ADVANCEMENT OF THE SCIENCE
Open Access
SPECIAL REPORT
Hurricanes, Pathogenic Diseases, and Health Disparities
Lisa R. Maness, PhD, MT(ASCP, AMT) Winston-Salem State University
underlying health problems, some do not evacuate because of economic constraints, and yet others cannot aord to travel to obtain needed medications and treatment after hurri- cane damage. Planning is needed, therefore, to mitigate the devastation from tropical storms, and this planning is most crucial for the dis- parate groups of people who tend to suer most. Planning should begin with increasing local awareness of the pathogens that increase after hurricanes and their impacts to health. It is important that people are aware of the environment around them, the role that hur- ricanes have in increasing human exposure to microorganisms, and how to prevent illness from these pathogens.. Pathogens Increase in Floodwater The number of potential pathogens often rises in public water systems and private wells after these events. For example, a study by Mapili et al. (2022) involved pro- cessing 211 private-well samples in Texas, Louisiana, Florida, and North Carolina after the Louisiana floods (August 2016), Hurri- cane Harvey (August 2017), Hurricane Irma (September 2017), and Hurricane Florence (August 2018). DNA markers were found for Legionella pneumophila , Mycobacterium avium , and Naegleria fowleri in 15.6%, 17.1%, and 6.6% of samples, respectively. Moreover, 40.3% of all wells tested were found to be positive for coliforms. This study is not unique in its findings. Hurricanes Irma and Maria both hit the U.S. Virgin Islands in 2017. Almost 3 months after Hurricane Maria, 22 water samples were collected from local households (Jiang et al., 2020). In addition, water samples from 20 coastal locations between St. Thomas and St. John were collected and 3 street runo samples were collected. Jiang et al. (2020) found that 82% of cistern waters, 30% of coastal waters, and 1 out of the 3 (30%) run-
Abstract Climate change will likely continue to increase the number of hurricanes. After a hurricane, a wide variety of pathogens increase in the environment and disproportionately aect humans. These pathogens include respiratory fungi and viruses, bacteria that cause flesh- eating wound infections, and microorganisms that cause gastrointestinal illnesses. The diseases caused by these pathogens might be contracted from flooded houses during cleanup, spread from person-to-person due to crowded conditions, passed from mosquitoes that increase in numbers after flooding, or spread directly from floodwater. Furthermore, these pathogens harm people with underlying health disparities to a greater degree than people who are not already at risk. Therefore, planning is important to ease the burden for populations already aected by health disparities. Without proper planning, the cost is much higher and has longer-term consequences for populations with underlying illnesses and other health risks. Keywords: hurricanes, pathogenic diseases, health disparities, emergency readiness, emergency planning
Introduction The most immediate considerations when it comes to hurricanes are wind, storm surge, and flooding—each with its own set of fears. A secondary concern to human health that results from hurricanes, however, is the increased level of a wide variety of patho- genic diseases (Maness, 2019). For example, pathogenic diseases can result from exposed wounds that can get infected during hurri- cane cleanup by organisms such as Leptospira interrogans and Vibrio vulnificus . Infectious diseases from tropical storms can increase due to crowded conditions that result from people filling up shelters that are opened during emergency responses. Crowded conditions have been linked to increases in conjunctivitis (commonly known as pink eye), gastrointestinal (GI) illnesses such as gastroenteritis commonly caused by noro-
virus, and other highly communicable ill- nesses. Increases in pathogenic illness can also result from fungi and their mycotoxins that are found growing in flooded buildings. Fungal and viral respiratory illnesses tend to spike after hurricanes, especially in individu- als who have asthma and other underlying issues. Dengue fever, West Nile virus (WNV), and other arboviruses also tend to increase due to surges in mosquito populations after flooding. Additionally, parasites such as Cryp- tosporidium and Giardia, as well as bacterial pathogens such as Salmonella and Legionella spp. increase in floodwaters after hurricanes, increasing the risk of human exposure. Pathogenic diseases from hurricanes tend to aect people who live in areas that are of lower socioeconomic status (SES) the most (Burrows et al., 2023; Flores et al., 2020). Some people in lower SES areas already have
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Volume 88 • Number 1
https://doi.org/10.70387/001c.142102
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