From Harvey to Irma, the 2017 hurricane season in the United States has been highly detrimental so far. Hurricane season in the North Atlantic lasts from June through November, with the worst storms hitting during late August and throughout September, and an annual statistical peak on September 10. With a particularly intense storm season well underway, it’s important to learn more about hurricane safety.

CareDash spoke with Dr. Amesh Adalja, a senior Associate at the Johns Hopkins Center for Health, about how to stay healthy during a hurricane. Dr. Adalja specializes in internal medicine, emergency medicine, infectious diseases, and critical care medicine.

What are the biggest health risks during a hurricane?

The most significant health dangers during a hurricane will vary depending on the phase of the storm. In the acute phase, traumatic injuries and drowning are high risks, but as the storm abates and after it passes, longer term risks include exposure to contaminated water, lack of medications, and the clustering of groups of people in temporary shelters. These conditions can result in the spreading of the common cold and other respiratory viruses like adenovirus or rhinovirus; gastrointestinal viruses like norovirus and rotavirus; parasites like Giardia; staph and strep skin infections; and other rarer conditions.

How do emergency health care providers respond to a hurricane?

During any emergency situation, various groups mobilize to provide care and accommodate the increase in people needing medical care. Some of these groups may be volunteer organizations, but during a major natural disaster, the federal government will activate the National Disaster Medical System (NDMS) and dispatch Disaster Medical Assistance Teams (DMATs) to provide care, set up temporary medical centers, and supplement the local providers.

Is there anything dangerous, like bacteria, in stagnant flood water?

It’s important to realize that bacteria and other microorganisms are present all over, including oceans, rivers, lakes, and ponds. During a hurricane, much of the infrastructure designed to keep water with harmful levels of bacteria and microorganisms segregated from water used for drinking and bathing fails. Also, infrastructure failures can allow sewage — which has higher amounts of these microorganisms present — to contaminate other water supplies. When the drinking water supply is compromised in this context, these microorganisms can cause gastrointestinal illnesses characterized by nausea, vomiting, diarrhea, and abdominal pain.

Why is it important to stay dry?

During hurricanes, the water that people are exposed to may have high levels of potentially dangerous microorganisms. If this water comes into contact with skin scrapes, abrasions, or lacerations, they could become infected. Therefore, staying dry and doing basic first aid wound care (cleaning, bandages, topical antibiotics) are crucial to staying safe and healthy.

How does a hurricane impact a community's overall health, in the long-term?

Long term, there can be cascading effects on a community’s overall health when a hurricane or other large scale natural disaster strikes. In some instances, health care facility operation may be disrupted, leaving a gap in resources. For example, after Superstorm Sandy in 2012, hospitals in New York City had to be evacuated and took some time to resume normal operations. Additionally, patients may be displaced and forced to seek healthcare at another site. Disruption of medication access in the aftermath of a devastating storm can also lead to worsening of chronic conditions such as diabetes or hypertension. Longer term health issues could also result from disease outbreaks (often in resource-poor nations vs. the US) similar to what occurred post-earthquake in Haiti. Post-traumatic stress disorder and other illnesses may also occur.

What are the most important health and safety tips for preparing for a hurricane and for staying well during the aftermath of a storm?

Hurricane preparation is essential and adhering to evacuation orders is crucial. Individuals should anticipate disruptions in access to medication and should attempt to have extra stock on hand as well as a list of your medical conditions and the medications you regularly take.