# How likely is a cholera outbreak in New Orleans? **URL:** \ **Category:** Factual Questions\ **Created:** [August 31, 2005, 7:56am UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400 "2005-08-31T07:56:43Z")\ **Posts on this page:** 17\ **Page:** 2
**Author:** ![What\_Exit](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/what_exit/32/10652_2.png) [@What\_Exit](https://boards.straightdope.com/u/What_Exit)\ **Post date:** [September 1, 2005, 1:40am UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/21 "2005-09-01T01:40:43Z")
> [@Inigo Montoya](#): > > Not when everythings soppin’ wet from rain & humidity! And where’s the diesel, Ace? And most of the generators? MMMmmmmmmmaybe under 20 feet of nasty water? Even the hospitals are having to send out scrounges for generator fuel to keep the life support gear going. > > No, I’m thinking the locals are pretty well screwed barring a massive invas…I mean, evacuation. Charity hospital has had all the patients evacuated. Generators ran out of fuel at 8am. Staff is still there. Plan is to evacuate every one from the city. By Bus and possibly by boat. Navy has troop transports and fast rescue boats on site or arriving soon. ---
**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\ **Post date:** [September 1, 2005, 1:59am UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/22 "2005-09-01T01:59:42Z")
Cholera is rare in the U.S. so it is very unlikely to be a problem; same with malaria. Wild speculation, as engaged in by some posters and the Secretary of HHS, is unnecessary. Your tax dollars (if you pay U.S. taxes) have been going for decades to scientists hired to study the health risks associated with floods, hurricanes, and other natural disasters. From a report on the aftermath of Marilyn which struck the Virgin Islands on 15-16 September 1995: "During September 16-30, a total of 3265 patient visits were recorded at the four primary medical treatment sites (i.e., the hospital and three DMAT sites). Of the 3265 visits, 1084 (33%) were storm-associated injuries involving minor wounds (i.e., abrasions, lacerations, punctures, and foreign-body removal) or trauma to the musculoskeletal system (i.e., fractures, sprains, strains, and dislocations). In addition, eight persons sustained burns while operating or refueling portable power generators. Other problems reported included upper and lower respiratory tract illnesses (383 {12%}) (e.g., sore throat, cough, pneumonia, and asthma) and dermatologic disorders (199 {6%}) (e.g., rashes, sores, and infections). Of the 167 visits for gastrointestinal disorders, 77 were for diarrheal illness (2.4% of total patient visits). The second largest category of visits (23.5%) was grouped as miscellaneous and was for problems unrelated to the storm (e.g., blood pressure and blood glucose screening, prescription refills, vaccinations, and other health-care services). " [http://www.cdc.gov/mmwr/preview/mmwrhtml/00040093.htm](http://www.cdc.gov/mmwr/preview/mmwrhtml/00040093.htm) From a report on the aftermath of Opal which struck Florida on 4 October 1995: “EDs treated 996 patients during the prehurricane period and 1135 during the post-hurricane period. For both periods, the proportion of ED visits were similar for lacerations, puncture wounds, musculoskeletal injuries, rashes, and gastrointestinal or respiratory illnesses. During the posthurricane period, the proportion of visits for insect bites increased from 0.2% to 1.7% (p less than 0.05). These findings were shared with local health officials and emergency management officials coordinating disaster relief.” [http://www.cdc.gov/mmwr/preview/mmwrhtml/00040093.htm](http://www.cdc.gov/mmwr/preview/mmwrhtml/00040093.htm) From a survey of Floridians after the 2004 hurricane season: “Physical injuries caused by the hurricanes were reported by 4.6% of persons in the hurricane paths and 3.8% not in the hurricane paths. Among persons with health conditions such as diabetes, asthma, or cardiovascular disease, 5.4% reported their conditions were made worse as a result of the hurricanes, including 6.4% in the hurricane paths and 4.1% not in the hurricane paths. Among those who said their health conditions were made worse by the hurricanes, 13.6% reported being prevented or delayed by the hurricanes from obtaining medication, and 9.0% reported barriers to accessing essential medical equipment (e.g., dialysis or oxygen). Persons living in counties in the hurricane paths were more likely (12.7%) to report difficulty in accessing essential medical equipment than persons not in the hurricane paths (1.9%).” [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5428a1.htm](http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5428a1.htm) From a report on injuries and illness related to Andrew in Louisiana in 1992: “Of the 462 hurricane-related events, 445 (96%) had nonfatal outcomes (Table 1, page 249). Of the 17 (4%) fatal outcomes, eight occurred before the hurricane made landfall: six were due to drowning; one, to an impact injury sustained in a motor-vehicle crash during the evacuation; and one, to a crush injury