Misinformation from those who should know better is also occurring in the aftermath of hurricane Katrina. DHHS Secretary Leavitt, for example, has warned of the risk of "typhoid and cholera" as a result of contaminated water, while others have talked generally of mosquito-borne disease and the hazards caused by dead people and animals. It is time to separate the real risks from the phantom risks.
Diarrheal disease from contaminated water is a concern, but not cholera and probably not typhoid. In order to get these diseases the water has to be contaminated with the organisms that cause those diseases, neither of which is endemic in that region. What is more likely is gastroenteritis or hepatitis A from enteric viruses or bacteria.[...]
Similarly the presence of dead animals and people is not a health hazard. Dead animals decompose naturally in the environment. Unless they were infected with a contagious organism before death, they will not themselves become the source of disease. The persistent concern in mass disasters over unburied bodies is an urban myth. Mass disasters like floods rarely cause epidemic disease and to suggest otherwise results in misplaced concern and potential diversion of resources from more important issues.
Mosquito-borne illness is a potential concern for some, but needs to be properly understood. Being bitten by mosquitoes is not a health hazard. The mosquitoes themselves must be vectors for a pathogenic agent like malaria or West Nile.[...]
The biggest health hazards may well be those we would classify under "injury." Heat-related illness might be at the top of the list here. As body core temperatures rise above 105 degrees F., mortality increases quickly. The high heat and humidity of the area, coupled with dehydration are a significant health hazard that requires intervention by providing fluids and cooler shelters. The many sources of physical injury, whether from feral animals (snakes, alligators, etc.), sharp metal debris, falls and injuries in an environment where the hazards are numerous and not easily visible can result in substantial accumulated morbidity and even mortality. The only remedy is removal of people to a safer environment, which should be the top priority. this is also true for the many chronically ill and vulnerable people who require medication, external support from power dependent devices and supervision. [edited for typos]
Hard to disagree with the conclusions of DemFromCT at Next Hurrah:
Leavitt needs to stay the hell away from a camera and microphone. Risk communication is a huge need right now. The CDC should have an available spokesperson to debunk fears about dead bodies causing or spreading disease. But the triage and evacuation of the ill from dehydration or existing medical conditions is the story here, followed by exposure, dehydration and other 'battlefield' situations like injuries, and not infectious diseases.
Just to be clear -- it's not that there are no increased risks to diseases like cholera nor that there's absolutely no risk from dead bodies floating about. It's a matter of putting risks in perspective and public health priorities for where immediate attention should be directed. Even if the government can't get in to affected areas to provide assistance, at least they should be providing accurate information so that people can better help themselves. It would also be nice if the media, instead of spreading titillating specters of future horror, could take its responsibilities seriously and start correcting these sorts of potentially fatal but widely shared misapprehensions.
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