FEDERAL GOVERNMENT

FEMA

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HHS

Public Health Emergency – ASPR

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CDC

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SAMHSA Disaster Distress

U.S. Army Corps of Engineers - Team New Orleans

National Weather Service

National Hurricane Center

National Weather Service – Lake Charles

National Weather Service - New Orleans/Baton Rouge

National Weather Service – Mobile/Pensacola

National Weather Service - Tallahassee

STATES

LOUISIANA

Louisiana Governor’s Office of Homeland Security and Preparedness

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Louisiana Health and Hospitals

Louisiana National Guard

Louisiana Dept of Wildlife and Fisheries

MISSISSIPPI

Mississippi Emergency Management Agency

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Mississippi Department of Health

ALABAMA

Alabama Emergency Management

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Alabama Department of Public Health

FLORIDA

Florida Division of Emergency Management

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Florida Department of Health

TRAVEL

FAA Flight Delays

AMTRAK Service Alerts

ORGANIZATION

American Red Cross

POTENTIAL TROPICAL STORM FORCE WINDS

CURRENT SITUATION

YALE/TULANE ESF-8 PLANNING AND RESPONSE PROGRAM SPECIAL REPORT

TROPICAL STORM KAREN KEY LINKS MAPS

ACTIVE WATCH AND WARNING

POTENTIAL HEALTH THREATS FROM HURRICANES

PREVENT ILLNESS AFTER DISATERS

72 HOUR RAINFALL FORECAST

PREPARATIONS

DECISION MATRIX

STORM SURGE

5 OCTOBER 2013 1500 EDT

CURRENT SITUATION

WHERE: North-Central Gulf Coast region of the Mexico WHEN: Saturday Oct 5 evening through Oct 6. SITUATION: TROICAL STORM KAREN As of the 100 PM CDT advisory, the center of Tropical Storm Karen was located near 27.9°N 91.8°W about 190 miles west-southwest of the mouth of the Mississippi River. The low level center of Karan remains exposed about 100 N miles to the west north-west of the deep convection. Maximum sustained winds are currently at 40 mph. The initial intensity of Karen remains 35KT. The environment remains unfavorable for intensification and gradual weakening is predicted. Karen is presently stationery, but a motion towards the north is expected to resume later this afternoon. Minimum central pressure is currently 1009mb. Karen is currently moving northward till Saturday night, but a turn towards northeast is expected Saturday night; followed by a faster motion towards the east-northeast Sunday night and Monday. Karen should dissipate or be absorbed by a cold front shortly after 48hours. TS WARNING: Morgan City Louisiana to the mouth of the Pearl

River TS WATCH: Metro New Orleans; Lakes Maurepas & Pontchartrain;

East of the Mouth of the Pearl River to Indian Pass, Florida

WINDS: • <39 mph over land and Lake Pontchartrain • 39-73 mph near immediate coast and off shore STORM SURGE: • 1-3 feet Terrebonne Bay Louisiana to Cedar Key, Florida • The highest water water will occur along the immediate

coast, where surge will be accompanied with dangerous waves

RAIN: 1 – 3 in over central gulf & southeastern US; isolated 6

inches possible

SOURCE: NATIONAL HURRICANE CENTER TS KAREN PUBLIC ADVISORY 5 OCT 2013

TS KAREN PREPARATIONS - LOUISIANA

• Governor declared a State of Emergency Oct 3

• GOHSEP - activated to Level III (Crisis Action Team)

• 650 National Guard personnel activated Oct 3 additional 7,000 on

standby • Oct 3 Brief-- CPRA is coordinating with the Army Corps of

Engineers, as well as area levee and conservation districts, to monitor rising water levels to determine appropriate times to close flood and navigation gates on area waterways if necessary

• Preparatory actions underway; working with USACE & staging assets

• Grand Isle, located on a barrier island, is under a state of emergency. The mayor called for voluntary evacuations

FEMA DAILY OPERATIONS BRIEF – 4 OCT 2013

• Mandatory Evacuations in effect for 3,500 residents located in Grand Isle (1,300), Jefferson Parish & the Plaquemines Parish East Bank (2,200)

• Voluntary evacuations in effect for Plaquemines Parish West

• 3 shelters open with 82 occupants

• New Orleans says it's monitoring the storm and asks residents to call 311 for preparation info

• Louisiana’s price gouging laws are in effect: prices must remain the same as they were before unless the increase is to offset reasonable extra costs incurred by the business because of the state of emergency.

