9 September 2005                                      Printable (pdf) version

Hurricane Katrina: Advice for Relief Workers

Hurricane Katrina hit coastal areas of the states of Mississippi, Louisiana and Alabama in the USA on 29 August 2005. The resulting devastation through wind damage and flooding has resulted in thousands of displaced people and many deaths and missing persons. Those planning to visit these areas, such as relief workers, should be aware of possible hazards and increased risk of injury and illnesses.

Food and water advice

Unsanitary living conditions, damage to sewage systems, flooding and limited supplies of clean drinking water, may increase the risk of diarrhoeal illnesses. Reliable sources of bottled water may not be available and water purification may be necessary. Cases of diarrhoeal illness have been reported in Mississippi [1].

Self-treatment for diarrhoeal illness can be carried by relief workers. This should include oral rehydration treatment, an anti-motility agent such as loperamide and a treatment course of ciprofloxacin (500mg twice daily for up to three days), in the absence of contraindications. Individuals with diarrhoea that is associated with fever or blood should seek prompt medical evaluation. Personal hygiene, including frequent hand-washing, is essential.

Vector-Borne diseases

Due to flooding and areas of standing water, there is the risk for outbreaks of endemic mosquito borne diseases such as West Nile Virus and St Louis encephalitis. Although this type of outbreak has not been typical of other similar events that have occurred in the USA, mosquito bite avoidance is recommended.

Vaccination advice

All travellers should be up-to-date with their routine immunisations, e.g. MMR.

In addition, the following should be considered:

Tetanus: Tetanus is transmitted via wound contamination with the bacterium Clostridium tetani. A booster is recommended if not received within the past 10 years. In the UK, when a tetanus booster is recommended the trivalent tetanus, diphtheria and polio vaccine, is the vaccine of choice.

Hepatitis B: Hepatitis B is transmitted by contact with bodily fluids or blood. Those involved with patient care or contact with bodily fluids should be vaccinated.

Hepatitis A: Although the USA has not identified transmission of hepatitis A during other natural disasters of flooding or hurricanes since the 1980’s, this vaccine may be considered for those travelling in affected areas, particularly areas with flooding.

The risk of typhoid, meningococcal meningitis, and cholera are considered to be low and currently routine vaccination is not necessary.

Rabies: Those exposed to potentially rabid animals should seek urgent post exposure prophylaxis vaccination.

Other health risks

The risk of injury after a natural disaster is high. Hazards such as downed power lines, structural damage to buildings and roads, and interruptions to basic services all pose a risk.

Particular care should be taken if wading in flood waters to reduce the chance of injury and secondary infections of any cuts in the skin with bacteria such as Vibrio vulnificus. The risk of leptospirosis should also be considered. Toxic industrial chemicals and hazardous waste may have been released during the devastation and are also a concern. Ongoing guidance for this risk is available [2], and guidance for protective clothing to be worn during flood cleanup has been published by the US National Institute for Occupational Safety and Health [3].

Snakes displaced from their natural environment may be encountered and should be avoided. If bitten seek medical attention urgently.

High temperatures in these areas may pose additional risks such as heat exhaustion and sunburn [4].

Risk from dead bodies

The infectious disease risk from handling dead bodies is low [5, 6]. Workers should be psychologically prepared to work in such difficult situations. Support from fellow workers and family may be helpful.

General advice

The British Consulate in Houston, Texas is providing a 24 hour telephone service for those concerned about friends and relatives: Tel No: +1 713-659-6275. The Foreign and Commonwealth Office can also be contacted on 020 7008 0000.

Persons planning to visit affected areas should regularly consult the Foreign and Commonwealth Office for up-to-date security and safety advice.

Before volunteering services or donating goods, interested persons should contact either:

Hurricane Katrina Volunteer Call Center: +1 866 528-6334; https://volunteer.hhs.gov

The Federal Emergency Management Agency (FEMA): +1 800 440-6728; www.usafreedomcorps.gov/   

References

1.Gastroenteritis, hurricane-related - USA (Mississippi). ProMed-mail [online resource]. 5 Sept 2005. www.promedmail.org/pls/askus/f?p=2400:1001:109917069159

14494990::NO::F2400_P1001_BACK_PAGE,F2400_P1001_

PUB_MAIL_ID:1000,30303.

2. US Environmental Protection Agency. Hurricane Katrina Response [online resource].

3. National Institute for Occupational Safety and Health. NIOSH interim guidance on personal protective equipment and clothing for flood response workers. [online resource]. http://www.cdc.gov/niosh/topics/flood/ppe-flood.html

4. US Centers for Disease Control and Prevention. Extreme Heat. [online resource]. http://www.bt.cdc.gov/disasters/extremeheat

5. Pan American Health Organization. Management of Dead Bodies in Disaster Situations. 2004. http://www.paho.org/English/dd/ped/ManejoCadaveres.htm

6. Healing TD, Hoffman PN, Young SEJ. The infection hazard of human cadavers. CDR Review. 5:1-16, 1995. http://www.hpa.org.uk/cdr/archives/CDRreview/1995/cdrr0595.pdf

Links

Centers for Disease Control and Prevention. Hurricane Katrina Health Information. http://www.bt.cdc.gov/disasters/hurricanes/katrina.asp