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Hazards

Infectious Disease Outbreak

Definition

An infectious disease is a viral, bacterial, parasitic, or fungal disorder that can be transmitted between people.  An outbreak is an increased number of cases of a particular disease and can include epidemics and pandemics.  Infectious Disease Outbreaks require more public health and medical resources than a day to day operations and may include responses such as infection control, contact tracing, quarantine, isolation, prophylaxis, and social distancing.

The Center for Disease Control (CDC) defines a pandemic as,

“A pandemic is a global outbreak of disease. Pandemics happen when a new virus emerges to infect people and can spread between people sustainably. Because there is little to no pre-existing immunity against the new virus, it spreads worldwide.”[1]

Communicable diseases are often of high concern as well. The Center for Disease Control (CDC) defines communicable disease per 42 CFR Part 70 as,

“Communicable diseases means illnesses due to infectious agents or their toxic products, which may be transmitted from a reservoir to a susceptible host either directly as from an infected person or animal or indirectly through the agency of an intermediate plant or animal host, vector, or the inanimate environment.”[2]

Communicable diseases are typically spread through direct contact.  The following are three of the most common ways of direct contact transmission:

Person to person. This involves a direct transfer of bacteria, viruses, or other germs from person to person. This may involve blood transfusion, coughing, kissing, sexual contact, touching, etc.

Animal to person. Infected animals can transfer communicable diseases to humans via biting and scratching. Coming in contact with an infected animal’s waste may also transmit diseases.

Mother to the fetus. Infected pregnant women can pass bacteria, germs, and viruses through the placenta, such as HIV. Bacteria, germs, and viruses can also be spread during labor, such as with group B streptococcus.

Communicable diseases are also transmitted indirectly, such as touching a germ infected door handle.

Other ways that communicable diseases are spread is through particle transmission through the air (such as tuberculosis or SARS), through bites and stings from insects (such as West Nile Virus or Lyme Disease), and through food contamination (such as E. Coli).

The following communicable diseases are tracked by the Louisiana Department of Health:

COVID-19 – a novel coronavirus discovered in 2019 and led to a global pandemic infecting millions of people worldwide. In the United States, according to the CDC, as of December 15, 2020, more than 16.52 million total cases with over 302,992 deaths. It will be some time before the fully borne impact of COVID-19 is known.

Chlamydia - A common STD that can infect both men and women. It can cause severe and permanent damage to a woman's reproductive system, making it difficult or impossible for her to get pregnant later on. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb).

Gonorrhea - A sexually transmitted disease (STD) that can infect both men and women. It can cause infections in the genitals, rectum, and throat. It is a very common infection, especially among young people ages 15-24 years.

Primary and Secondary Syphilis - An STD that can cause long-term complications if not treated correctly. Symptoms in adults are divided into stages. These stages are primary, secondary, latent, and late syphilis.

Influenza - There are two main types of influenza (flu) virus: Types A and B. The influenza A and B viruses that routinely spread in people (human influenza viruses) are responsible for seasonal flu epidemics each year. Influenza A viruses can be broken down into sub-types depending on the genes that make up the surface proteins. Over the course of a flu season, different types (A & B) and subtypes (influenza A) of influenza circulate and cause illness.

Viral Meningitis - An inflammation of the tissue that covers the brain and spinal cord. Infants younger than one-month-old and people with weakened immune systems are more likely to have a severe illness related to meningitis.

HIV - A virus spread through body fluids that affect specific cells of the immune system, called CD4 cells, or T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. When this happens, HIV infection leads to AIDS.

Acute Hepatitis B - A short term liver infection caused by the Hepatitis B virus. Hepatitis B is transmitted when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected.   Chronic Hepatitis B - A chronic, long term liver infection caused by the Hepatitis B virus, which can lead to cirrhosis or liver cancer. Hepatitis B is transmitted when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected.

It should also be noted that bioterrorism can also involve communicable diseases. The CDC has identified high priority biological agents that have the potential for major public health impact. These include:

  • Anthrax (Bacillus anthracis)
  • Botulism (Clostridium botulinum toxin)
  • Plague (Yersinia pestis)
  • Smallpox (variola major)
  • Tularemia (Francisella tularensis)
  • Viral hemorrhagic fevers (filoviruses [e.g., Ebola, Marburg] and arenaviruses [e.g., Lassa, Machupo])

Location and Extent of the Infectious Disease Hazard

The entire United States is considered at risk for disease outbreaks.  Within the planning area, the entire population is subject to communicable diseases. Locations with higher population density may be exposed to higher numbers of the aforementioned diseases than less dense areas.  In areas of concentrated poverty, especially in communities of color, the negative health impacts of pandemics are disproportionate, including the mortality rates. Other social indicators of vulnerability may include overcrowded housing, lack of health insurance coverage, increased unemployment, and poverty.

