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Hurricane Katrina caused unprecedented flood damage to New Orleans, Louisiana, and has been the costliest hurricane in US history. We analyzed the environmental and public health outcomes of Hurricane Katrina by using Internet searches to identify epidemiological, sociodemographic, and toxicological measurements provided by regulatory agencies. Atmospheric scientists have now warned that global warming will increase the proportion of stronger hurricanes (categories 4–5) by 25% to 30% compared with weaker hurricanes (categories 1–2). With the new $14.6 billion Hurricane Storm Damage Risk Reduction System providing a 100-year storm surge–defensive wall across the Southeast Louisiana coast, New Orleans will be ready for stronger storms in the future. [ABSTRACT FROM AUTHOR]

In Louisiana, the "Sportsman's Paradise," and throughout the Southern United States (US), outdoor pursuits are among the most popular physical activities, despite well-documented associations between excessive solar ultraviolet (UV) radiation and skin cancer. Although there have been recent advances in broad-spectru m sunscreens, photoprotective clothing, and photoprotective sunglasses, few peer-reviewed publications have focused specifically on recommendations for responsible sun behavior and photoprotection for residents of the South. In response, the objectives of this review will be (1) to describe the adverse health effects of excessive UV radiation exposures; (2) to review recent cohort studies of public perceptions regarding sun behavior and photoprotection; (3) to identify special populations at increased risks of UV-associated skin cancers; and (4) to recommend responsible sun behavior and photoprotection strategies. Internet search engines were queried with the key words as search terms to examine the latest references on photoprotection and the epidemiology of UV-associated skin cancers and other adverse effects of UV-radiation exposures. Observational studies have demonstrated that the public knows little about proper sunscreen selection and UV protection, and cohort studies have identified populations at increased risks of UV-associated skin cancers. Southerners should avoid intense sunlight, wear photoprotective clothing, wear sunglasses, and select the right sunscreen for their skin type. Physicians should counsel their patients about responsible sun behavior and photoprotection and encourage them to take advantage of recent advances in the development of more effective broad-spectrum sunscreens and photoprotective clothing and sunglasses for themselves and their children.

The American Association of Poison Control Centers has reported more than 50,000 calls annually relating to plant exposures, usually non-lethal ingestions in young adults, adolescents, and children. In addition, there has been more than a 100% increase in the mortality rate for unintentional poisonings in the United States (US) between 1999 and 2006, especially in males and in individuals aged 15-29 years. For children, the frequency of plant exposures is directly related to their presence and abundance in households. In contrast, adolescents and young adults may experiment with naturally hallucinogenic plants, often obtained over the Internet, or attempt suicide by ingesting poisonous plants. In light of these recent trends in plant poisonings, the objectives of this investigation will be to propose a rapid syndromic classification scheme of only four types of highly toxic plants (cardiotoxic, neurotoxic, cytotoxic, and gastrointestinal/hepatotoxic) for the initial evaluation of patients poisoned by indigenous and often unidentified toxic plants in Louisiana and the Gulf South. It will also discuss current strategies for early diagnosis, management, and prevention of potentially lethal plant poisonings. Although many plants contain toxins, plants provide more than 70% of new drugs today and continue to provide new therapies for infectious diseases and cancer. More leisure time spent outdoors seeking natural foods and surfing the Internet for natural substances to abuse will create more opportunities for plant poisonings among high-risk groups, such as immigrants foraging for greens and adolescents experimenting with natural hallucinogens.

Asbestosis is a debilitating, chronic, lung disease with no known treatment and most commonly occurs among workers in certain occupational settings. As a condition highly associated with occupational exposure, its incidence has been affected by changes in industry standards. In particular, the bans on both production and new uses of asbestos fibers put in place during the past 20 to 30 years have significantly reduced occupational exposures. Despite these restrictions, asbestos can still be found in many products. Louisiana has more facilities that produce, process, or use asbestos than any other state in the US. Health outcomes associated with asbestos exposure include asbestosis, mesothelioma, and lung cancer. To evaluate the impact of asbestos exposure on Louisiana residents, Louisiana Hospital Inpatient Discharge Data (LAHIDD) from 1999-2009 was analyzed. Results indicate that asbestosis hospitalizations have remained steady over the 11-year period with approximately 295 cases per year. White males have the highest rates, and cases are clustered geographically. Overall, Louisiana's rate is significantly greater than the US rate (p < 0.0001).

