Preventing Disease and Injury in a Flood
Preventing Disease and Injury in a Flood
During and following a widespread flooding disaster, many questions arise. Personal health and safety is a priority for everyone. The following information is aimed at preventing both disease and injury by answering many common concerns and providing valuable preventive health tips.
What immunizations will I need if I am exposed to flood water?
No special immunizations are necessary. Experience and studies from previous serious national floods demonstrate that increased risk or incidence of tetanus, typhoid fever or hepatitis A has not occurred. Recommendations for these immunizations are the same as during non-flood conditions.
· Tetanus - A booster for tetanus should be given to anyone sustaining an injury (particularly lacerations and puncture wounds) that has not received a vaccination within the last 10 years, 5 years for particularly major or unclean wounds.
· Hepatitis A - Immune globulin is given only to those persons known to be in direct contact with a confirmed case of hepatitis A. Hepatitis A vaccines are not required.
· Typhoid - Prophylactic Typhoid vaccinations is not recommended.
What disease-causing agents may be present in floodwaters?
Since local water systems may become contaminated and power outages are widespread following severe flooding, increased foodborne and waterborne diarrheal illness may occur.
· DIARRHEAL ILLNESS. Most diarrheal illnesses have incubation periods between one and seven days. Bloody diarrhea may occur with certain infections. Testing for illness should be performed prior to treatment with medications because of the large number of causative agents that may require different antibiotics. Fairfax County Health Department should be notified of stool culture results so cases can be investigated and appropriate follow up provided.
· HEPATITIS A. If hepatitis A is suspected, the doctor should draw blood and test for IgM antibodies for hepatitis A. It is especially important for Fairfax County Health Department to know if a person with this illness is a food handler or participates in a day care setting.
· PARASITES. Some waterborne parasites such as giardia, cryptosporidium may also cause chronic diarrhea; testing by a physician can identify theses diseases. Such diseases can be severe in persons with compromised immune systems.
· LEPTOSPIROSIS. During widespread flooding there may be potential, but small risk for this disease caused by exposure to animal urine. It is a bacterial disease that affects both humans and animals. Symptoms may range from none to high fever, headache, chills, muscle aches, vomiting, jaundice (yellow skin and eyes), abdominal pain, diarrhea, or rash.
· TIP: Do not allow children to play in floodwaters. Floodwaters may contain hazards, including sharp objects, open storm drains, ditches and potholes. Even six inches of fast moving water can knock an adult off their feet and two feet of water will carry away most automobiles. The water may have washed through sewers or contain other contaminants. Children who have been exposed to standing floodwaters should be bathed as soon as possible and watched for signs of infection or disease.
· TIP: Evidence of Sewage Contamination in Yards. If there is evidence of sewage contamination, yards should be disinfected with liberal application of lime. Keep children and animals away from limed areas until the lime is no longer visible.
What problems can I encounter with flooded buildings?
Residents working on or living in buildings damaged by water during
flooding should be aware of the potential for biological contamination to
their homes and drinking water.
If homes become flooded or wells are covered with water, then certain measures should be taken in order to protect your health and safety. The following describes the public health problems associated with flooding, and the measures to take to protect your health and safety after a flood.
· MILDEW, MOLD, FUNGI. Mold (fungi) will grow in flooded buildings that do not dry out quickly. People living or working in buildings with wet carpet, walls, mattresses and/or furniture can have health problems such as allergies, asthma (form of troubled breathing), and sneezing. Mold can grow in these materials to numbers that can present a health risk after being wet for only 48 hours. Persons at highest risk are asthmatics, people with allergies, infants and children, pregnant women, people with existing respiratory disease, and people with compromised immune systems. Spraying with household disinfectant for fungi and mold will not remove the organisms and can increase breathing problems.
TIP: Porous or spongy materials including carpet that have been saturated with floodwaters should be thrown away. Scrub hard surfaces of your home and its dried contents with warm soapy water using laundry detergent. Rinse with clear water, and rinse again with bleach solution (1/4 cup of household bleach to 1 gallon of water). Allow the bleach solution to stay in contact with the surfaces for five minutes and rinse again with clear water. Avoid skin contact with the solution and use only in well-ventilated areas. Wash all clothing in hot soapy water. Contaminated mattresses, upholstered furniture and carpets should be discarded because they cannot be thoroughly cleaned and dried. All cleaned items should be thoroughly dried, or mold and mildew will return.
TIP: Personal protective equipment should be worn when entering a flooded building. It is recommended to wear boots, puncture resistant gloves, and respiratory protection against mildew, mold, and fungi that may be in the air. The type of respirator that is recommended is known as a filter face piece respirator that can be obtained at a local hardware store. Look on the label for NIOSH N-95 filtering face piece with N-95 organic vapor for odor control.
TIP: Do not handle live electrical equipment in wet areas. Electrical equipment should be checked and dried before returning to service. Use only flashlights to examine buildings. Flammables may be inside. Report broken utility lines to Authorities.
TIP: Asbestos Building Materials. Homes may have building materials containing asbestos, which has been associated with respiratory disease. Building materials that may contain asbestos include flooring, siding, roofing, pipe insulation, fireproofing or decorative ceiling tiles. If suspected, the materials should be carefully wetted to minimize dust production whenever they are being disturbed or removed.
