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Dysentery outbreak feared
Authorities faced a deteriorating and disturbing public health crisis from Hurricane Katrina on Saturday as bodies continued to wash ashore after five days at sea and a possible dysentery outbreak shut down a shelter for hundreds.
Fuel shortages are hampering supply efforts and causing a breeding ground for disease. There is no working sewage system. Portable toilets are scarce. People are trying to live in damaged homes, finding refuge in their vehicles and in some cases living with strangers.
Authorities fear a disease outbreak could add to the toll of fatalities from the hurricane. The number of confirmed deaths in the six southern-most counties rose to 134. Family and friends are driving through the streets of ravaged neighborhoods asking the few residents still in their homes if they know what happened to their loved ones.
The stench of decay - human and animal - was growing stronger in flattened neighborhoods where cranes would be needed to untangle the debris. Bodies swept out to sea in the storm Sunday are still coming back, authorities said.
On the bright side, Gulfport officials reported some improvements in base conditions. At a late afternoon session, it was noted that the Chamber of Commerce has secured 700 Florida houses for displaced Gulfport residents and that a truckload of baby supplies is enroute to the city.
Water service is being restored neighborhood by neighborhood, and power is back on in some pockets of the city.
In other developments Saturday:
_A suspected dysentery outbreak resulted in the evacuation of an American Red Cross Shelter on Irish Hill Road across the street from Keesler Air Force Base.
_Fear of a cholera outbreak caused emergency officials to order that areas south of the CSX Railroad in Long Beach and Pass Christian be evacuated.
_The American Red Cross was running low on fuel for its relief efforts.
_No federal or private relief agency had erected tents or other temporary housing for the homeless.
_City and county officials across the Coast criticized the Federal Emergency Management Agency and Keesler Air Force Base for not doing enough.
_Unofficial damage estimates indicate that 75 percent of all structures in the three Coast counties sustained damage, according to information from a morning briefing with relief agencies
_Interstate 110 in Biloxi, the connector between Casino Row and I-10 has been reduced to one lane in each direction due to cracks detected under the northbound. People with no compelling reason to use the roadway are asked not to.
The shelter with the suspected dysentery outbreak has lacked functioning plumbing for five days. Hundreds of people stayed there after the storm. Eight buses arrived at Michele Seventh Grade School around 1 p.m. to begin taking the people to Georgia.
"There's a lot of diarrhea, a lot of bad water. Dysentery is the word," said Patrick Velasco, a member of the medical team under the direction of the Federal Emergency Management Agency.
Confusion ensued. People asked where they were going in Georgia.
"I cannot reveal that for fear of it being mobbed," Velasco said. "It is a state of the art Red Cross facility across the border.
Many who have spent the week at the shelter were walking around town, unaware of the urgent shutdown. Families were split up; those left at the shelter debated whether to evacuate.
Coastwide, there is no functioning plumbing in most neighborhoods, and portable toilets are scarce.
Officials reported trucks with supplies stranded without fuel in or near Meridian, about a four-hour from Gulfport. The American Red Cross faced the possibility of parking its supply trucks until more fuel arrives. Mississippi Public Broadcasting, a key source of news and critical information for many throughout the state, put out an urgent call for diesel fuel so it could continue to broadcast.
"Everybody is looking at the clock," said John McFarland, a board member of the Mississippi Coast Chapter of the American Red Cross.
Trucks with aid for the Biloxi area were stalled and out of gas near Meridian, according to Stephen Peranich, the chief of staff for U.S. Rep. Gene Taylor, D-Miss.
"This was known yesterday but it's still a problem today," Peranich said.
On the fuel front, the Chevron oil refinery in Pascagoula won't return to operation for weeks or months, a spokesman said Saturday, but it is pumping 300,000 gallons of gasoline onto tanker trucks daily.
The gasoline was stored as a precaution just before Hurricane Katrina struck on Monday, said the spokesman, Steve Renfroe. He said he did not know the volume of gasoline stored at the refinery.
Renfroe also said eight Chevron and Texaco stations had reopened in southern Mississippi as of Saturday afternoon, and the company expected five more to reopen in the area in the next week or so.
"Our hope is that people will see more stations open and significantly shorter lines," Renfroe said.
