"Disease carried by mosquitoes is always a concern at this time of year, but particularly so in the aftermath of flooding. Mosquitoes thrive in standing water and proximity to any such water increases the risk of bites," said Manian.

The main mosquito-borne diseases in our area include West Nile and St. Louis encephalitis. "Look out for mental status changes, especially in older people," said Manian. In younger folks, symptoms often include fever, headache, and/or stiff neck. And "when these diseases progress, people can get very ill and even become comatose."

The good news? "Not everyone bitten will get infected," reassured Manian. "The majority of mosquitoes are not infected. There is also evidence that many people have a 'subclinical infection' meaning they have no symptoms or only experience a self-limited, flu-like illness."

Still, Manian recommends taking precautions. These include avoiding areas known to be populated by mosquitoes, using adequate spray repellants such as those containing appropriate levels of DEET, and staying indoors at dusk, which is mosquito feeding time.

Don't Worry, Be Happy

Be alert to symptoms but don't panic, advises Manian.

"If there are no symptoms, we don’t have people come in," he said. If there are symptoms, however, "come in and be evaluated. It could be other things, too."

And Manian recalls other good news from the similar experience of 1993.

"In the Great Flood of '93, there were no major outbreaks of anything." In fact, the CDC reported that the most commonly reported illnesses and injuries were relatively minor issues such as sprains/strains, cuts and bruises, and rashes.

Covering All the Bases

Yet, "Any time there is a mix of sewage and water, there is the opportunity for enteric pathogens like E. coli, Shigella and Salmonella," which can cause outbreaks of gastrointestinal illness, cautions Manian. "The other thing with flooding is in the shelters. You can imagine the opportunity of a variety of different diseases because of the close proximity of people to each other." Such contact can lead to what's known as "indirect outbreaks."

And the toll of water within Missouri homes has yet to be fully evaluated in terms of medical impact from mold. "We have not started to see much, but we will," said Dr. H. James Wedner, chair of allergy/immunology for Washington University. "We will see people who are sensitive to mold growing in the house. They will come in with itchy, scratchy, watery eyes and other symptoms of allergy. If they have asthma, we'll see the asthma. This will occur as water recedes and people go back into their houses."

And people will also be coming in not because of any symptoms, but because they are worried. "They come and see me because they have a concern about 'what do I do now?'," said Wedner.

"First thing, if you have a flooded house, get it dried out ASAP, the faster the better. Get a quality person to evaluate and see what the damage is. Was there mold manifestation and if so, what can be done about it."

Bottom Line

Wedner agrees with Manian's advice not to sweat the small stuff and don't go looking for trouble if trouble is not finding you.

"If there's something in your environment and you’re not allergic, that's not bad. If you're allergic to something and it's not in your environment, that's not bad. It you're allergic to something and it is in your environment, then you need to take steps to get rid of it," said Wedner. "And in most of our homes, dust mites and dogs and cats are so much worse than the mold."

"We have to put everything into perspective."

For more information: Visit the CDC webpage "After a Flood"