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    <title>Short Answers to Hard Questions About Health Threats From Hurricane Harvey - The New York Times</title>
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<p class="byline-dateline"><span class="byline" itemprop="author creator" itemscope itemtype="http://schema.org/Person"  itemid="https://www.nytimes.com/by/sheila-kaplan">By <a href="https://www.nytimes.com/by/sheila-kaplan" title="More Articles by SHEILA KAPLAN"><span class="byline-author" data-byline-name="SHEILA KAPLAN" itemprop="name">SHEILA KAPLAN</span></a> and </span><span class="byline" itemprop="author creator" itemscope itemtype="http://schema.org/Person"  itemid="https://www.nytimes.com/by/donald-g-mcneil-jr"><a href="https://www.nytimes.com/by/donald-g-mcneil-jr" title="More Articles by DONALD G. McNEIL Jr."><span class="byline-author" data-byline-name="DONALD G. McNEIL Jr." itemprop="name">DONALD G. McNEIL Jr.</span></a></span><time class="dateline" datetime="2017-09-02T04:48:05-04:00" itemprop="dateModified" content="2017-09-02T04:48:05-04:00">AUG. 31, 2017</time>
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        <p class="story-body-text story-content" data-para-count="245" data-total-count="245" id="story-continues-1">The devastation caused by Hurricane Harvey in Houston has brought a host of health questions from residents of the area and concerned relatives and friends. Here are some answers to common questions showing up in Google searches and on Facebook.</p><h4 class="story-subheading story-content" data-para-count="60" data-total-count="305">Can I get a bacterial infection from the dirty floodwaters?</h4><p class="story-body-text story-content" data-para-count="391" data-total-count="696">Yes. Some Texas public health officials expect an increase in gastrointestinal problems from bacteria breeding in stagnant floodwaters that can contain Escherichia coli (E. coli), Shigella, and <a href="http://health.nytimes.com/health/guides/disease/cholera/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Cholera." class="meta-classifier">Vibrio</a> vulnificus. The latter, which is present in the Gulf of Mexico, can cause terrible infections that can lead to amputations. It is harmful if swallowed or if it comes into contact with a cut.</p><p class="story-body-text story-content" data-para-count="264" data-total-count="960">In <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5438a6.htm">a report issued one month after Hurricane Katrina</a> in 2005, the Centers for Disease Control and Prevention said it had counted 24 cases of hurricane-related wounds infected with Vibrio vulnificus or its relative, Vibrio parahaemolyticus, of which six were fatal.</p><p class="story-body-text story-content" data-para-count="198" data-total-count="1158">If you have walked through floodwaters, it is best to throw out the clothes and shoes you wore, said Winifred J. Hamilton, director of the environmental health service at Baylor College of Medicine.</p><div id="story-ad-1" class="story-ad ad ad-placeholder nocontent robots-nocontent ">
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        <p class="story-body-text story-content" data-para-count="318" data-total-count="1864" id="story-continues-4">Also, Houston – unlike New York and some other cities — has separate pipes for storm water and house sewage. “Our storm sewer system was overwhelmed, but our sanitary system did not get breached,” he said. “That water flows into treatment plants, and they did not get flooded or lose power that I know of.”</p><h4 class="story-subheading story-content" data-para-count="42" data-total-count="1906">Is the drinking water supply really safe?</h4><p class="story-body-text story-content" data-para-count="278" data-total-count="2184">Houston health officials said there have been no breaches to the city’s main public water supply, and that the drinking water is fine. But, they have warned residents who rely on small municipal water systems of potential contamination and have urged them to boil their water.</p><figure id="media-100000005403254" class="media photo embedded layout-large-horizontal media-100000005403254 ratio-tall" data-media-action="modal" itemprop="associatedMedia" itemscope itemid="https://static01.nyt.com/images/2017/09/01/science/01HEALTH-qa2/01HEALTH-qa2-master675.jpg" itemtype="http://schema.org/ImageObject" aria-label="media" role="group">