sustained during a tornado that preceded the hurricane (Figure 1). Of the 445 nonfatal events, 383 (86%) were injuries, and 62 (14%) were illnesses; 319 (72%) occurred among males. The most common nonfatal injury was a cut/laceration/puncture wound (184 {41%} of 445), followed by a strain/sprain (49 {11%}) (Table 1). The most common body parts reported affected by a nonfatal hurricane-related injury/illness were the upper extremities, including the fingers, hands, and arms (157 {38%} of 411), followed by the lower extremities, including the toes, feet, and legs, (89 {22%}).” [http://www.cdc.gov/mmwr/preview/mmwrhtml/00020139.htm](http://www.cdc.gov/mmwr/preview/mmwrhtml/00020139.htm) Notice a pattern? Any epidemics? Any cholera? Typhoid? Rabies? Any infectious diseases mentioned AT ALL? How about the huge epidemics of cholera, dysentery, malaria, dengue fever, and flu that followed the recent tsunami in Asia?? This is not rocket science but it is science. ---
**Author:** ![Inigo\_Montoya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inigo_montoya/32/124_2.png) [@Inigo\_Montoya](https://boards.straightdope.com/u/Inigo_Montoya)\ **Post date:** [September 1, 2005, 2:43am UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/23 "2005-09-01T02:43:22Z")
> [@Yeah](#): > > Notice a pattern? Any epidemics? Any cholera? Typhoid? Rabies? Any infectious diseases mentioned AT ALL? > > How about the huge epidemics of cholera, dysentery, malaria, dengue fever, and flu that followed the recent tsunami in Asia?? > > This is not rocket science but it is science. Right. And I’m not going to press an issue one way or another. But those places DRAINED after the storm, they didn’t continue to flood what…200,000 people…with noplace to go. As science goes I think that a huge volume of stagnant water, fouled by the backed up waste of an entire city, is a pretty significant variable not shared to this degree by the other storms you mentioned. But maybe the fuel oils & gasoline will leak out of the infrastructure and create a nice oily film over the water & kill off the insect larvae. Could happen I guess. But then what about the thousands of 40 foot alligators with laser beams shooting out of their eyeses that will invade from the adjacent swamps! ---
**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\ **Post date:** [September 1, 2005, 3:15am UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/24 "2005-09-01T03:15:19Z")
In response to **Yeah** , I don’t think the events you discussed were the same as this. If nothing else, the N.O. flooding is getting worse, not better as the days pass. It is also compounded by an almost total lack of power and medical help (at least for those still stranded). In terms of the tsunami, I believe that the salt water which comprised the flood water acted to “sterilize”, or in some other way inhibit the proliferation of pathogenic micro-organisms. There’s definitely malaria in Florida. I don’t know about Louisiana or Mississippi, though. Mind you, and I am serious in saying this, one can imagine mosquitos being carried from Florida to the gulf states by the hurricane winds. I’ll close by saying that if _one_ person is carrying cholera, that might be all that it takes. ---
**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\ **Post date:** [September 1, 2005, 12:49pm UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/25 "2005-09-01T12:49:28Z")
[QUOTE=KarlGauss] In response to **Yeah** , I don’t think the events you discussed were the same as this. If nothing else, the N.O. flooding is getting worse, not better as the days pass. It is also compounded by an almost total lack of power and medical help (at least for those still stranded). No disaster is quite the same as any other disaster. Maybe, because of all the water saturating an area with a high population of crayfish, we’ll see an invasion of humanoids from the deep as a consequence of this innundation. All I’m saying is that very observant people have been studying natural disasters, some worse than this, most not so bad, and I am unaware of ANY where infectious diseases were a big issue. Certainly when if comes of availability of power and medical care, the folks in Sumatra were much worse off. And they started out with typhoid, cholera, and malaria. As for the salt “sterilizing” the sewage, you can forget that. Bacteria that can live in the saline environment of human blood can tolerate a little brackish water. And there is no “malaria in Florida.” There are occasional cases or small clusters of cases in Florida as in California and other states but these result from importations and they don’t spread much because, in comparison with people in countries with endemic malaria, people with malaria in the United States tend to get treated sooner and are less like to be bitten by mosquitoes while they are infectious. (To say nothing of the fact that rising flood waters are unfavorable for the reproduction of malaria carrying mosquitoes.) Again, speculation is unnecessary. Look at the evidence. How many natural disasters in the past century can you name that were followed by outbreaks of infecious diseases? I’ll go with the experts. ---
