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UNMC infectious disease expert cautions Nebraskans about flood-related risks

Below is a dropbox link to two mp4 video and mp3 audio sound bites and their transcriptions featuring Mark Rupp, M.D., professor and chief of the UNMC Division of Infectious Diseases and medical director of the Infection Control & Epidemiology Program at Nebraska Medicine. Below he addresses infectious disease issues related to the flooding.
 
https://www.dropbox.com/sh/8y2pa65is189dbi/AACKN4rjZyASwloUw5fSyXgFa?dl=0
 
Video 1 – From an infectious disease standpoint, what are the concerns of people going back into their homes?
When folks are finally able to get back into their neighborhoods and their homes, there’s a number of concerns they need to be thinking about. First of all, you have the immediate hazard of electrocution and some chemical hazards from industry plants or maybe somebody stashed chemicals in their garage. But from the infectious disease side of things, those floodwaters are really a witches brew of different kinds of infectious agents. They’re contaminated with sewage, human as well as animal sewage, as well as a lot of organic material.
 
People need to be really careful when they’re in the cleanup mode to avoid injuries. There’s a lot of sharp objects in the water that they may or may not be able to see – broken glass, branches that are sharp and jagged – any of those sorts of things can injure people and inoculate those polluted water into their tissues. If that happens, they need to clean that area as quickly as possible with soap and water and bandage it with something that is impermeable to the water.
 
One of the things they don’t think about is the risk of tetanus. If it’s been more than about five years that they’ve had a tetanus booster and they get one of those wounds, then they probably should get that tetanus shot. Anybody should have it at 10-year intervals but if they have a tetanus prone wound, they would want to do that earlier.
 
In addition, there’s a lot of risk from swallowing the water. They’re not obviously drinking it, there’s a lot of ways they can get splashed and can swallow small amounts of the water which can carry a lot of intestinal parasites — everything from routine salmonella, shigella, to norovirus. Bacteria and viruses can be transmitted in floodwaters and cause diarrhea illness.
 
Video 2 – There a number of people in shelters, what precautions should they take to avoid being sick?
Often times people…they’re rescued from the flood waters and they’re under great stress and they finally get to a shelter and they think, ‘Oh, I’m saved.’ Unfortunately, there are some infectious problems that also go into the shelters with them. The people who run the shelters are trying to do a great job, but people are living in crowded conditions, with less hygiene than they normally might have. Diarrheal illness and respiratory tract illness can spread pretty rapidly in those settings. So the folks who set up shelters need to try to spatially separate people as much as possible.
 
Clearly, folks need to take precautions. If they know somebody is sick they may want to put those people in one part of the shelter. They need to have good hand hygiene facilities so lots of soap and water. If you can’t have that, then lots of alcohol gel to be frequently cleaning and trying to prevent the spread. If you have someone with diarrhea or vomiting, it’s important to clean it up quickly. Some of the shelters use kitty litter to absorb some of the fluids and then use bleach solutions to disinfect those areas – easy things that can be done to prevent the spread of those infections.
 
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