PRECAUTIONS AGAINST DISEASE AND INJURY

I. DISEASES :

1. TYPHOID - No cause for alarm

Typhoid immunization is not recommended during flooding. Routine

typhoid immunization in the United States during normal times is not

indicated, and immunizations administered at the time of flood will not be

effective due to the delay in development of the immune state (three

weeks). There is virtually no danger of contracting typhoid solely

because of a flood.

2. HEPATITIS -A

Hepatitis A vaccine preparation is currently available in the USA in two

forms. However, the use of hepatitis A vaccine or immune globulin is not

recommended because Hepatitis A outbreaks have not been associated

with floods.

3. INTESTINAL ILLNESS

Intestinal illness may occur with symptoms of nausea, vomiting,

diarrhea, and fever. Organisms that live in the intestines of animals and

sometimes humans may contaminate flood waters. The best and most

effective prevention against the disease agents that may be present in

flood waters is avoid contaminated drinking water and food (see the

hygeine andclean-up guidelines below).

4. TETANUS - A risk

Tetanus (Lockjaw) may result from any wound which breaks the surface

of the skin, particularly puncture wounds or deep cuts. Anyone receiving

a wound where the skin is penetrated should consult a physician to

assure that the wound is clean and not infected and that their tetanus

immunization is current.

Chemoprophylaxis against tetanus is neither practical nor useful in

managing wounds. Wound cleaning, debridement when indicated, and

proper immunization are important. The need for tetanus toxoid (active

immunization), with or without Tetanus Immune Globulin (TIG), depends

both on the condition of the wound and the patient’s vaccination history.

Rarely has tetanus occurred among persons who received a primary

series of toxoid injections.

Available evidence indicates that complete primary vaccination with

tetanus toxoid provides long-lasting protection for most recipients.

Consequently, after complete primary tetanus vaccination, boosters -

even for wound management - need only be given every ten years when

wounds are minor and uncontaminated. For other wounds, a booster is

appropriate if the patient has not received tetanus toxoid within the

preceding five years.
hemoprophylaxis against tetanus is neither practical nor useful in

managing wounds. Wound cleaning, debridement when indicated, and

proper immunization are important. The need for tetanus toxoid (active

immunization), with or without Tetanus Immune Globulin (TIG), depends

both on the condition of the wound and the patient’s vaccination history.

Rarely has tetanus occurred among persons who received a primary

series of toxoid injections.

Available evidence indicates that complete primary vaccination with

tetanus toxoid provides long-lasting protection for most recipients.

Consequently, after complete primary tetanus vaccination, boosters -

even for wound management - need only be given every ten years when

wounds are minor and uncontaminated. For other wounds, a booster is

appropriate if the patient has not received tetanus toxoid within the

preceding five years.

1. Such as, but not limited to, wounds contaminated with dirt, feces, and

saliva; puncture wounds; avulsions; and wounds resulting from missiles,

crushing, burns, and frostbite.

2. For children <7 years old; DPT. or DT is preferred.

3. Yes, if >10 years since last dose.
4. Yes, if >5 years since last dose.

5. RESPIRATORY/ ALLERGIC REACTIONS

Respiratory problems may be caused by bioaerosols, or airborne

particles, released by bacteria, fungi, molds and related organisms or by

the chemicals used to disinfect flooded living areas. Excess moisture in

buildings after a flood can create the potential for these respiratory

problems. High relative humidity (greater than 70%) in a structure leads

to problems. Many materials exposed to floodwaters will hold moisture for

an extended period and provide favorable conditions for these

organisms.

While respiratory ailments and allergies are the most common result of

inhaling these organisms, they can have much more serious effects. In

rare instances, exposure to bioaerosols can cause rampant infection

characterized by fever, malaise, respiratory distress, shock and even

death. Keeping the indoor environment free from water intrusion and at a

relative humidity less than 60% and removing any pooled water as quickly

as possible will retard indoor growth of bacteria and fungi. Surfaces

supporting the growth of these organisms are cleaned using dilute bleach

(half cup of bleach to a gallon of water), after which the surface should

be rinsed with clean water and dried. Contaminated soft material such as

carpets, draperies, furniture fabric, wallboard, paper, insulation materials

etc., may not be cleanable and should be discarded.

6. LEPTOSPIROSIS

Leptospirosis or mud fever is a group of bacterial diseases with various

manifestations. Common features are sudden-onset of fever, headache,

chills, severe muscle aches, and watery eyes. Other symptoms may

include rash, anemia, jaundice, mental confusion, and depression.

