THE PERILS AFTER THE FLOOD

 The receding water has left behind countless small, stagnant ponds that can become breeding sites for mosquitoes, raising the spectre of a dengue epidemic. They can also be contaminated by rodent and dog urine, exposing people – especially children – to leptospirosis infection.
    All those people who evacuated their residences are returning home to face the sanitary risks for the first time. It is essential that they realise the potential health hazards as they go about cleaning.
    First, the water that filled their houses could have been polluted with municipal, factory chemicals or the carcasses of dead animals. It may have left chemical and biological toxins. Cleaning up requires extreme precaution to avoid skin, eye and respiratory problems.
    Second, cleaning up is physically exhausting and emotionally draining. The unanticipated stress increases the risk of injury that can lead to skin infections.
    There have been news reports of widespread fungal infections such as athlete’s foot, but a study a few years ago found that eczema accounted for most skin disorders during floods in Thailand. The itchy and reddish rash has been linked to the immune system overreacting to an irritant, and floodwater contains numerous irritants.
    The researchers found that skin maceration between the toes – initially thought to be fungal infection – were in fact more often chronic irritant dermatitis with secondary bacterial colonisation. The most prevalent bacteria were the so-called Gram-negative types that usually turn up in sewage-polluted environment.
    Skin lesions affect people in different ways. Those who stayed in their flooded homes were obviously at higher risk due to regular immersion. Those who evacuated incur skin lesions by not taking adequate precautions when they return.
    It’s of the utmost importance to wear proper gloves and shoes as well as protective glasses. Masks with N95 disposable respirators are highly recommended because you can breathe in fungal spores from mouldy home fixtures.
    Inhaling these spores can bring on respiratory illnesses among predisposed individuals, especially asthmatics and people with low immunity.
    So find out the safe approaches to cleaning your premises – and don’t switch on any electricity until you’ve had a competent technician assess the wiring system.

Dr Gerard Lalande is managing director of CEO-Health, which provides medical referrals for expatriates and customised executive medical check-ups in Thailand. He can be contacted at [email protected].