**Author:** ![Umphreak](https://avatars.discourse-cdn.com/v4/letter/u/2bfe46/32.png) [@Umphreak](https://boards.straightdope.com/u/Umphreak)\ **Post date:** [September 1, 2005, 2:02pm UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/26 "2005-09-01T14:02:23Z")
> [@Yeah](#): > > Again, speculation is unnecessary. Look at the evidence. How many natural disasters in the past century can you name that were followed by outbreaks of infecious diseases? I’ll go with the experts. Again, NO is a very unique situation. How many of those natural disasters caused a major city (80% of it) to be severely flooded for weeks, maybe months? I think the concern is valid in this case. ---
**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\ **Post date:** [September 2, 2005, 1:07am UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/27 "2005-09-02T01:07:36Z")
> [@Umphreak](#): > > Again, NO is a very unique situation. How many of those natural disasters caused a major city (80% of it) to be severely flooded for weeks, maybe months? > > I think the concern is valid in this case. It’s also unique because how often is a whole city evacuated for weeks, maybe months? (If there’s no one there, how is disease going to be transmitted?) Let’s resurrect this thread on November 1st and see who’s right. Mark your calendar. ---
**Author:** ![Rysdad](https://avatars.discourse-cdn.com/v4/letter/r/7cd45c/32.png) [@Rysdad](https://boards.straightdope.com/u/Rysdad)\ **Post date:** [September 2, 2005, 3:16am UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/28 "2005-09-02T03:16:38Z")
I’m mostly on line with **Yeah**. Those other diseases don’t scare me. I differ just slightly in that I think the most likely cause of disease-related death will be from gastrointestinal disease. Death by diarrhea. Dehydration and electrolyte imbalance. What a pleasant way to go. In New Orleans’ case, the microbes are already existant in the water, and the water is becoming more befouled by the minute. Have you ever been to a swimming pool and read any of the signs that say something like, “Just once instance of a soiled diaper in the pool and it will require the pool be closed for at least an hour while it’s chemically treated”? And that’s highly chlorinated, fresh water. Each summer there are reports that beaches that have to be closed because kids have become infected with Salmonella, Shigella, noraviruses, enteroviruses, Cryptosporidium, and Giardia. It doesn’t necessarily require that you _drink_ the fouled water to get sick–a simple scratch will do, and I’d hazard a guess that hurricane survivors might have a scratch or two. Now, for a minute, think about what will be left on the ground after the water is drained out of the New Orleans basin: Mississippi River silt, also known as Concentrated Gluey Brown River Death. And it also carries heavy metals, toxins, carcinogens, and other super icky stuff to go along with the germs mentioned above. In places it will be _yards_ deep. It’ll be in every house that was flooded. In every _restaraunt_(!) that was flooded. Everywhere. In the end, I think it’ll be the all-pervasive, infectious silt that seals the deal for rebuilding in NO. You can’t build on it, and it will have leached through the existing top soil. You’d have to remove all of the dirt in New Orleans in order to create a livable climate. After bulldozing all of the houses first. Ain’t that the shits? ---
**Author:** ![Smeghead](https://avatars.discourse-cdn.com/v4/letter/s/f1d935/32.png) [@Smeghead](https://boards.straightdope.com/u/Smeghead)\ **Post date:** [September 2, 2005, 5:28am UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/29 "2005-09-02T05:28:57Z")
Yeah, they were just talking on the news about how after the water subsides, there will probably be a film of raw sewage and other gunk over every surface in the city. Not pretty. ---
**Author:** ![Hypno-Toad](https://avatars.discourse-cdn.com/v4/letter/h/b2d939/32.png) [@Hypno-Toad](https://boards.straightdope.com/u/Hypno-Toad)\ **Post date:** [September 2, 2005, 12:55pm UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/30 "2005-09-02T12:55:44Z")
> [@Smeghead](#): > > …a film of raw sewage and other gunk over every surface in the city. Not pretty. That pretty much describes N.O. throughout it’s history. ---
**Author:** ![Rysdad](https://avatars.discourse-cdn.com/v4/letter/r/7cd45c/32.png) [@Rysdad](https://boards.straightdope.com/u/Rysdad)\ **Post date:** [September 2, 2005, 5:57pm UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/31 "2005-09-02T17:57:42Z")
> [@Smeghead](#): > > Yeah, they were just talking on the news about how after the water subsides, there will probably be a film of raw sewage and other gunk over every surface in the city. Not pretty. Trust me, it won’t just be a thin film. I’ve seen houses that have been flooded and only under water for a few days. The silt accumulates amazingly fast, and it gets _deep_. Anywhere from a few inches to a couple of feet deep. Can you imagine what it’ll be like after it has been standing stagnant for up to 6 months (the best estimate of time that it’ll take to drain the basin)? ---
