Post-Trauma Stress From Floods Possible

Infectious diseases from overflowing sewage and animal wastes are not expected to be a major public health problem in the aftermath of the West Coast flooding so long as flood victims take simple precautions to sterilize water and keep themselves clean, authorities say.

Studies of past floods, such as the massive Iowa flooding of July 1993, show no significant increases in disease during the cleanup, and officials expect a similar outcome here.

But they do foresee a rash of wrenched muscles from handling sandbags and puncture wounds from stepping on submerged objects during the cleanup. “My gut feeling is that we are going to see much more trauma than infectious disease,” said Dr. Paul Stehr-Green, Washington state epidemiologist.

Clinics and hospitals are gearing up to provide tetanus shots to anyone who needs them.

In the longer term, physicians also expect to see an increase in mental health problems. “Our big problem [after the 1993 flood] was in the area of post-traumatic stress,” said Kevin Teale, communications director for the Iowa Department of Public Health.

Calls to a statewide counseling hotline increased by 50% in the months after that flood, Teale said, and admissions to substance-abuse treatment centers climbed about 20%.

Serious plagues such as typhoid and cholera are not a potential problem, according to Kay Golden of the Centers for Disease Prevention and Control, because the agents that cause them aren’t around to be spread by flood waters.

Instead, officials worry about organisms such as salmonella, cryptosporidium, shigella, campylobacter and giardia, which are present in sewage. But, “you need a high degree of concentrated exposure [to be infected] and dilution by the flood waters really reduces the risk,” said Dr. Kevin Reilly of the California Department of Health Services.

What little is left in the water can easily be killed with bleach, and officials recommend that everything touched by flood waters be washed with a bleach solution.

Pesticides and other agricultural chemicals “are also not a major concern” because they are diluted by flood waters, Reilly said. The only exceptions might be a pesticide manufacturing or storage facility where unusually large quantities are present, “but I am not aware of any such facility at risk,” he said.

Mosquito breeding in standing water is another risk after a flood. Iowa suffered a 100% increase in mosquito-borne encephalitis after the flood there, Teale said--from six known cases per year to 12.

That should not be a problem here, according to Reilly, because the breeding season for mosquitoes that carry such diseases does not begin until April, and virtually all of the water should be gone by then.

Other potential problems include disposal of toxic chemicals from water-soaked businesses; asbestos particles released into the air when rotted pipes dry up; and allergies flaring up from mold that grows in damp basement walls and other objects that can’t be thoroughly dried.

It is difficult to predict the extent of mental health problems from stress, experts agreed. Such stresses may have been greater than usual in Iowa because the July flood destroyed crops too late in the year for a second planting to take place--creating severe financial problems. That is not the case in the West Coast flooding.

But, added Teale, “Our psychiatrists say that flood is the worst disaster to have. Tornadoes, fires, even hurricanes, they’re over with quickly, you clean up and get on with it. Flood waters stick around much longer, so there is more anxiety.”