Asheville – Buncombe County’s Medical Director Dr. Jennifer Mullendore counsels citizens that the ravages of Hurricane Helene did not go away with the wind and the waves. Now, citizens must take precautions to prevent a third plague from the aftermath.
One very obvious risk is mold-related disease. A month after Hurricane Sandy, relief workers were still wearing masks to protect them against mold that smelled like bad feta and could grow over an inch thick on the underside of basement furniture. Even without flooding, mold has been known to grow on the inside of drywall, mystifying doctors who cannot explain why a patient is sick all the time. With all the post-flood mold growth, the air is thicker with higher concentrations of mold spores as well.
Mullendore described symptoms of a bad reaction to mold as similar to allergies. They can cause eye irritation, congestion, shortness of breath, rashes, and headaches. People with mold sensitivities, lung disease, or weakened immune systems will, of course, struggle more from mold infestation.
She said that mold must be removed completely or it will keep growing back. Flood remediation includes removing all mud (mucking) and all drywall and insulation exposed to floodwaters. It is best to throw away porous items like sofas and carpets, while nonporous surfaces, like countertops, may safely be used after bleaching. Unfortunately, another wave of post-flood doctor calls are made from mixing bleach with other chemicals, using it in confined spaces, and otherwise exposing the skin and lungs to it.
Given the risks, it is in the best interest of public health for persons who don’t feel up to cleaning their own houses to get somebody else to help. Local faith communities are jumping at the opportunity, as are volunteers with the open-source network crisiscleanup.org.
Mullendore wants those taking flood remediation into their own hands to take proper care of any wounds they may incur, as broken, jagged items will be covered in bacteria. “Flood rashes” are common and are caused by exposure to water-washed bacteria and fungi, as well as agents like pesticides, fertilizers, fiberglass, and cleaning supplies. Toxic levels of nitrites and nitrates also infiltrate well water.
Mullendore, however, is particularly concerned about Clostridium tetani. Popularly known to dwell on rusty nails, these bacteria are also found in dust, soil, and feces, all of which Helene caused to be kicked up and swirled around.
Tetanus typically enters the skin through a lesion. Symptoms can take three days to three weeks to appear and typically start with lockjaw. Muscle spasms, stiffness, and seizures can follow. While tetanus is a rare disease, the death rate among those who contract it is 10%.
Mullendore therefore recommends good wound care. Washing with soap and potable water and covering with a sterile bandage should suffice for minor injuries. A healthcare professional should be consulted immediately in the event of deep or puncture wounds, animal bites, injuries involving dead tissue, or concerning infection.
Tetanus vaccinations are recommended for serious, dirty wounds as well as prophylactically or even in the event of minor wounds. People who have had three vaccinations, including one no more than five years ago, will not need a vaccine. Currently, the Buncombe County Health and Human Services Board has waived fees for adult flu, COVID, Tdap (tetanus, diphtheria, and pertussis), and hepatitis A vaccines.
Carbon monoxide poisoning is another public health problem following floods. People fire up equipment without cleaning it first, or they may use fuel-burning appliances indoors or even too close to a house with inadequate ventilation. Poisoning frequently occurs with cleanup equipment like pressure washers, pumps, and dehumidifiers, too. Carbon monoxide is colorless and odorless, and inhalation can result in sudden death. Symptoms of exposure include headache, dizziness, weakness, upset stomach, and chest pain. Mullendore recommends fitting homes with carbon monoxide detectors and checking the batteries regularly.
Mullendore has also been telling people to throw away food that has not had proper refrigeration. A few dollars “saved” by eating rotten food is not worth the thousands in medical costs that may ensue and opportunities lost from feeling under the weather. Post-flood food diseases, including hepatitis A and dysentery, also spread from inadequate clean water for washing hands and cookware, not cooking food adequately with alternative heating appliances, and an increase in communal eating situations.
In days following a flood, the ground, trees, and electrical infrastructure may still be unstable and give way. There is also a risk that displaced, diseased animals may show up angry and hungry.