Scary Prognosis:Jim Diaz, MD, PhD and professor of public health for the Department of Environmental & Occupational Health at Louisiana State University Health Sciences Center in New Orleans, provided the following assessment of the current state and near future for the health of people along the Gulf Coast:
Vibrio cholerae is not endemic in Louisiana, but more pathogenic non-cholera Vibrios are, and they have already killed and will continue to do so.
I have been [back] to New Orleans, and there are no mosquitoes now; all larvae were killed by floating petrochemicals. The ARBOR diseases [Arthropod-borne viruses, i.e., arboviruses, are viruses that are maintained in nature through biological transmission between susceptible vertebrate hosts by blood feeding arthropods (mosquitoes, psychodids, ceratopogonids, and ticks). ] will return soon, principally West Nile virus — worse than in Mississippi — and spraying will be required later when the floodwaters recede.
Current mild diarrheal diseases are viral and secondary to poor sanitation and endemic RNA enteric viruses. More serious dysenteric disease outbreaks could follow among those who are not evacuating flooded areas and who are consuming contaminated food and water. Dysenteric diseases should not be a problem in well-run shelters.
Baton Rouge will probably have a hepatitis A outbreak in 4-6 weeks, but there are inadequate stocks of vaccine to respond to an outbreak.
As we enter flu season, viral upper respiratory infections will become a problem among the elderly in shelters and may result in community acquired pneumonias.
Since many TB-positive homeless persons and ex-prisoners may have been sheltered with the elderly, infants and the immunosuppressed, TB could be transmitted to these susceptible populations. Reactivation of non-MDR TB in the elderly is usually more of a problem, especially among older immigrants from countries where TB is endemic (Viet Nam, Mexico, etc.) and primary infections were acquired during childhood. The elderly often baby-sit infants, who are highly susceptible to TB.
TB should not be as much of a problem as viral URIs and secondary pneumonias.