• The Louisiana Department of Health and Hospitals have closed oyster harvest areas 1-23, which are located from Lake Borne in St. Bernard Parish to Oyster Bayou in Terrebonne Parish, effective on Friday, October 4, 2013.

LINKS

Louisiana Health and Hospitals

Department of Public Health

http://www.dhh.louisiana.gov/index.cfm/subhome/17/n/173

Louisiana Governor's Office

Homeland Security and

Emergency Preparedness

http://gohsep.la.gov/

Twitter http://twitter.com/#!/GOHSEP

Flickr http://www.flickr.com/photos/lagohsep/

Facebook http://www.facebook.com/gohsep

NOAA Weather Radio for LA http://www.nws.noaa.gov/nwr/Maps/PHP/Louisiana.php

National Weather Service Watches,

Warnings and Advisories http://www.weather.gov/alerts-beta/la.php?x=1

TS KAREN PREPARATIONS - MISSISSIPPI

FEMA DAILY OPERATIONS BRIEF – 4 OCT 2013 MSEMA – 4 OCT

• Traffic at the mouth of the Mississippi River stopped at 6 a.m.

Friday as coastal Louisiana prepares for a possible strike.

• A spokesman for the Port of New Orleans says cargo operations will continue as scheduled Friday, despite the river's closure at Southwest Pass. The Associated Branch Pilots, who guide ships through the river's twists and turns, are shutting down at daybreak.

• MDOT moving equipment (front end loaders, bull dozers, etc.) to the coast to stage them; immediately after the storm they can start removing sand from U.S. Highway 90.

• Miss. Department of Humans Services county directors in the potentially affected counties are working closely with local EMA Directors and Red Cross to open and staff shelters as requested.

• American Red Cross staff is communicating with local emergency managers and Department of Human Services to coordinate shelter openings if needed. Volunteers, shelter teams, and 11 emergency response vehicles have been placed on alert.

• Search and Rescue teams have been sent to support Jackson, Harrison and Hancock counties.

• State Emergency Response Team has deployed to the Combat Readiness Training Center in Gulfport.

• 300 Mississippi National Guard troops with high water vehicles have been deployed to affected areas.

Mississippi Department of Public

Health

http://www.healthyms.com/msdhsite/index.cfm/44,0,122,292,html

Mississippi Emergency

Management Agency

http://www.msema.org/

Twitter http://twitter.com/msema

Facebook

http://www.facebook.com/home.php#/pages/Pearl-MS/Mississippi-Emergency-Management-Agency/81599105731?ref=sgm

NOAA Weather Radio for

Mississippi

http://www.nws.noaa.gov/nwr/Maps/PHP/Mississippi.php

National Weather Service

Watches, Warnings and

Advisories

http://www.weather.gov/alerts-beta/ms.php?x=1

MS - LINKS

• State EOC is at Level I (Fully Activated)

• Mississippi Governor Phil Bryant declared a state of emergency as Karen approaches the state on October 3. MEMA has asked people in flood-prone areas to start thinking about a evacuation plan.

• Mississippi Dept. of Marine Resources said oyster reefs that had opened earlier in the week were closed as a precaution.

• 1000 EST, MSEMA messages on social media: “Things are looking good for Mississippi, but please don't let your guard down yet.”

• Health department (MSDH) issues precautionary risk warnings to population, in regards to assembly/evacuation, gas and electricity infrastructure, and a notice to boil water if specific area is notified.

