array of Hazards
Health Threats Include Toxins, Dehydration, Diseases
By Garret Condon
When news accounts refer to corpses floating in the floodwaters unleashed by hurricane Katrina, it's not hard to imagine the threats to life and health that storm survivors now face. The truth is that drifting dead bodies - although grim - are far from the worst health hazard.
The challenge for the living, faced with a staggering list of public health threats, is to keep from joining the lifeless flotsam. Here is some of what survivors and aid groups face in the weeks ahead.
Infectious Diseases
Water tainted with sewage and other contaminants can cause diarrheal illnesses. Dr. Eric A. Weiss, an assistant professor of emergency medicine at the Stanford University School of Medicine, said that it is unlikely that there will be outbreaks of such illnesses as cholera, which is rare in the developed world. The real threat is from more common kinds of intestinal bugs such as E. coli and coxsackievirus, which sometimes plague cruise ships, as well as respiratory infections. Unfortunately, he said, a large camp or center for the displaced is "like a massive cruise ship without the amenities."
Dr. James Hadler, Connecticut state epidemiologist, said that even outside the floodwater, many people can be infected by disease-causing bacteria, viruses and parasites by using any of the area's many backed-up toilets. Germs can pass quickly in close quarters - even after the sanitation issue is solved in various temporary camps and shelters, he said. Non-vaccinated people could be subject to outbreaks of such illnesses as chickenpox and measles. Various respiratory illnesses such as colds or flu can spread more rapidly than usual in crowded conditions.
Elaine Larson, a professor at the Columbia University School of Nursing and editor of the American Journal of Infection Control, said that hand-washing and the use of alcohol-based sanitizers could reduce the risk of infection for people evacuated to the Astrodome and other large centers.
Weiss observed that hungry survivors could be made sick by eating spoiled food and that expanses of standing water also could be breeding grounds for mosquitoes that could carry such illnesses as West Nile virus and dengue fever.
Drifting corpses, incidentally, are not a major disease threat, according to Dr. Jean-Luc Poncelet, who heads the Pan American Health Organization's emergency preparedness unit. "We have never seen an epidemic started from floating bodies," he said.
Chemical Toxins
Disease-causing microbes aren't the only foul ingredients in the stew of floodwater that residents are slogging and swimming through. The contents of automobile gas tanks and home heating oil tanks and many other harmful chemicals are part of the mix, said Dr. Vincent Quagliarello, a professor of medicine and acting chief of infectious disease at Yale School of Medicine.
He said exposure to these toxic chemicals could cause rashes and possibly neurological problems.
Dehydration
The lack of fresh water is a major threat to survivors, said Weiss at Stanford. The heat of the region - and of crowded buses, shelters and camps - can lead to heat illness, he said.
Hadler observed that people who are desperately parched and decide to drink contaminated water probably will end up vomiting or with diarrhea - which will lead to even faster dehydration. At the extreme, diarrhea can be lethal.
Dr. Eileen Storey, co-director of the University of Connecticut's Center for Public Health and Health Policy, said that the elderly and those with underlying disease are at highest risk for heat-related illness.
Mental Health
Many families in and around New Orleans are trying to deal with death, the destruction of their homes and possibly the loss of their livelihood in a post-apocalyptic landscape of looting, violence and hopelessness. "You are going to have tremendous psychosocial ramifications that I believe are a significant public health issue," said Weiss. Yale's Quagliarello said that many who live on will suffer from post-traumatic stress disorder, anxiety, depression and other psychological problems. "Mothers have seen their children die," he said. "The process of survival is like survival of the fittest."
Poncelet said that it is particularly important for survivors to know that it is normal to be stressed-out in such circumstances and imperative for aid groups to try to identify individuals who might need long-term psychological care.
Health Care Access
Many of the thousands displaced by the storm regularly take medications for heart disease, diabetes and other chronic conditions. Those who fled without the medications, or with only a small supply, could face heart attacks, strokes and death.
"People relying on medical equipment and medications have a major need for access," said Storey, who added that while many of these people know what pills they need, others may not, and medical records won't be available.
"They're going to need access to an emergency medical distribution system," she said.