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E.J. HANFORD & Carroll W. Bottoms Environmental Science & Biology Departments

SITE-SPECIFIC MORBIDITY CAUSES & POTENTIAL FOR ZOONOTIC DISEASE OUTBREAKS ASSOCIATED WITH FLOOD DISASTERS IN TEXAS. E.J. HANFORD & Carroll W. Bottoms Environmental Science & Biology Departments Collin College, Frisco TX . Causes of Flooding in Texas. Frontal Squall Lines Mid-Latitude Cyclones

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E.J. HANFORD & Carroll W. Bottoms Environmental Science & Biology Departments

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  1. SITE-SPECIFIC MORBIDITY CAUSES & POTENTIAL FOR ZOONOTIC DISEASE OUTBREAKS ASSOCIATED WITH FLOOD DISASTERS IN TEXAS E.J. HANFORD & Carroll W. BottomsEnvironmental Science & Biology Departments Collin College, Frisco TX 

  2. Causes of Flooding in Texas • Frontal Squall Lines • Mid-Latitude Cyclones • Isolated Supercells • Hurricanes & Tropical Storms 2001 June 19, 2006

  3. H. Ike coastal flooding Sept 23, 2008 Crystal Beach • Upstream runoff June 2007 Colorado River, Austin

  4. Flash Flood Alley Cameron Co 2005 - Rita Regional Flooding Sabine Pass 2008

  5. Potential Exposure Scenarios Jasper TX Edinburg TX - 2008 Tarantulas, ants, snakes

  6. Potential Zoonotic Diseases Dengue Eastern Equine West Nile Mosquito-borne Yellow Fever

  7. Black-legged / “Deer” Ixodesscapularis Tick-borne Lone star Amblyomma americanum American dog Dermacentor variabilis Borrelia burgdorferi  “Lyme” Tularemia ? Anaplasma “Erlichia” Southern tick assoc. rash illness (STARI) Rickettsia rickettsii  Rocky Mtn Spotted F.

  8. Critter-borne Streptobacillus moniliformis  rat-bite fever Bacillus anthracis Rabies

  9. E. coli Clostridium tetani Salmonella Vibrio vulnificus Water-borne & Food-borne V. parahaemoliticus V. cholerae

  10. Fecal-borne Leptospires Hantavirus Chagas

  11. Multiple pathways Rotavirus Norovirus

  12. Myth vs Reality What should we anticipate in TX ? ? ?

  13. Location & Events: Texas Gulf Coast Evacuation centers Hurricanes Flood / Flash flood Disaster Disease: Morbidity Mortality Disease outbreak Illness Zoonotic disease Bacterial infection Respiratory illness Emerging disease Arbovirus Search Terms

  14. Databases • PubMed • NCBI Entrez • InfoTrac • Google Scholar • Cross-referencing • 647 articles previewed • 167 articles reviewed • ~ 35 key articles selected • Duplicate data identified

  15. Good News !! • No epidemic occurrences reported • Outbreaks reported • Limited to evacuation centers • Post-impact (recovery) • Most are non-life threatening: Gastro-intestinal • Norovirus (up to 50 %) • Rotavirus • Non-toxigenic Vibrio cholerae • Non-Typhoidal Salmonella

  16. Other Reports of Concern Cases & Fatalities: • Vibrio vulnificus • Vibrio parahaemolyticus Anthrax • 1970s: Falls, Kinney, Val Verde, Uvalde, Edwards & Real Counties • Successive episodes to concentrate spores Other infections: • MRSA • “Skin rashes” • “Respiratory” illness

  17. Wisdom Gained • Expect what is ENDEMIC • Early & On-Going Surveillance • Evacuation Centers • Rescue & Relief workers • Pre-existing medical conditions  increased risk • B/C of warnings….most morbidity is post-impact • Time duration ~ magnitude of flood event Confounding Factors • Changes in human behavior  exposure • Reduction in disease control activities • Overcrowding • Co-morbidities

  18. Opportunity !! • Education of displaced & impacted • Basic hygiene practices • Prevention & Mitigation techniques • Immunization screening • Train public health professionals • Direct & indirect impacts • Emphasize surveillance & reporting • Collaborative efforts • Individual & aggregate

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