Jody Oggs LaFleur has an urgent message for people returning to clean up their homes after the floods caused by Hurricane Harvey: wear a mask.
Her warning was posted on social media as soon as Harvey hit south-east Texas last week, and her story of how a little-known post-flood danger nearly killed her has been shared 37,000 times since.
Ms LaFleur went to her mother's home a month after it was flooded during Hurricane Rita in 2005, to see what she could salvage. She was inside for only a few hours. Two years later, she was diagnosed with invasive pulmonary aspergillosis, a fungal infection caused by invisible spores that can enter any opening in the body, including cavities in teeth.
Ms LaFleur had no idea that the fungus was lurking inside her mother’s home, and when she finally got her diagnosis from an infectious disease specialist she was so close to death that she was put on a lung transplant list. She failed to respond to several weeks of intravenous anti-fungal medications or a subsequent six months of chemotherapy to kill the fungus living inside her body.
More than 10 years after being infected, the 48-year-old mother of three hopes her story will make Texans pay heed to the risk.
But the fungi and moulds that thrive in damp conditions are not the only dangers that follow a storm of this magnitude. The floods may have receded in many areas, but it is in the water that remains that people need to be on the lookout for hidden threats, ranging from alligators to electrocution.
“When these big floods happen, these alligators get flushed out of their normal habitats," said Dr Jeremy Finkelstein, chief of emergency medicine at Houston Methodist Hospital. "In past floods, we’ve had 6 and 7-foot long alligators cruising around. Alligators live in the bayous and those bayous have overflowed into neighborhoods. It’s a real threat.”
Even people who are well aware of such dangers can be caught off guard: one of Dr Finkelstein’s colleagues was bitten by a snake when he stepped on to his porch to survey the damage from Harvey.
Floating pods of venomous fire ants are also a real threat, said Dr Finkelstein. “As fire ants get flooded, they float on the surface and cling to whatever they can to get out of the water.”
Other threats are still to come, such as mosquitoes. During a hurricane, “mosquitoes get washed out with wind and high water and people get lulled into thinking the mosquitoes aren’t that bad”, said Dr Finkelstein. But, within a week or two, the larvae reappear with a vengeance in all the extra breeding area provided by stagnant floodwater.
In addition to a potential increase in cases of the mosquito-borne West Nile virus, as seen after Hurricane Katrina in 2005, Dr Finkelstein said the Zika virus also posed a threat. “You’ve got these winds that may have brought mosquitoes up from the Caribbean and Latin America, where Zika is much more prevalent, and then deposited them here.”
Then there is the risk of electrocution while walking through flooded areas, said Rick Kosecki, owner of Lake Houston Electrical Services.
On Tuesday, 25-year-old Andrew Pasek stepped on a live wire as he waded through ankle-deep water to rescue a cat from his sister’s house. He did not survive.
Even in homes that are now dry, the risk of electrocution remains as people return and start clearing up damage, Mr Kosecki said. “When they start ripping out sheet rock and walls, they can get into the wires and possibly get shocked or cause damage to the electrical wiring.”
He said it was imperative for people to turn the main circuit breaker off before they re-enter their homes, and to have their wiring inspected by a reputable electrician before they start making repairs. But there are simply not enough electricians to handle all the work.
“I don’t think people realise how few contractors there are out there to do this,” Mr Kosecki said. “We’re just getting started. We’re starting to see the magnitude of it and it’s starting to get a little overwhelming.”
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Eight million Texans live in areas affected by Harvey - just 1.4 million fewer than the entire population of the UAE. About 9,000 people are sheltering in the Houston convention centre and another 5,000 to 7,000 in the stadium of the city’s American football team.
Besides providing refuge, these shelters help the many people who forgot to take their medication with them when they fled the flooding. Doctors at the mobile medical units set up in the shelters write them 30-day prescriptions on the spot which are then filled at makeshift pharmacies at the shelter. “These doctors are working 24, 36 hours straight,” says Dr Finkelstein. “It’s been quite an amazing experience.”
Still battling the disease she contracted at her mother's flooded home, Ms LaFleur has been on an experimental drug protocol for the past five years. Last year, she also went through 16 rounds of radiation. Nothing has eradicated the fungus from her body.
“My life is totally different now than what it used to be," she said. "I don’t know my prognosis. I’m really fortunate to be alive but it’s truly a struggle every day.”
With so many threats facing the people going back to their flooded homes, she hopes her advice - to wear a mask - will protect them against at least one.
Dr Finkelstein agrees. “Probably the single most protective piece of equipment, if you could have just one, would be an N95 mask,” he said. “That’s your best protection.”
They cost about $15 (Dh55) and are readily available at home improvement stores.