A large number of people along the Louisiana and Mississippi coasts are developing a condition that some have dubbed "Katrina cough," believed to be linked to mold and dust circulating after Hurricane Katrina.
Health officials say they are trying to determine how widespread the problem is. There are suggestions that it is popping up regularly among people who have returned to storm-ravaged areas, particularly New Orleans.
Dr. Dennis Casey, one of the few ear, nose and throat doctors seeing patients in New Orleans, called the condition "very prevalent." And Dr. Kevin Jordan, director of medical affairs at Touro Infirmary and Memorial Medical Center in downtown New Orleans, said the hospital had seen at least a 25% increase in complaints regarding sinus headaches, congestion, runny noses and sore throats since Katrina.
In most cases, Casey said, patients appear to be "allergic to the filth they are exposed to." Those allergies make the patients more susceptible to respiratory illness, including bacterial bronchitis and sinusitis.
Among the public, the condition is known alternately as "Katrina cough" and "Katrina's revenge" -- much to the consternation of physicians who feel the monikers paint a needlessly alarming portrait of the environment.
"It started out as a sore throat and scratchy eyes. That turned into a cold, and that turned into a cough again, and that's where it stayed," said Christophe Hinton, 38, who was on the way to a medical clinic Thursday to address an illness that had hung around for weeks, impervious to over-the-counter cold medicine.
Hinton, who lives in the French Quarter, drove a taxi before Katrina but now is working with a chain-saw crew, cutting up toppled trees that need to be hauled away.
"Everybody's got this thing," he said. "Everybody I know."
Among healthy people, the condition is not considered serious and can generally be treated with antihistamines, nasal sprays or, in the case of bacterial infections, antibiotics.
"A lot of the patients I've been seeing, what they want to know is whether I see black, furry stuff inside of them. The answer is no," Casey said. "I think the air quality is safe. I think it's noxious. But is it dangerous? No."
But the condition could be more serious for people whose health is otherwise compromised -- for example, organ transplant patients; people who are undergoing chemotherapy; or people who suffer from emphysema, asthma, chronic bronchitis or other ailments.
"It could be life-threatening to those people," said Dr. Peter DeBlieux, associate medical director of the Spirit of Charity, a MASH-style clinic that has been set up in downtown New Orleans. "Those people are already living on a precipice and could be pushed off. Those people are encouraged not to come back to the city."
Some community and environmental advocates say that message is not getting through to the public.
"People are going back in and getting sick," said Wilma Subra, a Louisiana environmental consultant and activist. "They are letting people in without any information or any warning."
Health officials in fact have attempted to warn people with certain conditions to think twice before returning to New Orleans. State and federal officials have handed out hundreds of thousands of fliers and have taped warnings about mold to front doors in badly damaged neighborhoods.
"We have made an effort to get the message out there," said Kristen Meyer, spokeswoman for the Louisiana Department of Health and Hospitals. "But we're not working in ideal conditions here."
Numerous factors have contributed to the public's confusion, Subra and others said.
For example, despite the mold warnings, the government has issued repeated public assurances that the air quality in areas affected by Katrina is safe. But tests of air quality have been aimed almost entirely at toxins, such as benzene, in areas where the storm caused oil spills. There has been very little testing, officials said, of "biologicals" -- namely, the airborne mold that appears to be causing much of the problem.
Most state and federal officials believe there is no need for additional testing because the contamination is confined largely to houses that were flooded during the storm.
"It is an indoor environmental problem, primarily," said Dr. Stephen Redd, chief of the air pollution and respiratory health branch at the National Center for Environmental Health, an arm of the federal Centers for Disease Control and Prevention.
But some in the New Orleans area are developing respiratory conditions without going inside badly damaged buildings or homes, Casey said.
"People who are actually going into the destroyed residences are having a more severe time of it," he said. "But I've also seen some patients who have not actually engaged in that but have started having symptoms just after driving through some of the affected areas."
Several agencies have launched efforts to determine the scope of the problem. The CDC is working with state health officials in Louisiana and Mississippi to "see if it's more common than would be expected in a normal situation," Redd said. The CDC also will track records of healthcare facilities to determine if there is an "unusual pattern of illness," he said.
"We are being watchful," said Bernadette Burden, a CDC spokeswoman in Atlanta. "Everything is very much in the infancy stage."