Health Officials Warn of Mold After Hurricanes

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Health Officials Warn of Mold After Hurricanes

http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/tb/1836

By , MedPage Today Staff Writer

Reviewed by Jasmer, MD; Assistant Professor of Medicine,

University of California, San Francisco

September 28, 2005

Also covered by: CNN, MSNBC, USA Today

MedPage Today Action Points

Advise patients that many molds can cause infections, allergic

reactions and toxic reactions.

Note that removing the mold will usually remove the danger.

Review

ATLANTA, Sept. 28-In the wake of Hurricanes Katrina and Rita, health

officials are warning that conditions are right for explosive growth

of molds, with health consequences that can range from a runny nose

to full-blown pneumonia.

" The mold issue is something that will affect the entire Gulf Coast

region, but is going to be a particular problem in New Orleans

because of the flooding that occurred there and the duration of the

flooding, " said Redd, M.D., of the Centers for Disease

Control and Prevention here.

Ordinarily, molds can't grow in homes and other buildings because

there isn't enough moisture, Dr. Redd told a press briefing. " The

conditions for mold growth … are really optimal now, " he said.

He said the health consequences of mold exposure fall into three

categories:

Infections -- mostly a concern in people with suppressed immune

systems -- that can lead to such diseases as pneumonia and fungal

sinusitis.

Allergic reactions, causing runny nose, itchy eyes, and in some

cases shortness of breath.

In some circumstances, mold can produce toxins that are dangerous if

they're eaten or touched. (Some species of the mold aspergillus, for

instance, produce aflatoxins, which can cause liver damage.)

A Louisiana health official said so far there hasn't been increase

in mold-related complaints in New Orleans, but that may reflect the

fact that few people have yet been allowed back into the stricken

city.

" We haven't seen a spike, " said Fred Cerise, M.D., of the Louisiana

Department of Health and Hospitals. " But we are seeing some

respiratory symptoms -- cough, cold, and allergic-type symptoms --

and some rashes from contact with the environment. "

While New Orleans hospitals are still out of action, he told the

briefing, three institutions in the surrounding area are able to

take patients with mold-related illnesses. " We haven't seen those

hospitals reach capacity, " he said, " and they have significant

ability to ramp up should that be required. "

Moreover, emergency aid stations have been set up in the city " and

none of them has been close to being overwhelmed, " he said.

The spores that cause mold need nutrients and moisture to grow, said

Isham, laboratory supervisor at the Center for Medical

Mycology at the University Hospitals of Cleveland.

Many of them can break down cellulose for food, meaning they can

colonize everything from an old cardboard box to the studs and

rafters of a house, Isham said in an interview.

Depending on the extent of the mold colony, home- and business-

owners might be faced with a huge clean-up job, said Anupma Dixit,

Ph.D., of the School of Public Health at St. Louis University in St.

Louis, MO.

" If you have mold on drywall, for instance, the best solution might

be to get rid of the drywall, " Dr. Dixit said in an interview, and

the same reasoning would apply to insulation and wood studs.

Small colonies can be removed with a 10% solution of bleach, but

anything over about 10 square feet needs professional care,

Environmental Protection Agency spokesman told the

press briefing.

It's important to get rid of mold as completely as possible, said

Dr. Dixit, who studied the aftermath of the 1993 Mississippi River

floods, which saw 17,000 square miles of land in nine states under

water for several weeks.

" The flooding on the Gulf Coast has brought a lot of memories back, "

Dr. Dixit said.

One difference is that the Mississippi flooded land was mostly

agricultural, so relatively few buildings were affected, Dr. Dixit

said. Even so, when she studied the region later, a third of the

once-flooded buildings still had high levels of mold spores, despite

intensive efforts at renovation.

Dr. Dixit found that a third of the people who moved back into homes

that had been flooded saw allergy symptoms worsen.

" For allergy and asthma, the first line of defense is removal of the

allergen, " Dr. Dixit said; if the removal isn't complete, the

symptoms won't go away.

The most common indoor molds are Cladosporium, Penicillium,

Aspergillus, and Alternaria, according to the CDC, but flooding is

likely to bring many other species indoors, Dr. Dixit said.

The mold Stachybotrys chartarum -- which has been linked to

pulmonary bleeding in infants -- can also be found in buildings and

homes. " While it is less common than other mold species, it is not

rare, " the CDC Web site says.

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