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Raw sewage contains biological agents such as bacteria, viruses, fungi and parasites that can cause serious illness and even death. There is a further risk of contamination from unknown chemicals (such as solvents, carcinogens, pesticides) and from toxic, irritant, asphyxiating or flammable gases in confined spaces.
Always assume that floodwater is contaminated with sewage. Immediate clean up is essential to reduce the risk of infection and/or mould growth.
Tetanus is caused by a toxin produced by the bacterium Clostridium tetani that is common in soil and in sewage. The bacterium enters the body via open wounds. There is a high risk of death occurring if infected.
Anyone who may be exposed to sewage or soil should have prophylaxis tetanus vaccinations every ten years.
Leptospirosis is caused by the parasitic worm Leptospira icterohaemorrhegiae and is transmitted from water and damp earth contaminated primarily by rats that harbour the organism.
Symptoms: The initial septicemia phase lasts for 4-7 days and causes acute headache, chills, fever, severe muscle aching, anorexia, nausea and vomiting. The immune phase, characterised by aseptic meningitis, follows a 24-72 hour asymptomatic period.
Hepatitis A is caused by the Hepatitis A virus (HAV) that is transmitted primarily by ingestion. The virus must be present in sufficient quantities to cause infection. Infection occurs after an incubation period of three to four weeks. Hepatitis A is often mild, but can be severe or even fatal in some cases.
Symptoms are fever, headache, nausea and pain in the abdomen, dark urine and jaundice. People can spread the disease to others in the immediate period before and while they are ill. Recovery from Hepatitis A can be slow and require several weeks or months of increased rest. The majority of patients make a complete recovery but the disease can be more severe in older patients.
Giardia and Cryptosporidium are protozoan parasites, commonly found in sewage and surface waters, that can cause diarrhoea, stomach cramps, nausea and sometimes fever.
Symptoms may last for only a few days, for months or in some cases years. Many people, especially children, have no symptoms. Cysts from infected persons or animals enter sewage and if untreated may infect other people who ingest the cysts.
Gram-negative bacteria such as E.coli can cause gastro-intestinal diseases if ingested or airway problems, headache, tiredness and nausea if inhaled. Substances called endotoxins that are released at the time of death of the bacterium have been suggested as the cause of a wide variety of occupational diseases such as mill fever and grain fever.
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