2011 Essential Guide to Health and Medical Issues Involving Natural Disasters - Official Information for Individuals and Businesses on Dealing with Floods, Hurricanes, and other Emergencies
U.S. Government, Federal Emergency Management Agency (FEMA), Centers for Disease Control (CDC), Food and Drug Administration (FDA)
Smashwords Edition
Copyright 2011 Progressive Management
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Health and Medical Issues Involving Natural Disasters including Hurricanes and Floods
Hurricane Readiness: Emergency Supplies You Will Need
HIGHLIGHTS
* Stock your home with emergency supplies that you and your family may need during the emergency period.
* Make sure that you have at least a 3-5 day supply of non-perishable food and water.
* Include prescription medications, baby supplies and any additional items for special medical needs.
* Place an emergency kit in your car.
You should stock your home with supplies that may be needed during the emergency period. At a minimum, these supplies should include:
Hurricane Supplies
* Several clean containers for water, large enough for a 3-5 day supply of water (about five gallons for each person).
* A 3-5 day supply of non-perishable food.
* A first aid kit and manual.
* A battery-powered radio, flashlights, and extra batteries.
* Sleeping bags or extra blankets.
* Water-purifying supplies, such as chlorine or iodine tablets or unscented, ordinary household chlorine bleach.
* Prescription medicines and special medical needs.
* Baby food and/or prepared formula, diapers, and other baby supplies.
* Disposable cleaning cloths, such as "baby wipes" for the whole family to use in case bathing facilities are not available.
* Personal hygiene supplies, such as soap, toothpaste, sanitary napkins, etc.
* An emergency kit for your car with food, flares, booster cables, maps, tools, a first aid kit, fire extinguisher, sleeping bags, etc.
You can find more information on emergency plans and supply kits at www.ready.gov.
HURRICANE READINESS: MAKE A PLAN
Step 1. Take the First Steps for a Hurricane Plan
Hurricane Readiness Fact Sheet
HIGHLIGHTS
* Learn about your community's emergency plans, warning signals, evacuation routes, and locations of emergency shelters.
* Identify potential home hazards and know how to secure or protect them.
* Locate and secure your important papers.
* Inform local authorities about any special needs.
If you are under a hurricane watch or warning, here are some basic steps to take to prepare for the storm:
* Learn about your community's emergency plans, warning signals, evacuation routes, and locations of emergency shelters.
* Identify potential home hazards and know how to secure or protect them before the hurricane strikes. Be prepared to turn off electrical power when there is standing water, fallen power lines, or before you evacuate. Turn off gas and water supplies before you evacuate. Secure structurally unstable building materials.
* Buy a fire extinguisher and make sure your family knows where to find it and how to use it.
* Locate and secure your important papers, such as insurance policies, wills, licenses, stocks, etc.
* Post emergency phone numbers at every phone.
* Inform local authorities about any special needs, i.e., elderly or bedridden people, or anyone with a disability.
* Make plans to ensure your pets' safety.
HURRICANE READINESS: MAKE A PLAN
Step 2. Prepare to Evacuate
Hurricane Readiness Fact Sheet
HIGHLIGHTS
* Expect the need to evacuate and prepare for it.
* Never ignore an evacuation order.
* Follow the instructions on this page to prepare for evacuation and then to safely evacuate or get through the storm if ordered not to evacuate.
Expect the need to evacuate and prepare for it. The National Weather Service will issue a hurricane watch when there is a threat to coastal areas of hurricane conditions within 24-36 hours.
When a hurricane watch is issued, you should:
* Fill your automobile's gas tank.
* If no vehicle is available, make arrangements with friends or family for transportation.
* Fill your clean water containers.
* Review your emergency plans and supplies, checking to see if any items are missing.
* Tune in the radio or television for weather updates.
* Listen for disaster sirens and warning signals.
* Prepare an emergency kit for your car with food, flares, booster cables, maps, tools, a first aid kit, fire extinguisher, sleeping bags, etc.
