The immediate increase in cases may be attributed to increased human exposure to mosquitoes. Tens of thousands of persons in the hurricane-affected region were living in damaged housing or were waiting outside for days to be evacuated. The sudden decrease in WNND cases in the hurricane-affected areas 3 weeks after landfall could be attributed to reduced human exposure caused by eventual evacuation and aerial application of insecticides. The increase in WNND incidence in 2006 might also be due to increased human-mosquito exposure as a result of mosquito larval habitat creation (root ball voids from fallen trees, and flooded abandoned swimming pools), continued substandard living conditions, and increased outdoor reconstruction activities.
Friday, October 7, 2016
The largest concentration of Zika cases in the United States is in and around Dade County, which may be spared the direct impact of the storm, but a huge rain event like Matthew quite obviously would leave massive amounts of standing water within which Aedes aegypti, the mosquito that carried the virus, could breed and thrive.
(A large part of the hot zone is at an elevation of nine feet above sea level. Some predictions have the area being inundated by a 12-foot storm surge.)
And it is not just puddles, either. Think about how water can pool in piles of debris, and in scattered wreckage. Think about endless heaps of worthless household junk. Think about thousands of evacuees leaving the current hot zones in and around Miami. Now think about all the crews coming from all over the country to help with the recovery effort over the next several months, walking amid the debris, turning it over in the heat that always follows a hurricane. Now think about all those crews going back to Iowa or Maine.
The most direct precedent probably is the experience of Hurricane Katrina in 2005. A 2008 report from the Centers for Disease Control demonstrated how the mosquito-borne West Nile virus spiked in the immediate aftermath of the storm.