Tetanus, hepatitis A or tropical diseases: the risks to public health left by DANA in Valencia

From these infected wounds arises the risk of tetanus about which the president of the Generalitat, Carlos Mazón, warned this Monday, who has asked the volunteers and affected people who work in the cleaning tasks of the affected localities to be vaccinated if they suffer any wound. “There is talk of a tetanus epidemic, but in this case I think the most appropriate thing is to talk about the fact that outbreaks of tetanus cases can obviously appear, it is not a disease that spreads like Covid-19 or the flu,” explains Fernando Moraga. -Llop, pediatrician and senior member and spokesperson for the Spanish Association of Vaccinology (AEV). But given the situation, he points out, there may be an increase in cases when wounds occur and the first thing to do is go to the nearest center where the wound can be thoroughly cleaned.

Regarding vaccination, Moraga-Llop assures that “there is no need to be alarmed” because the population has high rates of tetanus vaccination. In principle, if the vaccination schedule is up to date, five doses of this injection have been received during childhood. “Then, older people, most for work or travel reasons or for other reasons, have been revaccinated every 10 years,” he explains, so immunization would be necessary in the event of an injury that requires it in people who have not received the vaccine before or have not completed those guidelines. “If there is any doubt, I would always be in favor of vaccinating,” he points out, but not en masse to the entire population of the area. And that is what they are doing in health centers, points out Inmaculada Cervera. «The young people who are coming are most vaccinated correctly. But if we have doubts or the vaccination record cannot be accessed at that time, a souvenir is given,” confirms this doctor.

Nor does Joan Caylà, epidemiologist and former head of the Epidemiology Service of the Barcelona Public Health Agency, believe that it makes sense to carry out a mass vaccination against tetanus, but that he does consult with health personnel in case injuries occur, as well how to cure them well. Consider that at this time we must pay attention to diseases derived from contaminated water, such as hepatitis A or salmonellosis. To avoid them, he says, you have to drink “guarantee” water, that is, bottled or drinking water that is guaranteed to be consumed, but also take care that the food you consume is not contaminated.

“There is a risk of all water-borne diseases,” points out María Dolores Bargues, professor of Parasitology at the University of Valencia, who points out the danger of amoebas appearing that cause dysentery or other parasites that cause severe gastrointestinal disorders. . «There is also a risk of other parasites called free-living amoebas, which are beings that are normally in the environment (water, mud, soil) but that if they enter humans they can cause diseases such as meningoencephalitis and can also affect the eyes, skin and brain,” he explains. To avoid this, says this expert, we must avoid consuming contaminated water, but she also recommends that people who participate in cleaning tasks and are therefore in contact with mud and debris use airtight glasses to prevent splashes on the surfaces. eyes and disinfect hands frequently.

Salmonella or listeria

In the health centers in the affected area, adds Inmaculada Cervera, they are not yet seeing intestinal viruses, but there is concern that cases of salmonella or listeria, among others, will soon begin to arrive due to this contamination of water and food. This family doctor also believes that in a matter of days, people with cardiovascular diseases due to abandonment of treatment, diabetics with decompensations due to loss or alterations in medication or, in the medium term, people with mental health problems will begin to arrive.

Experts also warn of the possibility of diseases transmitted by vectors, specifically mosquitoes, such as dengue or the West Nile virus. “There are still many waterlogged areas, which are breeding grounds for the proliferation of mosquitoes,” warns Bargues. .

The president of the Generalitat, Carlos Mazón, created five response groups this Saturday to deal with the management of the tragedy, including one from Health. The Ministry of Health has joined this, which has mobilized the Center for the Coordination of Health Alerts and Emergencies (CCAES) and the Carlos III Health Institute in anticipation of public health problems that may appear. Among other things, work is being done on the early detection of diseases, especially infectious diseases, on the control of water quality or on the evaluation of specific vaccinations against vaccine-preventable diseases.

For its part, the Ministry of Health has reiterated this Monday that there is no scientific evidence to support that, in the event of water contamination by corpses or humans, it poses a significant risk of epidemic diseases such as cholera or typhus. Most microorganisms, points out Mónica García’s department, do not survive long in the human body after death and if infections arise, they are more likely to come from survivors.

“These first days or weeks, the most frequent symptoms that may appear are those of a gastrointestinal nature, which can be caused by water contamination,” said the general director of Public Health of the Ministry of Health, Pedro Gullón, in a video sent to the media, in which he also warns about the appearance of mosquitoes due to stagnant water. “We are going to work to anticipate their appearance and detect them early,” he said.