Health officials say accidents like Robert's and the explosion of mold in homes and buildings pose the biggest health risks in Gulf Coast areas hit by hurricanes Katrina and Rita. The disease outbreaks feared earlier didn't materialize in the weeks after the storms.

"People are going back to their house, cleaning up, going up on their roofs, doing all kinds of stuff they're not used to," said Dr. Raoult Ratard, Louisiana's state epidemiologist.

Roberts said his one-story home was filled with 8 feet of water after Katrina and needs to be gutted. While waiting for his insurance payments, he's ripping out the walls himself.

"If I had the insurance, I could pay someone to do it," Roberts said Thursday. "But if you don't, you have to do it yourself."

In the days after Katrina hit, there were dire predictions of disease outbreaks from contaminated floodwaters, unsanitary living conditions and mosquitoes breeding in the hot and humid coastal climate.

Exposure to the mold flourishing in flooded buildings can pose health problems, especially for those who have weakened immune systems or mold allergies, said Dr. Stephen Redd of the Centers for Disease Control and Prevention's National Center for Environmental Health.

Symptoms include coughing, wheezing, stuffy nose and skin rashes.

At the downtown clinic, Dr. Peter DeBlieux said they're treating a lot of people with those kinds of problems.

"Everybody's calling it the 'Katrina cough,'" he said.

Sitting in the clinic's waiting room, Rose Howell, 21, of Detroit, coughed repeatedly while waiting to see a dentist. She said she developed the cough and a stuffy nose this week while helping a resident pack up and move furniture from a house and storage area.

NEW ORLEANS — 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."

Environmental monitoring in the wake of Hurricane Katrina is telling state and federal officials that some areas present possible health problems, some appear to be clean and some need additional investigation.
"This is a natural disaster the likes we have never seen before," U.S. Environmental Protection Agency Administrator Stephen Johnson said Thursday in a conference call with reporters.

He said initial sampling told the agency that "floodwaters were contaminated with bacteria and lead and a variety of other materials."

Sediment testing around expected environmental hot spots, such as the massive Murphy Oil refinery spill in St. Bernard Parish, tells officials that there are some dangers and concerns.

But a lot of environmental sampling is showing results below federal action levels.

Dr. Howard Frumkin of the Agency for Toxic Substances and Disease Registry said "it is very hard to say in a broad brush way" whether Katrina was the environmental disaster people predicted in early September.

"There are some areas that appear to be quite clean and quite safe. There are some areas where we are concerned and some areas still need investigation," Frumkin said.

Frumkin said some health tracking in clinics and hospitals around the New Orleans area has turned up anecdotal evidence of coughing and other respiratory problems and that is "exactly what is expected." The agency expected more cases of communicable diseases, but that concern never materialized.

A lot of injuries connected to the hurricane have been reported, such as carbon monoxide poisoning from use of generators in enclosed areas and cuts from chain saws. "I wish we had better data," he said.

For example, the agency can't discern the impacts of molds versus contaminated dust.

"We have more questions than answers," he said.

"It is plausible that some people are having reactions to mold and other substances there," Frumkin said.

Routine air sampling doesn't measure mold, he said.

EPA has conducted sampling around five Superfund sites flooded by Katrina. The Agriculture Street Landfill in New Orleans, Southern Shipbuilding in Slidell and Madisonville Creosote Works sites "were not affected by the hurricane, Johnson said.

Testing at the Bayou Bonfouca site in Slidell showed some water contamination, but all at levels below drinking water action levels, Johnson said.

At Delatte Metals near Ponchatoula, tests showed some elevated levels of metals, but none of the area's drinking water wells were contaminated, he said.

A storage tank on the Murphy Oil Refinery in Meraux collapsed during Katrina and about 1,700 St. Bernard Parish homes were contaminated. The oil company is working on cleaning up the area, Johnson said.

Murphy has taken about 1,500 samples and EPA has independently analyzed about 10 percent of them.

Many samples show levels of oil products that exceed safe levels for residential soils, he said.

He and Frumkin reiterated that residents returning to their homes should avoid direct contact with oil-contaminated sediments and should wear protective clothing. Children and pets should not be allowed into the area as they are more likely to be harmed by any contamination.

EPA Region 6 Administrator Richard Greene said he thinks some homeowners around the Murphy refinery will want to rebuild, but he said he doesn't know whether that will be reasonable or allowable.

"We do not have answers today," Greene said. "We expect Murphy to be responsible" and clean up the contamination to meet standards, he said.