From the CDC Director’s Emergency Operations Center - P.M. Update, September 26, 2005

Top Line - Public Health

CDC professionals quickly respond to Hurricane Rita as Hurricane Katrina response operations continue.

Infectious disease outbreak surveillance has intensified as the population of evacuation centers increased. Upper respiratory infections are being reported.

Residents and response workers are at high risk from injuries including falls, electrical hazards and traffic incidents.

CDC Public Health Workforce Deployed in Affected Communities:

• Total: 99 for Hurricane Katrina (128: 9/23) and 42 for Hurricane Rita: including the following specialties: public health nursing, occupational, laboratory, medical, epidemiology, sanitation, environmental health, disease surveillance, public information and health risk communication

• Preparing to Deploy: 17

• Supporting Hurricane Katrina Director’s EOC Response: @ 352 (as of 9/16)

• Federal Katrina Response Update (9/25):
  • Evacuation Centers: 80,000+ evacuees in 814 shelters nationwide
  • Disaster Registrations: 1.4 million
  • Expedited Assistance: $1.9 billion to 670,000 households
  • Housing Damage Inspections Completed: 153,726
  • National Flood Insurance Program: $128 million in advance payments to policy holders.
  • National Disaster Medical System (NDMS) has treated nearly 49,000 persons.
  • To date, CDC has deployed 426 professionals to support Hurricane Katrina recovery operations.

CDC Public Health Analysis:

Evacuation Centers: The number of people in evacuation centers has increased and CDC will continue to conduct rapid needs assessments and support intense infectious disease outbreak surveillance. Upper respiratory infections and scabies have been detected among some persons staying in evacuation centers, and public health measures are being employed. Any disease clusters will be quickly investigated to reduce the potential for disease. No culture-confirmed cases of influenza have been detected.

New Orleans Safe Return: The Greater New Orleans Public Health Support Team (GNOPHST) is made up of local, state, and federal agencies, including CDC. The GNOPHST’s mission includes providing acute public health services during rescue and reconstruction and rebuilding the public health system for the return of residents. Critical issues involve worker safety, environmental health, health surveillance, mental health, and injury prevention.

In addition, CDC’s environmental health experts are providing guidance to prevent the possibility of illnesses when building water systems are restarted in affected areas. CDC’s NIOSH has provided interim guidance for the cleaning and restarting of water drinking systems and HVAC systems.

CDC is concerned about residents and workers being injured in activities related to the return and recovery process. CDC has created simple safety posters on preventing falls, chainsaw injuries, electrical hazards, and safe driving in places where traffic lights may not be functioning. New Orleans officials are anticipating the return of residents to Algiers early this week.

Arkansas: Arkansas is poised to receive additional evacuees from Hurricane Rita. Aircraft and buses from Texas brought 337 relocated Katrina evacuees to Ft. Chaffee Tuesday and Wednesday. Space was readied for several thousand more, should that be necessary. The National Medical Disaster System was activated in Arkansas and medical patients were being received as of Thursday. On Thursday an estimated 2,381Katrina evacuees were still in 56 evacuation centers in Arkansas. Several thousand were processed through Fort Chaffee to various locations in Arkansas on September 3-4. CDC deployed 13 people to support surveillance, nursing and emergency operations related to the evacuee population. In addition, Arkansas responded to an EMAC request from Texas and dispatched 16 advanced life support ambulances and 34 EMT/EMT-P personnel.

Louisiana: Thirty-five (17%) of Louisiana hospitals remain closed. In anticipation of landfall by Hurricane Rita in southwest Louisiana, all primary care hospital patients were evacuated (except two critical patients in separate hospitals) and residents in 35 nursing homes there were also evacuated. In Baton Rouge, CDC epidemiologists are assessing the conditions of pet shelter locations adjacent to evacuation centers.

Mississippi: CDC vector control experts left Mississippi late last week because many of the local mosquito control districts are now resuming normal activity levels and are meeting community mosquito control services needed because of Hurricane Katrina.

