Hurricane Mitch and associated flooding have affected 3-5 million persons in Central America, and caused an unknown number of deaths. Although epidemics are relatively rare in the aftermath of natural disasters, in this case there is a combination of high-risk factors which could lead to an increase in the transmission of communicable diseases: the magnitude of the hurricane, the large number of displaced persons, the contamination of drinking-water and poor sanitation conditions.
Even though the mosquito population may decrease (washing effect of the storm) in the first weeks following the hurricane, it will inevitably rebound due to the subsequent accumulation of stagnant water. This could lead to an increased risk of malaria and dengue epidemics in an area that is already highly endemic for these diseases.

Cholera is also endemic in Central America, and again the risk of transmission is likely to increase. Information regarding suspected cases of cholera in the suburbs of Managua (Nicaragua) has recently been received from field workers.

Although no epidemic has been confirmed so far, WHO strongly recommends that relief agencies pay particular attention to epidemic readiness and water safety activities.

=A9 WHO/OMS, 1998