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<h4 class="story-subheading story-content" data-para-count="61" data-total-count="2245">What if we use a private water well, not a municipal system?</h4><p class="story-body-text story-content" data-para-count="222" data-total-count="2467">If you’re among the hundreds of thousands of Houston-area residents who rely on private wells, you are on your own. If flood water has gotten into your well, you need to get the water tested. Use bottled in the meantime.</p><p class="story-body-text story-content" data-para-count="288" data-total-count="2755">“If you’re on a well, you are your water system,” said Professor Marc Edwards, a drinking water expert at Virginia Tech. “That is why we have a special outreach effort, a collaboration with Louisiana State University, trying to get information to people who have private wells.”</p><h4 class="story-subheading story-content" data-para-count="51" data-total-count="2806">Can I get <a href="http://health.nytimes.com/health/guides/disease/aids/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about AIDS/H.I.V.." class="meta-classifier">H.I.V.</a> from exposure to the flood water?</h4><p class="story-body-text story-content" data-para-count="3" data-total-count="2809">No.</p><h4 class="story-subheading story-content" data-para-count="16" data-total-count="2825">How’s the air?</h4><p class="story-body-text story-content" data-para-count="389" data-total-count="3214">Not so good. In most cases the toxic air pollution given off by the refineries and chemical plants during emergency shut downs won’t cause severe problems right away. But older adults, those with <a href="http://health.nytimes.com/health/guides/disease/asthma/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Asthma." class="meta-classifier">asthma</a> and the immune-compromised may develop inflammations and other ailments. Long-term risks won’t be known until health officials figure out what, exactly, has been spewed into the air.</p><p class="story-body-text story-content" data-para-count="310" data-total-count="3524">Residents going back to their houses will have to rip out wallboard that has developed mold, which is also a health risk. And be careful when tearing out cabinets or walls: Houses may have asbestos and those built before 1978 are likely to have lead paint. You don’t want to expose yourself or your children.</p><h4 class="story-subheading story-content" data-para-count="84" data-total-count="3608">What’s the risk of mosquito-borne diseases like <a href="http://www.nytimes.com/news-event/zika-virus?inline=nyt-classifier" title="Complete coverage of the spread of Zika virus and efforts to contain it." class="meta-classifier">Zika</a> in the wake of the flooding?</h4><p class="story-body-text story-content" data-para-count="316" data-total-count="3924">At the moment, the risk is lower than normal. Floods and high winds whisked billions of mosquitoes and their larvae to their doom in the Gulf of Mexico. “When the water is raging and surging, everything’s washed away,” said Mustapha Debboun, chief of mosquito control for Harris County, which includes Houston.</p><div id="story-ad-2" class="story-ad ad ad-placeholder nocontent robots-nocontent ">
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<p class="story-body-text story-content" data-para-count="154" data-total-count="4078" id="story-continues-5">But once the waters settle, there will be countless low spots, old tires, flowerpots and the like where mosquitoes can begin rebuilding their populations.</p><p class="story-body-text story-content" data-para-count="227" data-total-count="4305">After Labor Day, Dr. Debboun said, he will send teams out to see how many land on an arm in a minute. If the situation gets bad enough, he said, he will start aerial spraying and probably ask for help from the federal agencies.</p><p class="story-body-text story-content" data-para-count="467" data-total-count="4772">To spread Zika or dengue, mosquitoes would have to pick up the virus from the blood of humans who recently returned from areas with outbreaks. Throughout most of the Western Hemisphere, Zika cases are down by more than 90 percent from last year’s peaks, according to the Pan American Health Organization. However, Mexico is having a modest uptick this year, including cases in the state of Tamaulipas, which is just across the border from Texas’s southeast coast.</p>        <a class="visually-hidden skip-to-text-link" href="#story-continues-6">Continue reading the main story</a>