* Secure any items outside which may damage property in a storm, such as bicycles, grills, propane tanks, etc.
* Cover windows and doors with plywood or boards or place large strips of masking tape or adhesive tape on the windows to reduce the risk of breakage and flying glass.
* Put livestock and family pets in a safe area. Due to food and sanitation requirements, emergency shelters cannot accept animals.
* Place vehicles under cover, if at all possible.
* Fill sinks and bathtubs with water as an extra supply for washing.
* Adjust the thermostat on refrigerators and freezers to the coolest possible temperature.
Hurricane Evacuation
If You are Ordered to Evacuate
Because of the destructive power of a hurricane, you should never ignore an evacuation order. Authorities will be most likely to direct you to leave if you are in a low-lying area, or within the greatest potential path of the storm. Be aware that most shelters and some hotels do not accept pets. If a hurricane warning is issued for your area or you are directed by authorities to evacuate the area:
* Take only essential items with you.
* If you have time, turn off the gas, electricity, and water.
* Disconnect appliances to reduce the likelihood of electrical shock when power is restored.
* Make sure your automobile's emergency kit is ready.
* Follow the designated evacuation routes—others may be blocked—and expect heavy traffic.
If You Are Ordered NOT to Evacuate
The great majority of injuries during a hurricane are cuts caused by flying glass or other debris. Other injuries include puncture wounds resulting from exposed nails, metal, or glass, and bone fractures.
To get through the storm in the safest possible manner:
* Monitor the radio or television for weather conditions, if possible.
* Stay indoors until the authorities declare the storm is over.
* Do not go outside, even if the weather appears to have calmed—the calm "eye" of the storm can pass quickly, leaving you outside when strong winds resume.
* Stay away from all windows and exterior doors, seeking shelter in a bathroom or basement. Bathtubs can provide some shelter if you cover yourself with plywood or other materials.
* Prepare to evacuate to a shelter or to a neighbor's home if your home is damaged, or if you are instructed to do so by emergency personnel.
HURRICANE READINESS: MAKE A PLAN
Step 3. Complete Your Family Disaster Plan
Hurricane Readiness Fact Sheet
HIGHLIGHTS
* Contact your local Red Cross and ask what types of disasters are most likely to happen.
* Meet with your family and discuss why you need to prepare for disaster.
* Complete the disaster plan checklist.
* Practice your plan.
By completing a disaster plan in advance, you can ensure that you and your family are more prepared for all types of disasters and other emergencies.
HURRICANE AND FLOOD RECOVERY:
Prevent Illness From Food and Water After a Hurricane or Flood
Download the Complete Hurricane Recovery Fact Sheet
HIGHLIGHTS
* Throw away food that may have come in contact with flood or storm water.
* Keep the refrigerator and freezer doors closed as much as possible and add block ice or dry ice if the electricity is expected to be off longer than 4 hours.
* Local authorities will tell you if tap water is safe to drink or use for cooking or bathing.
* If the water is unsafe, follow the directions of local authorities to safely disinfect the water.
Prevent illness from food
Identify and throw away food that may not be safe to eat
Throw away food that may have come in contact with flood or storm water. Throw away canned foods that are bulging, opened, or damaged. Throw away food that has an unusual odor, color, or texture. Throw away perishable foods (including meat, poultry, fish, eggs and leftovers) that have been above 40°F for 2 hours or more. Thawed food that contains ice crystals or is 40°F or below can be refrozen or cooked. If cans have come in contact with floodwater or storm water, remove the labels, wash the cans, and dip them in a solution of 1 cup (240 milliliters) of bleach in 5 gallons of water. Relabel the cans with a marker.
Store food safely
While the power is out, keep the refrigerator and freezer doors closed as much as possible. Add block ice or dry ice to your refrigerator if the electricity is expected to be off longer than 4 hours. Wear heavy gloves when handling ice.
Prevent illness from water
Listen to and follow public announcements
Local authorities will tell you if tap water is safe to drink or to use for cooking or bathing. If the water is not safe to use, follow local instructions to use bottled water or to boil or disinfect water for cooking, cleaning, or bathing.