The Chevron Products Corp. refinery, which employs about 1,200 people, was evacuated for the storm. He said engineers are still tyrying to assess the damage to the plant. Employees, many of whom won't be able to return to work until the plant goes back online, can call the company's newsline if they have phone service, he said. About 300 of the company's workers lost or suffered significant damage to their homes.
Peranich said he spoke Saturday with a federal emergency relief staffer he declined to name.
One caravan that did make it to the Coast consisted of eight charter buses with doctors and nurses from Baldwin and Mobile Counties. More National Guardsmen arrived, and Navy personnel continued to provide emergency services, but Keesler Air Force still had not initiated any response.
No new shelters had been provided for the homeless the day after President George W. Bush stood in hurricane-ravaged East Biloxi and promised help.
"FEMA will be providing a lot of temporary housing," he said. "That's one of the responsibilities that FEMA assumes, to find shelter for people. In terms of the longer term, the government has got the capacity to make low interest loans and help businesses get back going. Once the situation gets stabilized, there will be the appropriate authorities to start passing out the forms necessary for people to apply for the relief and the help they can get. The federal government will be providing the temporary housing."
Officials across the Coast said they were not satisfied with FEMA's response. Mike Beeman, the FEMA coordinator for Harrison County, said Friday that federal agencies are responding to the area's needs but several logistical problems had emerged_most notably the fuel shortage.
Donovan Scruggs, director of community development for Ocean Springs said on Saturday - five days after the hurricane struck - that his city did not even have a FEMA contact.
"Outside assistance from FEMA has been pretty much nonexistent," Scruggs said. "We've been running the show, but nobody here has any experience managing a disaster. We need the experienced show-runners."
One FEMA representative was present in Hancock County.
Mike Beeman, the FEMA coordinator for Harrison County, said Friday that federal agencies are responding to the area's needs but several logistical problems had emerged_most notably the gas shortage. Beeman said a task force for temporary shelters had been established. The U.S. Army Corps of Engineers is also in the area and has programs for people who need tarps and help with their homes.
Beeman said FEMA is only a partner in the relief efforts and the organization takes its cues on where to place needed services from local and state officials.
Harrison County Supervisor Connie Rockco said the Coast needed more aid from Keesler Air Force Base "during our worst time of need." Lt. Col. Claudia Foss, the communications director at Keesler Air Force Base, said on Friday that the base had been hard hit by Hurricane Katrina.
The county requested a special air conditioning system to keep the courthouse cool for those who are responding to the people's needs, she said, but had heard nothing back from the base.
"I'm an Air Force brat," Rockco said. "I'm totally, totally disappointed."
Foss said 50 percent of the base had been damaged, including major damage to housing areas.
"We are in contact with the local authorities to do what we can, but before we can help, we need to first take care of our folks and get the infrastructure in place," Foss said. "Keesler got hit as well."
The base had no electricity on Friday, but it did have water.
Joe Spraggins, director of civil defense for Harrison County, said the Seabee base in Gulfport has offered its engineering expertise and equipment to help in the Gulfport area.
On Saturday morning, Mississippi Power announced that it had restored power to about 40,000 Coast homes. Company spokesman Kurt Brautigan said it will take "several weeks" for power to everyone in the Coast's power grid to be restored.
Some of the injured and ill were transported from Coast hospitals to other locations after a caravan of eight charter buses manned by doctors and nurses from Mobile and Baldwin Counties arrived Saturday afternoon.
"Hospitals all along the Gulf Coast have made beds available," said Dr. Charles Johnson.
http://www.charlotte.com/mld/charlotte/news/nation/12555416.htm
Authorities fear a disease outbreak could add to the toll of fatalities from the hurricane. The number of confirmed deaths in the six southern-most counties rose to 134. Family and friends are driving through the streets of ravaged neighborhoods asking the few residents still in their homes if they know what happened to their loved ones.
The stench of decay - human and animal - was growing stronger in flattened neighborhoods where cranes would be needed to untangle the debris. Bodies swept out to sea in the storm Sunday are still coming back, authorities said.
On the bright side, Gulfport officials reported some improvements in base conditions. At a late afternoon session, it was noted that the Chamber of Commerce has secured 700 Florida houses for displaced Gulfport residents and that a truckload of baby supplies is enroute to the city.
