“Is the fear of some form of epidemic ruled out?” journalist Carlos Herrera asked the president of the Generalitat Valenciana early this Monday morning. “No, it’s not. “We are going to tell it like it is,” replied Carlos Mazón. All disasters like the one that occurred in Spain last week go through several phases. While the first and most acute is not yet over – saving all the victims – the second comes into play: preventing a public health emergency in a territory flooded with mud.
Experts consulted by elDiario.es do not foresee major epidemics or a demand for health care that would overwhelm hospitals, although there is a lot of uncertainty about how the situation will evolve because nothing of the sort is expected. is never before produced in Spain. “Although hoaxes are circulating, the ministry has not detected any epidemic due to the DANA floods for the moment,” said the Minister of Health, Mónica García, late in the afternoon through a message on X .
Most microorganisms do not survive long in the human body after death and infections that could cause these problems are not epidemic in Spain.
But “the danger is there”, recognizes the ministry. It is expected that in the coming weeks, gastrointestinal illnesses will increase, either as a result of ingestion of water or food contaminated with sludge – it is likely that they have been mixed to wastewater because the sewage system is not yet clean – or in poor condition because it could not be well preserved, explains Juan González del Castillo, coordinator of the Infectious Diseases group of the Spanish Society of Medicine emergency (Semes). “Common diarrhea can occur more intensely in unsanitary situations and usually occurs between the fourth day and four weeks after the disaster,” emphasizes González.
The Director General of Public Health of the Ministry of Health, Pedro Gullón, also argued that these conditions would be the “most frequent” and asked the population to go to health services in case of acute symptoms in order to stop transmission.
Health, which works in coordination in a specific committee with the Generalitat Valenciana to deal with the health aspect of the emergency, has issued in recent days some general recommendations so that residents of the affected areas avoid risks: make sure the water is drinkable – and if in doubt, take it from a bottle – do not eat food that is wet or in contact with mud; cover your body well when cleaning (long sleeves, long pants, gloves and mask) then practice good hand hygiene; or ventilate the rooms. “The priority is to minimize the risks because stagnant water can be dangerous. All alert and response systems must be strengthened,” said Minister García. Carlos Mazón assures that masks and gloves have been distributed to the population for 48 hours.
Let’s not think about very big things: that you could contract dermatitis from contact with sewage or have diarrhea from Escherichia coli, for example.
Isabel Vázquez, of the Spanish Society of Epidemiology
The authorities are trying to collect the experience of other countries facing similar situations, because in Spain there is no precedent. But epidemiologists and infectious disease specialists insist that diseases that are not endemic are “unlikely” to be seen and could, however, occur in similar disasters elsewhere, such as cholera or typhus. “Let’s not think about very big things: that you could contract dermatitis from contact with wastewater or have diarrhea from Escherichia Coli, for example,” explains Isabel Aguilar, of the Spanish Society of Epidemiology. The doctor also asks for particular attention to small or large wounds which can become contaminated, hence the importance of protecting the body.
Tetanus vaccines
The president of the Generalitat urged people who suffer “injuries or bleeding due to reconstruction work” to get vaccinated against tetanus, a bacterial infection, although the recommendation did not come from the joint working group between the Generalitat and the ministry. elDiario.es has learned. It is also important to remove children or people with respiratory illnesses from cleaning tasks. And the accumulation of waste can make problems worse.
Although the most urgent phase of rescuing the victims seems to have already ended, there are still garages and parking lots to be emptied where the deceased could be found. The health consequences of this situation, however, do not overly worry experts. “Contrary to popular belief, there is no evidence that corpses present a risk of epidemic after a natural disaster,” the Spanish Society of Epidemiology said in a statement. In any case, you must follow the obvious recommendation not to touch them and warn them so that they leave as quickly as possible. ”
“The majority of microorganisms do not survive long in the human body after death and infections that could cause these problems are not epidemic in Spain,” says the Ministry of Health. If infections occur, they will likely come from the survivors themselves.
Another fundamental issue to guarantee public health is to properly monitor the waters, because through them alerts come that can prevent diseases. “It is something that is always done, but which now takes on particular importance because it allows us to quickly see if there are new pathogens,” explains epidemiologist Isabel Vázquez. The public health services of the Valencian Community are responsible for carrying out this surveillance, which will be reinforced, according to sources close to the meetings between administrations.
On the other hand, the area affected by DANA is a humid area where mosquitoes multiply and the authorities will be on the lookout for possible vectors, even if it is not the worst period. “Things – according to the Spanish Society of Epidemiology – would have been worse if it had happened during the summer.” The Valencia lagoon and other similar areas like the Ebro Delta also present a risk of lectospirosis, warns González del Castillo, a disease caused by bacteria and transmitted through the urine of animals (especially rodents). “It can be trivial and self-limiting, but it can also cause fever, abdominal pain and serious infections,” notes the doctor.
More strokes than infections
Salvador Peiró, researcher at the Fisabio Foundation and member of the specific working group created to monitor the epidemiological situation in the area affected by the disaster, reveals that at present “there is not that much of a problem with infections so many accidents”: “people who cut, who break themselves while tripping, who collide while slipping on the mud. This situation occupies trauma operating rooms, but for the moment it does not pose major problems in hospitals. Most come in case of emergency. Another risk, Peiró points out, is electric shock when plugging in devices, for example on wet floors. About twenty volunteers inhaled carbon monoxide while cleaning a garage a few days ago.
Medical societies worry about chronic patients whose treatments may have been interrupted, but the Oncology Society has sent a message of calm: “In most cases, treatments can be delayed by a few days.”
The psychological impact of the disaster is another facet of reality whose consequences are still difficult to measure. Currently, the Ministry of Health has launched a psychological assistance unit for the families of victims of the Valencia Fair floods, which will have 30 psychologists, 10 consultations and two medical ambulances from 9 a.m. to 7 p.m.
“Requests are resuming”
By the end of Monday, activity had been restored in 47 of the 57 health centers affected by the disaster, according to data from the Generalitat. Hospital emergencies are operating normally and “outpatient consultations are gradually resuming”. Difficult situations for emergency medical care continue to occur because ambulances cannot enter certain areas, according to Peiró. “People are caught between firefighters or family; or in the most complex cases, the stretcher is loaded,” explains the epidemiologist.
Medical societies are concerned about chronic patients whose treatments may have been interrupted. The Oncology Department (SEOM) sent a reassuring message on this subject: “In most cases, treatments can be delayed by a few days without their effectiveness being compromised. » And he asked that no travel be made for this reason which could endanger patient safety.
DANA also reached more than a hundred pharmacies in the most devastated areas. A week later, there are 56 who have not yet resumed their activity, according to the monitoring carried out by the College of Pharmacists of Valencia, which guarantees that the supply is guaranteed for the entire population and that, in the event that the establishment is far away or there is no way to get there, a service is provided with volunteers and ambulances; or a medicine collection point in operational health centers.