Most emerging infectious diseases today, such as West Nile virus and sudden acute respiratory distress syndrome (SARS), arise from zoonotic reservoirs and many are transmitted by arthropod vectors. Ticks are among the most competent and versatile arthropod vectors of infectious diseases because ticks of all ages and both sexes remain infectious for generations without having to reacquire infections from reservoir hosts. Today, ticks transmit the most common arthropod-borne infectious disease in the United States (US), Lyme disease (LD); and the most lethal arthropod-borne infectious disease in the US, Rocky Mountain spotted fever (RMSF). Both LD and RMSF are endemic in Louisiana and the Gulf South. Ticks have also become frequent vectors of emerging zoonotic diseases in the Gulf South, including southern tick-associated rash illness (STARI), transmitted by the lone star tick, and Maculatum disease, transmitted by the Gulf Coast tick. Recent environmental changes and human lifestyle choices now place humans and ticks together outdoors in the Gulf South for longer periods in welcoming ecosystems for breeding, blood-feeding, and infectious disease transmission. An increasing incidence of emerging and re-emerging, endemic infectious diseases transmitted by existing and unanticipated tick vectors may be expected.

The Atlantic hurricane season of 2005 was not an ordinary season, and Hurricane Katrina was not an ordinary hurricane. Hurricane Katrina damaged more than 93,000 square miles of Gulf of Mexico coastline, displaced more than 1 million residents from New Orleans, and flooded more than 80 percent of New Orleans for weeks, which killed more than 1,300 people, mostly New Orleanians. Inland regional state and local healthcare and human services agencies rushed to assist evacuees, most of whom were uninsured or displaced without employer healthcare coverage. The initial evacuation brought more than 350,000 evacuees seeking shelter to the greater Baton Rouge area, LA, 80 miles north of New Orleans, the closest high ground. This investigation describes the rapid needs assessment developed and conducted by the Capital Area Human Services District of the greater Baton Rouge area, a quasi-governmental human services authority, the regional provider of state-funded mental health, addictive disorders, and developmental disabilities services, on a sample of 6,553 Katrina evacuees in the greater Baton Rouge area. In the event of catastrophic natural and manmade disasters, state and federal decision makers should follow the National Incident Management System and support local designated lead agencies with additional resources as requested. They must rely on designated lead agencies to use their knowledge of the locale, local resources, and relationships with other providers and volunteers to respond rapidly and efficiently to evacuee needs identified through a designated, concise tool that is singularly utilized across the impacted region by all providers to determine the needed response.

Chagas disease, or American trypanosomiasis, is an arthropod-borne protozoan infectious disease, hyperendemic throughout Latin America, caused by Trypanosoma cruzi, and transmitted to man by reduviid or kissing bugs. Throughout the Americas, Chagas disease shares many life cycle features with malaria, including transmission of infectious stages by local arthropods, exacerbation or reactivation of subclinical infections by immunosuppression (particularly HIV/AIDS) and pregnancy, and both transplacental and transfusion-related transmission. Although most cases of Chagas disease in the United States (US) are imported, significant numbers of Latin American immigrants contribute to the US blood supply and donate cadaveric tissues and organs for human transplantation, thus increasing the risks of both transfusion and transplantation-transmitted Chagas disease from unscreened blood products and transplantable tissues and organs. In addition, the risks of local reduviid bug-transmitted autochthonous or indigenous Chagas disease are also increasing as more immigrant workers enter the displaced populations of the Gulf South, including Louisiana, to assist in rebuilding efforts after Hurricanes Katrina and Rita. Although screening donated blood products for malaria remains impractical, consideration should now be given to serologically screening all donated blood and organs for Chagas disease in the US, as in most countries of Latin America, especially in high risk areas of California and the southern US, including Louisiana.