Skin infections most common ailment linked to Houston floodwaters
Amid concern about floodwaters brimming with contaminants, Houstonarea hospitals, emergency departments and clinics are reporting an influx of patients with symptoms related to Tropical Storm Harvey.
The numbers are not overwhelming, but health officials this week said they have begun seeing a significant number of patients with injuries suffered during clean-up efforts, respiratory problems including pneumonia and, most of all, skin infections contracted by those who spent time in the water.
“Harvey changed the composition of our Labor Day weekend census from the typical overload of trauma cases from traffic accidents to a lot of softtissue infections,” said Dr. James McCarthy, chief of emergency medicine at Memorial Hermann Hospital’s Red Duke Trauma Institute. “These are infections, involving wounds that stayed wet for long periods of time, suffered by flooding victims and responders, both civilian and professional.”
McCarthy said the skin infections have been treated well with antibiotics, though some cases have required hospital admission, which is highly unusual. Dr. Beau Briese, an emergency department doctor at Houston Methodist Hospital, said a few skin infections there had developed into advanced sepsis, a life-threatening condition caused by the immune system’s overreaction. None of those infections have been fatal.
Pleasant surprise
Medical leaders said Tuesday there have been no Harvey deaths, so far, resulting from health problems or injuries or the more than 1,500 patient evacuations that took place at hospitals suffering internal disasters or bracing for flooding.
A number of the leaders said they are surprised there have not been more Harvey-related health problems reported.
That is because floodwaters typically contain all manner of contaminants, including bacteria, viruses and fungi; fecal matter and sewer overflows; toxins such as pesticides and oil swept from people’s homes; and pollutants from petroleum refineries and chemical plants.
The city has begun testing Harvey’s floodwaters for specific contaminants, but has no results yet. Porfirio Lopez, a spokesman for the city health department, last week emphasized that even without such testing, it is obvious that the water is contaminated.
Much of the Harvey medical response has occurred at the NRG Center, south of the Texas Medical Center, and the downtown George R. Brown Convention Center, both of which have been set up as emergency shelters for storm evacuees. Medical units set up at the two sites have seen about 600 patients a day, of which a small percentage required ambulance trips to hospital emergency departments.
The units also arranged buses for patients in advanced kidney failure and in desperate need of urgent dialysis treatment.
Much of the activity at the NRG and George R. Brown involved providing pharmaceuticals for people who had been separated from their medications by the flooding.
Doctors at the two sites relied on donated supplies, initially in response to a Facebook appeal, then provided by CVS and Walgreens mobile clinics.
“We’ve actually picked up a lot of chronic problems in people not accessing the medical system,” said Briese, director of the medical volunteer staff at NRG. “It’s been a nice, unexpected benefit.”
Among them: a pale woman, initially thought to have severe anemia, turned out to have multiple myeloma, a blood cancer. She is receiving chemotherapy at Methodist.
By the weekend, ER doctors were reporting an increase in injuries, most minor but including cases of electric shock; mental health issues ranging from anxiety to schizophrenia to drug withdrawal; and respiratory problems, both allergic reactions to mold or clean-up efforts, and cases of pneumonia.
Cuts, scrapes, bites
The most common complaint has been the skin infections.
Memorial Hermann Urgent Care-Tanglewood, for example, said Tuesday the primary reasons why patientshave sought care there in recent days has been cuts, scrapes and bites they were concerned could become infected. Those not up-to-date on their tetanus shots have received boosters.
McCarthy, also chairman of emergency medicine at the University of Texas’ McGovern Medical School at Houston, said the number of skin infections at Memorial Hermann was high enough that he sent samples to the city health department for testing into whether there is a unique germ circulating or the number of cases merely reflects people’s exposure to floodwaters. He had not heard back Tuesday evening.
A Texas A&M research team last week reported Harvey floodwaters contained 125 times the amount of E. coli considered safe for swimming and 15 times the amount acceptable for wading. The water was collected from Cypress and tested in a College Station lab.
Emphasizing Harvey’s floodwaters are still a threat, Dr. David Persse, medical director for Houston’s Emergency Medical Services, warned people to stay out of it.
“Just because the water’s receding doesn’t mean anyone should get comfortable with it,” he said. “People need to think before they act. The emergency’s over, but they still need to plan ahead, use common sense, not try to be a hero.”