TS KAREN PREPARATIONS

ALABAMA • Alabama Gov. Robert Bentley declares state of

emergency on 4 Oct. • 200 National Guardsmen activated

• Mobile Ferry will not run Friday

• Dauphin Island Sea Lab Estuarium will be closed Friday

• Organizers of the Bayfest music festival say the show will

go on as much as possible

FEMA DAILY BRIEF – 5 OCT 2013 FEMA DAILY OPERATIONS BRIEF – 4 OCT 2013 THE WEATHER CHANNEL – 4 OCT 2013 6:11 PM EDT

FLORIDA • Governor declared State of Emergency (Oct 4)

• State EOC is activated to Level II (Partial Activation)

• National Guard personnel activated

• Tropical Storm emergency declaration for 18 counties:

Escambia, Santa Rosa, Okaloosa, Walton, Holmes, Washington, Bay, Gulf, Calhoun, Jackson, Franklin, Liberty, Gadsden, Wakulla, Leon, Jefferson, Madison, and Taylor Counties.

Alabama Department of Public Health

http://www.healthyms.com/msdhsite/index.cfm/44,0,122,292,html

Alabama Emergency Management http://www.ema.alabama.gov/

Twitter https://twitter.com/alabamaema

RSS Feeds: http://www.msema.org/wordpress/?feed=rss2

Facebook https://www.facebook.com/AlabamaEMA

NOAA Weather Radio for Alabama http://www.nws.noaa.gov/nwr/CntyCov/nwrAL.htm

National Weather Service Watches, Warnings and Advisories

http://www.weather.gov/alerts-beta/ms.php?x=1

AL - LINKS

Florida Department of Health http://www.doh.state.fl.us/

Florida Division of Emergency Management

http://www.floridadisaster.org/index.asp

Twitter https://twitter.com/flsert

RSS Feed http://floridadisaster.org/feeds/pressreleases.asp

Facebook https://www.facebook.com/FloridaSERT

NOAA Weather Radio for Florida http://www.nws.noaa.gov/nwr/CntyCov/nwrFL.htm

National Weather Service Watches, Warnings and Advisories

http://alerts.weather.gov/cap/fl.php?x=1

FL - LINKS

TS KAREN PREPARATIONS - FEMA

FEMA HEADQUARTERS: • National Response Coordination Center (NRCC) -

activated to Level III (Day only)

• National Watch Center - Enhanced Watch Level (8:00 pm to 8:00 am EDT)

• Resource Support - Atlanta Distribution Center (DC) has been activated

• National Processing Service Centers - activated from 7:00 a.m. to 1:00 am

• National IMAT-East - deploying to Florida EOC today

• Urban Search & Rescue - on Advisory status

FEMA DAILY OPERATIONS BRIEF – 4 OCT 2013 FEMA DAILY OPERATIONS BRIEF – 5 OCT 2013 NOAA

FEMA REGION IV:

• RRCC activated to Level III w/ ESFs 1,3,5, 6,8

• Region IV IMATs – deployed to AL & MS EOCs

• LNOs deployed to Florida, Mississippi & Alabama

• Region IV IMATs deploying to AL & MS today

FEMA REGION IV:

• RRCC activated to Level III w/ ESFs 1,3,6,8

• LNOs deployed to Florida, Mississippi & Alabama

• Region IV IMATs deploying to AL & MS today

ACTIVE WATCH / WARNINGS

National Weather Service

Severe Thunderstorm Warning Severe Weather Statement Civil Emergency Message Blizzard Warning Winter Storm Warning High Wind Warning Tropical Storm Warning Flood Warning Gale Warning

Freeze Warning Red Flag Warning Hurricane Watch Tropical Storm Watch Winter Weather Advisory Coastal Flood Advisory Dense Fog Advisory Small Craft Advisory For Hazardous Seas Small Craft Advisory For Winds

Small Craft Advisory Lake Wind Advisory Wind Advisory Blowing Dust Advisory Frost Advisory Rip Current Statement Winter Storm Watch Hard Freeze Watch Freeze Watch

Fire Weather Watch Special Weather Statement

Marine Weather Statement Air Quality Alert Hazardous Weather Outlook Hydrologic Outlook

ACTIVE WATCH / WARNINGS

Tropical Storm Warning

Coastal Flood Warning

Flood Warning

Tropical Storm Watch

Coastal Flood Advisory

Small Craft Advisory

Coastal Flood Statement

Hazardous Weather Outlook

Short Term Forecast

LAKE CHARLES BATON ROUGE/NEW ORLEANS

MOBILE/ PENSACOLA TALLAHASSEE

72 HOUR RAINFALL FORECAST

Image Source: http://www.nhc.noaa.gov/refresh/graphics_at2+shtml/144417.shtml?rainqpf?large#contents

• Karen is expected to produce rainfall amounts of 1 to 3 inches over portions of the Central and Eastern gulf coast through Sunday night, mainly near and to the right of the path of the center.

