This study examines the feasibility of rapidly training and fit testing health care workers to use elastomeric half-mask respirators (EHMRs), widely used in construction and manufacturing, as an alternative to N95 respirators during periods of shortage.

Hurricane Harvey made landfall in Houston, Texas on 25 August 2017, the psychological and physical effects of which are still unknown. We assessed hurricane exposure and the immediate mental health needs of the population to define public health priorities for a larger epidemiological study. Convenience sampling was used to recruit participants (n = 41) from the greater Houston area aged ≥18 years. Participants completed a questionnaire about demographics, hurricane exposures, and physical/mental health. Post-Traumatic Stress Disorder (PTSD) was measured with the Post-Traumatic Stress Disorder Checklist-S (PCL-S; a score ≥30 indicated probable PTSD symptoms). The Patient Health Questionnaire-4 (PHQ-4) was used to assess symptoms of depression and generalized anxiety disorder. The average PTSD score was 32.9 (SD = 17.1); a total of 46% of participants met the threshold for probable PTSD. Increased overall hurricane exposure (adjusted odds ratio (ORadj) 1.42; 95% confidence interval (CI): 1.06–2.05) and property-related exposure (ORadj 1.53; 95% CI: 1.07–2.18) were both statistically significantly associated with increased odds of probable PTSD symptoms. A perception of chemical/toxin exposure due to Hurricane Harvey was reported by 44% of participants. A higher number of personal or property exposures were associated with greater mental health symptoms three weeks post-hurricane. This work has implications for the ongoing response to Hurricane Harvey and for assessing the immediate needs of the population.

This descriptive prevalence study describes the relationships between mosquito density and the presence of arboviruses (in mosquitoes and humans) with various socioeconomic and environmental factors present near the time of teh arbovirus outbreak in Harris County, Texas, in 2002. This study suggests that mosquito density increased if the trap was located in an area with a large number of containers that may inadvertently retain rainwater (P = 0.056). When considering only virus-positive mosquitoes, significant relationships were observed if the trap was located near waste materials (P < 0.001) or near containers that may inadvertently retain rainwater (P = 0.037). Furthermore, the presence of arbovirus activity (in mosquitoes or humans) in a geographic area tended to be associated with the socioeconomic status of the local community. Although the results of socioeconomic comparisons were not significant, they were suggestive, demonstrating an interesting trend. Compared with communities where virus activity was not observed, the socioeconomic status of the arbovirus-positive community was consistently lower. Specifically, results showed that the populations residing in virus-positive census tracts attained less education, earned less income per household, and were more likely to be below the poverty level. In addition, this study found that virus-positive mosquitoes were randomly distributed throughout the study area, whereas severe human infection cases were clustered. Based on the results of this study, we conclude that the health outcome of a local community as it relates to West Nile virus and St. Louis encephalitis is dependent on many factors, including eh socioeconomic and environmental characteristics of the community.

Disaster recovery provides an opportunity to build healthier and more resilient communities. However, opportunities and challenges encountered by local health departments (LHDs) when integrating health considerations into recovery have yet to be explored. Following Hurricane Harvey, 17 local health and emergency management officials from 10 agencies in impacted Texas, USA jurisdictions were interviewed to describe the types and level of LHD engagement in disaster recovery planning and implementation and the extent to which communities leveraged recovery to build healthier, more resilient communities. Interviews were conducted between December 2017 and January 2018 and focused on if and how their communities were incorporating public health considerations into the visioning, planning, implementation, and assessment phases of disaster recovery. Using a combined inductive and deductive approach, we thematically analyzed interview notes and/or transcripts. LHDs reported varied levels of engagement and participation in activities to support their community’s recovery. However, we found that LHDs rarely articulated or informed decision makers about the health impacts of recovery activities undertaken by other sectors. LHDs would benefit from additional resources, support, and technical assistance designed to facilitate working across sectors and building resilience during recovery.