Hurricane Helene’s flooding has subsided, but health risks are growing in hard-hit regions of the North Carolina mountains , where many people lost access to power and clean water. More than 150 deaths across the Southeast had been attributed to Hurricane Helene within days of the late September 2024 storm, according to The Associated Press, and hundreds of people remained unaccounted for. In many areas hit by flooding, homes were left isolated by damaged roads and bridges .

Phone service was down. And electricity was likely to be out for weeks. As a disaster epidemiologist and a native North Carolinian, I have been hearing stories from the region that are devastating.

Contaminated water is one of the leading health risks, but residents also face harm to mental health, stress that exacerbates chronic diseases and several other threats. Water risks: What you can’t see can hurt you Access to clean water is one of the most urgent health concerns after a flood. People need water for drinking, preparing food, cleaning, bathing, even flushing toilets.

Contact with contaminated water can cause serious illnesses . Floodwater with sewage or other harmful contaminants in it can lead to infectious diseases, particularly among people who are already ill, immunocompromised or have open wounds. Even after the water recedes, residents may underestimate the potential for contamination by unseen bacteria such as fecal coliform, heavy metals such as lead, and organic and inorganic contamin.