EINet Alert ~ Sep 02, 2005

*****A free service of the APEC Emerging Infections Network*****
APEC EINet News Briefs offers the latest news, journal articles, and notifications for emerging infections affecting the APEC member economies. It was created to foster transparency, communication, and collaboration in emerging infectious diseases among health professionals, international business and commerce leaders, and policy makers in the Asia-Pacific region.
In this edition:

1. Notifications
- APEC EINet Alert--Hurricane Katrina

1. Notifications

APEC EINet Alert--Hurricane Katrina
In view of the devastating Hurricane Katrina, APEC EINet is on heightened alert for disease occurrence in the affected areas of the southern USA. EINet sends sympathy to those affected by this devastating disaster. The primary challenges in these early hours are relief and providing access to clean water, food supplies, sanitation, healthcare, and adequate shelter. Many relief organizations are mobilizing to respond and we will update our users as we learn useful information about these efforts. It is possible that infectious diseases--especially those that are waterborne--will increase in incidence in the area.

After the devastating tsunami in Southeast Asia, fortunately, there were no large epidemics, only isolated outbreaks of measles, dengue, and malaria. Michael Leavitt, secretary of Health and Human Services, declared a public health emergency for Hurricane Katrina-affected areas 31 Aug 2005. He warned there were concerns about cholera, typhoid and dehydrating diseases. The biggest risk is expected to come from contaminated water, which as well as being harmful to health, provides an ideal breeding ground for mosquitoes. CDC is advising people to throw away food that may have come into contact with flood water and only to drink bottled water. CDC records from previous US disasters show the majority of medical problems after the events have been associated with diarrhea and asthma. Viruses such as hepatitis A could be a threat as well as dangerous strains of E.coli. Another virus which may cause a problem is West Nile Virus, which peaks in the US in August and September (PAHO/BBC 9/1/05).

The following are some relevant websites pertaining to Hurricane Katrina:

CDC Hurricane Recovery website
CDC offers updated information on: “Infectious Diseases”, “Mental Health”, “Keep Food & Water Safe”, and “Electrical Hazards”. “Worker Response & Cleanup” has been updated with immunization recommendations for Katrina Responders. Specifically, these recommendations for Responders include:

- Interim Immunization Recommendations for Emergency Responders: Hurricane Katrina
- Hurricane Disaster in the U.S.: Interim Health Recommendations for Relief Workers
- Interim Guidance for Healthcare Professionals Advising Travelers to Hurricane Affected Areas in the US
- Interim Guidance for Travelers to Hurricane Affected Area in the US (http://www.bt.cdc.gov/disasters/hurricanes/index.asp)

HHS: Disasters & Emergencies: Hurricanes
US Health and Human Services offers information on: “After the Storm”, “Press Releases”, “Other Federal Resources”, and “State Health and Emergency Management Agencies”. (http://www.hhs.gov/emergency/hurricane.html)

Federal Emergency Management Agency
FEMA Hurricane Katrina Recovery Resources include: “Locate missing relatives and friends”, “Evacuees and Disaster Victims”, “Volunteer or Make a Donation”, “Businesses, Contractors, Vendors”, “National Emergency Resource Registry”, “Emergency Personnel”, “Frequently Asked Questions”, “Disaster Assistance Process”. (http://www.fema.gov/)

PAHO Hurricane Katrina website
Press releases include: “Katrina Raises Health Concerns: PAHO Director Offers Help to U.S. Health Secretary Mike Leavitt”, “Central American Ministers Pay Homage to Hurricane Victims”, and “Is there a risk of storm disease?”. Links include: “PAHO Disaster Management Tools”, “More on Health Effects of Disasters”, and “Links” to other sites. (http://www.paho.org/English/DD/PIN/katrina.htm)

International Federation of Red Cross and Red Crescent Societies
IFRC: the world's largest humanitarian organization. (http://www.ifrc.org/)

American Red Cross
Comprehensive donation site with the latest news regarding Hurricane Katrina. (http://www.redcross.org/)

International Society for Infectious Diseases
ISID publication "A Guide to Infection Control in the Hospital" (from Promed 12/29/04): has a chapter entitled "Infection Hazards of Human Cadavers" written by T.D. Healing, MSc, PhD, P. Hoffman, BSc, and S.E.J. Young, FRCP.

- The major hazard facing emergency service personnel is spilt blood and any risk can be greatly reduced by preventing contact with blood (use of gloves, face and eye protection, and protective clothing where necessary).
- Bodies that have been decaying for some time present little risk. The organisms likely to be present are their own body flora and water or environmental organisms. The use of proper protective clothing will protect personnel handling such material.
- Bodies should always be transported to mortuary facilities in waterproof body bags or cleanable, fluid retentive (e.g. fiberglass) temporary coffins." (http://www.isid.org/publications/)

Comprehensive Resource: “Public Health Management of Disasters, The Practice Guide”
The 2nd edition of this landmark book consolidates important information on disaster-related resources into 1 source. It is designed to help the public health profession plan for tasks for which "on the job" is the chief teacher. The author has recognized striking improvements in disaster readiness in the US, including inter-organizational cooperation and planning among response agencies, and greater technological capability for monitoring and response. Additional information has been added on morbidity and mortality for several new types of disasters; updated structure and organization to reflect changes in federal response and organization including national incident management system, public health incident command, volunteers, GIS and public health response; expanded disaster communications including working with the media, communication systems, information technology recovery; surge capacity and surge capacity planning; worker safety; handling human remains; ensuring food safety and feeding large numbers of displaced persons; organizing mental health services, including staff training, setting up assistance services; death notification; disasters and people with disabilities, including building preparedness, disaster planning councils; point of dispensing sites; updated laboratory response network; and maintaining the vaccine cold chain. (APHA http://www.apha.org/)

APHA offers disaster management information, including infectious disease related information (Common Foodborne Diseases Caused by Bacteria; Diseases Affecting Displaced Persons in Disasters). APHA’s 133rd Annual Meeting, which was scheduled for November 5-9, 2005 in New Orleans, USA, will be held in an alternative location. A list of FEMA’s recommendations for support organizations are provided, hyperlinked with telephone numbers (http://www.apha.org/meetings/new_orleans_update.htm). (http://www.apha.org/preparedness/Katrina_relief.htm)