After a Hurricane: Key Facts About Infectious Disease

Although infectious diseases are a frightening prospect, widespread outbreaks of infectious disease after hurricanes are not common in the United States. Rare and deadly exotic diseases, such as cholera or typhoid fever, do not suddenly break out after hurricanes and floods in areas where such diseases do not naturally occur.

Communicable disease outbreaks of diarrhea and respiratory illness can occur when water and sewage systems are not working and personal hygiene is hard to maintain as a result of a disaster. However, no disease outbreaks have been reported as of September 3, 2005 in areas affected by Hurricane Katrina.

· Decaying bodies create very little risk for major disease outbreaks.

· Outbreaks of infectious diseases following hurricanes are rare in developed countries (such as the United States) and only slightly more common in the developing world.

· Numbers of short-term, self-limiting gastrointestinal illnesses and respiratory infections sometimes increase in developed countries. However, numbers of communicable diseases (including gastrointestinal and respiratory illnesses as well as cholera and typhoid) more typically do not increase in either developed or developing countries.

· Unless a disease is brought into a disaster area from elsewhere, any outbreaks that occur are almost always from diseases that were already in the disaster-affected area before the disaster struck.

· Because cholera and typhoid are not commonly found in the U.S. Gulf States area, it is very unlikely that they would occur after Hurricane Katrina.

· Communicable disease outbreaks can occur when sanitation and hygiene are compromised as a result of a disaster.

· As has been the case in past hurricanes, the U.S. Department of Health and Human Services quickly sets up tracking systems that monitor illnesses in hurricane-affected areas. In the unlikely event that a disease outbreak occurs, these systems provide an early warning that enables prompt public health response.

DISASTER RECOVERY INFORMATION

Interim Immunization Recommendations for Individuals Displaced by a Disaster

The purpose of these recommendations is two-fold:

1. To ensure that children, adolescents, and adults are protected against vaccine-preventable diseases in accordance with current recommendations. Immunization records are unlikely to be available for a large number of adult and child evacuees. It is important that immunizations are kept current if possible.
2. To reduce the likelihood of outbreaks of vaccine-preventable diseases in large crowded group settings.

I. Recommended Immunizations

If immunization records are available:

Children and adults should be vaccinated according to the recommended child, adolescent, and adult immunization schedules.

See the following:

• Childhood and Adolescent Immunization Schedule 
• Adult Immunization Schedule 

If immunization records are not available:

Children aged 10 years and younger should be treated as if they were up-to-date with recommended immunizations and given any doses that are recommended for their current age. This includes the following vaccines:

• Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP)
• Inactivated Poliovirus vaccine (IPV)
• Haemophilus influenzae type b vaccine (Hib)
• Hepatitis B vaccine (HepB)
• Pneumococcal conjugate vaccine (PCV)
• Measles-mumps-rubella vaccine (MMR)
• Varicella vaccine unless reliable history of chickenpox
• Influenza vaccine for all children 6-59 months of age, and all children 6 months through 10 years of age with an underlying medical condition that increases the risk for complication of influenza (MMWR 2006 Jul 28;55[RR10]:1-42).
• As of May 2006, Hepatitis A vaccination is recommended for children 1 year of age and older in the United States (MMWR 2006 May 19;55[RR07]:1-23).
• Rotavirus vaccine

Children and adolescents (aged 11-18 years) should receive the following recommended immunizations:

• Adult formulation tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap)
• Meningococcal conjugate vaccine (MCV) (ages 11-12 and 15 years only)
• Influenza vaccine for all children 6-59 months of age, and all children 6 months through 10 years of age with an underlying medical condition that increases the risk for complication of influenza (MMWR 2006 Jul 28;55[RR10]:1-42)
  

Adults (over 18 years of age) should receive the following recommended immunizations:

• Adult formulation tetanus and diphtheria toxoids (Td) if 10 years or more since receipt of any tetanus toxoid-containing vaccine.
• Pneumococcal polysaccharide vaccine (PPV) for adults 65 years of age or older or with a high risk condition (MMWR 1997 Apr 4;46[RR-08]:12-13)
• Influenza vaccine (MMWR 2006 Jul 28;55[RR10]:1-42)
  

School requirements

It is not necessary to repeat vaccinations for children displaced by the disaster, unless the provider has reason to believe the child was not in compliance with applicable state requirements