Public Health Recommendations: Pass it on

During flooding, systems for heating, ventilating, and air conditioning (HVAC) can become submerged in flood waters. As a result, these systems may contain substantial amounts of dirt and debris and may also become contaminated with various types of microorganisms such as bacteria and fungi. If the HVAC systems are not cleaned and disinfected properly, these microorganisms can cause building occupants to have a variety of health effects such as itchy eyes, runny nose, sneezing, and difficulty in breathing. Exposures to microorganisms have been documented to cause allergic respiratory diseases in agricultural, biotechnology, office, and home environments.

The following interim recommendations will help ensure that HVAC systems contaminated with flood water are properly cleaned and remediated to provide healthy indoor environments.
www.cdc.gov/niosh/topics/flood/Cleaning-Flood-HVAC.html

Legionnaires Disease
Legionellosis is an infection caused by the bacterium Legionella pneumophila. The disease has two distinct forms:

• Legionnaires' disease, the more severe form of infection which includes pneumonia, and

• Pontiac fever, a milder illness.

Legionnaires’ disease (LEE-juh-nares) is caused by a type of bacteria called Legionella. The Legionella bacteria are found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems, or parts of the air-conditioning systems of large buildings. They do not seem to grow in car or window air-conditioners. People get Legionnaires' disease when they breathe in a mist or vapor (small droplets of water in the air) that has been contaminated with the bacteria. One example might be from breathing in the steam from a whirlpool spa that has not been properly cleaned and disinfected.

The bacteria are NOT spread from one person to another person. Outbreaks occur when two or more people become ill in the same place at about the same time, such as patients in hospitals. Hospital buildings have complex water systems, and many people in hospitals already have illnesses that increase their risk for Legionella infection.

A milder infection caused by the same type of Legionella bacteria is called Pontiac Fever. The symptoms of Pontiac Fever usually last for 2 to 5 days and may also include fever, headaches, and muscle aches; however, there is no pneumonia. Symptoms go away on their own without treatment and without causing further problems.

Legionnaires' disease can be very serious and can cause death in up to 5% to 30% of cases. Most cases can be treated successfully with antibiotics [drugs that kill bacteria in the body], and healthy people usually recover from infection.
www.cdc.gov/ncidod/dbmd/diseaseinfo/legionellosis_g.htm

Where to Find Out More About:

Complete information on the full range of accelerated benefits available from HHS for hurricane victims is available at www.hhs.gov/katrina.

CDC Grants: Find information about the treatment of grants under emergency conditions due to Hurricane Rita
www.bt.cdc.gov/disasters/hurricanes/pdf/grantuse-rita.pdf

Chemicals: Protect Yourself by Taking These Steps

• If you suspect someone has been poisoned by a chemical, call 911 or the national poison control center at 1-800-222-1222.

• If you suspect that a pet has been poisoned by a chemical, call the Animal Poison Control Center toll-free at 1 -888-426-4435.

• Report oil and chemical spills to the local authorities or to the U.S. Environmental Protection Agency (EPA) National Response Center at 1-800-424-8802.

DHHS Helplines: Mental health 1 800-273-TALK (1 800-273-8255); Head Start services 1 866-763-6481; Medicare 1 800-MEICARE (1 800-633-4227); and Elder Care 1 800-677-1116.

Free Health Education Information: The CDC has produced free information in many languages on topics such as hand washing, returning to your home, protecting yourself from carbon monoxide poisoning and from mold.. A comprehensive index of available resources can be found at: www.bt.cdc.gov/disasters/hurricanes/printindex.asp.

A number of free Public Service Announcements produced by both CDC and HHS are available at: www.bt.cdc.gov/disasters/hurricanes/psa.asp

CDC Foundation Emergency Preparedness and Response Fund: The CDC Foundation has activated its Emergency Preparedness and Response Fund and is seeking donations. Contributions can be made online at www.cdcfoundation.org or by calling 1-888-880-4CDC.

The next CDC DEOC Hurricane Katrina update will be Monday , Sept. 28, 2005

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