Tuesday, May 13, 1997
Local officials, N.D. alerted
to deadly disease linked to floods

BY ELIZABETH NEUS
Gannett News Service

Health officials in southern Ohio and North Dakota have been put on notice that the severe flooding in their regions might lead to clusters of a deadly lung disease that made more than two dozen Cleveland-area infants ill.

The disease, acute pulmonary hemorrhage - hemosiderosis, has been linked to a slimy black mold called Stachybotrys atra that can grow in homes that have been flooded.

Oddly enough, Cleveland - whose northern border consists of Lake Erie - does not flood the way the riverfront cities of Cincinnati and Grand Forks do. Some federal health officials think the mold may be peculiar to the Cleveland area, but the flooded communities are keeping an eye out just in case.

"There is a risk . . . but we've not seen any cases yet," said Dr. Robert Wilmott, director of pulmonary medicine at Cincinnati's Children's Hospital Medical Center.

The flood can be of the proportions of the biblical deluge that submerged Grand Forks, N.D., last month, or as small as a day's worth of standing water in the basement from a backed-up storm drain. In 1994, Cleveland doctors reported that eight infants who lived in one area of the city all suffered bleeding in their lungs. Five had a second lung hemorrhage after they went home, and one died. Since then, investigations have turned up more than 30 cases in Cleveland alone, plus another 47 possible cases in the rest of the country. Symptoms include a cough (sometimes producing blood), lung congestion, dark stools, and nosebleeds. Babies who live with smokers are at higher risk.

Lake County, next to Cleveland's Cuyahoga County, is under a medical alert after two cases of the disease were diagnosed within a week in infants living in Fairport Harbor, population 3,000. The other cases have occurred in infants who live in older, inner-city homes, said Dr. Dorr Dearborn, a pediatrician at Rainbow Babies and Childrens Hospital in Washington, D.C., where much of the research into the disease is being done.

Portions of Cincinnati and several nearby Ohio and Kentucky communities were severely damaged when the Ohio River overflowed its banks in March. Most sick children are sent to Children's.

Officials at the federal Centers for Disease Control and Prevention (CDC), which sent a team to Grand Forks this week, planned to check that ravaged city - underwater since late April - for molds and other potential health hazards.

But despite the clusters of hemosiderosis in Cleveland, CDC emergency response specialist Jim Rabb said the agency never had seen similar cases after large floods. Iowa health officials said they saw no cases after the 1993 Mississippi River flooding that ravaged Des Moines.

"So I don't think it's going to happen," Mr. Rabb said.

While cases have been diagnosed outside Cleveland, it is unclear - apart from the more vigilant surveillance - why that area should see so many more cases, especially because it does not experience regular river-style flooding.

Any homeowner who has had any water in the basement should clean thoroughly before moving an infant back in, Mr. Dearborn said. The CDC also warns people with compromised immune systems - such as those suffering from cancer or AIDS, or who have had organ transplants - to also wait until the home is cleaned before going back.