Unhealthy conditions ripe for disease
Survivors from the gargantuan tsunami that swept across Asia will face a host of new threats in the coming days and weeks: viruses and bacteria in the water, diseases seeping from human remains, and the vulnerability to bugs and other predators that comes from having no shelter.
"Whatever number of people have been killed immediately by the tsunami, the possibility of a doubling or a tripling of that number through secondary public-health issues is possible," said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health.
Many of the health problems likely to emerge will come from water people use for drinking, washing, and cooking that has been contaminated by sewage, human remains, and storm debris. The result, disease specialists predicted, will be epidemics of illnesses such as typhoid fever, which is caused by salmonella bacteria that spread through contaminated water and food.
Those waterborne diseases can spawn fever, diarrhea, and damage to the liver and spleen.
In a statement from the United Nations, Jan Egeland, undersecretary general for humanitarian affairs, said that the devastation from the calamity will come in two waves: the first being the immediate loss of life.
"The second wave, the aftereffects, can touch millions of people as water and sanitation systems are damaged or destroyed," the UN statement said.
Survivors will find scant refuge from these threats.
With their homes washed to sea, they do not have the protection afforded by the walls of even modest domiciles, making it easier for mosquitoes to spread malaria and other deadly diseases.
"If you lose your shelter, you lose your barrier from disease," said Dr. Bradley Woodruff, a medical epidemiologist at the US Centers for Disease Control and Prevention. "Most places in the world have some sources of health care, they have some sources of water, albeit of different cleanliness and safety. When such a comprehensive disaster as this occurs, it wipes out all these things."
Speed will be pivotal to preventing a massive, secondary surge of deaths and illness, Redlener said. Relief agencies will need to move swiftly to provide water and shelter so that diseases that are easily spread person-to-person cannot take root.
"Every hour and every day of delay here is going to cost lives," Redlener said. But even those relief efforts pose health risks. Refugee camps, with thousands of adults and children jammed into cramped quarters, can prove to be ideal breeding grounds for viruses and bacteria.
Stephen Smith can be reached at stsmith@globe.com. 