Aside from the billions of dollars’ worth of damage caused by hurricane Irma, flood waters pose various threats of infectious diseases. According to reports filed with Florida’s Department of Environmental Protection, it is estimated that more than 28 million gallons of treated and untreated sewage spilled across the state.

After Irma (The New York Times)

This can cause a number of infectious diseases which can be acquired in various ways.

1. E. coli bacteria

These are a large and diverse group which are found in the environment, people, animals, and food. Some strains of the bacteria cause intestinal infections. You can get infected by drinking contaminated water or from swimming in it. Symptoms include cramping, gas, nausea, fever, and dehydration. Five to ten percent can develop hemolytic uremic syndrome, a life threatening condition which can lead to kidney failure.

E. coli (CDC.gov)

In most instances, home care is all that is needed to treat this infection. Drink lots of water, get plenty of rest, and monitor for more severe symptoms that require you to see a doctor. Uncomplicated cases can be treated with a 3-day course of TMP/SMZ or fluoroquinolone. More complex cases are treated with third-generation cephalosporins.
2. Cryptosporidium

These are microscopic parasites that is most commonly spread through drinking water and recreational water. It is a leading cause of waterborne infections in the United States. Community-wide outbreaks have been linked to drinking municipal water contaminated with Cryptosporidium. Symptoms include watery diarrhea, nausea, vomiting, and dehydration.

Cryptosporidium (CDC.gov)

People with healthy immune system will recover with proper hydration. People with poor immune system are treated with anti-parasitic drugs such as nitazoxanide.

3. Giardia

This is a microscopic parasite that causes diarrhea. People can get infected by drinking contaminated water. It is the most commonly diagnosed intestinal parasitic disease in the United States and among travelers.

Giardia – By Dr. Stan Erlandsen (1988) – Public Health Image Library (PHIL) — image #11632,

Treatment includes metronidazole, tinidazole, or nitazoxanide. Avoid infection and spread by washing hands before handling food and using bottled water where water supply is likely to be unsafe.
4. Leptospira

Another infection that can be acquired from floodwaters is leptospirosis. Bacteria is spread through urine of infected animals such as cattle, pigs, horses, dogs, rodents, and wild animals which can get into floodwaters. Humans can get the disease through contact with water infected with urine of infected animals. Outbreaks can occur by exposure to contaminated floodwaters.

Leptospira (By CDC/ Rob Weyant [Public domain], via Wikimedia Commons)

5. Invasive fungal infections

After a major disaster, wound contamination with organic matter can lead to skin and soft tissue fungal infections especially on the feet. Fungal foot infections such as athlete’s foot and atopic dermatitis are very common.

Athlete’s Foot By Wes Washington (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

6. Staphylococcus aureus

Staph and MRSA can cause a variety of skin infections as well as bloodstream infections. Often, it causes sores, boils, and more serious skin infections. Although MRSA has only been around since 1961, staphylococcus has developed a gene mutation that makes it resistant to methicillin, thus needing more expensive and stronger intravenous medications. A deadly complication is deep infection called necrotizing fasciitis which can lead to “flesh-eating” infection.

7. Clostridium tetani

This is the bacteria responsible for the fatal disease tetanus. To avoid infection during flood cleanup, wear hard-heeled shoes, heavy work gloves, and protective clothing. Take care of any wounds by washing with soap and water and seeing your doctor if you need a tetanus shot.

Clostridium tetani By Content Providers(s): CDC [Public domain], via Wikimedia Commons

8. Trench foot

This is a condition caused by prolonged exposure of the feet to unsanitary and damp conditions. Feet may become red or become blue due to poor blood supply. The feet may also become numb and may begin to swell. If a person has open sores or blisters, the foot can develop tropical ulcer or jungle rot and can lead to gangrene.

Trench foot By Mehmet Karatay (Own work) (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons

This poses a rare but potentially deadly risk to people with open wounds. Although these organisms live in the ocean, floods can sweep them into urban areas. Any scape or wound that has been exposed to floodwaters should be monitored for redness. Any change in the appearance of the skin should be a cause of concern since vibrio infection can progress to a point of no return in less than 24 hours.

Vibrio By CDC/ Janice Haney Carr (phil.cdc.gov (search for “Vibrio Vulnificus”)) [Public domain], via Wikimedia Commons

With proper treatment, prognosis is excellent.

People with open wounds should be extra careful. Avoid exposure to flood waters, keep open wounds clean by washing with soap and water. Seek medical treatment if the wound develops swelling, redness, or drainage.

Call (239) 430-3668 or visit NaplesPodiatrist.com for more information.

After a death in Everglades City, rising concerns of a public health crisis
(Naples Daily News)

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