Correctly boil or disinfect water
Hold water at a rolling boil for 1 minute to kill bacteria. If you can't boil water, add 1/8 teaspoon (approximately 0.75 mL) of newly purchased, unscented liquid household bleach per gallon of water. Stir the water well, and let it stand for 30 minutes before you use it. You can use water-purifying tablets instead of boiling water or using bleach. For infants, use only pre-prepared canned baby formula. Do not use powdered formulas prepared with treated water. Disinfect children's toys that have come in contact with water. Use a solution of 1 cup of bleach in 5 gallons of water to disinfect the toys. Let toys air dry after cleaning. Some toys, such as stuffed animals and baby toys, cannot be disinfected; they should be discarded.
Prevent and Treat Other Illnesses and Injuries After a Hurricane or Flood
HIGHLIGHTS
* Prevent Carbon Monoxide poisoning: Don't use a generator, pressure washer, charcoal grill, camp stove, or other gasoline- or charcoal-burning device inside your home or near a window, door, or vent.
* To prevent mold growth, clean wet items and surfaces with detergent and water.
* Avoid lifting any material that weighs more than 50 pounds (per person).
Prevent carbon monoxide poisoning
Carbon monoxide is an odorless, colorless gas that is produced by many types of equipment and is poisonous to breathe. Don't use a generator, pressure washer, charcoal grill, camp stove, or other gasoline- or charcoal-burning device inside your home, basement, or garage or near a window, door, or vent. Don't run a car or truck inside a garage attached to your house, even if you leave the door open. Don't heat your house with a gas oven. If your carbon monoxide detector sounds, leave your home immediately and call 911. Seek prompt medical attention if you suspect carbon monoxide poisoning and are feeling dizzy, light-headed, or nauseated.
Avoid floodwater and mosquitoes
Flood Water
Follow all warnings about water on roadways. Do not drive vehicles or heavy equipment through water. If you have to work in or near floodwater, wear a life jacket. If you are caught in an area where floodwater is rising, wear a life jacket, or use some other type of flotation device. Prevent mosquito bites by wearing long pants, socks, and long-sleeved shirts and by using insect repellents that contain DEET or Picaridin.
Avoid unstable buildings and structures
Stay away from damaged buildings or structures until they have been examined and certified as safe by a building inspector or other government authority. Leave immediately if you hear shifting or unusual noises that signal that the structure is about to fall.
Beware of wild or stray animals
Avoid wild or stray animals. Take appropriate precautions to avoid animal bites and rabies exposure (see Rabies Exposure: What You Need to Know). Call local authorities to handle animals. Get rid of dead animals according to local guidelines.
Beware of electrical and fire hazards
NEVER touch a fallen power line. Call the power company to report fallen power lines. Avoid contact with overhead power lines during cleanup and other activities. If electrical circuits and equipment have gotten wet or are in or near water, turn off the power at the main breaker or fuse on the service panel. Do not turn the power back on until electrical equipment has been inspected by a qualified electrician. Do not burn candles near flammable items or leave the candle unattended. If possible, use flashlights or other battery-operated lights instead of candles.
Beware of hazardous materials
Wear protective clothing and gear (for example, a respirator if needed) when handling hazardous materials. Wash skin that may have come in contact with hazardous chemicals. Contact local authorities if you are not sure about how to handle or get rid of hazardous materials.
Clean up and prevent mold growth
Clean up and dry out the building quickly (within 24 to 48 hours). Open doors and windows. Use fans to dry out the building. To prevent mold growth, clean wet items and surfaces with detergent and water. To remove mold growth, wear rubber gloves, open windows and doors, and clean with a bleach solution of 1 cup of bleach in 1 gallon of water. Throw away porous items (for example, carpet and upholstered furniture) that cannot be dried quickly. Fix any leaks in roofs, walls, or plumbing.
