Outbreaks of Some Diseases Among Hurricane Katrina Survivors Unlikely, CDC Says

No disease epidemics have materialized thus far at shelters for Hurricane Katrina evacuees, and CDC officials say an outbreak of diseases such as cholera or typhoid is highly unlikely, the Chicago Tribune reports.

Medical experts say their main concerns are potential outbreaks of gastrointestinal diseases and flu-like illnesses among evacuees living in close quarters. Doctors have reported some clusters of diarrhea cases, in addition to skin rashes and infected wounds, stemming from the lack of clean water, clean food and sanitation, according to Janis Tupesis, emergency medicine professor at the University of Chicago. He added that cases of diarrhea and vomiting are appearing mostly in elderly or young evacuees (Peres/Janega, Chicago Tribune, 9/9).

A survey of Mississippi shelters this week found no unexpected illnesses and "surprisingly few" incidents of gastrointestinal disease, despite the lack of running water and sewage service. In addition, lab tests in the area have shown that a diarrheal illness feared to be dysentery at one shelter instead was caused by the Norwalk virus (McCullough/Krieger, Knight Ridder/Philadelphia Inquirer, 9/9).

Tupesis said most health problems that emerged in the first week after the hurricane had to do with "the basic infrastructure breaking down -- the lack of access to medications and electricity." She added, "Now what we're starting to see are diseases of large groups of people in the same place. We're seeing upper respiratory infections, pneumonias. There's a concern about tuberculosis."

Mosquito-borne illnesses, including encephalitis and West Nile virus, also present potential health problems. CDC is urging people traveling to the Gulf Coast to receive inoculations against tetanus, diphtheria and hepatitis B. Additionally, those who come in contact with floodwater should scrub with soap and water, public health officials said (Peres/Janega, Chicago Tribune, 9/9).

CDC, which has established a command center at Kindred Hospital in New Orleans, on Friday plans to dispatch medical teams to functioning area hospitals to "determine what diseases are appearing in the wake of the hurricane," the Wall Street Journal reports.

Meanwhile, the Journal reports that the "mass evacuation in the Gulf region has produced a troubling medical mess for thousands across the country."

Evacuated patients are seeking to continue medical treatments or receive diagnoses, many without medical charts because "[y]ears of medical histories have been lost" in hurricane damage, according to the Journal. In addition, the "displacement of doctors is creating a major medical crisis," the Journal reports.

Toni Brayer, an internal medicine specialist from San Francisco volunteering at a Baton Rouge, La., Red Cross shelter, said the medical confusion highlights the need for a national clearinghouse for doctors and patients. "All the New Orleans doctors are displaced, and there's no coordinating body to connect them with their patients," Brayer said.

Meanwhile, Walgreen and other pharmacies have been providing prescription drugs to some evacuees. Walgreen is providing drugs at no cost to evacuees who cannot obtain a Red Cross voucher or prove Medicaid enrollment. In addition, some pharmacists are dispensing medication to patients after "listening to them describe the shape and color of their medications -- or even just their symptoms -- to determine what they were taking," the Journal reports.

Walgreen officials say they hope to be reimbursed by drug companies, but the majority have not yet made a commitment. Philip Burgess, Walgreen's national director of pharmacy affairs, said, "We do have some significant dollars that are at risk based on the (assumption) that manufacturers will reimburse us" (Adamy et al., Wall Street Journal, 9/9).

Thousands of drug abusers and alcoholics have been displaced by the hurricane, some of whom have never been in treatment programs and others who have lost access to their recovery programs, the Tribune reports. Doctors, counselors and treatment centers nationwide are volunteering supplies, services and offering residential treatment programs at no cost to evacuees and are holding 12-step meetings at area shelters.

According to Charles Curie, head of the Substance Abuse and Mental Health Services Administration, the federal government has allocated $600,000 to help pay for treatment for evacuees with substance abuse problems, and more funds likely will be available in the future. He also noted that traumatic events can spur drug and alcohol use. "We can anticipate ... spikes in abuse after an event like this," Curie said (Keilman, Chicago Tribune, 9/9).

The New York Times on Friday profiled Norman McSwain, chief of trauma surgery at New Orleans' Charity Hospital, who became one of Hurricane Katrina's "reluctant celebrities."

McSwain, who was trapped at the public hospital with about 1,000 staff members and 250 patients for five days in flooded conditions, said there was never a plan to evacuate the hospital, and as the situation worsened, it became more difficult to contact authorities who could help. McSwain "finally despaired of official channels and cried out to the news media" for help, the Times reports.

In a phone call to reporters from the Associated Press and USA Today, McSwain described the deteriorating conditions at Charity -- employees and patients faced low supplies of water, food, electricity and oxygen, as well as looters firing guns at rescue workers -- and said, "We have been trying to call the mayor's office. We have been trying to call the governor's office. We are turning to you. Please help us."

Ultimately, he appealed to executives of HCA Healthcare -- which operates Tulane University Hospital, across the street from Charity -- and they offered Charity the use of 20 helicopters that HCA had hired to evacuate its own patients and staff (McNeil, New York Times, 9/9).

• NBC's "Nightly News": The segment reports on the medical response to Hurricane Katrina in the Gulf states (Bazell, "Nightly News," NBC, 9/8). The complete segment is available online in Windows Media.
  


• PBS' "NewsHour with Jim Lehrer": The segment reports on how the Pete Maravich Assembly Center at Louisiana State University is coping with an influx of patients (Dentzer, "NewsHour with Jim Lehrer," PBS, 9/8). The complete segment is available online in RealPlayer.
  


• "Ask the White House": U.S. Surgeon General Richard Carmona is scheduled to answer questions about medical and health issues related to Hurricane Katrina on Friday at 10 a.m. A transcript of the chat will be available online.