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        <h4 class="story-subheading story-content" data-para-count="64" data-total-count="4836">What about other diseases spread by mosquitoes, like West Nile?</h4><p class="story-body-text story-content" data-para-count="433" data-total-count="5269" id="story-continues-7"><a href="http://health.nytimes.com/health/guides/disease/west-nile-virus/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about West Nile Virus." class="meta-classifier">West Nile virus</a> is endemic in the United States and outbreaks are triggered by several factors, including the concentrations of culex mosquitoes, humans who are not immune, and birds who are not immune. (The virus builds up to higher concentrations in bird blood than in human blood, so mosquitoes tend to pick it up from them to give to humans.) Birds were also probably driven away from coastal Texas by Hurricane Harvey’s winds.</p><p class="story-body-text story-content" data-para-count="747" data-total-count="6016">In 2005, in the wake of <a href="http://topics.nytimes.com/top/reference/timestopics/subjects/h/hurricane_katrina/index.html?inline=nyt-classifier" title="More articles about Hurricane Katrina." class="meta-classifier">Hurricane Katrina</a>, there was initially no increase in cases of West Nile virus or St. Louis <a href="http://health.nytimes.com/health/guides/disease/encephalitis/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Encephalitis." class="meta-classifier">encephalitis</a>, which is also spread by mosquitoes, noted Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. But a year later, there was a surge in dangerous “neuroinvasive” West Nile disease in the affected regions of Louisiana and Mississippi: Cases of encephalitis and <a href="http://health.nytimes.com/health/guides/disease/meningitis/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Meningitis." class="meta-classifier">meningitis</a> more than doubled. Researchers from Tulane University’s School of Public Health and Tropical Medicine speculated that more people were bitten that year because they were outside doing reconstruction work or living inside partially-destroyed houses that mosquitoes could invade easily.</p><div class="newsletter-signup hidden auto-newsletter variant-1-hidden " id="newsletter-promo" data-newsletter-productCode="" data-newsletter-productTitle="" aria-labeledby="newsletter-promo-heading">
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<h4 class="story-subheading story-content" data-para-count="45" data-total-count="6061">What about disease transmission in shelters?</h4><p class="story-body-text story-content" data-para-count="221" data-total-count="6282">“The big thing I’m worried about is norovirus,” said Dr. Persse, Houston’s chief medical officer. “That’s the ‘cruise ship virus’ – with a lot of people in a small space, it can spread really quickly.”</p><p class="story-body-text story-content" data-para-count="160" data-total-count="6442">The disease causes <a href="http://health.nytimes.com/health/guides/symptoms/nausea-and-vomiting/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Nausea and vomiting." class="meta-classifier">vomiting</a>, <a href="http://health.nytimes.com/health/guides/symptoms/diarrhea/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Diarrhea." class="meta-classifier">diarrhea</a> and <a href="http://health.nytimes.com/health/guides/disease/dehydration/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Dehydration." class="meta-classifier">dehydration</a>. It is not normally fatal to otherwise healthy people, but severe dehydration can kill frail older adults.</p><p class="story-body-text story-content" data-para-count="247" data-total-count="6689">In shelters, it can be hard to control. Health officials try to stop outbreaks by quickly taking the sick to separate rooms where they are given food and entertainment, there is no wait for toilets and the floors are washed frequently with bleach.</p><p class="story-body-text story-content" data-para-count="208" data-total-count="6897">Dr. Persse’s medical teams are walking through shelters now looking for people vomiting. Shelter populations are thinning out as people return home or find other places to stay, so the danger is decreasing.</p><div id="story-ad-3" class="story-ad ad ad-placeholder nocontent robots-nocontent ">
