A Johns Hopkins emergency physician who spent the past five weeks working on public health issues in the Gulf Coast region following hurricane Katrina warns that the disaster's potential for wreaking havoc and damage to people's health may continue for months after the hurricane has passed.
In an editorial published this month in The New England Journal of Medicine, Thomas Kirsch, M.D., M.P.H., an assistant professor and director of emergency operations at The Johns Hopkins University School of Medicine, reports that large numbers of displaced people are at increased risk of infectious diseases, such as chicken pox, gastroenteritis, scabies and influenza, which can spread quickly in disaster shelters. In these confined quarters, Kirsch says, crowded and poor sanitary conditions, including limited access to clean water and insufficient numbers of toilets, help spread disease from person to person.
However, Kirsch notes that people with chronic health conditions face the biggest threats by far, lacking immediate access to their routine medical services for hemodialysis, or access to medications for diabetes, heart disease, HIV or tuberculosis.
Kirsch, who went to the Gulf Coast area to conduct medical needs assessments for the American Red Cross, says constant monitoring and surveillance are required to contain disease outbreaks. More importantly, he adds, improving the current public health care system so that it is strong enough to prevent disease through mass vaccinations and large enough to survive a natural disaster is the best means of guarding population health.
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