Valley anticipates spread of health crisis

J. Craig Anderson

Thursday, Sept. 8, 2005 | 8:50 a.m.

The Las Vegas Valley will inherit a growing share of the widespread public health crisis caused by Hurricane Katrina as hundreds of hurricane survivors and rescue workers from the Gulf Coast begin pouring into the area.

The most immediate task will be screening and medicating those with chronic illnesses who have been denied proper medication throughout the disaster, which has now passed the 10-day mark.

A lesser risk -- but still very real -- is that evacuees infected with communicable diseases could spread them to local family members and others with whom they share close quarters.

"This is a public health emergency," said Dr. Mary Guinan, dean of the UNLV School of Public Health, adding that she is confident county health officials can handle the situation.

Guinan said the biggest health risk to survivors of the hurricane's immediate effects is among those who suffer from chronic illnesses such as cancer, heart disease, diabetes and lung disease.

"They have no access to their medications -- they have no access to their doctor," she said. "Some of these people were dying of asthma."

What will make matters worse for Las Vegas-area health officials attempting to treat ailing survivors is that many, particularly the elderly, often don't know what pills they are supposed to be taking, Guinan said.

Clark County government officials opened a hurricane survivor "assessment center" Wednesday and began offering services from the American Red Cross, the state Mental Health Division, United Way of Southern Nevada, Catholic Charities and other organizations.

County officials said they referred some of the more than 350 evacuees to various medical facilities for health screening.

No indications of diseases or infections that could threaten public health were found, officials said.

Floodwaters in New Orleans contain levels of bacteria found in sewage that are at least 10 times higher than acceptable safety limits, endangering rescue workers and remaining residents who even walk in it, federal officials said during a teleconference Wednesday.

Hurricane survivors traveling to Las Vegas -- either on their own or as part of an organized evacuation effort -- also could be afflicted with a host of illnesses from drinking contaminated water, including Hepatitis A, Norwalk virus, salmonella and cholera.

"There's just a whole lot of things you can get from contaminated water, because it's sewage," Guinan said.

In a teleconference Wednesday, Stephen L. Johnson, Environmental Protection Agency administrator, said contact with the floodwater "should be avoided as much as possible."

Elevated levels of brain-damaging lead, a risk if people, particularly children, were found in the floodwater.

The Centers for Disease Control and Prevention in Atlanta said that four people have died from a diarrhea-causing virus after they were evacuated to Houston's Astrodome. The deaths appear to have been caused by Vibrio vunificus, a virus common to the warm Gulf Coast waters. The virus is usually spread by eating contaminated food, but it can invade open wounds, too, CDC spokesman Tom Skinner said during the teleconference.

Still, Clark County Health District senior epidemiologist Brian Labus said the most serious illnesses spread among Katrina's survivors are more likely the result of human-to-human contact in enclosed spaces packed with thousands of people for prolonged periods without access to clean water.

People in tight quarters, such as they were in the Louisiana Superdome, could have acted as disease incubators, allowing the spread of more severe illnesses such as tuberculosis.

Labus said the county and its medical partners, including University Medical Center, expect to encounter a wide variety of health conditions.

"It's the whole range, from things that spread to things that don't, from the very minor to the very serious," he said.

George Ann Rice, the Clark County School District's associate superintendent of human resources, said Wednesday she consulted with Dr. Donald Kwalick, Clark County's chief health officer, to find out whether the School District should expand its infectious disease requirements for teachers coming from hurricane-affected areas. The only requirement currently for school employees is that they be tested for tuberculosis.

Kwalick "strongly advised" that teachers displaced by the hurricane also be immunized against hepatitis A and hepatitis B, Rice said.

"We're planning to follow his advice and require those shots," Rice said.

Kwalick offered to send out a team from his staff to administer the immunizations if it turns out that the School District hires a large number of teachers from the affected region, Rice said.

Nevada requires children to be vaccinated for Hepatitis A, while Louisiana, Mississippi and Alabama do not require the shots, he said.

But any children enrolling in school here are required to get such immunizations, Labus said.