I have lived through two hurricanes, Camille, and Agnes. I was a child, and when I lived for time in St. Petersburg, Florida, hurricanes were nothing but fun and games. We skipped school, had no power, and ate snacks. When it cleared, we rowed, paddled and boated all over the streets and the bayous which had become one. Harvey and Irma are another matter entirely.

I encourage everyone everywhere to explore the internet or other news media to understand the gravity and breadth of the situation. See the radar, see the satellite video, see the webcams, news and personal videos, the photos, and hear the personal accounts.

Put yourself in these people’s shoes. And then consider the ramifications of all of this on health. I will present some data and recommendations gathered by the CDC (Centers for Disease Control) in the wake of Hurricane Katrina. It is hard to say exactly how much of this could be generalized to other areas such as Houston or the Florida area, but I would suppose it is a reasonable starting place.

Here are some key points from the CDC:

Illnesses in the wake of a hurricane are predictable.
Long term displacement ( homelessness) poses treatment challenges.
Medical system disruption poses treatment challenges.

Here is a key recommendation:

Unified registration for evacuees complete with medical history, treatment and vaccination records would assist with care.

Consider that structures and infrastructure are damaged. This means not only homes and public buildings, but power plants, power lines, sewage treatment plants, and water lines. It means chemical plants and damaged. It also means that people in shelter are in close quarters with out adequate food or sanitation. Telecommunications are disrupted. Finally it means that hospitals, clinics and the movement of medical personnel are all disrupted.

What illnesses are to be expected ? In the above described setting, infectious rashes are common, with near universal exposure to polluted floodwaters. Respiratory infections come next, followed by Gastrointestinal illness. Vibrio cholera played a large role in GI illness, and other forms of the waterborne vibrio bacteria accounted for the serious skin infections.

Viruses also entered the picture, particularly the mosquito borne type. Remember that mosquitos reproduce in standing water. Human West Nile Virus had an uptake, but this year, officials anticipate Zika virus will be the major player.

Trauma of all kinds counts for most presentations to hospitals. Cardiovascular causes are a far second, with medication refills being a third. These three accounted for the vast majority of presentations to hospitals in the wake of Katrina.

Evacuees in the aftermath of hurricanes are at the most risk. Vaccinations are a key aspect of care for evacuees. For those evacuees in a group setting, the following are recommended: Influenza, varicella, MMR and Hepatitis A.

Emergency responders are another special group requiring care. Vaccination recommendations for this group include Tetanus if not up to date, Hepatitis B, and the same vaccinations as are given to evacuees if responders are working in large group settings.

reference :

https://depts.washington.edu/einet/symposium/USA031210.pdf

For critical additional reading :

https://www.cdc.gov/disasters/hurricanes/index.html

http://www.weather.gov

Please familiarize yourself with what is going on. Figure out how you can help.

Here are some key points:

Illnesses in the wake of a hurricane are predictable.
Long term displacement ( homelessness) poses treatment challenges.
Medical system disruption poses treatment challenges.

Here is a key recommendation:

Unified registration for evacuees complete with medical history, treatment and vaccination records would assist with care.

A brief search on the Apple App store reveals several useful apps. Check out the ones from the Red Cross, FEMA, and the National Weather Service. As of yet there is no comprehensive evacuee app.

Viruses also enter the picture, particularly the mosquito borne type. Human West Nile Virus had an uptick in Katrina, but this year, officials anticipate Zika virus will be the major player.

reference :

https://depts.washington.edu/einet/symposium/USA031210.pdf

For critical additional reading :

https://www.cdc.gov/disasters/hurricanes/index.html

http://www.weather.gov

Please familiarize yourself with what is going on. Figure out how you can help. Click on the up to date radar image below to help.

https://radar.weather.gov/Conus/full.php

If you do not know about Hurricane Matthew and what it is doing, then stop reading this blog post right now and check out this link on the weather channel:

https://weather.com

This is one of the most devastating storms our nation has ever faced. Hurricane Matthew is a Category 4 of 5 hurricane. This ratings are done by the wind speeds observed in the storm and these are currently at 130 miles per hour, enough to tear the roof off a house. It is not terribly uncommon for a hurricane to achieve this category. What makes the potential for damage so great in this case is the path that this hurricane is likely to take. It will travel straight up the populated Florida coast, passing over Cape Canaveral and onto the southern part of the Eastern Seaboard. These are low lying populated areas.

