Western Kentucky tornadoes create infection risk

The University of Kentucky’s Office of Public Relations and Strategic Communications offers a weekly health column that can be used and reprinted by the media. This week’s column is written by Craig Martin, Pharm.D., Professor and director of operations at the College of Pharmacy, University of Kentucky.

LEXINGTON, Ky. (December 23, 2021) – In 2011, a devastating tornado destroyed much of Joplin, Missouri, killing more than 150 people and causing billions of dollars in damage. In the following days, local doctors and Centers for Disaster Control and Prevention (CDC) has reported and investigated several unusual infections in injured survivors. A soil mold was found to be the culprit, infecting patients with contamination from wounds sustained during the storm and causing a disease known as mucormycosis. Thirteen patients suffered from wound infections, 10 had to be hospitalized in the intensive care unit and five died.

Infections after disasters are not new. Tornadoes send debris and soil into the air, flooding can allow mold to infect homes, and earthquakes can aerosolize microorganisms living below the Earth’s surface. After any natural disaster, epidemiologists and public health officials play a game of watchful waiting, looking for any signs of a post-disaster epidemic.

On December 10, 2021, western Kentucky suffered one of the worst tornadoes on record. Our state, nation and world were moved to tears upon hearing stories of loss and heroism. Dozens of people have lost their lives, others have been injured and it will take years to repair the damage.

In the aftermath, survivors should be diligent to watch for signs of infection.

After natural disasters, the most common infections affect the lungs (called respiratory infections) and the surrounding skin and soft tissues (called skin infections). Lung infections result from inhaling aerosolized organisms. Soft tissue infections occur either from wounds with contaminated debris or from organisms that infect open wounds after the initial injury. The timeline can vary widely, from a few days to a few weeks after the initial event.

Survivors who have suffered lacerations or fractures should be especially careful to keep these wounds clean while they heal. They should regularly inspect the wound for signs of infection, which may include redness, warmth, or pus. Another sign of a serious infection can be fever. If any of these are present, the patient should see a doctor.

Lung infections can be caused by inhaling large amounts of organisms that are usually found in the soil. The risk of disease is correlated with the number of organisms one breathes, so the greatest threat lies in the victims directly affected by the tornado. Anyone who experiences a new cough, shortness of breath, wheezing, or fever should report these symptoms to their healthcare provider.

It is also essential to put these risks in perspective. In most cases, the number of people affected by post-disaster infections is small compared to those affected by the disaster itself. In Joplin, only 13 infections have been confirmed. We hope there aren’t any in western Kentucky, but we also know that early detection and treatment is the key to success if these infections occur. The best chance we have of achieving these goals is that everyone involved is informed.

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