Experts stepped up warnings not to even touch the floodwaters in New Orleans.

Tom Skinner, a spokesman for the government's Centers for Disease Control and Prevention (CDC), said the five died this week from vibrio vulnificus, a bacteria that is part of the cholera family.

He said one case was reported in Texas and the others in Mississippi. Skinner said all the victims had been evacuated from areas pounded last week by Katrina. He added that more deaths were likely.

"There will be some more deaths associated with vibrio vulnificus in the affected areas, particularly New Orleans."

Vibrio vulnificus can enter the body through a cut, scratch or wound that comes in contact with contaminated water, often salt water. The elderly or those with a weak immune system are most at risk.

Symptoms include vomiting, diarrhea, cramps, nausea, headache and fever. If the bacteria infects the bloodstream, the mortality rate is 50 percent, according to the CDC, but it is not contagious.

CDC Director Julie Louise Gerberding said the disease "in no way resembles cholera".

Doctors have been warning that the Gulf Coast, where thousands were feared killed by Katrina, could become a haven for cholera, malaria, typhoid, West Nile virus and other ailments. But no major outbreaks have been reported.

Meanwhile officials said tests showed New Orleans floodwaters contain unsafe levels of E. coli and coliform bacteria, as well as lead, and contact with the water should be avoided, Environmental Protection Agency chief Stephen Johnson urged Wednesday.

"Our initial findings indicate that counts for E. coli and coliform bacteria greatly exceed EPA-recommended levels for contact," Johnson told reporters. "Human contact with the floodwaters should be avoided as much as possible."

In Houston, Texas, a suspected case of tuberculosis was found at the Astrodome stadium where thousands of Katrina evacuees are being housed. But no diagnosis has been confirmed, Skinner said.

Texas has the biggest number of Katrina evacuees, especially from New Orleans, where Mayor Ray Nagin has ordered the evacuation of all remaining residents because of the health risks.

Running water was restored to parts of the city, officials said, but people were advised not to drink the water or bathe in it.

Gerberding went on television Wednesday to urge survivors still in New Orleans to listen to the authorities.

"Right now, everyone needs to heed the warnings about the safety of the water, not drink the water, and leave," she said.

She added that "rescue workers do need to take care to clean themselves when they're out of the water and use the kind of protective equipment that can keep them dry."

Army engineers worked to pump floodwaters, littered with human bodies, waste and dead animals, back into New Orleans's Lake Pontchartrain after a major break in the levee was repaired over the weekend.

Gerberding said the health danger posed by the floodwaters was more immediate than long-term.

"Over time, these bacteria will dissipate and die," she said. "But the short-term issue is they could be concentrated in the waters in the city, and it's a health hazard in that context."

Experts also said that for the moment there was little risk of a mass epidemic in the disaster zone.

Jean-Luc Poncelet, a World Health Organisation emergency and disaster relief expert based in Washington, said it was possible there would be a case of cholera in the disaster zone but there should be no major epidemics.

"People exposed to this water will have problems, they will probably have diarrhea," said Poncelet. "But if they keep to basic hygiene guidelines, avoid contact with the water, there should be no important problems."

Herbert DuPont, head of internal medicine at St Luke's Episcopal Hospital in Houston, said that all people from the disaster zone should make sure they are vaccinated against hepatitis A. He said there was a 10 percent chance of an epidemic.

New Orleans Not A "Toxic Gumbo": Expert
by Marc Lavine
Baton Rouge, Louisiana, Sept 7 (AFP) The greatest health risk in the aftermath of Hurricane Katrina is a possible outbreak of gastro-intestinal disease in refugee shelters, not the "toxic gumbo" of New Orleans, a medical expert said Wednesday.

Doctor Raoult Ratard, Louisiana chief epidemiologist, downplaying reports that epidemics of cholera, typhoid, malaria and yellow fever are lurking in the putrid floodwaters covering the city, said the threat was more mundane.

"People have been talking about malaria, yellow fever and about Dengue," he told reporters in Baton Rouge, the Louisiana state capital. "We are not concerned about that."

"The only source of these diseases is infected people. These people were not here. If you don't have a bunch of people out there being bitten by mosquitoes, and it takes more than one person, you don't have the disease."

The water-borne bacteria that killed five survivors of the New Orleans floods, vibrio vulnificus, only targets the elderly and sick and is very unlikely to spread, Ratard said.

"I am not surprised that some people have been exposed to it and that it turned into blood poisoning.

"But a lot of people have been exposed to sea water, where this bacteria lives, and will not get sick.

"This is not transmitted person to person and its not going to spread," he said, adding, however, that nursing homes and hospice patients were vulnerable.

Even West Nile virus, a mosquito-related fever, is not a big risk because the storm probably killed mosquito larvae and mosquitoes and chased away the birds.

Some medical experts have warned that hurricane and flood-stricken zones in Louisiana and Mississippi could become a breeding ground for infectious diseases.

But Ratard said the biggest danger was the virulent gastro-intestinal sickness Noro virus, which is born in human waste, which he said was liable to break out in shelters, where many of the one million people displaced by the storm and flooding are housed.

"The main concern is that you have a shelter with 6,000 people who are going to go there, then you will have someone who has diarrhoea. The fear is that it could spread," he said.

Some 14 "clusters" of people, groups of five to 15, have already come down with diarrhoea in shelters.

But even common gastric ailments are not spreading fast yet, he said.

"Right now we don't have large outbreaks of people that have been out of New Orleans for more than 72 hours," Ratard said.

While the medical official warned survivors and rescuers to avoid drinking or wading in the fetid swamp of New Orleans, he added that simply coming into contact with it would not necessarily result in infection.

"The water is not safe to drink, it's not a good idea to go and wade in the water," he said. "It's also not a toxic gumbo that going to kill people. We don't want them to be scared for no reason."

If rescuers or survivors come into contact with the rank water, the treatment is simple.

"The best contamination is a shower with soap and water," Ratard said.

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