Q: What do you expect to be the health effects on children following Hurricanes Katrina and Rita?
A: I think the biggest health effects are how children are going to deal with it psychologically and the manifestations of how the psychological effects will affect their physical health. Some of those effects have been abdominal pains, worsening acne. There are several ways our psychological health affects us physically. For adults, it's easier for us to say, "I know my belly hurts because I'm upset." With children, parents are afraid they are ignoring something seriously wrong with the child (if they pass such pains off as the result of being upset).
Q: You mentioned seeing abdominal pains; is that true pain or nausea?
A: With children they don't necessarily describe something specific other than saying their tummy hurts. And with adolescents, there are more problems with constipation or diarrhea. For adolescents, we're also seeing more headaches. The headaches are a little harder to sort out the cause because people with asthma or allergies are going to be more sensitive to all the things (dust, mold, etc.) left behind. Even if your home wasn't damaged, people are moving so often it just stirs stuff up.
Q: Let's talk about respiratory problems inherent in returning to a place with so much debris and mold.
A: In general, the most common types of mold should not have an effect on a healthy person. There are certainly some more severe molds, like the black mold that develops for reasons that are not clear, but for a person who has asthma or already has respiratory problems, the mold can mechanically set them off. One of the other things ... there were several fires around after the time of the storm, and being around the smoke was a problem.
Q: What about the sludge that came with the flooding that now has dried and turned to dust?
A: I don't know if it's totally clear what the effects of that will be; it might take a while to determine that. To me, it's going to quantify how to determine that airborne problems from the hurricane are truly what's causing our problems. There is no test for airborne bacteria or fungus. There's not any way to isolate it in the respiratory tract without being invasive. How do we know what we're looking for? I don't mean that in a doom and gloom way; in general, I think we're going to do fairly well.
Q: What should parents do to help their kids through this?
A: Parents need to do their best in spending some quality alone-time in reassuring their children. Discussing (the storm and its effects) with them but at the same time letting them know their families are OK, and the buildings' damages will be repaired and things will be OK again if their families are around. If the pain persists, seek out a doctor and put their fears at rest. Sometimes the reassurance of knowing the child is not really ill helps the child and the parents feel better.
Q: What treatments are there?
A: For the things we're worried about -- respiratory-wise it's mostly setting off asthma -- it's the traditional treatments like albuterol and steroid breathing treatments. For the most part, if you have a healthy immune system, you just let it take its course or take allergy treatments. We've not yet had to treat these problems any differently than before the storm, although we've noticed they're a little more frequent.
Q: How toxic is this stuff we're around?
A: I don't know that we really know yet. I think general precautions -- washing your hands, wearing a mask if you are doing cleaning-out type of work, and for children, making sure their regular immunizations are up to date, including tetanus and hepatitis B -- will work.
Q: Should children even be returning to areas that are really flooded or have had extensive damage?
A: I don't see any direct reason that they can't be there. If the family is ready and has a suitable place to live, I think it's fine to be back in the city. I think parents are better judges of that than anyone else.
Q: How important are flu shots for kids this season?
A: I think they're a good idea. Certainly as people have lived more closely together and have been more crowded in schools and also that people don't want to deal with a major illness on top of everything else. The flu is something that if you're a healthy person without asthma can put you in bed for a week. With everyone pushing to not miss school, etc. ... there is a tendency for even children not to allow themselves to be (in bed) that long. But if you have an underlying illness, the flu can put you in the hospital. Children six-months to a year old is another high-risk group. We've started to give vaccine already; so far this year there is no shortage.
Q: How worried are you about this new bird flu we hear about that has no vaccine and concerns about a flu epidemic or pandemic?
A: Right now I'm very glad that the Center for Disease Control is worried about it and planning for it. I think appropriately and hopefully we will have answers to it because of their forward work. What we're hearing (concerns) about is the flu pandemic or epidemic that cycles every hundred years or so and mutates a different way. The concern is that the next mutation could be the one that introduces (a strain) we aren't prepared for.