Pace yourself and get support
Be alert to physical and emotional exhaustion or strain. Set priorities for cleanup tasks, and pace the work. Try not to work alone. Don't get exhausted. Ask your family members, friends, or professionals for support. If needed, seek professional help.
Prevent musculoskeletal injuries
Use teams of two or more people to move bulky objects. Avoid lifting any material that weighs more than 50 pounds (per person).
Keep Cool - Stay cool
When it's hot, stay in air-conditioned buildings; take breaks in shaded areas or in cool rooms; drink water and nonalcoholic fluids often; wear lightweight, light-colored, loose-fitting clothing; and do outdoor activities during cooler hours.
Treat wounds
Clean out all open wounds and cuts with soap and clean water. Apply an antibiotic ointment. Contact a doctor to find out whether more treatment is needed (such as a tetanus shot). If a wound gets red, swells, or drains, seek immediate medical attention.
Wash your hands
Use soap and warm water to wash your hands. If water isn't available, you can use alcohol-based products made for washing hands.
Wear protective gear for cleanup work
Wear hard hats, goggles, heavy work gloves, and watertight boots with steel toes and insoles (not just steel shank). Wear earplugs or protective headphones to reduce risk from equipment noise.
Returning Home After a Disaster: Be Healthy and Safe
HIGHLIGHTS
* Prevent carbon monoxide poisoning by placing generators, pressure washers, charcoal grills, camp stoves, or other fuel-burning devices outside and away from open doors, windows, and air vents.
* Clean your home as recommended to stop mold. Never mix bleach and ammonia, because the fumes could kill you.
* Eat and drink only food and water you know are safe.
* Drive safely, wear your seatbelt, and don’t drink and drive
* Do not enter a building if you smell gas. Call 911. Do not light a match or turn on lights.
* Wear waterproof boots and gloves to avoid floodwater touching your skin.
* Wash your hands often with soap and clean water, or use a hand-cleaning gel with alcohol in it.
* Avoid tetanus and other infections by getting medical attention for a dirty cut or deep puncture wound.
Clean Your Home and Stop Mold
* Take out items that have soaked up water and that cannot be cleaned and dried.
* Fix water leaks. Use fans and dehumidifiers and open doors and windows to remove moisture.
* To remove mold, mix 1 cup of bleach in 1 gallon of water, wash the item with the bleach mixture, scrub rough surfaces with a stiff brush, rinse the item with clean water, then dry it or leave it to dry.
* Check and clean heating, ventilating, and air-conditioning systems before use.
* To clean hard surfaces that do not soak up water and that may have been in contact with floodwater, first wash with soap and clean water. Next disinfect with a mixture of 1 cup of bleach in 5 gallons of water. Then allow to air dry.
* Wear rubber boots, rubber gloves, and goggles when cleaning with bleach. Open windows and doors to get fresh air. Never mix bleach and ammonia. The fumes from the mixture could kill you.
Protect Yourself from Carbon Monoxide Poisoning
Do not use generators, pressure washers, charcoal grills, camp stoves, or other fuel-burning devices indoors or in enclosed or partially enclosed areas such as garages, even with doors or windows open. Do not put these devices outside near an open door, window, or air vent. You could be poisoned or killed by carbon monoxide, an odorless, colorless gas from burning fuel such as gasoline, charcoal, or propane. Make sure a battery or electric powered CO detector is functional to alert you to dangerous levels of carbon monoxide in your home.
Keep Drinking Water and Food Safe
* Listen to public announcements to find out if local tap water is safe for drinking, cooking, cleaning, or bathing. Until the water is safe, use bottled water or boil or disinfect water.
* If a "boil water" advisory is in effect, do not drink tap water or use it to brush your teeth unless water has come to a rolling boil for at least 1 minute or is treated with unscented household chlorine bleach. To treat water, add 1/4 teaspoon (approximately 1.5 mL) bleach to 1 gallon of cloudy water or 1/8 teaspoon (approximately 0.75 mL) bleach to 1 gallon of clear water . Stir well and let it stand for 30 minutes before you use it.
