Health concerns after disasters

March 1, 2005
Natural disasters are very much in the news these days. Recent events began with the hurricanes that struck the southeast United States last fall, followed by the tsunami in Asia in December, and more recently the Midwest flooding and the mudslides in California.

Natural disasters are very much in the news these days. Recent events began with the hurricanes that struck the southeast United States last fall, followed by the tsunami in Asia in December, and more recently the Midwest flooding and the mudslides in California. We’ve heard about a host of health problems that can arise in the event of such disasters. But what could we do now to be prepared? And what should we do if a disaster strikes?

The tsunami survivors face the greatest threat of infectious disease, given the scope of the destruction. But such an event could also occur in the United States, perhaps on a smaller scale.

According to the Centers for Disease Control and Prevention (CDC), illnesses may result from contact with contaminated water, animals or mosquitoes, and wound-associated infections. Illnesses that may be contracted through contaminated food and water include cholera, severe diarrhea, hepatitis A, hepatitis E, and leptospirosis. Parasitic disease threats include amebiasis, cryptosporidiosis, cyclospirasis, and giardiasis. Rotavirus, shigellosis, and typhoid fever may also occur. Specific information about these infectious diseases is available at the CDC Web site (

In addition to diseases spread by food and water, animals and/or mosquitoes may cause the spread of plague, rabies, malaria, Japanese encephalitis and dengue fever. Respiratory illnesses, such as avian flu, respiratory syncytial virus (RSV), and tuberculosis (TB) could also spread within the affected countries.

Many of the tsunami survivors suffered cuts or punctures from debris or from being slammed against coral in the water. These wounds increase the survivors’ susceptibility to tetanus. Survivors of the hurricanes and the mudslides received similar types of puncture injuries.

As world health officials warn, any of these diseases can cause widespread casualties, if clean water and medication doesn’t reach the survivors in time. The challenge is not so much procuring the water and medications for the tsunami survivors, it’s reaching the many remote areas where survivors are located. A major advantage that we have in this country is access, almost immediately, to disaster relief services.

But what could or should we do to protect ourselves and our families in the event that a major catastrophe might occur? How can we protect ourselves from widespread outbreak of infectious disease?

A first step is to make sure that your vaccinations are up to date, in particular tetanus vaccination. The CDC recommends that adults receive a booster dose of vaccine every 10 years, although in the case of a puncture injury or deep cut, a booster may be recommended if the last vaccination was more than five years prior. Recently updated adult vaccination recommendations are available at the CDC website at

Other precautions might include having a supply of alcohol-based hand-washing products available at work and at home, in the event that clean water and soap are not available for handwashing. Remember that handwashing is a basic and highly effective tool in preventing the spread of disease. A supply of bottled water and a first aid kit are also items that would be helpful in the event of a weather-related or other type of disaster.

Even an event such as a wide-spread power outage can affect the public water supply. If water treatment plants are unable to operate and render public drinking water safe for use, they may issue a boil-water advisory in a community. If this is the case, dental procedures should not be performed using public water, nor should this potentially contaminated water be used for washing hands, or for patient rinsing. Bottled water should be used for

all procedures and when the boil-water advisory is lifted, the dental practice should follow the local water treatment plants guidelines for flushing all waterlines that utilize the public water system.

The following organizations are excellent resources for disaster planning:

• American Red Cross,
• Department of Homeland Security,
• National Weather Service,

The Red Cross recommends that personal workplace preparedness should include the following items:

• A flashlight with extra batteries
• A battery powered radio
• Food (non-perishable)
• Water (at least one gallon)
• Medications (prescription and non-prescription)
• First aid supplies
• Tools and supplies.

Tools and supplies might include blankets, paper plates, cups and plastic utensils, personal hygiene items, plastic garbage bags (for personal sanitation), clothing, including closed-toed shoes or boots, and extra glasses if you wear prescription glasses. An emergency preparedness kit should not include candles, weapons, toxic chemicals or controlled drugs unless prescribed by a physician. These same items should be kept on hand for disaster preparedness in your home.

Whether a disaster is weather-related or an act of terrorism, the potential for disruption of home and workplace is possible and the spread of disease is real. How we prepare for this potential may mean the difference between becoming a survivor or a casualty.

Mary Govoni, CDA, RDH, MBA, is the owner of Clinical Dynamics, a consulting company based in Michigan. She is a member of the Organization for Safety and Asepsis Procedures and is a featured speaker on the ADA Seminar Series. She also writes a column for Dental Equipment & Materials magazine. She can be contacted at [email protected].