Health officials focus on infectious diseases

Four reported dead from infections

crowding, floodwaters seen as threat

Katrina's Wake

September 07, 2005|By Jonathan D. Rockoff | Jonathan D. Rockoff,SUN NATIONAL STAFF

WASHINGTON - As evacuees received medical aid in shelters across the South yesterday, federal health authorities said they were investigating four deaths from infections, as well as reports of tuberculosis and intestinal diseases among those displaced by Hurricane Katrina.

But officials expressed more concern about common colds and less exotic ailments flourishing in the crowded, makeshift relief centers.

Julie Gerberding, director of the federal Centers for Disease Control and Prevention, said she would not be surprised to see outbreaks of digestive tract diseases, such as the noroviruses that sicken cruise ship passengers.

"What we are concerned about are the things that could more likely persist in water in this society. That would include E. coli, diarrhea and potentially some other infectious diseases," she said at a news conference.

The four deaths appear to have been caused by Vibrio vulnificus, a germ common in warm Gulf Coast waters that is usually spread by eating contaminated food but can also penetrate open wounds.

CDC officials attributed the deaths - one victim was a hurricane victim evacuated to Texas, and the other three were in Mississippi -to wound infections.

Although Gerberding said it was too early to tell whether those reports signal widespread problems, some doctors and scientists fear that residents who have stayed in New Orleans - and many who were evacuated after several days in the flooded city - might have been infected by dangerous bacteria.

This is about the time that severe diarrhea, skin infections and other symptoms of infectious disease should begin appearing, experts said yesterday.

`Mind-boggling' array

"The spectrum of infectious diseases that we could see is mind-boggling," said Dr. Trish M. Perl, an infectious-disease expert and epidemiologist at the Johns Hopkins University School of Medicine.

Hurricanes and their aftermath don't usually prompt serious public health concerns, partly because cholera, typhoid and other dangerous diseases aren't common in the United States, so the organisms that carry them aren't widely available to infect the flood zone.

Federal health authorities have largely dismissed the danger from such deadly outbreaks on the flooded Gulf Coast, and they emphasize that they have epidemiologists on the scene to monitor the situation.

"I think we're much more concerned about the common illnesses that any crowded condition can promote," Geberding said, referring to the spread of colds, the flu and perhaps tuberculosis in crowded shelters.

Some experts are speculating that the waters covering much of New Orleans present a serious, continuing threat, however, because their mixture of sewage, rotting food and possibly toxic chemicals has had days to provide a fertile breeding ground for dangerous microorganisms.

Mosquitoes, which transmit a variety of deadly and debilitating diseases, also flourish in the stagnant water. Some doctors and scientists worry about outbreaks of West Nile virus, dengue fever or malaria.

Underlying their concerns are the unprecedented scale of the devastation on the Gulf Coast and the slowness of the initial emergency response.

"If they can't get the people out, you can imagine what they're not doing with the health hygiene," said Dr. S. Michael Phillips, an immunologist and professor of medicine at the University of Pennsylvania.

Experts fear that New Orleans residents stranded for days might have contracted diseases by drinking contaminated water, eating with dirty hands or using unsanitary toilets.

Residents also could have been infected through cuts and open wounds. And those returning to homes and buildings to inspect damage could come into contact with bacteria, mold and parasites, public health officials said.

Though they aren't more likely than others to contract diseases, children, the elderly and the infirm would have a tougher time combating infections.

CDC officials said there won't be an accurate assessment of the health hazards until the most recent reports of disease outbreaks have been investigated. Similarly, the Environmental Protection Agency must complete testing of the waters before assessing the danger.

Precautions urged

Health experts urged storm victims and relief workers yesterday to drink bottled water, wash their hands regularly and flush toilets after use. They said relief workers should wear protective gear while wading in floodwaters and shower afterward.

Federal health officials say those steps are being taken and that they are arranging medical care for anyone contracting an illness.

Robert Edelman, an expert on infectious diseases at the University of Maryland School of Medicine, said he doubted Katrina would present a major public health threat, especially regarding diseases such as cholera and typhoid.

He said the nearly completed evacuation of New Orleans residents removes them from exposure to dangerous microorganisms.

For that reason, however, he worries about residents who haven't left. "Those people are running a risk," he said.

The Associated Press contributed to this article.

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