• Isolated storm total amounts of 6 inches are possible.

NATIONAL HURRICANE CENTER TS KAREN PUBLIC ADVISORY 5 OCT 2013

STORM SURGE

The combination of storm surge and the tide will cause normally dry areas near the coast to be flooded by rising waters. The water could reach the following heights above ground if the peak surge occurs at the time of high tide:

• West of the Mississippi river to Terrebonne Bay 1 to 3 feet

• Mouth of the Mississippi River to Mobile Bay 1 to 3 feet

• East of Mobile Bay to West of Apalachee Bay 1 to 3 feet

• Apalachee Bay including Cedar Key 1 to 3 feet

The highest water will occur:

• Along the immediate coast near and to the east of where landfall occurs.

• Where the surge will be accompanied by dangerous waves .

Chances storm surge >= 2 ft.

NATIONAL HURRICANE CENTER TS KAREN PUBLIC ADVISORY 5 OCT 2013

POTENTIAL TROPICAL STORM FORCE WINDS

Information source: http://forecast.weather.gov/wwamap/wwatxtget.php?cwa=usa&wwa=Tropical%20Storm%20Warning

Image source: http://www.nhc.noaa.gov/refresh/graphics_at2+shtml/145003.shtml?tswind120

• Hurricane conditions are possible in portions of the hurricane watch area by Sunday morning but probability remains low

• Tropical storm conditions

will remain in storm watch areas. Expect winds to subside in speed by 5 knots by midnight Saturday. Winds will shift path from Northeast to North by midnight Sunday.

NATIONAL HURRICANE CENTER TS KAREN PUBLIC ADVISORY 5 OCT 2013

2

Decision Point 2: (TROPICAL STORM)

Prepare

24 hours to 12 hours prior to impact

Primary Activities:

Complete evacuation operations

Execute Shelter in Place activities

Complete early discharge activities

Harden facility through protective measures

Monitor facility and area conditions as impact occurs

Finalize staffing arrangement Take appropriate actions to maintain operations

THREAT INFORMATION REQUIREMENTS CRITICAL INFORMATION REQUIREMENTS

What is the level of the threat?

How large is the area projected to be impacted?

How much of the populations are projected to

be impacted?

Is the facility located in the impacted zone

Has the facility been impacted?

Have services been impacted?

Which ones?

To what degree?

Are any of your remote facilities in the impacted

zone?

Do any of your employees or staff live in the

impacted zone?

AC

TIO

NS

COMMAND OPERATIONS PLANNING FACILITIES/LOGISTICS ADMIN/FINANCE

Review all policies, plans and procedures to

ensure that they are current and reflect any

changes to the facility or infrastructure since

last season

Review Shelter in Place and Evacuation

decision-making requirements

Review various agreements with area

hospitals, agencies and vendors

Ensure that the staff is familiar with the All

Hazards Plan

Ensure that families have a care plan in case

of emergencies

Conduct/review hazard vulnerability

assessment for each activity. Include

specific projects and research vulnerability.

Prioritize resources for response and

recovery efforts based on cost-benefit

analysis.

Monitor forecasted flood areas,

track current, impending, and

potential impact

Begin movement to secondary

facilities for operational integrity

if severe flooding is imminent

Synchronize activities with

appropriate local/regional/State

agencies

Determine status and needs,

coordinate relief as necessary,

continue regular conference calls

Test redundant communications

systems

Implement facility physical

security plan

Draft and maintain IAP for next

operational period

Disseminate approved IAP

Review all applicable plans

Review gap analysis

Review dormant contracts

Identify requirements for

sheltering in place (SIP)

Identify requirements for

evacuation

Vertically

People

Specimens

Primates

Review MOUs, MOAs and Mutual

Aid Agreements

Elevate the generator, furnace,

water heater, and electric panel

if susceptible to flooding.

