TUESDAY, Sept. 6, 2005 (HealthDay News) -- Top U.S. health officials said Tuesday they were doing everything possible to meet the mounting medical needs of victims of Hurricane Katrina.
At the same time, an official in the office of New Orleans Mayor Ray Nagin told CNN that floodwater in the battered city was contaminated with potentially deadly E. coli bacteria.
E. coli comes from human and animal waste and can be found in untreated sewage. If water and food is contaminated with the germ, serious illness -- even death -- can result without proper treatment.
The official in Nagin's office declined to be identified, CNN said.
A spokesman for the U.S. Centers for Disease Control and Prevention said Tuesday afternoon that the agency had not received confirmation of reports that E. coli was in the New Orleans water, however.
"The assessment teams that are there are certainly looking into that as well as other things that could be contaminating the water," said the CDC's Von Roebuck. "Information as to what contaminants are in the water has yet to come forward."
U.S. Health and Human Services Secretary Mike Leavitt, who had just finished touring evacuation centers as well as the Gulf Coast destruction zone, said during a teleconference Tuesday that the health-care response to the disaster had been "massive."
But one of the major public health challenges is to prevent and manage outbreaks of infectious diseases along the entire Gulf Coast.
Conditions are ripe at crowded shelters for the spread of infectious disease, officials said.
Reports of diarrheal illness are under "active investigation," CDC director Dr. Julie Gerberding, who has also been touring the affected areas, said at the teleconference.
Noroviruses, like those that plague cruise ships, are a big concern. "They are so easily transmitted. It almost requires perfection in personal hygiene to be completely safe," Gerberding said. And hygiene at the overwhelmed evacuation centers is a major challenge.
In addition, people who have already been diagnosed with tuberculosis are being provided with medication, while potential new cases are being investigated and "appropriate containment steps taken," she said.
Health-care workers are also making sure that routine childhood immunizations are up-to-date, especially given that "many of the people in shelters are those that already experience health disparities," Gerberding said. For adults, workers are focusing on tetanus and, when it becomes available, flu shots.
Then there's the additional challenge of maintaining chronic-care services for people who had pre-existing conditions and, Gerberding said, "to provide a sense of hope." Over the long-term, survivors of the hurricane will need continued medical support, as well as mental health support, education, housing and job training, she said.
Officialsat the teleconference were not able to detail any specific environmental threats. Raw sewage certainly poses a threat but tends to support diseases that had already been present in the community. That means cholera is not likely to be an imminent danger. But E. coli-induced diarrhea and other infectious diseases could emerge, Gerberding said.
And floating dead bodies, while "horrifying," pose little health concern, she said.
There is, however, a potential issue of industrial contaminants. "What I'm really concerned about from the standpoint of water is that we don't know if it's containing any toxic chemicals," Gerberding said.
The New York Times reported Tuesday that Louisiana official said two major oil spills were now under control and 170 sources of radiation, ranging from hospitals to pipe-welding plants, have been secured.
On the down side, the newspaper also reported, officials now estimate that 140,000 to 160,000 homes had been submerged or destroyed; 60 to 90 million tons of solid waste must be cleaned up, and 530 sewage treatment plants were inoperable.
The Army Corps of Engineers reported Tuesday that it had begun pumping out water that had inundated 80 percent of the below-sea-level city, after two broken levees released huge amounts of water from Lake Pontchartrain. Water levels were dropping noticeably across the city, the Associated Press reported.
"I'm starting to see water levels much lower than I've seen," Mayor Nagin told the AP after touring the city by air. "Even in areas where the water was as high as the rooftops, I started to see parts of the buildings."
Still, he warned that the death toll in New Orleans could reach 10,000 as water levels fall and the full extent of damage becomes visible.
There were also encouraging developments Tuesday, officials reported.
Hospitals were being constructed out of the wreckage. "Four or five days ago, they were empty, hollow shells with nothing," U.S. Surgeon General Dr. Richard Carmona said at the teleconference. "When we went through, we saw large metropolitan hospitals functioning as multidisciplinary, tertiary-care facilities in convention centers."
According to Leavitt, close to 2,000 people had been evacuated from area hospitals and taken to hospitals with available rooms. In addition, 2,600 hospital rooms in 12 states and 40,000 hospital rooms nationally have been identified as potential sites for casualties from Katrina. With the most acute patients already transferred, Leavitt said patient transfers were slowing.
In New Orleans, he said, 1,000 hospital beds are functioning with plans to bring another 1,000 on line.
Responding to questions on why refugees in the Superdome had not been given access to medical care, Leavitt said, "It's very difficult to know what went on in the Superdome because reports were so widespread and varied ... The health community was moving rapidly and successfully in being able to establish centers for health care and people received remarkable care under the circumstances."
Doctors on the ground in Louisiana pointed to other immediate challenges.
Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Clinic Foundation in Baton Rouge, said he had seen about a dozen cancer patients in the past four days, but they didn't know what kind of cancer they had or what kind of treatment they had been receiving before Katrina struck.
Ochsner has electronic medical records so if a person was a patient at the center his or her records are intact. But other patients from other facilities must undergo additional biopsies and repeat lab tests. The treatment protocols, Brooks said, must be "pieced together."
"Things like this [Katrina] can happen again and probably will," Brooks said. "The things I think are most important are to tell people: know your diagnosis, know what medicines you're on, know what treatment you're on."
Patients are also beginning to call for narcotics and, Brooks said, "you have to be very leery of that."
Dr. Jason Wuttke, a child and adolescent psychiatrist at the Ochsner Clinic in New Orleans, said the catastrophe may prove especially traumatic for children.
"There are not yet many children with mental health needs presenting to the emergency room but, as a child psychiatrist, I know they are out there," he said.
Wuttke weathered Katrina in the hospital, then returned home. When the levees broke, he was trapped there for five days. On Saturday, a boat ferried him to dry land and he walked the rest of the way to the hospital. He has been there ever since. His family is in Oklahoma. "They're alive," he said.
More information
The Red Cross has more on relief efforts.
