Long Term Health Threats From Hurricane Harvey

Texas Governor Greg Abbott has issued a warning that floodwaters from Hurricane Harvey would remain a health hazard for several weeks.

Gov. Abbott said "although the rains have stopped, the expertise of Texas physicians, nurses and pharmacists will be called upon as people begin to return their homes and rebuild their lives."

"People need to understand this is not going to be a short-term project. This is going to be a multi-year project for Texas to be able to dig out of this catastrophe," Abbott said on "GMA".

Based on the health problems people in New Orleans faced after Hurricane Katrina in 2005, experts expect major public-health emergencies, environmental illnesses, and virus outbreaks in the aftermath of Harvey.

Hurricane Harvey has created several health questions from residents of the Houston, Texas area, such as:

1.  Can I get a bacterial infection from the floodwaters?

Yes. Health officials expect an increase in gastrointestinal problems from bacteria breeding in stagnant floodwaters that can contain Escherichia coli (E. coli), Shigella, and Vibrio vulnificus.

In a report issued one month after Hurricane Katrina in 2005, the Centers for Disease Control and Prevention (CDC) said it had counted 24 cases of hurricane-related wounds infected with Vibrio vulnificus and Vibrio parahaemolyticus, of which six were fatal.

2. Can you catch cholera from the floodwaters?

Probably not. The Houston sanitary system was not breached. Which means bacteria have not been released into the drinking water. But, officials have also warned residents who rely on small municipal water systems of potential contamination, and have urged them to boil their water.

Cholera is an extremely virulent disease that can cause severe acute watery diarrhoea. It takes between 12 hours and 5 days for a person to show symptoms after ingesting contaminated food or water.

Most of those infected with cholera will have no or mild symptoms, and can be successfully treated with oral rehydration solution.

Safe oral cholera vaccines should be used in conjunction with improvements in water and sanitation to control cholera outbreaks and for prevention in areas known to be high risk for cholera.

3.  What about water quality from private water wells?

Hundreds of thousands of Houston-area residents rely on private wells that may have been breached. Health officials recommend If flood water goes into your well, you should have the water tested. 

The EPA is conducting damage assessments of both drinking water and wastewater systems to identify impacts to critical assets and assist in the recovery.

And, if you have any doubts, the EPA strongly suggests boiling your water before consumption.

4.  Can I get HIV from the flood water?

No, flood waters do not convey HIV. HIV isn’t spread through flood water. Additionally, there is no risk of HIV transmission from scratches because no body fluids are transferred between people, which is how HIV is passed.

5.  What about other diseases such as West Nile?

The greatest health risk, according to the WHO, “comes from population displacement. If people are crowded in shelters with insufficient sanitation, that could create the conditions for disease to spread.”

In 2005, a study found in the wake of Hurricane Katrina, there was initially no increase in cases of West Nile virus, which is spread by mosquitoes. But, after Hurricane Katrina, 200,000 refugees ended up in 750 shelters in 18 states, and there were scattered outbreaks of various diseases.

​A 2008 study found there were no significant or lasting increases in mortality rates in the greater New Orleans area following Hurricane Katrina.​

6.  Should I worry about catching the Zika virus?

The timing of Harvey is a major consideration for Zika. Texas has been on alert for the Zika virus this summer, and have reported one local transmission, but several travel-related Zika cases.

Texas has several weeks left in its summer season and virus spreading mosquitoes could certainly reappear before the fall weather arrives.

If mosquitoes do return in September, “those will be nuisance mosquitoes,” says Chris Van Deusen, a spokesman for the Texas DSHS,  “However there is certainly a potential that we could see disease vectors in increasing numbers.”

With the ongoing threat of Zika, the Texas Department of State Health Services has updated its advice to test pregnant women three times during pregnancy, rather than two times.

7.  Will Harvey impact Houston’s mental Health?

Yes, according to research in 2015, mental health issues are actually the most predictable and durable of health problems that follow floods. The stress of flooding triggers post-traumatic stress disorder, even for people with well-managed illnesses, floods often mean a disruption in therapy and prescriptions.

This is important because acute stress-related response, if not addressed properly, can evolve to more severe disorders such as PTSD and depression. Therefore, information about PTSD symptomatology, depression, and risk of suicide should be routinely assessed.  

8.  Do I need a Tetanus booster?

Both the Centers for Disease Control and Prevention and the Occupational Health and Safety Administration recommend that anyone involved in flood cleanups ensure that their tetanus vaccination status is up to date, every ten years. Tetanus is uncommon in the United States, with an average of 30 reported cases each year.

Nearly all cases of tetanus are among people who have never received a tetanus vaccine. The disease is particularly common and serious in newborn babies and their mothers, when the mothers are unprotected from tetanus by the vaccine.

9. Will the air quality in Houston be tested?

Yes, the Houston Health Department air-inspection teams will begin on Tuesday to monitor air quality around the city’s petroleum and chemical manufacturers, targeting roughly 100 of the largest locations.

The EPA said Sunday that 70% of air-monitoring equipment that had been shut down ahead of the storm in the Houston area, Corpus Christi and Beaumont is back up and running. The remaining equipment should be operating by next week.  

To find additional Hurricane Havery information related health issues and emergency resources, various pharmacy associations have compiled easy to use listings:

• Texas
• National