Inventory stockpiles to determine

(and augment) self-sustainability

when municipal systems are

inoperable

Inspect Alternate Sites

Review Regulated Medical Waste

disposal surge contract s and

processes

Review Trash disposal/storage

plan

Review mortuary plans

Capture cost

Ensure continuity of

current staff throughout

operational period

3

Primary Activities:

• Assess damages to the facility and injuries to employees and staff • Maintain accountability • Safety for employees and staff • Make emergency repairs • Take appropriate actions to maintain operations • Evacuate if necessary • Move to an alternate facility if necessary • Information Dissemination • Report status

Decision Point 3 (TROPICAL STORM)

Response

Impact +24 Hours

THREAT INFORMATION REQUIREMENTS CRITICAL INFORMATION REQUIREMENTS

Have/When will adverse conditions subside?

How large was the impact?

What are the cascading effects as a result of

the threat?

What is forecasted for the next 24 hours?

What additional information is being

provided by the local weather forecasters?

Has criminal activities increased?

What is status of your facility?

What is the status of your remote facilities?

What services have been impacted?

What capabilities have been degraded?

What is the status of your staff and their families? Are all accountable for? Any

fatalities?

Has the disaster generated a mass casualty incident?

What is the status of municipal utilities, water and waste water?

What roads are closed due to the impact?

What is the status of local emergency response agencies?

Has NDMS been activated? If so, which portions

Has the FEMA ambulance contract been activated?

What information is being provided to the public?

What is the status of airports being used for additional evacuations?

What resources are available to assist your facility?

What capability shortfalls are there?

Has patient care been compromised?

AC

TIO

NS

COMMAND OPERATIONS PLANNING FACILITIES/LOGISTICS ADMIN/FINANCE

Assess the threat and the damage

Determine the need to evacuate the facility,

continue Sheltering in Place

Is an alternative care sites for patient treatment

needed?

Is an effective patient ID and tracking system in

place?

Contact and notify staff of the facility status,

operational capacity and timeline for return to work

Contact higher headquarters with status and relay

needs

Report situation to :

Higher HQ

Local government

Health authorities

Maintain staff and employee accountability

Maintain full activation of the Command Center

Approve the IAP for next operational period

Maintain close coordination with departments and

address requirements

Ensure Shelter in Place needs/provisions are in

place and being met

Determine if it is necessary to evacuate the facility

completely

Determine if it is necessary to close down

operations or limit services

Contact staff to relay needs and operability

Determine if it is necessary to move to some or all

services an alternate facility

Conduct damage, risk and injury

assessments to determine

operational status and capacity of

the facility

Coordinate search an d rescue

activities

Establish triage areas if needed

Synchronize activities with

appropriate local/regional/State

agencies

Ensure EOC is fully operational at

current facility, if necessary

relocate or work remotely

Determine operational status of

remote clinics

Determine status and needs,

coordinate relief as necessary,

continue regular conference calls

Implement redundant

communications as necessary

Account for staff and employees

Review staffing requirements

Coordinate evacuation if

necessary

Establish accountability methods

for patient counts & movements

Issue needed risk communication

messages

Identify critical objectives

based on the planning

requirement, provide a

complete and integrated

picture of the sequence and

scope of the tasks to achieve

the objectives, and ensure the

objectives are implementable

within the time frame

contemplated within the plan

using available resources for

prevention-related plans.

Develop and execute

appropriate courses of action

in coordination with Federal,

state, local, and private sector

entities in order to prevent an

imminent terrorist attack

within the United States.

Maintain an Incident Action

Plan (IAP) for next operational

period

Disseminate approved IAP

Assess the damage

Prioritize and perform repairs

to the facility as necessary

Monitor all departments and

portions of the facility, take

appropriate actions to harden

the facility and take any

protective measures to

prevent damages

Conduct periodic inventory

checks to ensure there is

adequate supply for sustained

operation and allow plenty of

time to obtain additional

supplies if necessary.