Water service is being restored neighborhood by neighborhood, and power is back on in some pockets of the city.
In other developments Saturday:
_A suspected dysentery outbreak resulted in the evacuation of an American Red Cross Shelter on Irish Hill Road across the street from Keesler Air Force Base.
_Fear of a cholera outbreak caused emergency officials to order that areas south of the CSX Railroad in Long Beach and Pass Christian be evacuated.
_The American Red Cross was running low on fuel for its relief efforts.
_No federal or private relief agency had erected tents or other temporary housing for the homeless.
_City and county officials across the Coast criticized the Federal Emergency Management Agency and Keesler Air Force Base for not doing enough.
_Unofficial damage estimates indicate that 75 percent of all structures in the three Coast counties sustained damage, according to information from a morning briefing with relief agencies
_Interstate 110 in Biloxi, the connector between Casino Row and I-10 has been reduced to one lane in each direction due to cracks detected under the northbound. People with no compelling reason to use the roadway are asked not to.
The shelter with the suspected dysentery outbreak has lacked functioning plumbing for five days. Hundreds of people stayed there after the storm. Eight buses arrived at Michele Seventh Grade School around 1 p.m. to begin taking the people to Georgia.
"There's a lot of diarrhea, a lot of bad water. Dysentery is the word," said Patrick Velasco, a member of the medical team under the direction of the Federal Emergency Management Agency.
Confusion ensued. People asked where they were going in Georgia.
"I cannot reveal that for fear of it being mobbed," Velasco said. "It is a state of the art Red Cross facility across the border.
Many who have spent the week at the shelter were walking around town, unaware of the urgent shutdown. Families were split up; those left at the shelter debated whether to evacuate.
Coastwide, there is no functioning plumbing in most neighborhoods, and portable toilets are scarce.
Officials reported trucks with supplies stranded without fuel in or near Meridian, about a four-hour from Gulfport. The American Red Cross faced the possibility of parking its supply trucks until more fuel arrives. Mississippi Public Broadcasting, a key source of news and critical information for many throughout the state, put out an urgent call for diesel fuel so it could continue to broadcast.
"Everybody is looking at the clock," said John McFarland, a board member of the Mississippi Coast Chapter of the American Red Cross.
Trucks with aid for the Biloxi area were stalled and out of gas near Meridian, according to Stephen Peranich, the chief of staff for U.S. Rep. Gene Taylor, D-Miss.
"This was known yesterday but it's still a problem today," Peranich said.
On the fuel front, the Chevron oil refinery in Pascagoula won't return to operation for weeks or months, a spokesman said Saturday, but it is pumping 300,000 gallons of gasoline onto tanker trucks daily.
The gasoline was stored as a precaution just before Hurricane Katrina struck on Monday, said the spokesman, Steve Renfroe. He said he did not know the volume of gasoline stored at the refinery.
Renfroe also said eight Chevron and Texaco stations had reopened in southern Mississippi as of Saturday afternoon, and the company expected five more to reopen in the area in the next week or so.
"Our hope is that people will see more stations open and significantly shorter lines," Renfroe said.
The Chevron Products Corp. refinery, which employs about 1,200 people, was evacuated for the storm. He said engineers are still tyrying to assess the damage to the plant. Employees, many of whom won't be able to return to work until the plant goes back online, can call the company's newsline if they have phone service, he said. About 300 of the company's workers lost or suffered significant damage to their homes.
Peranich said he spoke Saturday with a federal emergency relief staffer he declined to name.
One caravan that did make it to the Coast consisted of eight charter buses with doctors and nurses from Baldwin and Mobile Counties. More National Guardsmen arrived, and Navy personnel continued to provide emergency services, but Keesler Air Force still had not initiated any response.
No new shelters had been provided for the homeless the day after President George W. Bush stood in hurricane-ravaged East Biloxi and promised help.
"FEMA will be providing a lot of temporary housing," he said. "That's one of the responsibilities that FEMA assumes, to find shelter for people. In terms of the longer term, the government has got the capacity to make low interest loans and help businesses get back going. Once the situation gets stabilized, there will be the appropriate authorities to start passing out the forms necessary for people to apply for the relief and the help they can get. The federal government will be providing the temporary housing."
