State of public health in wake of floods

Prague, Karlin

When devastating floods hit the Czech Republic in August, many feared that infectious diseases would spread around the affected areas. Diseases not only from contaminated food and drinking water, but also from large areas of floodwater full of decomposing matter, an ideal breeding ground for various germs. High waters also destroyed a large number of waste water treatment facilities across the country and those will remain out of order for weeks or even months.

Prague, Karlin
Jaroslav Kinkor is a water quality expert at the Environment Ministry.

"The flood knocked a number of water-treatment facilities out of operation. We had been building them in order to improve the condition of our rivers since the beginning of the 1990's. On the Vltava and the Elbe, 30 plants out of 100 were severely damaged. We can expect that within a month or two, some basic repairs will be carried out, and the plants will resume basic operation. One exception is the water-treatment plant in Prague, which is expected to start working in the same capacity as before the floods at the end of this year or at the beginning of 2003."

Immediately after the floods, rivers were highly polluted, as all kinds of chemical and organic substances washed away from fields, industrial and residential areas seeped into them.

"It's not only the shutdown of the water-treatment facilities that influences the quality of water. During the floods, a number of chemical or organic substances were flushed away from fields and waste water from towns got into rivers. Other sources were industrial facilities, such as the notorious Spolana chemical plant, but also stores of herbicides, fertilisers for agricultural use."

It's organic pollution that health authorities were most worried about in connection with infectious diseases.

"As we expected, organic, faecal pollution represented by coliform bacteria, reached the highest levels. But we can see that the quality of water in the upper parts of rivers is quickly returning to normal, and the lower parts of rivers have a high self-cleaning ability, provided that the flow is strong enough."

As a precaution, using water from polluted sources for any purpose, including bathing, has been prohibited until further notice and so far, no diseases contracted from streams have been reported.

Czech village of Dolni Ostrovec
People can contract flood-related diseases mostly during clean-up operations if they don't use protective gear. Leptosipirosis is one such infection. In South Bohemia, where the floods came first, eight cases of leptospirosis have been registered so far and nine people are suspected of having the disease, caused by bacteria in rodent droppings or urine and spread by water. All the patients were cleaning up their houses after the floods. All of them are showing only milder symptoms, similar to the flu. Despite the extreme circumstances this year, the number of people who have contracted leptospirosis is almost the same as last year. Although total protection does not exist, people should wear gloves and rubber boots, and wash their hands frequently when working in the flood-stricken areas.

The same preventive measure applies to another highly contagious disease, hepatitis A. Hepatitis A is a liver disease caused by the hepatitis A virus. It can affect anyone, and can occur either as an isolated case or widespread epidemics.

"I'm glad to be here at the Ministry of Health and to get a briefing on how the health situation stands in the Czech Republic. I congratulate the government on an excellent job in dealing with the public health issues. I met last week with Prime Minister Splidla and he asked for United States assistance to focus on three areas: vaccines, particularly hepatitis A, dryers and contamination equipment."

The United States ambassador Craig Stapleton speaking at the Health Ministry upon presenting the Czech Republic with a donation from US health organisations. The Czech Health Minister Marie Souckova explains who is the most vulnerable to hepatitis A.

"Only those people who don't respect basic hygiene put themselves at risk. That means people who don't wash their hands properly, eat fruit from trees which were underwater in the flooded areas, eat food which was not stored properly and then disposed of in the recommended way, or drink water from sources which have not yet been approved by health authorities."

Good personal hygiene and proper sanitation can help prevent hepatitis A. Vaccines are also available for long-term prevention of hepatitis infection in people over the age of 2. At the end of August, the Health Ministry decided to immunise children from the affected areas in an effort to prevent them from contracting the disease as clean-up work went on. Michael Vit is the chief hygiene officer for the Czech Republic.

"We shall vaccinate children in the affected areas, who were born in 1997, 1998, 1999. At the moment we have 70,000 doses for children. We decided to do a complete immunisation - that means vaccination with two shots. The second dose will be administered in 6 months and these age groups will develop long-term immunity against hepatitis A, for 15 years at least."

Altogether, the Ministry is planning to vaccinate 70,000 children from flooded areas. 27,000 professional rescue workers have already been vaccinated. Health Minister Marie Souckova explains more.

Prague, Karlin
"We are not planning any nation-wide vaccination. At the first stage we vaccinated selected groups of people who came into contact with floodwater. Those were rescue workers and volunteers who took part in the clean-up work after the floods. Now we're immunising children aged 3 to 5 years. That concerns only a limited number of children from the flooded areas. These children are potentially most vulnerable because they haven't yet developed the necessary personal hygiene habits."

After the floods, the inundation areas became an ideal breeding ground for mosquitoes. The hardest hit was the surroundings of the Dyje in South Moravia. The situation was critical for more than a month and insecticides had to be sprayed over the region. Fortunately, the cold weather of recent weeks ended the mosquito problem and staved off the fear of the so-called Valtice fever, a viral illness lasting for a few days, with high temperatures as the main symptom.

Although in August, many people were pessimistic, now, seven weeks after the floods, Health Minister Marie Souckova says, the health situation in the country is normal.

"There is no risk of epidemic. We monitor any incidence of disease and I can say that after the floods that hit our country, no sign of any epidemics has been reported."