Severity of Pandemics

The severity of outbreaks is expected to change annually, depending on variables such as weather patterns and trends in disease outbreaks. While there have been historically severe impacts of a pandemic in Orleans Parish, modern public health and disease prevention are capable of treating most communicable disease outbreaks. Communicable diseases do, however, have the potential to be catastrophic.

As the 2020 Covid-19 pandemic has made clear, pandemics can have major impacts beyond causing sickness and death. The economic shock caused by the pandemic is creating hardship across the country, and the full impacts will certainly be felt for some time, especially food and housing insecurity.

Previous Occurrences of the Hazard

New Orleans has had few communicable disease outbreaks, all of which occurred nearly 100 years ago. The first pandemic reported in New Orleans occurred in the 1830s, in which cholera killed 3,000 people in New Orleans. A subsequent cholera event in New Orleans during the 1870s claimed the lives of thousands more. In 1847 and 1852, over 40,000 people died from yellow fever. The most well-documented pandemic in Orleans parish involved the 1918 flu epidemic, also known as the Spanish Flu, which caused 15,494 cases of influenza statewide in September of 1918, with approximately 7,000 of those cases located in New Orleans. Between October 1918 and April 1919, the city experienced a staggering 54,089 cases of influenza. Of these, 3,489 died – a case fatality rate of 6.5% and an excess death rate of 734 per 100,000. Only Pittsburgh (806) and Philadelphia (748) - the two cities with the worst epidemics in the nation – had higher death rates. Cases gradually lessened during the winter and spring. By the summer, the disease had disappeared from the state, without the aid of vaccination.

New Orleans also experienced a heightened awareness of communicable/infectious diseases following Hurricane Katrina. This is especially true given the post-disaster context with flooding, a lack of medical care options, limited housing, along with a number of other environmental and social conditions. The CDC was involved in supporting the Department of Health and Human Services response. CDC helped with health issues that involved:

  • infectious disease detection, prevention, and outbreak control in shelters and in affected communities,
  • injury prevention for displaced people and rescue workers
  • environmental health and safety monitoring of homes, water quality, and shelters
  • rebuilding public health infrastructure,
  • school health, and
  • worker and responder safety recommendations and monitoring.

Before 2020, only one known outbreak of communicable disease (norovirus) requiring unusual mobilization of public health resources had been reported as of September 23, 2005. New Orleans has seen 597 deaths and 13,629 cases as of November 3, 2020.

In December of 2018, a Hepatitis A outbreak was declared, and New Orleans has been actively addressing cases since then.

In recent months we have seen first-hand how an infectious disease outbreak can turn into a global pandemic. It has been more than 100 years since this type of event has happened with the Spanish Flu in 1918, which reinforces that the likelihood that these infectious disease outbreaks will lead to large-scale epidemics or pandemics is highly unlikely based on the historical record.

Probability

Based on the historical record, there is a 100% probability that infectious disease outbreaks, such as seasonal influenza, will occur annually.

Hazard Impacts

Impact on Life and Property

The severity of outbreaks is likely to change annually, depending on variables such as weather patterns and trends in disease outbreaks. In most infectious disease outbreak, the impact of this hazard is limited, with the majority of illnesses treatable and the likelihood of fatalities low. Large-scale outbreaks like the onset of COVID-19 in the spring of 2020 can strain existing health care facilities.

Vulnerability

There are a number of factors that can contribute to increased vulnerability, including age and underlying health, overcrowded housing, poverty, race, and employment status.


[1] Centers for Disease Control and Prevention. (2020, January 21). CDC COVID Data Tracker. Coronavirus Disease 2019 (COVID-19).

[2] U.S. Department of Health and Human Services. (2019, October 1). Title 42 - Public Health. Code of Federal Regulations.

