You have seen the flooding in Iowa on the news, read about it in the papers, heard about it on the radio, and some of you may be living with flooding issues on a daily basis. As the water rises and falls, there are health issues we all need to be reminded of, or become aware of.
Nancy Hall, public health microbiologist at The University of Iowa Hygienic Lab, what health issues might lurk in the murky floodwaters:
What precautions should someone helping with sandbagging or walking through the floodwaters take?
We always need to remember basic hygiene practices, even in times of disaster and crisis like we're going through now. With sandbagging—other than the obvious lifting and strain that one must prevent—the obvious health prevention measure is always to wash your hands with soap and water after these activities and after handling articles contaminated with flood water.
I believe you asked about walking through floodwaters, always proceed with caution. Best is to wear waterproof boots--at least something on your feet--to prevent cuts and injuries. And if you've had skin contact with flood water, showering is recommended, especially cleaning the bare skin with hot soap and water.
Why is floodwater more dangerous to our health than lake water, or a river contained in its banks?
Floodwater may, and usually does, contain fecal material from overflowing sewage systems, and here in the Midwest it contains agricultural runoff and industrial byproducts. Sewage contaminated with floodwater is likely to contain microorganisms that can make us sick, especially if ingested or if it gets in cuts or wounds.
What illness can floodwater cause if it gets in an open cut or is accidentally swallowed?
The two main illnesses generally seen due to exposure to contaminated floodwater are to the skin or wound and diarrhea infections.
If you have an open cut or sore that will or has been exposed to floodwater, make sure to keep it as clean as possible--again, by washing well with soap and water to control the infection. If the wound develops redness, swelling, or drainage, seek medical attention immediately.
Another illness we should mention is tetanus or lockjaw, which is a potentially serious health threat to those who sustain injuries in flood waters.
So anyone receiving a wound, especially if it's a puncture wound, should seek a health care professional to assure the wound is clean, not infected, and that their tetanus immunization is current.
Then there's diarrhea illness, which is acquired by accidentally drinking water that has been contaminated with floodwater. I know we've heard a lot about the water supplies that have been inundated by the flood and people have been instructed to boil their water before drinking. We have another group of individuals who have their own well supply and if floodwater goes over the well, it is not safe to drink unless disinfected. We're recommending they boil the water for one minute.
As the water start to go down, what health issues should families be aware of who are returning to their homes that were flooded?
The immediate health concerns are what we saw after '93 and that has to do with the home's utilities:
- Be sure the electricity has been turned off to prevent the possibility of electrocution
- Be sure the gas has been turned off
- Be aware of the possibility of carbon monoxide poisoning from running generators inside the home
- A big threat of injury is from collapsing floor or ceiling structures
And then there's the task of cleanup. The Iowa Department of Public Health has some wonderful educational materials for cleaning and disinfecting items after flooding. Simply discard any items that can't be completely washed and disinfected. Their basic motto—which I like and want to pass on to the listeners—is 'when in doubt, throw it out.' I think that is really good.
Drinking water. The city water people have been giving their patrons guidelines for the water supply and will be testing the water to make sure it's safe. If you’re on a private well water, you'll have to get the wells flushed and shock chlorinated and tested to make sure they're now safe.
We have been sending out hundreds of water testing kits to the county health departments now that have been affected by flooding for this purpose.
When should someone who is not feeling well and has been working in floodwater seek medical attention?
They need to give the physician as much information as possible, especially the dates and duration of exposure, and what activities they were performing in the floodwaters, just like you would in any injury or illness so that they can give the right treatments and advice.
Overall, what is your best advice with regard to floodwater health precautions?
Don't forget the basic hygiene:
- Wash your hands
- Clean up bare skin that has had contact with floodwater, always
- Wash hands before preparing or eating food.
- Remember food and drinking water safety. If you're on a private well that has been inundated by the floodwaters, follow the recommendations with shock chlorination and retesting.
- Keep children and pets out of the floodwaters. Children are a susceptible population and we want to make sure that they're safe. Any toys that have been in flood water--make sure they're disinfected.
- Use insect repellent to discourage biting insects
Iowa has a very good public health surveillance network to ensure detection and quick remediation of possible flood-related illnesses. For example, Iowa State, IDPH, and the Hygienic Lab have an ongoing, statewide arbovirus surveillance program as long as I can remember.
Mosquitoes are counted, identified and then sent to us for testing of many types of the arboviruses, such as West Nile, so that we can tell the health professionals what we're seeing and they can make proper recommendations. And luckily, after the flood of '93, there were no reports of waterborne diseases identified. We hope this is the case for this year with our good hygiene and surveillance programs. |
