From: "Susan McLellan" <smclell@...>
Date: Tue Sep 27, 2005 11:20 pm

The health risks of exposure to contaminants that may be in the mud currently left from the flood waters should be assessed with some degree of rationality. If you touch sewerage, and let me be blunt, if you stick your hand into someone else’s feces, it is very unlikely to cause you harm unless you then proceed to lick your hand or eat without washing. This is the basis for a huge assortment of diseases throughout the world that are transmitted by the oral fecal route. The vast majority of the world has to live with the reality of water contaminated with coliforms, not to mention other bacterial, viral, and parasitic critters, on a daily basis. The presence of bacteria in the MUD which remains after our poor lake merged with our sewers and came to visit our homes is essentially inconsequential – no one has ever devised a way to determine a safe standard of coliform contamination for dirt – dirt is not designed to be eaten, despite the routine activities of the under 3 crowd. As far as bacterial disease from the mud, don’t eat the stuff and don’t rub it into open wounds (not a good idea in the best of circumstances) and it should pose little risk for most persons.
Chemical contaminants are potentially another issue; (really) high levels of certain mercury compounds, for example, might penetrate unprotected skin. However there’s no evidence so far for levels of any chemicals in the flood waters which would pose a hazard purely from contact. Again, if you intend to drink the stuff, it may be another matter. The levels of potentially dangerous chemicals in the flood waters have at max so far been of the order that a small child would have to DRINK a liter per day of flood water in order to have adverse consequences. Read the reports.

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Stepping on the mud should not be a major hazard, even grubbing around in it to retrieve belongings, as I expect to be doing this weekend if we can get in. Bring extra water and soap to wash off with.
Real risks: injuries (wear decently protective gear, and for God’s sake don’t pull out the chain saws unless you really know what you are doing!), infected bug bites, and heat-related illness. Not to mention stress. Bring lots of insect repellent. If you haven’t had a tetanus shot in 10 yrs, get one (that is routine health maintenance, disaster or not). If you had one 5-10 yrs ago, you only need one if you get a dirty injury. If you had one in the last 5 yrs you don’t need one even if you do take off a few toes with a dirty chainsaw. Hep A is unnecessary unless you plan to live or work in a crowded shelter (or go to Cancun for a break after all this). Hep B is unnecessary unless you intend to do healthcare work (or have unprotected relationships with friendly locals in Cancun, or elsewhere). By the way, you shouldn’t drink the water in Cancun, either, but I bet no one would think twice about bathing in it…
To clarify my rights to spout off about the health risks, I’m an infectious diseases, tropical medicine, and public health specialist, and I hang around for fun in places with SERIOUS water and sanitation contamination issues (it’s odd to be getting notes of condolences from my Haitian colleagues). I’m also a Lakeview resident (assuming we folks in Lakewood South count) and a mom who herded her kids through the floodwaters (admittedly in Metairie at the time) after spending a few days trying to wait it out. The kids are already planning their Halloween costumes as products of the “toxic stew”.
If you are very sensitive to environmental stuff, have underlying illnesses which might be exacerbated by heat, stress, bad smells, or increased exertion, or are just nervous, please wait until you feel comfortable before coming in. If you have data which conflicts with what I have stated, please post it, but I think what is above is consistent with the evidence available (as opposed to dire and unfounded possibilities). If you are a non-medical person wondering what to think of all the horrendous stories floating about, I hope my comments are helpful.
Susan L F McLellan, MD MPH