Health Hazards After a Hurricane

The 2024 Atlantic hurricane season may have gotten off to a late start, but three of this year’s storms – hurricanes Francine, Helene, and Milton in the Gulf Coast – have generated 13% more accumulated cyclone energy than an entire average hurricane season.¹

For those in a hurricane’s path, the first order of business is survival. After the storm clears, people still face a multitude of dangers for days, weeks, months, and sometimes years. In fact, research shows that tropical cyclones (ie, hurricanes and tropical storms) in the United States cause a surge of deaths for nearly 15 years after a storm hits due to indirect effects.²

Direct health hazards associated with flood exposure include contaminated flood water, disease outbreaks due to tight quarters in evacuation centers or shelters, difficulty accessing medical care and filling prescriptions, mosquito-borne diseases, mold and mildew, water, gas and electricity shortages, weakened infrastructure, and mental health effects.

Awareness of the various hazards that follow a hurricane is crucial to mitigating risks and speeding recovery.

Contaminated Flood Waters Cause Infections and Injuries

Floodwater can become contaminated with all kinds of things from bacteria, viruses, and parasites to sewage and chemical pollutants.

• Vibrio vulnificus is a virulent, gram-negative rod commonly found in warm coastal waters that can cause wound infections and primary septicemia resulting in loss of limbs and even death.
• Contaminated flood water can cause soft tissue infections like cellulitis, MRSA, and necrotizing fasciitis in individuals with open wounds or cuts.
• It can also cause gastrointestinal illnesses if the water is ingested, which can happen inadvertently if there is no place to properly wash hands, if food has come in contact with floodwater, or as cleanup efforts get underway.

Another danger of floodwater is the hidden objects and creatures that may be present.

• People can injure themselves (eg, puncture wounds, cuts, sprained ankles) as they run across objects that cannot be seen while wading through murky water.
• Snakebites are also a hazard as snakes try to move to higher ground.
• Fire ant colonies are also known to abandon their underground homes and form floating clumps that, when disturbed by a human, can turn into an aggressive attack force that delivers hundreds of stings.

Tight Quarters Lead to Outbreaks of Illness

Close quarters can lead to outbreaks of common communicable diseases like rotavirus, norovirus, and respiratory infections including influenza.

Limited Access to Medical Care

For those who require medical care for chronic conditions such as kidney disease, diabetes, heart disease, and asthma, a hurricane can present a serious problem. Most hospitals have emergency plans in place, but they may still become overwhelmed with patients. Pharmacies can become inaccessible or lose inventory, leaving people without necessary prescriptions. People may not even be certain of the names of drugs they are taking, and medical records may be hard to access during an emergency.

Mosquitoes Thrive

During hurricanes, wind and water wash away most of the mosquito population. However, they usually rebound quickly, as rain and flooding leave lots of standing water in which to lay eggs.

• The Aedes aegypti are the mosquitoes responsible for transmitting a number of tropical illnesses including chikungunya, Zika, and dengue fever.
• The Culiseta melanura mosquitoes are a vector for Eastern equine encephalitis.
• The Culex mosquito can infect people with  Louis encephalitis or West Nile virus.

Mold and Mildew

Mold and mildew begin to take hold in houses almost immediately after flooding. Mold can cause respiratory problems, bringing on coughing, wheezing, allergic reactions, infections, and asthma attacks.

Shortages of Water and Gasoline, Plus Power Outages

Due to flooding, water treatment facilities may not be functioning properly in areas hit by hurricanes. This can lead to water shortages and the resulting inaccessibility of drinking water, water for cooking and cleaning, and clean water for bathing. Gasoline also comes at a premium, as gas stations wait for more fuel and for flooding to clear. People face difficulty in charging cell phones and powering important medical devices that require electricity. Affected residents may turn to alternative power sources like generators, grills, or camp stoves to heat or cool their homes, or to cook their food. This raises the risk of carbon monoxide poisoning.

Mental Health Concerns

People who live through a hurricane are vulnerable to depression and post-traumatic stress disorder (PTSD) because of their experiences. Studies after Hurricane Katrina showed that 30%-50% of survivors had PTSD, and 36% of children showed serious emotional disturbances. After Hurricane Sandy, PTSD was seen in 20% of residents, while 33% reported depression and 46% said they were experiencing anxiety.³ Communities that experience a hurricane and the resulting mental anguish are likely to see an uptick in substance abuse and domestic violence.⁴

Knowledge and Awareness Can Help

After a hurricane, it is vital for healthcare professionals, first responders, and community members to recognize potential risks and dangers to ensure optimum care and protection for vulnerable residents and facilitate safe rebuilding efforts.

Originally published Oct. 5, 2017. Updated Oct. 14, 2024.

References

1. Cappucci M. After Milton, what’s next for Atlantic hurricane season? The Washington Post. October 11, 2024. Accessed October 11, 2024. https://www.washingtonpost.com/weather/2024/10/11/next-hurricane-after-milton-atlantic-hurricane-season/
2. Young R, Hsiang S. Mortality caused by tropical cyclones in the United States. Nature. Published online October 2, 2024. doi:10.1038/s41586-024-07945-5. Accessed October 11, 2024. https://www.nature.com/articles/s41586-024-07945-5
3. Kim H. Why Harvey will be a mental health disaster, too. Fortune. September 6, 2017. Accessed October 11, 2024. http://fortune.com/2017/09/06/hurricane-harvey-health-risks
4. Gluck F. Hurricane Irma’s mental health impact will linger long after the damage is repaired. News-press.com. September 17, 2017. Accessed October 11, 2024. http://www.news-press.com/story/news/2017/09/17/hurricane-irmas-mental-health-impact-linger-long-after-damage-repaired/666742001