* Do not eat food that smells bad, looks bad, or has touched floodwater. When in doubt, throw food out.
Prevent Electrical Injuries
* Do not touch fallen electrical wires. They may be live and could hurt or kill you.
* Turn off the electrical power at the main source if there is standing water. Do not turn on power or use an electric tool or appliance while standing in water.
Avoid Contact with Animals and Insects
* Reduce mosquito bites. Consider avoiding outdoor activities during the evening and early morning, which are peak biting times for many mosquitoes. Use an insect repellent with DEET or Picaridin.
* Stay away from wild or stray animals. Stray dogs may be hurt or afraid and may bite. Call local authorities to handle animals.
* Get rid of dead animals according to local guidelines.
Drive Safely
* Stop and look both ways at all intersections. Drive slowly and keep space between you and other vehicles. Watch out for trash on the road.
* Wear your seatbelt.
* Do not drive if you have been drinking.
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FAQ: Hurricane Recovery and Leptospirosis
What is leptospirosis?
Leptospirosis is an infection of both humans and animals. It is caused by bacteria called Leptospira. In humans it causes a wide range of symptoms. Some infected persons may have no symptoms. Others may have high fever, severe headache, and muscle aches. In severe cases, people may have jaundice (yellow skin and eyes) from liver failure. Severe disease may also cause kidney damage and respiratory distress. In rare cases death occurs.
Many of these symptoms can be mistaken for other diseases. Leptospirosis is confirmed by testing of a blood or urine sample.
How do people get leptospirosis?
People get leptospirosis from exposure to infected animals. They can also be infected when exposed to water contaminated with the urine of infected animals.
Many different kinds of animals carry Leptospira. Animals may carry the bacterium but have no symptoms. Leptospira have been found in cattle, pigs, horses, dogs, rodents, and wild animals. The disease is not spread from person to person.
In Louisiana, leptospirosis occurs in cattle, skunks, and nutria (large rodents). Urban leptospirosis caused by exposure to rats occurs in the U.S.
How long is it between the time of exposure and when people become sick?
People may develop symptoms from 2 days to 4 weeks after exposure. Illness usually begins abruptly with fever. Leptospirosis may occur in two phases. In the first phase, fever, chills, headache, muscle aches, vomiting, and diarrhea, are common. The patient may get better for a time but become ill again. If a second phase occurs, it is usually more severe. Severely ill person may develop kidney or liver failure.
The illness lasts from a few days to 3 weeks or longer. Without treatment, recovery may take several months.
Where is leptospirosis found?
Leptospirosis occurs worldwide but is most common in tropical climates. Many people who work outdoors or with animals may be at risk. People exposed to urine-contaminated water during work or recreation may also be at risk.
Between 1965 and 1993, the incidence rate of leptospirosis in Louisiana ranged from 1 to 14 per 100,000 people per year.
How is leptospirosis treated?
Leptospirosis is treated with antibiotics. Doxycycline or penicillin are usually used. Treatment is most effective when given early in the course of disease. Intravenous antibiotics may be used for severe disease. Persons with symptoms suggestive of leptospirosis should contact a health care provider.
Can leptospirosis be prevented?
The risk of getting leptospirosis can be reduced by avoiding contact with urine-contaminated water. Protective clothing and footwear should be worn if exposure to urine-contaminated water is unavoidable.
What is the risk of leptospirosis along the Gulf Coast after hurricane Katrina?
Outbreaks of leptospirosis have occurred following flood events. Leptospirosis cases may occur in the days to weeks following Hurricane Katrina.
Persons exposed to flood waters from Hurricane Katrina who develop fever should see a healthcare provider.
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CDC Emergency Preparedness and Response - Health and Safety Concerns for All Disasters
Prevent Illness After a Disaster
HIGHLIGHTS
* Clean up, disinfect, and practice good hygiene to avoid illness from bacteria, viruses, mold, and mildew.
