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Wednesday, September 7, 2005 - Page updated at 12:00 AM

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Diseases feared in disaster's aftermath

Seattle Times medical reporter

Dirty water, contaminated food, crowded conditions, mosquitoes and searing Southern heat all will invite disease and infection among Hurricane Katrina survivors, say local disease experts watching the catastrophe.

But they predict that serious medical problems from germs won't affect as many people as some might imagine. Environmental specialists are still assessing whether chemical and petroleum factories could have leached toxic chemicals into floodwaters.

"I think there will be a general increase in the usual illnesses we see [from germs]. ... But I wouldn't expect big outbreaks of disease," said Dr. Jeff Duchin, director of communicable-disease control for Public Health — Seattle & King County. "In other disaster situations in this country we haven't seen them."

Nine days after Hurricane Katrina hit, many people along the Gulf Coast still may not have easy access to clean drinking water. Floodwater still fills many parts of New Orleans and other cities.

Drinking contaminated water is a significant concern for increased illness, with diarrhea a common result, Duchin and others said. Viruses and bacteria invade the gut, causing days of diarrhea, and dehydration can result.

Similarly, improper food handling leads to intestinal-tract infections such as salmonella and shigella, said Duchin and Dr. Danielle Zerr, an infectious-disease specialist at Children's Hospital & Regional Medical Center.

Scattered reports of diarrheal illness have come from New Orleans and the Gulf Coast. But they have been contained. It was unclear whether the illnesses spread in the shelters or the people arrived with them, Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, said yesterday.

"They're likely to be identified quickly and managed aggressively," Duchin said.

Infections also can set in when people with scrapes and cuts wade through dirty floodwater. An inability to keep even minor wounds clean can lead to more serious problems with infections such as staphylococcal and streptococcal bacteria.

On the other hand, Duchin said, diseases such as cholera and typhoid are uncommon in the U.S. and are unlikely to emerge in the post-hurricane devastation.

Still, with people crowded into shelters such as the Astrodome in Houston, respiratory problems, such as colds and flulike illnesses, have a better chance of spreading. Whooping cough, a serious threat for babies, also could spread among the unimmunized, though most people have had childhood shots and are protected, the experts said.

The Gulf Coast heat is also a problem. Temperatures reach the low 90s and drop only to the high 70s at night. Heat stroke from extensive exposure to the sun can lead to seizures and life-threatening conditions.

That same heat turns stagnant water into breeding pools for mosquitoes, which could spread the West Nile virus. Even before the hurricane, Louisiana has had 52 cases of West Nile this year, ranking it third in the U.S. for the disease.

People with chronic diseases such as asthma, diabetes, heart disease and hypertension are at increased risk. "The stress will exacerbate lots of physical conditions," Duchin said.

Children, the elderly and people with suppressed immune systems also are in more danger.

"The things that everybody is at risk for are more pronounced in children," said Zerr, of Children's Hospital. "They suffer more. ... They're just more vulnerable."

Material from the Associated Press was used in this report.

Warren King: 206-464-2247 or wking@seattletimes.com

Copyright © 2005 The Seattle Times Company

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