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Floods can also indirectly impact human health by supporting or spreading breeding grounds and dispersal of pathogen vectors. Flooding along the Yangtze River, China corresponded with the spread of schistosomiasis carrying snails to previously disease-free areas. Cases of schistosomiasis among humans and animals rose after a large flood in the area and the highest rates were localized to lakeside provinces along the Yangtze (Wu et al. 2008). Malaria was found to increase after extreme flooding in multiple studies due to the creation of stagnant pools of water that are necessary breeding grounds for the mosquitoes that carry and spread the pathogen. Boyce et al. (2016) showed malaria rates increased by 30% in areas bordering a recently flooded river. This spike in morbidity occurred at a time that was uncharacteristic for malaria season and was attributed to the flood waters creating stagnant waters for breeding that otherwise would not be present (Boyce et al. 2016). A temporal analysis of malaria after extreme flooding showed peak malaria rates at 25 days post-flood, consistent with the delay expected for mosquito growth, disease transmission and presentation (Ding et al. 2014). This lag period is much longer than that associated with viral GI illness and raises the issue of identifying an appropriate surveillance period when monitoring flood-related disease outbreaks. For certain diseases, a flood-related event might not show increases in cases until weeks after the flood has receded, especially if the organisms are able to remain in the soil. An outbreak of cryptosporidium among children in Halle, Germany was linked to their participation in activities on a floodplain 2 weeks after flood waters had receded and the floodplain had been reopened to the public (Gertler et al. 2015).
From our literature review, we found that recreation is negatively impacted by extreme flooding. People were less likely to visit a recreational site, such as a park, after extreme flooding had occurred (Rung et al. 2011). Small floods had a general positive impact on recreation. Small experimental floods increased recreation by increasing the size and number of sandbars suitable for boats to stop at below the Glen Canyon Dam, Arizona (Stewart et al. 2003). Additionally, one study found that a study group comprised of students preferred rivers and streams located within parks to have dynamic hydrology (Eder and Arnberger 2016). Therefore, people are more likely to recreate in parks where natural water features have dynamic hydrology. Small floods increase hydrologic variability without causing the damages associated with extreme flooding. The effects of extreme flooding on tourism were mixed. Negative impacts included revenue losses (Kala 2014), evacuations (Faulkner and Vikulav 2001), and tourists deciding to avoid visiting the flooded area (Walters et al. 2015). These effects were temporary and tourism returned to pre-flood values after flood waters receded. In one study, tourists simply rescheduled their trips instead of traveling to an unaffected area (Faulkner and Vikulav 2001). It was also reported that flooded areas can appeal to travelers who want to help those affected (Walters et al. 2015). We were unable to make any conclusions on the impacts of small floods on tourism since we found no literature. However, there is some evidence that people tend to desire visiting areas with dynamic river systems so small floods may enhance tourism. As with recreation, the post-flood recovery efforts and the message communicated to the public play a crucial role (e.g. Walters et al. 2015). Education of the public through media presentations and outreach activities is very influential in restoring recreational activities. Having a disaster preparedness plan prior to an extreme flood, with effective implementation following a flood, can significantly improve the post-flood recovery in recreational and tourist activity (Faulkner and Vikulov 2001).
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