Bugs in floods

Floods are natural disasters that affect millions of people every year, with escalating impact due to a combination of factors that include increasing urbanisation of previously uninhabited land, deforestation, and climate change. Floods do not discriminate between lower–middle income countries (LMICs) and high-income countries, though the types of damage can differ. As a ‘fire or flood’ country, Australia is no exception. Apart from the obvious physical damage to infrastructure and direct impact on human health due to injury and drowning, there is a more insidious danger lurking in floodwaters – a range of microbial pathogens that can opportunistically cause additional morbidity and mortality. These health effects can be both acute, and longer term. This review focuses on bacterial infections that can be attributed to floods, divided into sections that summarise opportunistic infections by commonly seen human pathogens, versus infections caused by more unusual microbes that are normally not encountered until they are released by floods.