Illness in floods

Today, scores of households in New Orleans in the United States are still struggling to recover from the ravages of Hurricane Isaac just a few weeks ago. The city, pounded by Katrina seven years earlier, strengthened its defences, a development that worked efficiently for the majority, but left a minority suffering from flooding so severe it even covered roofs.

A large part of the problem the city faced with Isaac was that the storm literally sat overhead for almost 48 hours — so while it was not nearly as strong as Katrina, the relentless rain was just too much for some.

The lesson here for us in Barbados is that while we may prepare our homes to stand up to the massive winds of a category five hurricane, depending on where we live severe flooding may be inevitable — and we may be able to do little about it other than to simply flee.

It was not so long ago that some residents of Wotton in Christ Church found themselves marooned in their own home by flooding that resulted from heavy overnight rainfall. As a result the nation saw many photos of neighbours, up to their necks in flood waters trying to be their “brother’s keeper”.

But before we jump headlong into flood water in a country where just about every home has a well accepting sewage, which, if the district is flooded must also be flooded, what should we know about the possible dangers contained in that water?

Here’s an extract from the World Health Organisation on the subject: Floods can potentially increase the transmission of the following communicable diseases:

* Water-borne diseases, such as typhoid fever, cholera, leptospirosis and hepatitis A

* Vector-borne diseases, such as malaria, dengue and dengue haemorrhagic fever, yellow fever, and West Nile Fever.

Flooding is associated with an increased risk of infection, however this risk is low unless there is significant population displacement and/or water sources are compromised…

There is an increased risk of infection of water-borne diseases contracted through direct contact with polluted waters, such as wound infections, dermatitis, conjunctivitis, and ear, nose and throat infections. However, these diseases are not epidemic-prone.

The only epidemic-prone infection which can be transmitted directly from contaminated water is leptospirosis, a zoonotic bacterial disease. Transmission occurs through contact of the skin and mucous membranes with water, damp soil or vegetation (such as sugarcane) or mud contaminated with rodent urine. The occurrence of flooding after heavy rainfall facilitates the spread of the organism due to the proliferation of rodents which shed large amounts of leptospires in their urine.

Vector-borne diseases

Floods may indirectly lead to an increase in vector-borne diseases through the expansion in the number and range of vector habitats. Standing water caused by heavy rainfall or overflow of rivers (and wells) can act as breeding sites for mosquitoes, and therefore enhance the potential for exposure of the disaster-affected population and emergency workers to infections such as dengue, malaria and West Nile fever. Flooding may initially flush out mosquito breeding, but it comes back when the waters recede. The lag time is usually around six to eight weeks before the onset of a malaria epidemic.

Malaria epidemics in the wake of flooding are a well-known phenomenon in malaria-endemic areas world-wide. (This does not include Barbados)…

The risk of outbreaks is greatly increased by complicating factors, such as changes in human behaviour (increased exposure to mosquitoes while sleeping outside, a temporary pause in disease control activities, overcrowding), or changes in the habitat which promote mosquito breeding.

Other health risks posed by flooding

These include drowning and injuries or trauma. Tetanus is not common after injury from flooding, and mass tetanus vaccination programmes are not indicated. However, tetanus boosters may be indicated for previously vaccinated people who sustain open wounds or for other injured people depending on their tetanus immunisation history.

Hypothermia may also be a problem, particularly in children, if trapped in floodwaters for lengthy periods. There may also be an increased risk of respiratory tract infections due to exposure (loss of shelter, exposure to flood waters and rain).

Power cuts related to floods may disrupt water treatment and supply plants thereby increasing the risk of water-borne diseases, but may also affect proper functioning of health facilities.

So, we admonish you to be cautious before you take the plunge — even as we encourage you to always be neighbourly.

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