**Author:** ![Smeghead](https://avatars.discourse-cdn.com/v4/letter/s/f1d935/32.png) [@Smeghead](https://boards.straightdope.com/u/Smeghead)\ **Post date:** [September 2, 2005, 6:36pm UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/32 "2005-09-02T18:36:39Z")
Back to the OP, [this](http://www.bt.cdc.gov/disasters/hurricanes/infectiousdisease.asp) is what the CDC has to say about the subject. ---
**Author:** ![Yeah](https://avatars.discourse-cdn.com/v4/letter/y/dbc845/32.png) [@Yeah](https://boards.straightdope.com/u/Yeah)\ **Post date:** [September 3, 2005, 1:50am UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/33 "2005-09-03T01:50:26Z")
> [@Smeghead](#): > > Back to the OP, [this](http://www.bt.cdc.gov/disasters/hurricanes/infectiousdisease.asp) is what the CDC has to say about the subject. It is extremelyl gratifying to see that someone has read what the experts have concluded after decades of careful study. Now, if only HHS Secretary “cholera and typhoid” Leavitt, Senator “fatal diarrhea, telediagnosis” Frist, J-Lou Gerberding, and whoever edits Bloomberg News would jst do as Smeghead has done we’d be f far ahead of where we are now. The CDC used to be run and staffed by people who shared Cecil’s outlook. It is still staffed, by and large, by the same kind of people. ---
**Author:** ![Inigo\_Montoya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inigo_montoya/32/124_2.png) [@Inigo\_Montoya](https://boards.straightdope.com/u/Inigo_Montoya)\ **Post date:** [September 6, 2005, 8:54pm UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/34 "2005-09-06T20:54:20Z")
And now, [e-coli](http://www.cnn.com/2005/US/09/06/katrina.impact/index.html). ---
**Author:** ![Jurph](https://avatars.discourse-cdn.com/v4/letter/j/50afbb/32.png) [@Jurph](https://boards.straightdope.com/u/Jurph)\ **Post date:** [September 6, 2005, 10:42pm UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/35 "2005-09-06T22:42:20Z")
> [@Rysdad](#): > > Each summer there are reports that beaches that have to be closed because kids have become infected with Salmonella, Shigella, noraviruses, enteroviruses, Cryptosporidium, and Giardia. > > It doesn’t necessarily require that you _drink_ the fouled water to get sick–a simple scratch will do, and I’d hazard a guess that hurricane survivors might have a scratch or two. I had a nasty rash on my ankles after Hurricane Gloria; I had to wade through the two-day-old flooding, and chose to go barefoot rather than ruin my shoes. It took a day or two to really kick in, but once it did I was not well – the itching was bad, and a fever came shortly thereafter. I got some antibiotics and a skin cream and got better pretty quickly. Let’s hope the Nawlinsers have access to that kind of help. ---
**Author:** ![Inigo\_Montoya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inigo_montoya/32/124_2.png) [@Inigo\_Montoya](https://boards.straightdope.com/u/Inigo_Montoya)\ **Post date:** [September 7, 2005, 5:08pm UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/36 "2005-09-07T17:08:12Z")
Take it with a grain of salt, CNN and all, but here’s some [disease spin on the situation](http://www.cnn.com/2005/HEALTH/09/06/katrina.water/index.html). > [@](#): > > CNN gave three samples to Analytical and Environmental Testing Inc., in Baton Rouge, Louisiana, which found 20,000 fecal coliform colonies per 100 milliliters of water, the highest the lab could count. That’s 100 times the normal count found in water runoff from storms, the company said. and > [@](#): > > The CDC said that five people who survived Hurricane Katrina in New Orleans died after becoming infected with Vibrio vulnificus, caused by a form of the bacteria that also causes cholera. One of the deaths occurred in Texas; the other four were in Mississippi, CDC spokesman Tom Skinner said. So no cholera in NO, but something kinda like it elsewhere. I’m a little skeptical about this last bit. I didn’t do so well in biology, but to say a killer bacterium is “related” to the one that causes cholera seems a lot like saying someone who got scratched by a housecat was mauled by a creature related to a tiger. ---
**Author:** ![Smeghead](https://avatars.discourse-cdn.com/v4/letter/s/f1d935/32.png) [@Smeghead](https://boards.straightdope.com/u/Smeghead)\ **Post date:** [September 7, 2005, 5:21pm UTC](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400/37 "2005-09-07T17:21:05Z")
Vibrio vulnificus is not a “form of the bacteria that causes cholera”. It’s a different species, just in the same genus. The way they put it, it makes it sound like it could switch over to causing cholera at any time, and that’s just not true. V. vulnificus infections are most commonly caused by people scraping themselves on ocean coral reefs. It can be a nasty infection, but it’s treatable. As for the fecal coliforms, well, that’s no surprise. I certainly hope no one’s out there drinking the flood water, though. [Previous page](https://boards.straightdope.com/t/how-likely-is-a-cholera-outbreak-in-new-orleans/319400.md?page=1)