Relevant Actions

Hazard:
Flooding, Storm Surge, Extreme Heat, Subsidence, Coastal Erosion, Infectious Disease Outbreak
Goal:
Goal 1: Reduce risk and vulnerability to the human environment including cultural resources, homeowners, renters, visitors, and transient populations.
Status:
Timeframe:
1-3 years
Priority:
Medium
2015 Priority:
N/A
Lead Agencies:
CNO (Office of Resilience & Sustainability)
Support Agencies:
Cost:
City Staff Time
Funding source:
CNO General Fund, State and Federal Grants, Philanthropic Grants
Emergency Support Function:
ESF 14

Comment on this action item

Hazard:
Flooding, Tornadoes, Tropical Cyclones, Severe Thunderstorms, Extreme Heat, Subsidence, Winter Weather, Coastal Erosion, Infectious Disease Outbreak, Active Threats, Infrastructure Failure, Hazardous Materials, Economic Shock
Goal:
Goal 4: Maximize the involvement of individuals, businesses, and groups in risk reduction measures through education/outreach on hazard mitigation appropriate to all groups, particularly vulnerable populations.
Status:
Timeframe:
3-5 years
Priority:
Medium
2015 Priority:
N/A
Lead Agencies:
CNO (Homeland Security & Emergency Preparedness)
Support Agencies:
Cost:
City Staff Time, Contract Labor
Funding source:
City capital bond funds, GOMESA, CDBG, CDBG-NDR, Sewerage and Water Board, State capital outlay, FHWA, FEMA-HMGP, US Army Corps of Engineers, FEMA
Emergency Support Function:
ESF 1, ESF 3

Comment on this action item

Hazard:
Flooding, Storm Surge, Tornadoes, Tropical Cyclones, Severe Thunderstorms, Extreme Heat, Subsidence, Winter Weather, Coastal Erosion, Infectious Disease Outbreak, Active Threats, Infrastructure Failure, Hazardous Materials, Economic Shock
Goal:
Goal 4: Maximize the involvement of individuals, businesses, and groups in risk reduction measures through education/outreach on hazard mitigation appropriate to all groups, particularly vulnerable populations.
Status:
Timeframe:
1-5 years
Priority:
High
2015 Priority:
N/A
Lead Agencies:
CNO (Office of Resilience & Sustainability)
Support Agencies:
Cost:
City Staff Time
Funding source:
CNO General Fund, State and Federal Grants, Philanthropic Grants
Emergency Support Function:
ESF 15

Comment on this action item

Hazard:
Flooding, Tornadoes, Tropical Cyclones, Severe Thunderstorms, Extreme Heat, Subsidence, Winter Weather, Coastal Erosion, Infectious Disease Outbreak, Active Threats, Infrastructure Failure, Hazardous Materials, Economic Shock
Goal:
Goal 4: Maximize the involvement of individuals, businesses, and groups in risk reduction measures through education/outreach on hazard mitigation appropriate to all groups, particularly vulnerable populations.
Status:
Timeframe:
1-5 years
Priority:
Medium
2015 Priority:
N/A
Lead Agencies:
CNO (Homeland Security & Emergency Preparedness)
Support Agencies:
Cost:
City Staff Time
Funding source:
State and Federal Grants
Emergency Support Function:
ESF 5, ESF 7

Comment on this action item

Hazard:
Flooding, Tornadoes, Tropical Cyclones, Severe Thunderstorms, Extreme Heat, Subsidence, Winter Weather, Coastal Erosion, Infectious Disease Outbreak, Active Threats, Infrastructure Failure, Hazardous Materials, Economic Shock
Goal:
Goal 6: To protect Orleans Parish and the surrounding region from the effects of natural and manmade hazards, ensuring community continuity in the event of such hazards.
Status:
Timeframe:
3-5 years
Priority:
Medium
2015 Priority:
N/A
Lead Agencies:
CNO (Office of Resilience & Sustainability, Neighborhood Engagement Office)
Support Agencies:
Cost:
City Staff Time
Funding source:
CNO General Fund, State and Federal Grants, Philanthropic Grants
Emergency Support Function:
ESF 7, ESF 14

Comment on this action item

Hazard:
Flooding, Tornadoes, Tropical Cyclones, Severe Thunderstorms, Extreme Heat, Subsidence, Winter Weather, Coastal Erosion, Infectious Disease Outbreak, Active Threats, Infrastructure Failure, Hazardous Materials, Economic Shock
Goal:
Goal 6: To protect Orleans Parish and the surrounding region from the effects of natural and manmade hazards, ensuring community continuity in the event of such hazards.
Status:
Timeframe:
1-5 years
Priority:
Medium
2015 Priority:
Lead Agencies:
HANO
Support Agencies:
Cost:
TBD
Funding source:
TBD
Emergency Support Function:

Comment on this action item

Hazard:
All
Goal:
Goal 2: Reduce risk and vulnerability to the built environment including current and future structures; critical facilities; historic structures; and infrastructure, including communications infrastructure.
Status:
Timeframe:
TBD
Priority:
Medium
2015 Priority:
N/A
Lead Agencies:
SWBNO Emergency Mgmt
Support Agencies:
Cost:
21000000
Funding source:
PDM/SWBNO
Emergency Support Function:
ESF 6

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