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With hurricane Delta poised to make landfall in the same area struck by hurricane Laura 7 weeks ago, it is worth remembering that most deaths and injuries from hurricanes come after the storm has passed. A review, therefore, of some of the common post-storm hazards people along the Gulf Coast are likely to face in the days ahead.
The CDC is once again reminding the public and clinicians to be alert to the signs of Carbon Monoxide poisoning, a tragedy we often see in the days and weeks following a hurricane.
Despite the warnings issued before every hurricane, within a few days of Laura's landfall last August we saw headlines like:
2 new carbon monoxide deaths reported, Hurricane Laura's death toll now 16
3 dead and 23 hospitalized in Port Arthur, all due to possible CO poisoning
Eight years ago, in MMWR: Carbon Monoxide Exposures Related To Hurricane Sandy, we looked at a CDC Notes From The Field report on the the large number (260+) of CO exposures linked to the aftermath of hurricane Sandy in the Northeast, and two years ago we looked at a CDC HAN on CO poisoning following Hurricane Florence which affected the Carolinas.
Hurricane Delta—Clinical Guidance for Carbon Monoxide (CO) Poisoning
Distributed via the CDC Health Alert Network
October 8, 2020, 7:30 PM ET
CDCHAN-00437
Summary
The Centers for Disease Control and Prevention (CDC) is reminding healthcare professionals seeing patients from the areas affected by Hurricane Delta to maintain a high index of suspicion for carbon monoxide (CO) poisoning. Other people who may be exposed to the same CO source may need to be identified and evaluated.
The signs and symptoms of CO exposure are variable and nonspecific. A tension-type headache is the most common symptom of mild CO poisoning. Other common symptoms of CO poisoning are dizziness, weakness, drowsiness, upset stomach, vomiting, chest pain, and confusion.
Clinical manifestations of severe CO poisoning include cardiovascular and neurological effects: tachycardia, tachypnea, hypotension, metabolic acidosis, dysrhythmias, myocardial ischemia or infarction, noncardiogenic pulmonary edema, irritability, impaired memory, cognitive and sensory disturbances, ataxia, altered or loss of consciousness, seizures, coma, and death, although any organ system might be involved.
Although CO poisoning can be fatal, children, pregnant women, the unborn, persons with sickle cell disease, older adults, and persons with chronic illness (e.g., heart or lung disease) are particularly high risk.
Background
High winds and heavy rain from Hurricane Delta will begin affecting the Gulf Coast around October 9, 2020. Those who lose power may turn to alternate power sources such as gasoline generators and may use propane or charcoal grills for cooking. If used or placed improperly, these sources can lead to CO build up inside buildings, garages, or campers and poison the people and animals inside.
When obtaining a focused history of patient activities and health symptoms, exposure to a CO source may become apparent. Appropriate and prompt diagnostic testing and treatment are crucial to reduce morbidity and prevent mortality from CO poisoning. Identifying and mitigating the CO source is critical in preventing other poisoning cases.
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After the storm has passed, flood waters are often slow to recede, and they can leave behind a multitude of dangers (see What Lies Beneath (the flood waters)). Downed electrical lines, dangerous debris, weakened and compromised structures, and even displaced wildlife (think : alligators, snakes, rats, etc.) can pose ongoing threats following the storm.
While most will (hopefully) have battery operated flashlights or LED lanterns (no candles, please!) for lighting, people should also consider they may lose perishable food items as freezers and fridges begin to lose their chill.Not only do flood waters easily hide dangerous objects - like broken bottles, razor sharp metal sheeting, live electrical wires, and rusty nails – they can also harbor nasty viruses and bacteria.
My most vivid memory of standing in the French Quarter of New Orleans a few weeks after Hurricane Katrina was the staggering number of refrigerators and freezers dragged out to the curbs - filled with rotting food - waiting to be hauled away.
The USDA maintains a Food Safety and Inspection website with a great deal of consumer information about how to protect your food supplies during an emergency, and how to tell when to discard food that may no longer be safe to consume.
A Consumer's Guide to Food Safety: Severe Storms and Hurricanes
Note: This text-only version of the Guide has been optimized for accessibility. The illustrated PDF version (2.1MB) is recommended for printing.
Power Outages
Safety of Food in Containers Exposed to Flood Waters
Removing Odors from Refrigerators & Freezers
Refrigerator Foods
Frozen Food
Food Safety Contacts for Areas Affected by Severe Storms and Hurricanes
FOOD SAFETY DURING AN EMERGENCY
Did you know that a flood, fire, national disaster, or the loss of power from high winds, snow, or ice could jeopardize the safety of your food? Knowing how to determine if food is safe and how to keep food safe will help minimize the potential loss of food and reduce the risk of foodborne illness. This Consumer's Guide will help you make the right decisions for keeping your family safe during an emergency.
Preventing Chain Saw Injuries During Tree Removal After a Disaster
Stay Safe
- Wear proper protective clothing and glasses.
- Choose the proper size of chain saw to match the job.
- Operate, adjust, and maintain the saw according to manufacturer’s instructions.
- Take extra care in cutting “spring poles” trees or branches that have been bent, twisted, hung up on, or caught under another object during a high wind.
- Be sure that bystanders are at a safe distance from cutting activities.
- Check around the tree or pole for hazards, such as nails, power lines, or cables, before cutting.
Each year, approximately 36,000 people are treated in hospital emergency departments for injuries from using chain saws. The potential risk of injury increases after hurricanes and other natural disasters, when chain saws are widely used to remove fallen or partially fallen trees and tree branches.
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While the psychological impact of a major disaster cannot be fully prevented, individual, family, and business preparedness can go a long ways towards reducing the impact of any disaster.
There are websites devoted to learning the techniques of Psychological First Aid (PFA), such as NCTSN's (National Child Traumatic Stress Network):
About PFAPsychological First Aid (PFA) is an evidence-informed modular approach to help children, adolescents, adults, and families in the immediate aftermath of disaster and terrorism. Individuals affected by a disaster or traumatic incident, whether survivors, witnesses, or responders to such events, may struggle with or face new challenges following the event. PFA was developed by the National Child Traumatic Stress Network and the National Center for PTSD, with contributions from individuals involved in disaster research and response.
A small reminder that in the wake of a major disaster not all wounds bleed, not all fractures show on an X-ray, and that the best treatment doesn't always come from inside your first aid kit.