We are told the main hazards are wind, as wind, but also as a fringe of tornados at the edge of the hurricane. Other hazards are the sheer volume of rain and flooding, powerful waves at the coast battering the shoreline, but even more so the so called storm surge, which is like a monstrous high tide coming far higher and more inland than it should, amidst everything else, complicating the task of dealing with buildings compromised by wind and falling debris.

Power will be lost, and food likely spoiled. Tap water may not necessarily be safe. Food will be a challenge. In the aftermath, people may eat the spoiled food and get sick. Water born illness may spread, as may common maladies like pneumonia, since people will either be without shelter, or in crowded shelter where illness is easily acquired.

The Red Cross is the preeminent organization for disaster relief in this country. For this reason I have devoted food Friday to a link to direct you to their donation page. I was going to talk about Kombucha, a delicious probiotic drink, but I cannot get my mind off the hurricane and its victims.

When I was a little girl, ages 6-12, I lived in St. Petersburg, Florida. I lived through hurricanes Agnes and Camille. Camille was class 5, though it merely sidelined us. I have many vivid memories of being in a hurricane. Oddly, all of them are pleasant.

For kids, a hurricane was all excitement. There was no school. It was 1967, and everyone gathered around the TV to watch Meteorologist Roy Leep track the storm. He was kindly but authoritative, with the air of a scientist. Where the colorful and dynamic realtime satellite images are now, there was a large very much analog wall map full of symbols, isobars and moveable pieces. Almost all children had a hurricane preparedness booklet. I even had a felt map of Florida, and had cut out the official symbols for tropical depressions and hurricanes so I could move them along the map. I was familiar with the tracking terminology. I tried to predict time and place of landfall.

Once during a hurricane my mother made me sit on the couch in the middle of the house with her and would not permit me to get near the windows as I wished. In that same incident, large lightning strikes caused sparks to come out of the wall outlets. Eventually the power went out and we lit candles, which I though was wonderful. We got to eat snack foods, which were normally not allowed.

Once, when I lived on a small residential island on a bayou, we had a tremendous hurricane related storm surge. I slept through it, and the next morning it was bright sunshine. I, together with all the other children in the neighborhood took to the streets... in boats. There were also pool toys like floating seats. Everyone got out and had a grand day, and were all the happier when we learned that the one bridge had washed out. We all swam like fishes in the first place, living there. We all had pools, and seawalls, and boats. But now, our boats banged awkwardly against their pylons whose lines had been slacked, and our pools had all become contiguous with the ocean waters which had come over the seawall and across the lawn.

Somehow I think the adults did not have the same experience. As I got older, more toward two digits, I didn't either. I learned in retrospect, that during Camille, two states away, many had lost life. Our Florida houses were made of concrete and screened porches, but in the old south, they were made of wood. Homes and lives had been lost, and would be again and again.

I got to where I could readily discern that strange green light in the sky which precedes the hurricane and occupies the eye. I could literally feel the lightness of the fall in barometric pressure. Once here in Montana my daughter and I were taking our groceries to the car during a bad windstorm. Though it had been over 40 years, I remembered that green light in the sky, so beautiful. I told her if I didn't know better, I could feel the lift of the whole atmosphere. I told her about the funnel clouds I'd seen over the Gulf of Mexico, and how they started as a dark grey V shaped little buds off a big cloud. We looked around and thought maybe we saw one. As we got home, ten minutes away, we passed by what had been a stand of massive old cottonwood trees. Now there was just a giant pile of sawdust and twisted roots. The three homes in proximity including ours were untouched, though people in the neighborhood said the wind had been a deafening roar. We later learned that two small tornadoes had been believed to touch down. I was heartbroken for the magnificent trees, but then ashamed of my sentiment compared to what victims of violent storms must feel.

By morning, the Red Cross will be badly stretched for resources of all kinds. We all need to do what we can to help. Here is their link.