PLEASANT VALLEY, Iowa -- This tiny rural hamlet now sits sunken under the murky, fetid waters of the swollen Mississippi River. Tim Shoemaker, a 25-year-old sheet-metal worker, gets to and from his house by boat, navigating a tricky course past the tops of cottonwoods and maple trees.
He has weeks of cleanup ahead, and the prospect of illness is on his mind.
"There's a guy down here, he got sick last week," Mr. Shoemaker recalled the other day, sitting in the vessel he usually uses to fish. "He was getting out of his boat and he got wobbly and dropped some food in the water. Well, he just drained the water out of it and ate it and he had diarrhea for two days. I'll tell you what. I won't be touching none of this stuff."
The tale of Mr. Shoemaker's neighbor makes Al Moore wince. As the deputy director of the local health department, which encompasses the nearby city of Davenport, he -- and his counterparts throughout the flood-ravaged Midwest -- are working night and day to get the message out that this water is a public health menace.
And their work is only beginning.
Although a feared outbreak of waterborne diseases has thus far failed to materialize, experts say the threat has not passed. Indeed it may increase as people wade into the waters, contaminated by raw sewage and pesticides, to clean up their homes and businesses. The assault of the raging Mississippi and its tributaries have also produced broader health concerns, both for the short and long term.
When the rivers recede, stagnant pools will become breeding grounds for mosquitoes, which carry diseases such as encephalitis, a rare but fatal brain affliction. Any outbreaks, however, would not likely occur until September or October, after the insect larvae have had a chance to mature.
If past experience with disasters is any guide, "the acute part of the flooding isn't really the trouble," said Dr. Julius Conner, head of the Polk County Department of Health in Des Moines. "It's the cleanup. This is where people are going to get injured," he said, as was the case when Hurricane Andrew devastated South Florida last year.
Clinics and hospitals are offering free tetanus shots to protect those who suffer puncture wounds. The state shipped out 42,000 doses of vaccine to flood-stricken counties last week, and residents have been turning out in droves for the shots.
Dr. Conner's list of potential problem areas includes environmental hazards, as well: disposal of toxic chemicals from water-soaked businesses; asbestos particles released into the air when rotted-out pipes dry up; allergies flaring up from mold that grows in damp basement walls.
Mental health is also a big concern. Nerves are shot. People are exhausted.
The director of the U.S. Office of Emergency Preparedness has warned Iowa state officials not to underestimate the psychological fallout of the storms. During a visit last week to Des Moines, Dr. Frank E. Young, who helped supervise relief efforts after the Florida hurricane, said substance abuse, suicide attempts and domestic violence all took an upturn after that disastrous storm.