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<p class="story-body-text story-content" data-para-count="153" data-total-count="7050" id="story-continues-8">After Hurricane Katrina, 200,000 refugees ended up in 750 shelters in 18 states, and there were scattered outbreaks of various diseases, the C.D.C. said.</p><p class="story-body-text story-content" data-para-count="192" data-total-count="7242">About 1,000 cases of diarrhea in more than 20 shelter clusters were reported. One Dallas-area shelter had 30 skin infections with <a href="http://health.nytimes.com/health/guides/disease/mrsa-infection/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about MRSA Infection." class="meta-classifier">MRSA</a>, an <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/antibiotics/index.html?inline=nyt-classifier" title="Recent and archival health news about antibiotics." class="meta-classifier">antibiotic</a>-resistant form of staphylococcus bacteria.</p><figure id="media-100000005403255" class="media photo embedded layout-large-horizontal media-100000005403255 ratio-tall" data-media-action="modal" itemprop="associatedMedia" itemscope itemid="https://static01.nyt.com/images/2017/09/01/science/01HEALTH-qa4/01HEALTH-qa4-master675.jpg" itemtype="http://schema.org/ImageObject" aria-label="media" role="group">
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<p class="story-body-text story-content" data-para-count="323" data-total-count="7565">Officials worried about tuberculosis transmission, one new case was found in a shelter. Health authorities were able to trace about 70 percent of the patients they knew had previously been on <a href="http://health.nytimes.com/health/guides/disease/pulmonary-tuberculosis/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Pulmonary tuberculosis." class="meta-classifier">TB</a> treatment so they could be kept on it, the C.D.C. said. TB patients who are taking their antibiotics are usually not infectious.</p><h4 class="story-subheading story-content" data-para-count="42" data-total-count="7607">Can I get sick from exposure to a corpse?</h4><p class="story-body-text story-content" data-para-count="129" data-total-count="7736">That is not likely, but dead bodies may leak feces that will contaminate the water and could lead to gastrointestinal infections.</p><h4 class="story-subheading story-content" data-para-count="34" data-total-count="7770">What should I do when I get home?</h4><p class="story-body-text story-content" data-para-count="109" data-total-count="7879">First, make sure that your electrical system is safe and there are no gas leaks. Check for structural damage.</p><p class="story-body-text story-content" data-para-count="225" data-total-count="8104">Once inside, there is likely to be toxic sludge. Throw out any food that has come into contact with floodwaters, unless it’s well packaged in metal, waterproof glass or hard plastic containers. Even then, wash it off first.</p><p class="story-body-text story-content" data-para-count="150" data-total-count="8254">Don’t run gas-powered electrical generators indoors or use gas or charcoal grills indoors. These can cause <a href="http://health.nytimes.com/health/guides/poison/carbon-monoxide/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Carbon monoxide." class="meta-classifier">carbon monoxide</a> to build up and kill you.</p><p class="story-body-text story-content" data-para-count="282" data-total-count="8536">“Many people are already back into their homes that have been flooded with two or three feet or more of water,” said Winifred J. Hamilton, director of the environmental health service at Baylor College of Medicine. “We are already seeing piles of carpet and sofas on the curb.</p><p class="story-body-text story-content" data-para-count="90" data-total-count="8626">“As the water dries,” she said, “you are going to have mold spores made airborne.”</p><p class="story-body-text story-content" data-para-count="259" data-total-count="8885">She advised anyone who has asthma, <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/respiratorydiseases/index.html?inline=nyt-classifier" title="Recent and archival health news about respiratory diseases." class="meta-classifier">respiratory disease</a> or is immune-compromised not to take on the cleanup. “You should get someone else to do it if possible,” she said. “And wear personal protection equipment so that you are <a href="http://health.nytimes.com/health/guides/symptoms/breathing-slowed-or-stopped/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Breathing - slowed or stopped." class="meta-classifier">not breathing</a> in toxins.”</p><div id="story-ad-4" class="story-ad ad ad-placeholder nocontent robots-nocontent ">
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<h4 class="story-subheading story-content" data-para-count="18" data-total-count="8903">Any other advice?</h4><p class="story-body-text story-content" data-para-count="90" data-total-count="8993" id="story-continues-9">Yes, watch out for snakes. Humans aren’t the only creatures who were seeking dry ground.</p><footer class="story-footer story-content">
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                <div class="story-notes"><p>Denise Grady contributed reporting.</p></div>
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