Officials across the Coast said they were not satisfied with FEMA's response. Mike Beeman, the FEMA coordinator for Harrison County, said Friday that federal agencies are responding to the area's needs but several logistical problems had emerged_most notably the fuel shortage.
Donovan Scruggs, director of community development for Ocean Springs said on Saturday - five days after the hurricane struck - that his city did not even have a FEMA contact.
"Outside assistance from FEMA has been pretty much nonexistent," Scruggs said. "We've been running the show, but nobody here has any experience managing a disaster. We need the experienced show-runners."
One FEMA representative was present in Hancock County.
Mike Beeman, the FEMA coordinator for Harrison County, said Friday that federal agencies are responding to the area's needs but several logistical problems had emerged_most notably the gas shortage. Beeman said a task force for temporary shelters had been established. The U.S. Army Corps of Engineers is also in the area and has programs for people who need tarps and help with their homes.
Beeman said FEMA is only a partner in the relief efforts and the organization takes its cues on where to place needed services from local and state officials.
Harrison County Supervisor Connie Rockco said the Coast needed more aid from Keesler Air Force Base "during our worst time of need." Lt. Col. Claudia Foss, the communications director at Keesler Air Force Base, said on Friday that the base had been hard hit by Hurricane Katrina.
The county requested a special air conditioning system to keep the courthouse cool for those who are responding to the people's needs, she said, but had heard nothing back from the base.
"I'm an Air Force brat," Rockco said. "I'm totally, totally disappointed."
Foss said 50 percent of the base had been damaged, including major damage to housing areas.
"We are in contact with the local authorities to do what we can, but before we can help, we need to first take care of our folks and get the infrastructure in place," Foss said. "Keesler got hit as well."
The base had no electricity on Friday, but it did have water.
Joe Spraggins, director of civil defense for Harrison County, said the Seabee base in Gulfport has offered its engineering expertise and equipment to help in the Gulfport area.
On Saturday morning, Mississippi Power announced that it had restored power to about 40,000 Coast homes. Company spokesman Kurt Brautigan said it will take "several weeks" for power to everyone in the Coast's power grid to be restored.
Some of the injured and ill were transported from Coast hospitals to other locations after a caravan of eight charter buses manned by doctors and nurses from Mobile and Baldwin Counties arrived Saturday afternoon.
"Hospitals all along the Gulf Coast have made beds available," said Dr. Charles Johnson.
http://www.charlotte.com/mld/charlotte/news/nation/12555416.htm
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Another 20 people in the area also were treated for vomiting and diarrhea.
The shelter at a Biloxi school had been without water and power since Katrina hit Monday. About 400 people had been staying there, and doctors said some may have ignored warnings to stay away from water.
Some running water came back on late Friday, but it was not safe to drink or even to use to brush teeth or wash, said Dr. Jason Dees, a volunteer working at Biloxi Regional Medical Center.
Most of the patients were treated with antibiotics. About 30 ill residents were taken to a hospital in Mobile, Alabama, while the rest were bused to a shelter in Thomasville, Georgia.
Biloxi police Cpl. Kayla Robert said she had no idea what caused the illnesses.
"Who knows what they swallowed before they got here," she said. "Half of them were swimming in stuff that we don't even know what it was."
http://www.cnn.com/2005/US/09/04/katrina.sick.shelter.ap/index.html
---
CHOLERA
What it is: Cholera is a bacteria spread by ingesting water or food contaminated by cholera bacterium. You can also get it by accidentally touching infected stool and getting in your mouth.
Symptoms: Abrupt, painless, watery diarrhea and vomiting are usually the initial symptoms.
Effects: Severe dehydration and electrolyte (salt) depletion leads to intense thirst, decreased amount of urine, muscle cramps, weakness, and marked loss of skin firmness, with sunken eyes and wrinkling of skin on the fingers.
People will also act confused or like they can't hear you. The fatality rate can be more than 50 percent in untreated severe cases - usually due to dehydration.
Cures: Some antibiotics can immediately lessen the symptoms and effects of cholera. However, if that is not immediately available, it is crucial that the infected person be rehydrated with lots of water or a prepackaged mixture of sugar and salts, like Gatorade.