· CONTAMINATED DRINKING WATER. Unhealthy bacteria may be present in residents' water if the public water supply has lost power (a boil water notice will be issued through the media) or if a private well has been flooded. The water in the home may be unsafe for drinking, cooking, making ice, brushing teeth and washing.
TIP: Residents under a boil water notice should bring water to a rolling boil for one minute. The "flat" taste of boiled water can be improved by pouring it back and forth from one clean container to another, allowing it to stand for a few hours or adding a pinch of salt for each quart of water boiled. Boiling water can increase nitrate levels seen after flooding, young infants and pregnant women should not drink boiled water. Bottled water should be used by pregnant women and be used for preparing infant formula.
TIP: If you cannot boil water, add six to eight drops of newly purchased 5% unscented liquid household bleach per gallon of water (1 teaspoon to 10 gallons). Stir well and let the water stand for 30 minutes before using it. Remember that bleach will not kill parasitic organisms. You can also use water-purifying tablets from your local pharmacy or sporting goods store.
TIP: Residents with a well that has been flooded should follow the same tips above until water tests show not bacteria in the water. Water should not be consumed until bacteriological testing indicates the well is not contaminated. Two samples taken on consecutive days are recommended. Contact your local health department for information on where to have samples tested.
Disinfect your well by adding household bleach mixed with water to the well. The recommended amount of bleach varies depending on the amount of water in the well; however a half-gallon of unscented bleach should be adequate for most home wells. To be certain that your water lines have been disinfected, turn on the faucets until a chlorine smell is detected. Turn off the faucets and allow the bleach to sit in the well for at least four hours (overnight is preferable). The water should then be turned on until the chlorine smell dissipates.
Water must be tested after this is done to ensure that the chlorine has destroyed bacteria. High levels of contamination may not be controlled by a single chlorine treatment.
TIP: If on public water supply, you do not need to have your water tested. The water authority will conduct proper testing once the floodwaters receded and power is restored.
TIP: Other considerations to ensure safety:
· Utensils can be made safe by dipping them in a solution of one teaspoon of bleach per gallon of water after washing with soap.
· Automatic dishwashers can be used if you use the heat cycle and dishwashing detergent.
· Use of disposable plates, cups and utensils can reduce the need for washing
· Icemakers should be turned off
· Normal laundry activities are safe
· Bathing is generally safe except for persons with compromised immune systems
· Bathing of infants and children is generally safe if they do not drink the water. Don't let babies suck on the washcloth.
· SEWAGE BACKUP IN THE HOME. Flooding may cause wastewater to back up into homes that receive service from either public sewer system or private septic systems. Once the water recedes, a high water table may still prevent private septic systems from functioning for some time.
TIP: Wear personal protective equipment. Rubber boots and waterproof gloves should be worn. Remove and discard contaminated household goods such as wall coverings, rugs, cloth and drywall that cannot be disinfected.
What concerns should I have about wild animals and insects?
· MOSQUITOES. Flooding can result in excessive breeding of mosquitoes, resulting in the possibility of disease being carried by the insects. Swarms of mosquitoes may be seen in the affected regions several weeks after the storm. Mosquito's eggs can lie dormant for years without water. Those eggs will now hatch.
Tip: Residents should remove excess water from birdbaths, flowerpots, tires, buckets and other containers to minimize the breeding of mosquitoes.
· OTHER INSECTS. Bees, wasps, and hornets may have had their nests disturbed by excessive wind and rain. The insects can become very aggressive.
TIP: Before beginning clean up, survey the site to see if bees, wasps, or hornets are hovering in the area. If they are, use a commercially available pesticide to get rid of them before entering the area.
· SNAKES. Snakes will also have their nest disturbed during flooding. Also, with less land for them to seek shelter, they are prone to enter abandoned homes, vehicles, furniture and equipment.
TIP: Before reentering homes or vehicles, check thoroughly for snakes.
· WILD ANIMALS. Wild animals displaced from their natural habitats may seek shelter in places where they may be exposed to people. These animals may be infected with rabies.
TIP: Avoid contact with wild animals such as raccoons, possums, squirrels, etc.. Animal bites should be reported to the Fairfax County Animal Services Division Dispatch at 703-830-1100 - Option 3 during normal business hours or 571-274-2296 after hours, weekends, and holidays.
· DEAD ANIMALS. Dead animals may be found around your home after a flood. The presence of these animals may result in excessive odor and increased in the number of flies.
TIP: Do not handle with bare hands. Small dead animals may be placed in dumpsters or buried three feet in the ground. If large livestock are found, notify a the Fairfax County Health Department.
How can I be sure the food I eat is safe?
Foods that have come in contact with flood waters including canned goods. Refrigerated food is generally safe if the power has not been off more than 2 hours. Most freezers will keep food safe without power for 36 to 48 hours if left closed.
TIP: If a power outage, the perishable, refrigerated foods including meats, dairy products and eggs that have been without refrigeration for more than 2 hours must be discarded.
TIP: If power comes back on after food in freezer begins to thaw. Use a thermometer to check the temperature in your freezer. Food stored in the freezer at 40 F or colder is safe and may be refrozen. If a thermometer was not in the freezer, check each package of food to determine the safety.
TIP: When in Doubt, throw it out. Do not rely on appearance or
odor. Any food item discarded should be disposed of in well-tied
double-bagged plastic garbage bags.