From the CDC Director’s Emergency Operations Center - P.M. Update, October 7, 2005

Important Note: This is the last Hurricane Response Update, published by the Emergency Communications System/National Center for Health Marketing and the Office of Enterprise Communication. After today, CDC Connects will feature regular updates on CDC hurricane response, as well as talking points, and features on CDC staff involved in the response. Many thanks to all who contributed to the updates!

Motor vehicle crashes are increasing as more residents and workers return to New Orleans neighborhoods. CDC urges residents and workers to slow down, wear seat belts, and treat all intersections as 4-way stops.

To prevent health problems from mold, throw out anything in a hurricane-damaged home that can’t be completely cleaned and dried. Even dead mold can cause allergic reactions in some people. When in doubt, throw it out!

It’s still mosquito season in many hurricane-affected states. Fight the bite! Use screens on dwellings; wear long pants, socks, and long-sleeved shirts; and use repellents that contain DEET or Picaridin. To stop mosquitoes from multiplying, drain all standing water in open containers, such as flower pots, tires, pet dishes, or buckets.

CDC Public Health Workforce Deployed in Affected Communities:

• Total: 146 for Hurricane Katrina (128: 10/4) and 43 for Hurricane Rita (62: 10/4): including the following specialties: veterinarians, public health nursing, occupational health, laboratory, medical, epidemiology, sanitation, environmental health, disease surveillance, public information, and health risk communication

• Preparing to Deploy: 30 for Hurricane Katrina-related missions and 0 for Hurricane Rita-related missions

• Supporting Hurricane Katrina Director’s EOC Response: about 644 cumulative (as of 10/7)

Deaths from Hurricanes Katrina/Rita:
In states affected by Hurricanes Katrina and Rita and states housing displaced persons, 1,253 deaths were reported as of October 5. Deaths were reported by states directly affected by the hurricane and those housing evacuees. Two deaths related to Hurricanes Katrina and Rita, both in Georgia, were reported in the past 24 hours.

CDC Public Health Analysis:

Louisiana: Concerns as New Orleans Residents Return
A number of public health issues are looming as residents return to New Orleans, where health care services aren’t yet widely available, sewer and water services aren’t 100%, and structural inspections aren’t complete.

Residents have requested a mobile health facility and a health assessment to address their concerns about the Murphy oil spill, mold contamination, and the possible long-term health effects related to mold, chemical exposures.

The Red Cross requests information on acceptable water use, treatment for mold and rashes, and other public health concerns. They report residents returning to New Orleans to find their homes inhabitable because of mold, or that they’ve been evicted. Many residents don’t have their own transportation and there may be a shortage of shelter space for those who can’t live in their homes during cleanup.

Rebuilding Louisiana PH Lab Capacity:
The CDC Lab Team is working with state and local laboratory officials to determine how to rebuild LA public health laboratory capacity. Newborn screening activities continue; team members are contacting labor and delivery units and hospital labs to address issues related to those tests.

Lab Team members are also identifying private labs in the area that can test for reportable diseases and will determine the appropriate way to submit specimens in coordination with the regional laboratory in Shreveport.

Occupational Health Surveillance:
The CDC Occupational Health Team will conduct a cross-sectional prevalence study of injuries, illness, and occupational stress among New Orleans police officers. The team also presented information on mold hazards and remediation to city business leaders and will consult with local landlords on mold remediation.

Illness Surveillance:
Between 9/8 and 10/4, the most common diagnoses in reporting hospitals and clinics were injuries (26.2%) and acute respiratory illness (8.7%). As of 10.4, falls continued to be the major causes of injuries (26.2%), but motor vehicle crash-related injuries (25.9%) moved ahead of cutting/piercing and blunt trauma as the second leading cause of injuries. This is likely to be related to continued repopulation of New Orleans and missing or nonfunctioning traffic signs, signals.

To date, there is no evidence of rabies infection associated with animal bites in Louisiana. However, it’s unclear if that is due to lack of documentation on human immunoglobulin or vaccine given.