Prevention: Human excrement must be properly disposed of and water supplies purified. Drinking water should be boiled or chlorinated and vegetables and fish cooked thoroughly. Hands should be disinfected frequently, especially before meals.
---
TYPHOID
What it is: Typhoid is a life-threatening illness caused by the Salmonella bacteria. Although rare in the United States, it is still easily spread in areas with poor sanitation.
Symptoms: The onset of typhoid is usually gradual, with fever, headache, painful joints, sore throat, constipation, loss of appetite, and abdominal pain and tenderness. Less common symptoms include painful urination, and bloody nose.
Effects: Painful intestinal bleeding and bloody stools are the most severe effects. Dehydration is also a danger.
Cures: Some antibiotics can immediately lessen the symptoms and effects of cholera. However, if that is not immediately available, it is crucial that the infected person be rehydrated with lots of water or a prepackaged mixture of sugar and salts, like Gatorade. Antibiotics markedly decrease the severity and duration of illness and also reduce complications and mortality.
Prevention: There is a Typhoid vaccination. In addition, human excrement must be properly disposed of and water supplies purified. Drinking water should be boiled or chlorinated and vegetables and fish cooked thoroughly. Hands should be disinfected frequently, especially before meals.
---
DYSENTERY
What it is: Dysentery is a bacteria or a protozoa that enters the body in much the same way as Typhoid and Cholera. It is still easily spread in areas with poor sanitation.
Symptoms: Diarrhea and sever abdominal pain due to swelling in the intestines.
Effects: Painful intestinal bleeding and bloody stools are the most severe effects. Dehydration is also a danger.
Cures: Some antibiotics can immediately lessen the symptoms and effects of dysentery. However, if that is not immediately available, it is crucial that the infected person be rehydrated with lots of water or a prepackaged mixture of sugar and salts, like Gatorade.
Prevention: Human excrement must be properly disposed of and water supplies purified. Drinking water should be boiled or chlorinated and vegetables and fish cooked thoroughly. Hands should be disinfected frequently, especially before meals.
---
Sources: Merck Manual of Diagnosis and Therapy, 17th edition and Elizabeth Norman, R.N., Ph.D., professor at New York University.
http://www.myrtlebeachonline.com/mld/myrtlebeachonline/news/nation/12555593.htm
"The bell was rung, the e-mails were sent off. ...We all got off work and deployed," said one of the frustrated surgeons, Dr. Preston "Chip" Rich of the University of North Carolina at Chapel Hill.
"We have tried so hard to do the right thing. It took us 30 hours to get here," he said. That government officials can't straighten out the mess and get them assigned to a relief effort now that they're just a few miles away "is just mind-boggling," he said.
While the doctors wait, the first predictable signs of disease from contaminated water began to emerge on Saturday: A Mississippi shelter was closed after 20 residents got sick with dysentery, probably from drinking contaminated water.
Many other storm survivors were being treated in the Houston Astrodome and other shelters for an assortment of problems, including chronic health conditions left untreated because people had lost or used up their medicine.
The North Carolina mobile hospital stranded in Mississippi was developed with millions of tax dollars through the Office of Homeland Security after 9-11. With capacity for 113 beds, it is designed to handle disasters and mass casualties.
Equipment includes ultrasound, digital radiology, satellite Internet, and a full pharmacy, enabling doctors to do most types of surgery in the field, including open-chest and abdominal operations.
It travels in a convoy that includes two 53-foot trailers, which as of Sunday afternoon was parked on a gravel lot 70 miles north of New Orleans because Louisiana officials for several days would not let them deploy to the flooded city, Rich said.
Yet plans to use the facility and its 100 health professionals were hatched days before Hurricane Katrina devastated the Gulf Coast, doctors in the caravan said.
As they talked with Mississippi officials about prospects of helping out there, other doctors complained that their offers of help also were turned away.
A primary care physician from Ohio called and e-mailed the U.S. Department of Health and Human Services after seeing a notice on the American Medical Association's Web site about volunteer doctors being needed.
An e-mail reply told him to watch CNN that night where U.S. Health and Human Services Secretary Michael Leavitt was to announce a Web address for doctors to enter their names in a database.
"How crazy is that?" he complained in an e-mail to his daughter.
Leavitt, U.S. Surgeon General Richard Carmona, and Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, were in Louisiana on Sunday, and Gerberding planned to go to Texas where many evacuees are now housed.
