Exotic diseases unlikely health threats

Health experts say the big danger facing people in the aftermath of the Gulf Coast hurricane has little to do with pathogens from dead bodies or exotic infectious diseases.

Serious public health problems are expected to emerge as the floodwaters recede, but they may stem from more banal sources than the grisly images of disaster suggest: lost medical records, outbreaks of everyday bacteria and difficulties managing chronic diseases such as diabetes and blood disorders.

Frightening scenarios of a Third World-style cholera epidemic seem less plausible than might be imagined, even though strains of the microbe can be found in the warm waters of the Gulf Coast, according to infectious-disease specialists such as Dr. Warren Levinson, a professor of microbiology at the University of California-San Francisco.

"I hesitate to mention cholera -- it's such a scare word," he said. "There is at least a possibility of cholera there. But I think it's probably unlikely."

Cholera, a diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae, is relatively rare in the United States. It usually spreads through drinking water contaminated with human waste, or occasionally from eating undercooked seafood harboring the cholera bacterium.

But it doesn't move directly from one person to another so it's considered a manageable risk for the disaster zone. Symptoms in most cases are mild, becoming life-threatening only in about one case in every 20.

By contrast, common bugs such as shigella, salmonella and campylobacter, which account for large numbers of bacterial diarrhea cases in the United States, can spread havoc through a population subjected to extended homelessness, crowded conditions and high levels of stress, which can lower immune defenses. But even then, controlling infectious diseases should be straightforward if authorities can provide adequate water and hand-washing facilities.

"Clean drinking water shouldn't be that big of a problem in a developed country like the United States," said Dr. Eric Weiss, an assistant professor of emergency medicine at Stanford University Medical Center. "This is not like places in Africa where water is always rare and something you have to struggle for. We should be able to get fresh drinking water to these individuals in a timely fashion."

One concern, medical experts said, is the displaced may have lost access to their medical providers, as well as their records and medical supplies including insulin, blood thinners or high-blood-pressure pills.

People with chronic conditions could face severe consequences in a hurry if their routine medical care and drug regimens are interrupted. The incidence of diabetes, for example, is particularly high in the Southeast.

Medical crews will be confronting "people with all kinds of chronic medical disorders, who have been going to a particular pharmacy, and all of a sudden their records are gone, and their ability to contact their physician is gone," said James Karboski, a clinical associate professor of pharmacy at the University of Texas in Austin. "Many of those people are just a few days away from being out of medications they rely upon."