Disastrous floodwaters from Hurricane Harvey have left Houston residents at risk of chronic diseases and infections.
The storm has already forced thousands to be homeless with dirty water soaking through drywall, carpeting, mattresses and furniture across the area.
And the massive cleanup challenge ahead for the cities will pose short and long-term health problems.
The water has likely dredged up sewage, chemicals and waterborne germs that will put anyone in contact at risk for intestinal issues, wound infections and the West Nile virus.
Health and Human Secretary Dr Tom Price declared a public health emergency in the state of Texas on Sunday due to the extreme hazards from the hurricane.
But now hospitals and shelters are scrambling across the area to protect people from the many diseases the storm could cause.
A family in Houston, Texas, waited to be rescued from their flooded home on Monday. The flood waters can contain chemicals and sewage water, which could cause infection
One health concern is the mold left behind in homes that were flooded from Hurricane Harvey. Families like this one, who were waiting to be rescued in Houston, will have to be careful when they are cleaning up their home because the mold that is left behind
Water-borne infections and diseases
While the rain might be clean, what it dredges up from the sewers and around the area is not.
Floodwater can contain harmful sewage, chemicals and waterborne germs that can cause infections and diseases for people.
Risk of diseases such as cholera, typhoid and yellow fever is a huge risk in developing countries.
But none of these diseases are common in Texas, so it is unlikely that anyone will get one.
People in Texas could get viruses from ingesting the water or food that has been in contact with the floodwater, which would cause symptoms such as diarrhea and vomiting.
At a shelter set up inside Houston’s George R. Brown Convention Center, Dr. David Persse is building a clinic of doctors and nurses and trying to prevent the spread of viruses or having to send people to hospitals already stretched thin.
‘This is rapidly evolving,’ said Persse, Houston Director of Emergency Medical Services. ‘I always worry in these large congregations of people about viral outbreaks that cause nausea, vomiting and diarrhea. And we are just getting started.’
Hurricane Katrina also taught officials lessons.
‘In Katrina, a lot of people were concerned about illnesses from contact with the floodwater, but more infectious disease was associated with poor hygiene in overcrowded shelter facilities,’ said Karen Levy, associate professor of environmental health at Emory University in Atlanta.
At Houston-area shelters, access to clean water or hand sanitizer and proper disposal of human waste should be stressed, she said.
Objects that have been submerged in water can also cause infection if touched or used after.
The Centers for Disease Control and Prevention recommends parents to throw out toys for children that were in the rain water unless they are thoroughly cleaned.
Wound infections
Floodwater can be dangerous for people with open wounds, particularly if they have other health conditions.
Wounds can easily occur from a sharp object hidden in the water and could get infected if not treated.
Harmful bacteria in the water will require some people to need stronger antibiotics than usual to treat infections.
After Hurricane Katrina, five people with infected wounds died and health officials believe that exposure to brackish floodwater contributed to the deaths.
Tetanus is also a concern for people that got cut on glass or debris in the hurricane.
Officials are recommending everyone to get a tetanus shot just in case to ensure they are protected from the disease.
People with open wounds need to take special care to keep them clean and wrapped away from any of the dirty water.
Mosquito infections
After the hurricane ceases, there will be pools of warm and stagnant water left behind forming the perfect breeding ground for mosquitoes.
Zika and West Nile were some of the diseases that increased after Hurricane Katrina in areas of Louisiana and Mississippi.
People will need to consistently use insect repellent to prevent mosquitoes from causing a infecting them.
Poor people are of highest concern for contracting Zika or West Nile because most don’t have air conditioning or window screens.
This puts them at a higher risk for getting one of the diseases.
Volunteers with the American Red Cross register evacuees at George R. Brown Convention Center in Houston. The center is trying to prevent the spread of viruses between evacuees
Mold and cleanup concerns
The most common flood-related deaths occur when people try to drive through flooded areas, according to the CDC.
Carbon monoxide may kill more as people return to homes without electricity and hook up generators, said the CDC’s Renee Funk.
‘Any sort of roof over a generator is actually a problem,’ Funk said. ‘When people go in and out to refill the generator they can be overcome. If a structure is attached to the house, the house can fill with fumes.
Best advice: Use a battery-operated carbon monoxide detector in the house if you’re using a generator for power, she said.
Mold is also a health hazard.
The CDC recommends removing and disposing of drywall and insulation that was tainted by floodwater or sewage.
Mattresses, pillows, carpeting – even stuffed toys – should be tossed out. Hard surfaces can be disinfected with a solution of one cup of bleach to five gallons of water.
‘That little spot of mold can grow in the home especially in the heat of the South,’ said Dr. Parham Jaberi of the Louisiana Department of Health.
If mold covers more than 100 square feet, a trained mold remover is recommended, he said.
Mental health concerns
Katrina left a wake of post-traumatic stress disorder and depression, said Dr. Pierre Buekens, dean of Tulane University’s School of Public Health and Tropical Medicine.
He said their surveys showed roughly 10 percent had PTSD, but also that people were resilient.
‘I’m sure this will happen in Houston,’ he said.
People who have strong bonds with friends and family tend to recover easier from PTSD after a natural disaster because they have a support system.
Counseling is recommended for people with lingering mental illness concerns after the natural disaster.