Many other doctors have been able to volunteer, and were arriving in large numbers Sunday in Baton Rouge. Several said they worked it out through Louisiana state officials.
Dr. Bethany Gardiner, a 36-year-old pediatrician who just moved to Santa Barbara, Calif., from Florida, had been visiting parents the Sunshine state when the hurricane hit.
"I left my kids and just started searching places on the Web" to volunteer, eventually getting an invitation to come to Baton Rouge, she said.
http://www.wjla.com/news/stories/0905/257399.html
David Fickling reports on fears of disease and assesses the risks to those caught up in the disaster
Monday September 5, 2005
An apparent outbreak of dysentery in the Mississippi town of Biloxi has sparked fears that Hurricane Katrina may cause further suffering and danger in the form of an epidemic of waterborne diseases.
Officials closed down a disaster shelter in the town after more than 20 people complained of diarrhoea and vomiting, though they later denied that dysentery was to blame.
The sight of 25,000 refugees from the flooding crammed into the Superdome sports arena in New Orleans, where the toilets had broken down in the immediate aftermath of the hurricane, had already raised concerns about potential epidemics.
But public concern far outpaces the frequency of serious outbreaks. In the first few weeks after the Asian tsunami there were concerns that waterborne epidemics could double the death toll, but a month after the disaster the World Health Organisation reported that even in Aceh - the Indonesian province most severely hit by the tsunami, - outbreaks had been prevented by a well-coordinated public health programme.
The 2000 floods in Mozambique made more than 500,000 people homeless in a country with high levels of endemic diseases and little infrastructure to cope with the effects of a major natural disaster. But only 2,200 people died of gastric disease as a result.
Basic hygiene rules are enough to prevent most waterborne diseases. Washing your hands with soap and clean water, drinking only bottled water, and cleaning all unpackaged food products in boiled water are enough to kill off most pathogens.
Such measures, however, become nigh on impossible following a major disaster in which water, electricity and gas supplies have been cut off and flooding is widespread - hence the US government's insistence that the New Orleans be evacuated.
With estimates of the death toll topping 10,000, there is also a great deal of public concern about the health impact of dead bodies still to be recovered.
Health experts say such concern is unnecessary. A few diseases - such as HIV and tuberculosis - can persist in a body after death, and they are only likely to infect doctors and recovery workers in close contact with the bodies. Few of the diseases associated with flooding carry an extra risk from dead bodies.
A greater risk of epidemics comes from pathogens such West Nile virus, which is highly already prevalent in the US, and would potentially thrive in the conditions left behind by Katrina.
On top of this are the often-ignored effects of stress caused by the displacement and chaos brought on by a major disaster.
"After an incident like this people get run down, their immune systems are compromised, they get gastric and respiratory infections, and particularly old people can go into a terminal decline," said Professor Sandy Cairncross of the London School of Hygiene and Tropical Medicine.
"A large number of the elderly people who have been bussed out of New Orleans after this storm will die of pneumonia in the coming year, but that won't get counted in the official disaster statistics," he said.
There are also significant mental health issues to be considered following an event on the scale of Hurricane Katrina. A 1998 paper in the New England Journal of Medicine found that suicide rates increase markedly following natural disasters.
In normal times, 11 people out of every 100,000 in the US commit suicide each year, but the researchers found that flooding leads to a 14% increase in the suicide rate and hurricanes to a 19% increase.
Much of this depression is caused by the stress of having to rebuild shattered lives - an aspect often shied away from by governments in their impact assessments.
Professor Cairncross says it is essential the problem is seriously addressed by politicians.
"In the Netherlands, flood insurance is provided by the public, not the private sector," he said. "The federal government in America, having skimped on the flood defences around New Orleans, should be helping people to rebuild."
The following is a summary of the principle health risks faced in Katrina's wake:
DYSENTERY
How do you get infected?
Most of the microbes that cause dysentery can be passed on via contaminated water. The most common bacterial infections are caused by E coli, shigella, and salmonella. Floodwaters can be tainted with faecal matter from overflowing sewers, and the microbes can be present in food exposed to infected water even after it is dried.
What does it do to you?
