STORY BYAs evacuees from Katrina swell the population of Houston, rumors continue to circulate about potential outbreaks of cholera, typhoid and dysentery.
So what’s the real story?
Doctors are treating patients in Houston shelters primarily for gastrointestinal problems, such as vomiting and diarrhea, caused by stress and contaminated water and food. About 700 evacuees have been treated for the norovirus, or Norwalk virus, often seen on cruise ships. The disease isn’t pleasant, but rarely deadly.
Cases of diarrhea seem to be decreasing in shelters, due to better infection control and more sanitary living conditions, according to the Centers for Disease Control and Prevention (CDC). Three weeks after the hurricane, infectious disease experts don’t anticipate widespread outbreaks of rare life-threatening viruses.
“There has been the rare case of cholera along the Louisiana coast (in the past), but it is just that, it is rare,” says Dr. Charles Ericsson, professor of internal medicine at The University of Texas Medical School at Houston and an expert in infectious disease. “Unless it is imported into our country, it is highly unlikely that we will have an outbreak.”
Public health officials are concerned about
health
risks caused by pests
in the areas
affected by
Hurricane
Katrina.
Mosquitoes can spread West Nile and other
viruses such as St. Louis Encephalitis. New
Orleans began spraying last week. People
returning to the area can further protect
themselves by continually applying repellant
that contains DEET.
Rodents, or water contaminated with the urine
of
rodents, can spread the bacteria that cause
leptospirosis. The disease causes no symptoms
in some people, but can be deadly in
others.
Leptospirosis is not spread from person to
person. For more information about these
diseases, visit http://www.bt.cdc.gov/
disasters/hurricanes/infectiousdisease.asp.
But public worry persists. An e-mail that’s circulating warns people against going to Houston on business: “There will be an epidemic of Hepatitis A and Typhoid of epidemic proportions,” says the author. His brother-in-law who works for the government told him so. Then, there are the news reports speculating on diseases that evacuees could be carrying from wading in the “toxic soup,” that floods New Orleans.
The truth?
The floodwater in New Orleans is definitely dangerous to drink or wade in, and may contain the deadly Vibrio bacteria. As of September 15, 22 people in the area affected by Hurricane Katrina have illnesses from infections caused by bacteria in the Vibrio family. Five have died. Infection is caused by direct contact with contaminated water and is not contagious.
The water also contains high levels of E. coli, but not the life-threatening strain, according to samples taken by the Environmental Protection Agency.
And while evacuees are being routinely vaccinated for Hepatitis A, the risk for contracting the disease is low among the general public. So low that the CDC did not recommend that volunteers who work closely with evacuees get vaccinated.
“The CDC recommended Hepatitis A vaccinations because of the crowding among evacuees,” says Dr. Luis Ostrosky, assistant professor of internal medicine at the UT Medical School specializing in infectious diseases. “Hepatitis A isn’t really an epidemic issue in our country.”
An outbreak of typhoid is also unlikely, according to the CDC.
“Because cholera and typhoid are not commonly found in the U.S. Gulf States area, it is very unlikely that they would occur after Hurricane Katrina,” states the CDC in bold letters on its Katrina fact sheet.
We can thank Houston’s medical community for preventing and containing viral outbreaks. Doctors and public health officials working in the shelters closely monitor patients for symptoms of infectious disease. Then, patients with symptoms are isolated until they no longer are contagious, and the case is reported to the CDC.
Ostrosky treated patients in the UT clinic at the George R. Brown Convention Center for the last two weeks. The majority of patients he saw needed help for chronic illnesses or new prescriptions, not rare infectious diseases.
As time goes by and more people leave large crowded shelters for other living arrangements, the risk of viral disease outbreaks will continue to decrease.
“Anytime you have a lot of people in a close environment, you can see outbreaks. The goal is to try to relocate people in big shelters ASAP and then to close those shelters,” Ostrosky says. “The way that the medical establishment has responded is really remarkable. We had a working clinic with x-rays, labs with rapid turnaround times and medicine within 24 hours of opening a shelter.”
He encourages Houstonians not to let fear of disease prevent them from helping evacuees.
“(Evacuees) have the normal diseases that people in the southern United States have, the same that we have in Houston,” Ostrosky says. “Any kind of outbreak is going to be promptly detected and isolated. At this time, there’s no real danger in helping these people. They are going to need our help for a long time to come.
UPDATED: 09-19-2005
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Dr. Charles D. Ericsson is professor and clinical director of infectious diseases at the UT Medical School.
See Dr. Ericsson also at:
Dr. Luis Ostrosky-Zeichner is an assistant professor in the Division of Infectious Diseases at the UT Medical School.
See Dr. Ostrosky also at:
Add fiber to your diet... slowly
Dietary fiber is versatile and talented. It assists in discouraging a long list of woes: constipation, hemorrhoids, heart disease, diabetes, bad cholesterol and certain cancers.
Foods such as apples, berries, oranges, beans, broccoli, bran, multigrain breads and cereals should be added slowly into your diet, followed by an increase in fluid intake. Eventually you want to work up to 4 ½ cups of high fiber foods a day.
Otherwise, you might find yourself feeling more bloated, gassy or experiencing stomach cramps.So, add one high-fiber food at a time about a week apart. Increase your water intake (which includes unsweetened teas, diet sodas, juice) to eight glasses a day to help the fiber move through your system.
