Disasters happen all over the world. Different regions experience different kinds of disasters. Within the past month, the East Coast of the US, Caribbean, and Gulf of Mexico have experienced 4 major hurricanes. The official hurricane season does not end until November 30! While natural disasters can be as varied as earthquakes, tornados, hurricanes, winter storms, tsunamis, floods, etc. we do see commonalities after these events. Most deaths that happen are mainly from trauma, crush, or drowning from the event itself, not disease 9. With events like hurricanes, even in first world countries, the experience of a second wave of public health and hygiene issues are similar to those seen in third world countries. The disaster’s destruction of power grids, sanitation systems, water systems, and displacement of people from their homes becomes extremely important in keeping the public safe. In the massive blackout of 2003 in NYC (which I experienced first-hand) 9 million people lost power; from a few hours to several days. What investigators noticed after the blackout was a significant increase in diarrheal illness, which they found was linked to eating meat and seafood after the onset of power loss 9.
“After a major disaster your risk of becoming ill from disease or infection go way up” 5. After a hurricane or flooding situation, the greatest disease risk is from gastrointestinal illnesses which come from damaged sewer systems 10. The waters flood the area with pathogens like E. coli, Shigella, Norovirus, Hepatitis A and E; which are transmitted through fecal-oral contamination. Therefore it is important to prevent flood waters from touching your skin, your clean water, your food, open cuts, etc. Flood waters should be treated as infectious material. Clean, safe, running water is the number one tool to help keep you free from disease. The maintenance of personal hygiene and a hygienic environment are the biggest priorities after a disaster has ended. Being clean is the best way to prevent yourself from getting ill during this time. Washing hands, brushing teeth, and taking showers are our first line of defense against disease.
Clean hands saves lives in emergency situations” 4. “In every single disaster situation- from hurricanes to grid outages to warfare- one thing is almost always certain; hygiene disasters” 6. If we understand this statement, we can understand what to expect and learn how to prepare properly. You must have a way to clean and sanitize your hands. This is the best method to keep illness free at an extremely stressful time. If tap water is not running or safe, use boiled, treated, or bottled water with soap. Also have plenty of alcohol-based hand sanitizers on hand. It is easy to stockpile bottled water, soap, and hand sanitizers future use. You will be washing your hands frequently after a disaster. When should you wash? Before preparing or eating food, after the bathroom, after handling uncooked or partially defrosted foods like meat and seafood, handling an animal or animal waste, before and after treating a cut or wound, handling garbage, and anytime flood waters come in contact with your skin 1. Here is a simple handwashing station that is easy to set up that many people can use.
Keeping food and water safe will help you to prevent illness and possible food poisoning. Throw out any food that has had contact with flood water. Because of the power disruption, food that was kept in the refrigerator or freezer is suspect. Any food with unusual odor, color, texture should also be thrown out. Follow these steps to determine the safety of your food 7:
1. Check the temperature when the power comes back on. If the freezer thermometer reads 40° F
(4° C) or below, the food is safe and may be refrozen.
2. If a thermometer has not been kept in the freezer, check each package of food to determine its safety. If the food still contains ice crystals or is 40° F (4° C) or below, it is safe to refreeze or cook.
3. Refrigerated food should be safe as long as the power was out for no more than 4 hours and the refrigerator door was kept shut. Discard any perishable food (such as meat, poultry, fish, eggs, or leftovers) that has been at temperatures above 40° F (4° C) for 2 hours or more (or 1 hour if temperatures are above 90º F or 32° C ).
4. Do not eat any food that may have come into contact with flood water.
5. Discard any food and beverage that is not in a waterproof container if there is any chance that it has come into contact with flood water.
6. Food containers that are waterproof include undamaged, commercially prepared foods in all-metal cans and “retort pouches” (like flexible, shelf-stable juice or seafood pouches).
7. Food containers that are not waterproof include those with screw-caps, snap lids, pull tops, and crimped caps.
8. Also discard cardboard juice/milk/baby formula boxes and home canned foods if they have come in contact with flood water, because they cannot be effectively cleaned and sanitized.
9. Discard any food in damaged cans. Damaged cans are those with swelling, leakage, punctures, holes, and fractures, extensive deep rusting, or crushing/denting that is severe enough to prevent normal stacking or opening with a manual, wheel-type can opener. See box on next page for steps to clean/save undamaged packages.
10. Thoroughly wash metal pans, ceramic dishes, and utensils (including can openers) with soap and water, using hot water if available. Rinse and then sanitize them by boiling in clean water or immersing them for 15 minutes in a solution of 1 tablespoon of unscented household (5.25% concentration) liquid bleach per gallon of water.
11. Thoroughly wash countertops with soap and water, using hot water if available. Rinse and then sanitize by applying a solution of 1 tablespoon of unscented household (5.25% concentration) liquid bleach per gallon of water. Allow to air dry. 7
We may have no warning when the next disaster will occur. That is the whole purpose in learning about emergency preparedness for yourself and your family. Some situations will require you sheltering in place at home. Other instances may require you to evacuate your home. You will need to have all your supplies packed and ready to go if required. Now is the time to start learning about making a to-go bag and what important supplies need to go inside. If you have questions about what to include or how to make a to-go kit for you, your family, or your pets, please reach out to me. The Red Cross, CDC, and FEMA all have resources online as well.
1. Personal Hygiene After a Disaster or Emergency/Floods www.cdc.gov/disasters/floods/sanitation.html
2. Fact Sheet: Clean Up Safely After a Disaster www.cdc.gov/disasters/cleanup/facts.html
3. Keep Food and Water Safe After a Disaster or Emergency www.cdc.gov/disasters/foodwater/facts/html
4. Clean Hands Save Lives: Emergency Situations www.bt.cdc.gov/disasters
5. Post-Disaster Protection You Can’t Be Without https://independentlivingnews.com/2014/06/13/201114-post-disaster-protection-you-cant-be-without/amp/
6. The Emergency Hygiene Problems No Prepper Wants to Talk About https://www.primalsurvivor.net/emergency-hygiene/
7. Food and Water Safety During Power Outages and Floods https://www.fda.gov/food/resourcesforyou/consumers/ucm076881.htm
8. Hidden Health Hazards After Hurricanes: What To Expect After Harvey https://www.forbes.com/sites/judystone/2017/08/26/hidden-health-hazards-after-hurricanes-what-to-expect-after-harvey/#763f072631a6
9. Epidemics after Natural Disasters https://wwwnc.cdc.gov/eid/article/13/1/06-0779_article
About the Author
Lisa A. Mack MS, MPH is an Epidemiologist and Communicable Disease Investigator. In addition, she is a certified HIV counselor and tester in a county sexually transmitted disease (STD) clinic. She received a Master of Science degree (Epidemiology) from the University of Massachusetts-Amherst, School of Public Health and a Master of Public Health degree (Epidemiology) from Columbia University, Mailman School of Public Health.
Her current research interest is investigating the antibacterial properties of essential oils to be used in treating multidrug resistant bacteria (MRSA, MSSA, Pseudomonas aeruginosa, etc.) in the healthcare setting. She loves germs, diseases, public health, educating & empowering people about their health and well-being. Public Health Rocks!