Dysentery describes any form of diarrhoea with blood in it. Infections can be relatively benign but often cause fevers, cramps, nausea and vomiting. Dehydration is a serious risk as sufferers often have difficulty holding down water.
How is it cured?
Antibiotics are effective in tackling most forms of dysentery. Sometimes injections are needed if a patient is vomiting antibiotic pills.
What is the level of risk?
High. Despite evacuation efforts, many people still remain in hurricane-effected areas where hygiene is poor. Overcrowding in relief centres can also result in poor hygiene, and the microbes causing dysentery are more common in the US than those linked with more severe gastric upsets.
WEST NILE VIRUS
How do you get infected?
A bite from an infected mosquito. The disease is often spread by birds, which can carry the virus in their bloodstreams and are bitten by mosquitoes.
What does it do to you?
Most people experience no symptoms at all, but one in five people develop fever that in rare cases can develop into a more severe disease attacking the brain and spinal cord.
How is it cured?
There is no vaccine, and treatment can only mediate the symptoms of the disease.
What is the level of risk?
High. West Nile virus is already a serious risk in the summer months in the US, and flooding increases the risk of mosquitoes breeding.
HEPATITIS
How do you get infected?
Ingesting viruses of the picornaviridae family, which can get into floodwaters in the same way as diarrhoea microbes, via contaminated sewage.
What does it do to you?
The disease attacks the liver and causes jaundice, fever and nausea.
How is it cured?
There is a vaccine, but if you have not received it the only treatment is rest and the avoidance of fatty foods and alcohol which could upset the liver.
What is the level of risk?
Medium to low. The disease is more commonly passed on through the handling of food by infected people, and there has not been a serious outbreak of waterborne Hepatitis A in the US since the 1980s.
WEIL'S DISEASE
How do you get infected?Exposure to water, soil or vegetation contaminated by rat urine containing the leptospirosis bacterium. Even skin contact is enough to cause infection. What does it do to you?
In most cases, the infection results in flu-like symptoms, fever and jaundice. In more severe cases it can lead to liver and kidney damage, meningitis and death.
How is it cured?
Antibiotics should be given as soon after the infection as possible.
What is the level of risk?
Medium to low. The bacterium can only survive in fresh water, and most of the flooding along the US Gulf coast involves saltwater from coastal lakes and lagoons.
TYPHOID
How do you get infected?
By ingesting infected water and food products.
What does it do to you?
A very high fever, stomach pains, and skin rashes which can last up to a month and that lead to death in up to 30% of cases.
How is it cured?
A course of antibiotics brings the fever under control within a matter of days.
What is the level of risk?
Low. The disease needs to be prevalent in the local area to cause an epidemic, and typhoid is very rare in the US.
CHOLERA:
How do you get infected?
Drinking water or eating food contaminated with the vibrio cholerae bacterium, which gets into the water via infected faecal matter.
What does it do to you?
Symptoms are often mild, but in severe cases the disease can lead to acute diarrhoea and vomiting so serious that dehydration can lead to death within a matter of hours.
How is it cured?
The simplest treatment is to drink plenty of water and rehydration salts. The disease typically runs its course within a matter of days, though in severe cases a saline drip may be needed to replace body fluids. Antibiotics can shorten the attack.
What is the level of risk?
Extremely low. Like typhoid, cholera is extremely rare in the US and is unlikely to cause an epidemic.
http://www.guardian.co.uk/katrina/story/0,16441,1563222,00.html
Although the organism, Vibrio vulnificus, is in the family of bacteria that cause cholera, no cholera cases have been found among people who survived Hurricane Katrina, CDC spokesman Van Roebuck said.
"There's a lot of self-diagnosis going on," he said.
When open wounds are exposed to warm sea water, skin infections result that can lead to skin breakdown and ulceration, the CDC said.
People whose immune systems are compromised, including transplant ecipients and people infected with the AIDS virus, are at greater risk of dying from bloodstream infections the bacterium can cause, according to the agency.
A Vibrio vulnificus infection is diagnosed via routine stool, wound or blood cultures, and it is treated with antibiotics such as doxycycline or ceftazidime. After recovery, the CDC said there are no long-term consequences.
Another problem rescuers have found is that people with chronic conditions such as diabetes and heart problems have worsened because they have
gone without their medications for several days, Roebuck said.