* Get medical care if you are injured, sick, or having trouble coping with stress.
* To prevent carbon monoxide poisoning, only use generators, pressure washers, grills, camp stoves, or other gasoline, propane, natural gas, or charcoal-burning devices outside and away from open windows, doors, and air vents.
* Stay cool and drink plenty of fluids to prevent heat-related illness.
Protect Yourself from Animal- and Insect-Related Hazards
*Avoid wild or stray animals and biting or stinging insects.
* Call local authorities to handle animals.
* Get rid of dead animals, according to local guidelines, as soon as you can.
* For more information, contact your local animal shelter or services, a veterinarian, or the Humane Society for advice on dealing with pets or stray or wild animals after an emergency.
Prevent Carbon Monoxide Poisoning
* Carbon monoxide (CO) is an odorless, colorless gas that can cause sudden illness and death if you breathe it. Never use generators, pressure washers, grills, camp stoves, or other gasoline, propane, natural gas, or charcoal-burning devices inside your home, basement, garage, or camper—or even outside near an open window, door, or vent.
* Don't heat your house with a gas oven.
* If you are too hot or too cold, or you need to prepare food, don't put yourself and your family at risk for CO poisoning—look to friends, family, or a community shelter for help.
* If your CO detector sounds, leave your home immediately and call 911.
* Seek prompt medical attention if you suspect CO poisoning and are feeling dizzy, light-headed, or nauseated.
Clean Up Safely After Floods
* To prevent illness, disinfect and dry buildings and items in them. This will prevent growth of some bacteria, viruses, mold, and mildew that can cause illness.
Keep Food and Drinking Water Safe
* Food may not be safe to eat during and after an emergency. Water may not be safe for cooking.
* Water may not be safe to drink, clean with, or bathe in after an emergency, such as a hurricane or flood. During and after a disaster, water can become contaminated with microorganisms (for example, bacteria), sewage, agricultural or industrial waste, chemicals, and other substances that can cause illness or death.
* Listen to and follow public announcements. Local authorities will tell you if water is safe to drink or to use for cooking or bathing. Follow local instructions to use bottled water or to boil or disinfect water for cooking, cleaning, or bathing.
Wash Your Hands
* Always wash your hands with soap and boiled or disinfected water before preparing or eating food, after toilet use, after participating in cleanup activities, and after handling articles contaminated by floodwater or sewage. Use warm water when available. Wash children's hands frequently (always before meals).
* Disinfect water for washing by mixing 1/8 teaspoon of household bleach per 1 gallon of water). Let it stand for 30 minutes. If the water is cloudy, use a solution of 1/4 teaspoon of household bleach per 1 gallon of water.
* If water isn't available, use alcohol-based products made for washing hands.
Infectious Disease
Short bouts of diarrhea and upset stomach and colds or other breathing diseases sometimes occur in developed countries, such as the United States, after a natural disaster, particularly among large groups of people in a shelter. Basic hygiene measures like frequent hand washing or use of an alcohol hand gel, especially after using the restroom or changing diapers and before eating, can help prevent these diseases.
Diseases like cholera or typhoid are rare in developed countries and do not typically occur after a natural disaster.
Protect Mental Health
* The days and weeks after an emergency are going to be rough. Some sleeplessness, anxiety, anger, hyperactivity, mild depression, or lethargy are normal and may go away with time. If you feel any of these symptoms acutely, seek counseling. Your state, local, tribal health departments will help you find local resources, including hospitals or health care providers that you may need.
* Seek medical care if you are injured, feel sick, or have acute stress and anxiety.
* Keep as many elements of your normal routine incorporated into the disaster plans as possible, including activities to calm children's fears.
* Be aware that you may have fewer resources to attend to your day-to-day conflicts, so it is best to resolve what you can ahead of time.
* Turn to family, friends, and important social or religious contacts to setup support networks to deal with the potential stressors.
* Let your child know that it is okay to feel upset when something bad or scary happens. Encourage your child to express feelings and thoughts, without making judgments.