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September 07, 2005

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The boring recitation of the few known facts doesn't begin to paint the picture of medical needs, but there's no dramatic outbreak of Black Plague or Andromeda strain.

What's going on is routine medical needs on a grand scale.

The other piece, which is not well covered here, is the evacuation of the 9 NOLA hospitals to other places. Once the patients are elsewhere, that's presumably routine as well. The story there, I suppose, is keeping track of where they are.

from Effect Measure on the reports of E Coli in the water.

Some E. coli is a problem, but most isn't. If it were, we'd all be dead, since the organism constitutes about 4% of our normal gut flora. True, there are some special strains that carry genetic sequences that either make toxins or confer the ability to invade the gut wall, but for the most part the significance of the presence of "coliform organisms" is that they signal the potential contamination of water or food with the feces of warmblooded animals and hence with other pathogens. E. coli is thus an "indicator organism." Moreover, what is often called "E. coli" is not even that, but rather a whole group of organisms that are easily tested for ("total coliforms" or "fecal coliforms" being the most common). These organisms are commonly and normally found in storm runoff. They are killed by primary disinfection in a water treatment plant, so their appearance in a drinking water supply is evidence that something has gone amiss, usually resulting in a "boil water order" until it can be corrected. This is just by way of making clear things that are anything but clear from news reports.

Er, hate to be picky, but I think the hepatitis these people are at risk of contracting is Hep A, not C. C is thought to be spread through direct contact with infectious bodily fluids (e.g. IV drug abuse), and is possibly transmitted through sexual contact. Hep A is fecal-oral, and is the most likely of the hepatidities to affect the victims of Katrina.

All 3 of them have been mentioned, according to various news reports, though news reports are often wrong.

Hep B is the worry. I will correct.

Required immunizations: Tetanus and diphtheria toxoid (receipt of primary series, and Td booster within 10 years)



Hepatitis B vaccine series for persons who will be performing direct patient care or otherwise expected to have contact with bodily fluids
There is no indication for the following vaccines given the anticipated conditions in the region:
hepatitis A vaccine (low probability of exposure, even under these conditions, in U.S. ) No transmission from contaminated water has been identified in the U.S. since the 1980's. Hepatitis A outbreaks have not occurred following other hurricanes or floods in other parts of the country, including the devastating hurricanes in Florida last year, and the Midwestern floods of the late 1990's. The Gulf Region has had few hepatitis A cases in recent years, with less than 10 in the past 3 months reported from the New Orleans area. Thus, even though the water and sewage systems are damaged or out of operation in many areas along the Gulf Coast , the risk of a hepatitis A epidemic is extremely low. Vaccine will take at least one to two weeks to provide substantial immunity.


typhoid vaccine (low probability of exposure, even under these conditions, in U.S. ).


cholera vaccine (low probability of exposure, even under these conditions, in U.S. , plus no licensed cholera vaccine available in the U.S. ).


meningococcal vaccine (no expectation of increased risk of meningococcal disease among emergency responders).


rabies vaccine series (the full series is required for protection). Persons who are exposed to potentially rabid animals should be evaluated and receive standard post-exposure prophylaxis, as clinically appropriate.


There is no mention of hep C by the CDC.

I think health awareness is a key area where about every thing which related to health care are visible progress has been made in modern time.

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