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Skin Problems after Floods

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Introduction[edit]

In a flood emergency many residents are forced to wade through flood waters to escape, rescuers are exposed to flood waters in the effort to help and some citizens choose to walk in water for recreation. These waters are laden with pathogens and chemicals and represent a significant exposure to those people. Some of the potential contaminants in the flood water include raw sewage, oil, gasoline, and household chemicals such as paints (sometimes lead based) and insecticides. A major concern is large scale, unintentional release of contaminants from industrial, superfund, or agricultural sites.[1]

Dermatological Manifestations[edit]

Communicable Diseases[edit]

Bacterial and fungal skin infections have both been reported after exposure to floodwaters. The risk of infection is increased with traumatic injury to the skin and also in people with certain underlying conditions such as diabetes, chronic venous insufficiency and immunosuppression.[2] Staphylococcal and Streptococcal organisms remain the most common causes of superficial infection after a flooding event.[3] However, exposure to floodwaters is associated with increased risk of infection from atypical bacteria such as vibrio vulnificus and mycobacterium marinum when exposed to saltwater and aeromonas when exposed to contaminated freshwater.[4] People with liver cirrhosis or immunosuppression are at increased risk of developing severe disease with vibrio and aeromonas infections.[2][4] Fungal infections such as tinea corporis have also been reported especially in warm humid climates.[5]

Contact Dermatitis[edit]

Contact dermatitis occurs when the skin comes into contact with chemicals that cause a reaction, often redness, swelling or itchiness. Flood water often contains chemicals from industries or households that can cause such a reaction, these include pesticides, bleach and detergents.[6]

Traumatic Injuries[edit]

Flood water consumes land that previously did not contain water.  This makes it hard for residents and rescuers to see clearly where they are going, which can hide potential risks for traumatic injuries. This includes the covering of sharp objects (metals, glass, sticks), rocks and ditches, electrical hazards (down power lines) and animals that can be displaced from the flood waters.[7] 

Other Manifestations[edit]

Additionally, psychological stress associated with a flooding event can lead to psycho-emotional aggravated primary skin disease, which exacerbates pre existing skin diseases such as: atopic dermatitis, alopecia areata, and psoriasis.[7]

Prevention[edit]

In systems already stressed by the natural disaster, the potential morbidity associated with skin infections or reactions can be life threatening and is, ultimately, preventable if exposure is limited and post-exposure safety measures are taken. Skin should be thoroughly cleaned and people with exposures should ensure their tetanus vaccinations are up to date.

CDC recommendations:[8]

  • Avoid contact with flood waters if you have an open wound.
  • Cover clean, open wounds with a waterproof bandage to reduce chance of infection.
  • Keep open wounds as clean as possible by washing well with soap and clean water.
  • If a wound develops redness, swelling, or oozing, seek immediate medical care.

References[edit]

  1. Young, Stacy; Balluz, Lina; Malilay, Josephine. "Natural and technologic hazardous material releases during and after natural disasters: a review". Science of the Total Environment. 322 (1–3): 3–20. doi:10.1016/s0048-9697(03)00446-7.
  2. 2.0 2.1 Diaz, MD, MPH&TM, DrPH, FCCM, James H.; Diaz, James H.; MD; MPH&TM; DrPH; FCCM. "Superficial and invasive infections following flooding disasters". American Journal of Disaster Medicine. 9 (3): 171–181. doi:10.5055/ajdm.2014.0169.CS1 maint: Multiple names: authors list (link)
  3. "Infectious Disease and Dermatologic Conditions in Evacuees and Rescue Workers After Hurricane Katrina --- Multiple States, August--September, 2005". www.cdc.gov. Retrieved 2017-10-29. line feed character in |title= at position 64 (help)
  4. 4.0 4.1 Bandino, Justin P.; Hang, Anna; Norton, Scott A. (2015-10-01). "The Infectious and Noninfectious Dermatological Consequences of Flooding: A Field Manual for the Responding Provider". American Journal of Clinical Dermatology. 16 (5): 399–424. doi:10.1007/s40257-015-0138-4. ISSN 1175-0561.
  5. Tempark, Therdpong; Lueangarun, Saoraya; Chatproedprai, Susheera; Wananukul, Siriwan (2013-10-01). "Flood-related skin diseases: a literature review". International Journal of Dermatology. 52 (10): 1168–1176. doi:10.1111/ijd.12064. ISSN 1365-4632.
  6. "Contact dermatitis - Symptoms and causes - Mayo Clinic". www.mayoclinic.org. Retrieved 2017-10-29.
  7. 7.0 7.1 Shultz, James M.; Galea, Sandro (2017-10-17). "Mitigating the Mental and Physical Health Consequences of Hurricane Harvey". JAMA. 318 (15). doi:10.1001/jama.2017.14618. ISSN 0098-7484.
  8. "Personal Hygiene After a Disaster or Emergency|Floods". www.cdc.gov. 2017-10-12. Retrieved 2017-10-29.


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