Cases of “shelter cough” continue to be reported from Louisiana shelters. A small spike in conjunctivitis was noted in reports from across Louisiana, perhaps a seasonal effect as children return to school.

Medications available for people with TB and HIV:
People with TB in need of medications can contact the Jefferson Parish Health Unit in Metairie. HIV-infected persons whose medications are provided by the ADAP program can receive those medications at any public hospital in Louisiana.

Environmental Update:
People are urged to avoid contact with water from Lake Pontchartrain after tests of water samples showed elevated E. coli levels, indicating a threat to human health.

Preliminary analysis of sediment collected in New Orleans shows evidence that some chemicals exceed recommended long-term screening levels. The levels are not expected to cause adverse health effects from shorter exposures.

FEMA has requested help in deciding the type of environmental sampling to conduct to determine potential health effects of placing temporary housing (trailers) on property formerly used to grow rice, cotton, pecans.

Public Health Recommendations: Pass it On

Motor Vehicle Safety:
Be extra careful when driving in hurricane-affected areas. The usual traffic signs may be missing and traffic lights may not work. It helps to drive more slowly than usual and to keep extra space between you and other drives. Stop and look both ways at all intersections. Wear your seatbelt and be sure children are also belted in. Watch for trash on the road. Never drink and drive.
www.bt.cdc.gov/disasters/hurricanes/injury.asp

Preventing Health Effects Related to Mold:
Many residents returning to their homes after Hurricanes Katrina and Rita may face health effects as a result of mold caused by standing water. Returning residents should clean and dry out their homes as quickly as possible, ideally within 24 to 48 hours. Open doors and windows and use fans to speed the drying out. A few tips to remember:

• When in doubt, take it out! Remove all porous items that have been wet for more than 48 hours and that cannot be thoroughly cleaned and dried. Removal and cleaning are important because even dead mold may cause allergic reactions in some people.

• Porous, noncleanable items include carpeting and carpet padding, upholstery, wallpaper, drywall, floor and ceiling tiles, insulation material, some clothing, leather, paper, wood, and food.

• To remove mold growth from hard surfaces use commercial products, soap and water, or a bleach solution of 1 cup bleach in 1 gallon of water. Use a stiff brush on rough surface materials such as concrete.
  www.bt.cdc.gov/disasters/mold/protect.asp

Protect the Health of Children in Shelter Play Areas:
Children who have vomiting, diarrhea, fever, cough, or draining skin sores should stay away from common play areas until a pediatrician has indicated it’s safe for them to return. All children and parents should wash their hands with soap and water, or clean hands with antiseptic gel before joining or leaving common play area. Toys in play areas should have smooth solid services that can be easily cleaned and disinfected. Clean and disinfect toys at least 3 times a day and whenever they are soiled with body fluids.
www.bt.cdc.gov/disasters/hurricanes/katrina/shelterplayareas.asp

Where to Find Out More about:

CDC has developed a variety of health and safety messages for English and non-English-speaking persons affected by Hurricanes Katrina and Rita or involved in response and recovery. For reader-friendly information about hurricane readiness, preventing chain saw injuries, reentering your flooded home, and tips for preventing heat-related illness: www.bt.cdc.gov/disasters/hurricanes/printindex.asp

CDC has compiled updated contact information for state TB control programs, to assist hurricane-affected states and states sheltering evacuees in finding and assisting persons having tuberculosis:
www.cdc.gov/nchstp/tb/katrina/tbcontrollers.htm

The Substance Abuse and Mental Health Services Administration has published self-care tips for responders and disaster relief workers:
www.mentalhealth.samhsa.gov/publications/allpubs/KEN-01-0098/

Figure: Carbon monoxide (CO) poisonings and deaths continue to be concerns after Hurricanes Katrina and Rita. The figure below documents CO poisoning cases in states affected by Hurricane Katrina through late September.

Click for larger image

(Source: MMWR, volume 54, no. 30, pg. 997. (PDF)