September 19, 2003 - Hurricane Isabel, now a tropical storm, has caused widespread power outages and flooding in North Carolina, Virginia, and surrounding states. Story from CNN.

When floods occur, municipal water treatment officials may add large doses of chlorine/chloramines to water supplies in order to prevent outbreaks of infectious diseases. This practice may present a danger to dialysis patients.

When chlorine/chloramines are present in high enough concentrations in dialysate, they can cause hemolysis (red blood cell destruction). Carbon filters in dialysis unit water treatment systems, designed to remove normal levels of chlorine/chloramines from city water, may be overwhelmed in these situations. Additional carbon filters, frequent changing of carbon filters, or frequent backwashing of the carbon beds may be required.

Special web sites inspired by Hurricane Isabel were activated this week at the Department of Health and Human Services and the Centers for Disease Control.

A major risk for dialysis patients and staff is drowning in vehicles when attempting to reach dialysis treatment centers.

Inland flooding is the leading cause of hurricane-related death in the U.S. When hurricane Floyd hit the eastern U.S. in 1999, of the 56 people who perished, 50 drowned due to inland flooding.

Flood safety information. Most flood deaths are due to FLASH FLOODS. Nearly half of all flash flood fatalities are auto related!!! Never drive your automobile into moving water, especially if you cannot tell how deep the water is.

Here is the 3-day forecast track for hurricane Isabel.

Here is the State of North Carolina Department of Crime Control & Public Safety Division of Emergency Management web site and their Hurricane Isabel web page.

Here is the State of Virginia Department of Emergency Management web site.

Here are some other on-line resources:

• Medicare has a 34-page guide with useful information entitiled, "Preparing for Emergencies: A Guide for People on Dialysis" (Adobe PDF). Medicare web page.
  
  
  
• How dialysis patients can plan for weather emergencies by Stephen Fadem, MD
  
  
  
• The National Hurricane Center web site
  
  
  
• The Weather Channel on-line.

[This message has been edited by Gary Peterson (edited 10-15-2003).]