Coordinate needs and actions

through the Command Center

Review staffing requirements

Assess facility functionality,

determine operational

capacity and requirements for

repairs

Monitor emergency systems

and determine fuel capacities

to inform sustainability

requirements

Identify most urgent food &

non-food requirements

Capture cost

Ensure continuity of

current staff throughout

operational period

Set up disaster

accounting systems

Work with appointed

authorities to determine

applicant and

reimbursement eligibility

for disaster-related

expenses

PREVENT ILLNESS AFTER A DISASTER

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.

For information on specific animal and insect issues, see protect yourself from animal- and insect-related hazards after a natural disaster.

PROTECT YOURSELF FROM ANIMAL - AND INSECT-RELATED

HAZARDS

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.

For further guidance on avoiding co poisoning, see protect yourself from carbon monoxide 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.

For more information, see flood water after a disaster or emergency.

KEEP FOOD AND 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.

For more information, see keep food and water safe after a natural disaster or power outage.

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.

For more tips on washing your hands, see hand hygiene after a 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.

For additional resources, see disaster mental health resources and CDC Coping with a Disaster or Traumatic Event

PREVENT ILLNESS AFTER A DISASTER PREVENT ILLNESS FROM SEWAGE

PREVENT TEMPERATURE-RELATED ILLNESS

PREVENT OR TREAT WOUNDS

AVOID WILD OR STRAY ANIMALS

If there is flooding along with a hurricane, the waters may contain fecal material from overflowing sewage systems and agricultural and industrial waste. Although skin contact with floodwater does not, by itself, pose a serious health risk, there is risk of disease from eating or drinking anything contaminated with floodwater.

If there has been a backflow of sewage into your house, wear rubber boots and waterproof gloves during cleanup. Remove and discard contaminated household materials that cannot be disinfected, such as wall coverings, cloth, rugs, and drywall.

If you have any open cuts or sores that will be exposed to floodwater, keep them as clean as possible by washing them with soap and applying an antibiotic ointment to discourage infection.

Wash clothes contaminated with flood or sewage water in hot water and detergent and separately from uncontaminated clothes and linens.

Do not allow children to play in floodwater areas and do not allow children to play with floodwater-contaminated toys that have not been disinfected. Disinfect toys by using a solution of one cup of bleach in five gallons of water. Some toys, such as stuffed animals and baby toys, cannot be disinfected; they should be discarded.

When standing or working in water that is cooler than 75 f (24°c): Wear rubber boots.

Ensure that clothing and boots have adequate insulation.

Take frequent breaks out of the water.

Change into dry clothing when possible.

Immediately clean out all open wounds and cuts with soap and clean water. Keep wounds covered with clean, dry bandages that are large enough to cover the wound and contain any pus or drainage.

Change bandages as needed and when drainage can be seen through the bandage. 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.

TETANUS IMMUNIZATION

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.

For information on infectious disease, see infectious disease after a disaster.

INFECTIOUS DISEASE

IMMUNIZATIONS

For information on immunizations for evacuees, relief workers, emergency responders and travelers, see immunization after a natural disaster.

See CDC Extremes Heat

Call local authorities to handle animals. Secure all food sources and remove any animal carcasses to avoid attracting rats. Get rid of dead animals, according to guidelines from your local animal control

authority, as soon as you can. See “Animal Disposal” www.bt.cdc.gov/disasters/animaldisposal.asp

For guidance on caring for animals entering shelters and for people working with or handling animals following an emergency, see “Interim Guidelines for Animal Health and Control of Disease Transmission in Pet Shelters” (www.bt.cdc.gov/disasters/hurricanes/katrina/animalhealthguidelines.asp).

Also see “Resources for Planning How to Protect Your Pets in an Emergency” (www.bt.cdc.gov/disasters/petprotect.asp).

In most settings, a disaster does not increase the risk for tetanus. However, the risk of tetanus among disaster survivors and emergency responders can best be minimized by following standard immunization recommendations and providing proper wound care.

See Tetanus Prevention After a Disaster