JIM LEHRER: Getting people to leave New Orleans is related directly to the growing public health concerns there and elsewhere on the coast.
Gwen Ifill has the latest on that. She spoke this afternoon with the head of the Centers for Disease Control, Dr. Julie Gerberding.
GWEN IFILL: Dr. Gerberding, welcome. We have heard reports today that there are three dead in Mississippi from water-borne illness. We have heard other larger numbers but there's some confusion about how many people have actually been casualties so far -- fatal casualties because of the diseases that came in the wake of Hurricane Katrina, can you clear that up for us?
DR. JULIE GERBERDING: I think we're in a situation right now where these cases are being investigated. There's a lot going on right now. We have to try to ascertain which cases are attributable to the hurricane, per se, what things might be coincidental -- a lot of work in progress. But we do know that there are some people who acquired an infection called Vibrio vulnificus, and at least three of those people have died.
It makes it sense that this could be a consequence of the hurricane because this organism is in saltwater and people who have exposure to the saltwater as a consequence of the hurricane, especially if they're injured and have wounds on their arms or legs that allow the bacteria to get into their body, they could have acquired the infection as a result of this situation -- a lot more work to be done though before we'll really understand the scope and magnitude of the problem.
GWEN IFILL: So only three that we know of right now but potentially more?
DR. JULIE GERBERDING: We have to keep an open mind. Again, it is very early in the process. And there are lots of parts of the country where we don't yet know all the information about who has sustained injuries and who is in the hospital and who's at risk and what they ultimately will be diagnosed with.
So we have to keep an open mind and be prepared that there will be additional cases of any of these problems that we're concerned about right now.
GWEN IFILL: We also, however, have all been looking at the water in New Orleans as it has grown, what appears to be more fetid day after day. Can you give us a sense of what kinds of diseases that your testing in your on the ground experience have told you can be found in those waters that rescuers as well as residents should be guarding against.
DR. JULIE GERBERDING: Well, let's talk about the water situation in New Orleans, particularly, because today the EPA did announce the first results from tests that are ongoing there. These very preliminary first test results did indicate that there was a very high degree of sewage contamination of that water.
So of course the infections that could be present in sewage are a hazard to the people who are in that water. That's why we are urging everyone to follow the mayor's orders about evacuation, to leave that area, to get out of the water. And for goodness sakes, don't drink it. It is also why today CDC posted some specific recommendations about protecting the workers who are going in there to conduct the rescue and cleanup operations.
GWEN IFILL: Like what, for instance?
DR. JULIE GERBERDING: Well, for example, we want workers to wear the kinds of very heavy boots that protect them from injuries while they are walking with their feet underwater. We're also recommending that they wear heavy-duty gloves so they don't get cut or injured and create a place where these infections could gain entrance into their body, and of course the kind of face shield that would keep water from splashing up into their mouth or mucous membranes.
Most of the infections that could be present in sewage are transmitted by the oral route -- meaning you get them in your mouth and you swallow them and they cause diarrhea or vomiting. And sometimes they can enter through the skin. So protecting your skin and keeping them out of your mouth and eyes are really important parts of safety precautions for these workers.
GWEN IFILL: You are recently returned from the region. As you toured there, what kinds of health conditions did you see or unhealthy, I guess I could say, conditions did you see on the ground?
DR. JULIE GERBERDING: Well, let me just first say that what I think was the overall impression of our visits to all of the shelters and the environment in the South was what an incredible amount of heroism is going on there.
I was also very impressed in the shelters, particularly the large shelters where we know there would be a risk for infection transmission from respiratory or possibly even hand to hand contact, the emphasis on hygiene and the emphasis on hand cleaning and prevention of transmission really started as soon as these refugees arrived.
The Astrodome in Texas where there are 24,000 people -- we've got the entire community of health care workers in the Texas area right in there with a row of sinks down the hall to really emphasize: let's keep people safe while they're here.
GWEN IFILL: I have read that the population that you are serving, the people who are in so many of these shelters, are people who were vulnerable health-wise even before this happened. To what extent do you have to compensate for the fact that you are dealing with an underserved population when it came to health care?
DR. JULIE GERBERDING: Well, I think we are appreciating that many of the people who went to the Superdome in New Orleans as a shelter of last resort were the people who had the least means for leaving the city. And that means that they are at increased risk for many of the health disparities that plague our society in certain areas. So there are many special-needs people there.
And that's really, I think, one of the miracles of the sheltering system that is going on, that not only are we worrying about the immediate problems of the hurricane and its -- the injuries that ensued from that, but already Secretary Leavitt and the whole department as well as the state and local health officials everywhere we traveled are concentrating on mental health services, on restoring people's benefits, on linking them back up to Medicaid, whatever state they end up in, and really recognizing that this isn't just about a temporary loss of home or the horror of a hurricane, this is about really helping people protect their health and move on to a state of hope so that we can get them to a home in the very near future.
GWEN IFILL: So you are confident, based on what you saw and what reports you've gotten back from your teams on the ground, that the potential for a widespread - a widely spreading disease in these shelters and in New Orleans because of the water because of the conditions, has been largely averted?
DR. JULIE GERBERDING: I'm not ready to say that. I think what we recognize is there is certainly a potential for a risk here. We've got a high degree of contamination in the water and a lot that we'll learn as we go forward with more testing and more evaluation of that water. So we're not out of the woods yet in the city of New Orleans. And certainly any time you put so many people together in a crowded place, there is very high potential for disease transmission.
What I am encouraged by is that people started out with the awareness. CDC has 24 disease detection teams around the country working with the shelter officials and the local health officials to detect cases as they emerge and to take the steps necessary to prevent transmission. This will go a long way to avoiding a large-scale event.
GWEN IFILL: Once the water is finally drained from New Orleans -- who knows how long that will take -- but once that happens is your job largely done?
DR. JULIE GERBERDING: I don't think any of us know when our work will be done. This is going to be an ongoing health issue for a long period of time. So we're just at the very early stages. And from a Health and Human Services perspective, we're concentrating first on helping those people who need it the most and then helping them on the way to a situation where they can really benefit from the governmental programs and sustain their dignity and get back to a home where they can look forward to their future.
GWEN IFILL: Dr. Julie Gerberding at the Centers of Disease Control, thank you very much for joining us.