Yale Tulane ESF-8 VMOC Special Report - Tropical Storm Karen 3 PM EDT - 5 OCT


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In light of Tropical Storm Karen the Yale-Tulane ESF #8 Planning and Response Program has produced a special report that can be downloaded at fb.me/112ZZzHeB

The Yale-Tulane ESF #8 Program is a multi-disciplinary, multi-center, graduate-level, program designed to produce ESF #8 planners and responders with standardized skill sets that are consistent with evolving public policy, technologies, and best practices. The group that produced this summary and analysis of the current situation are graduate students from Yale and Tulane Universities.

It was compiled entirely from open source materials. Please feel free to forward the report to anyone who might be interested.

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Yale Tulane ESF-8 VMOC Special Report - Tropical Storm Karen 3 PM EDT - 5 OCT

  1. 1. FEDERAL GOVERNMENT FEMA Facebook full site Twitter full site Ready. Gov HHS Public Health Emergency – ASPR Twitter | Facebook CDC Twitter | Facebook 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 Facebook | Twitter Louisiana Health and Hospitals Louisiana National Guard Louisiana Dept of Wildlife and Fisheries MISSISSIPPI Mississippi Emergency Management Agency Facebook | Twitter Mississippi Department of Health ALABAMA Alabama Emergency Management Facebook | Twitter Alabama Department of Public Health FLORIDA Florida Division of Emergency Management Facebook | Twitter 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 LINKSMAPS 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
  2. 2. 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
  3. 3. 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/Louisian a.php National Weather Service Watches, http://www.weather.gov/alerts-beta/la.php?x=1
  4. 4. 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/44,0,122,2 92,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.
  5. 5. 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
  6. 6. 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
  7. 7. 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 HazardousSeas 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
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 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
  12. 12. 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? ACTIONS 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
  13. 13. 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? ACTIONS 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
  14. 14. 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 informationon 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 monoxideCLEAN UP SAFELY AFTER FLOODS  To prevent illness, disinfectand 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
  15. 15. 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 informationon infectious disease, see infectious disease after a disaster. INFECTIOUS DISEASE IMMUNIZATIONS For informationon 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
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