Symptoms usually appear within 10 days. The disease is treated with

antibiotics, penicillin, and erythromycin. If treated, the symptoms usually

lasts a few days to three weeks or longer. Leptospirosis occurs when a

person is exposed to water contaminated by the urine of domestic or wild

animals.

Following preventive measures may reduce the risk of exposure to these

bacteria:> Avoid swimming or wading in potentially contaminated waters.> If working in an environment where exposure is possible,
individuals should wear protective clothing.> Recognize potentially contaminated soil and waters and drain such
waters when possible.> Control rodents in human habitations.> Segregate domestic animals to prevent them from contaminating
living, working and recreational areas with urine.> Immunize farm animals and pets to prevent disease.

7. NORWALK VIRUS

Norwalk Virus causes an acute infectious gastroenteritis. Norwalk is a

common water-borne agent and may be carried on foods whose

preparation requires extensive hand contact. The illness may be caused

by eating uncooked clams and oysters. Norwalk virus causes no longterm

health effects. Symptoms usually last from one to two days or

more, with an incubation period of about the same duration.

The symptoms include diarrhea, dehydration, cramps, vomiting, fever,

muscle aches, headache, chills and weakness. Victims may require

hospitalization to replace lost fluids. Antibiotics are not used to treat

Norwalk viruses. Prevention requires proper hand-washing after using

bathrooms, especially for those who handle food. Consumption of clams

and oysters from a flooded area is risky until effective control measures

are taken. Sanitary disposal of feces and protection of water

contamination by sewage is an essential preventive measure.

8. TULAREMIA

Tularemia is a bacterial disease that is also known as rabbit fever. The

disease is most commonly transmitted by the blood or tissue of an

infected animal or spread by the bite of ticks and deerflies or by drinking

contaminated water. People may become infected from handling dead

animal carcasses. Symptoms may include slow growing ulcers usually

on the hand and swollen lymph nodes. If the bacteria are inhaled, a

pneumonia-like illness can follow. If the bacteria are ingested, they may

cause throat sore, abdominal pain, diarrhea and vomiting. The

symptoms may emerge two to 10 days after exposure to the bacteria.

Tularemia is treated with streptomycin, although other antibiotics also are

effective. This sickness is not transmitted from person to person.

The following measures may help prevent tularemia:> avoid bites of flies, mosquitoes, and ticks.> Avoid drinking, bathing, swimming or working in untreated water
where infection is common among wild animals.> Use impervious gloves when skinning or handling animals,

especial

rabbits. Cook the meat of wild rabbits and rodents thoroughly.

9. INFESTATIONS -SCABIES, HEAD LICE
The crowded conditions in shelters during flooding, may result in
infestations of scabies or head lice.A. SCABIES

Scabies is a skin disease caused by an almost invisible organism

commonly called the “itch mite” (Sarcoptes Scabiei). Scabies is

transmitted through direct contact with an infected person. Once

the mite is transmitted to a person, the male and female mate on

the surface of the skin and eggs are laid under the surface of the

skin. The eggs hatch in a few days. An infestation is most often

found in the spaces between the fingers, elbows, armpits, breasts,

groin, along the belt line and on the back or buttocks causing

intense itching, especially at night. The only way to confirm

scabies is to see the physician who can identify with microscopic

examination. To prevent infection wash hands often, wear clean

clothes daily and do not exchange clothes with others. If any

member of your family has scabies, all others should be checked

immediately.B. HEAD LICE

Head lice or Pediculosis may be transmitted through direct or

indirect contact. The earliest common symptom of an infestation

is itching, particularly in the area behind ears and at the nape of

the neck. Intense scratching may lead to secondary bacterial

infection. Prescription and over the counter remedies are effective

in treating head lice. Overuse of these pediculicides may cause

dermatitis. The pediculicides usually do not kill nits (lice eggs)

completely. It is recommended that infested patients be treated

twice. The interval between treatments should be approximately

the incubation period for the nits (seven to 10 days). For specific

methods used to treat the infested person consult your family

physician.

10. HYPOTHERMIA

Hypothermia is a concern at any time of the year. A wet body loses heat

30 times faster than a dry body. Water below 80 degrees poses a risk of

hypothermia; water less than 50 degrees is extremely dangerous.

Hypothermia can lead to shock or death and contributes to drownings.

Effort should be made to avoid getting wet, in particular, avoid entering

the flood waters.

11. OTHER DISEASES

Other diseases may appear because of flooding, notably dysentery or

diarrhea. There is no good immunization against these diseases.

Excellent personal hygiene and the avoidance of eating or drinking

contaminated food are the prime preventive measures.

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