PREPARE BEFORE A HURRICANE OR SEVERE FLOODING

During and after a hurricane, you may need supplies to keep your family safe and healthy. Remember that a hurricane could cut off your power and water supply. You also may not be able to drive because of damage to your car. Roads may be flooded or blocked.

Make a plan Stock up on emergency supplies for your home and car:

• First aid kit and instructions
• Fire extinguisher
• Battery- powered radio
• Flashlights
• Extra batteries
• Sleeping bags or extra blankets

Health and Safety Supplies:

Make sure you have all the health and safety supplies you need before the storm such as prescription medications, hand sanitizer, and wet cleaning cloths in case you don’t have clean water.

Write down emergency phone numbers and keep them near every phone in your house or on the refrigerator. Program them into your cell phone, too.

Prepare an emergency food supply A disaster can easily disrupt the food supply at any time, so plan to have at least a three to five day supply of food on hand. Keep foods that:

• Have a long storage life or are non-perishable, such as canned food
• Require little or no cooking, water, or refrigeration, in case utilities are disrupted
• Meet the needs of babies (baby food or formula, if needed) or other family members who are on special diets
• Meet pets' needs

Preparing food:

Preparing food after a disaster or emergency may be difficult due to damage to your home and loss of electricity, gas, and water. Having the following items available will help you to prepare meals safely:

• Fuel for cooking, such as charcoal.  (CAUTION: Only use charcoal grills or camp stoves outside of your home to avoid smoke inhalation and carbon monoxide poisoning.)
• A manual can- and bottle-opener
• Cooking utensils
• Knives, forks, and spoons
• Paper plates, cups, and towels

Prepare an emergency water supply

• Store at least 1 gallon of water per day for each person and each pet. Consider storing more water than this for hot climates, for pregnant women, and for people who are sick.
• Store at least a 3-day supply of water for each person and each pet. Try to store a 2-week supply if possible.
• Gather clean containers for water.

Prepare your family for the storm Know the difference between a hurricane "watch" and "warning".

Get your family ready

• Go over your emergency plan with your family.
• Make sure you have the supplies you need.
• Keep checking for updates. Watch TV, listen to the radio, or check online.
• Listen for disaster sirens and warning signals.
• Call the hospital, public health department, or the police about special needs.

If you or a loved one is older or disabled and won't be able to leave quickly, get advice on what to do.

Check your carbon monoxide detector. Carbon monoxide poisoning can be deadly.

Get your home ready for the storm

• Clear your yard. Make sure there's nothing that could blow around during the storm and damage your home. Move bikes, lawn furniture, grills, propane tanks, and building material inside or under shelter.
• Cover up windows and doors outside.  Use storm shutters or nail pieces of plywood to the window frames to protect your windows. This can help keep you safe from pieces of shattered glass.
• Be ready to tum off your power. If you see flooding, downed power lines, or you have to leave your home, switch it off.
• Fill clean water containers with drinking water. You'll want to do this in case you lose your water supply during the storm.  You can also fill up your sinks and bathtubs with water for washing.
• Check your CO detector to prevent CO poisoning.
• Lower the thermostat in your refrigerator and freezer to the coolest possible temperature. If your power goes out, your food will stay fresh longer.

 Prepare your car for the storm

• Fill your car's gas tank. You may also want to consider making plans with friends or family to get a ride.
• Double check your car's emergency kit.
• Move cars and trucks into your garage or under cover.
• Have an emergency water supply.

Make an emergency car kit:

Always keep an emergency kit in your car in case you need to leave quickly during a hurricane. Make sure you include:

• Flares
• Jumper cables (sometimes called booster cables)
• Maps
• Tools, like a roadside emergency  kit
• A first aid kit and instructions
• A fire extinguisher
• Sleeping bags
• Flashlight and extra batteries

Evacuate or stay at home

If a hurricane or severe flooding is coming, you may hear an order to evacuate (leave your home). Never ignore an order to evacuate. Even sturdy, well-built houses may not hold up against an extreme storm with strong wind and high water. Staying home to protect your property is not worth risking your health and safety.

You may also hear an order to stay at home. Sometimes, staying at home is safer than leaving.

If you need to evacuate:

• Only take what you really need with you, like your cell phone, chargers, medicines, identification (like a passport or license), and cash.
• Make sure you have your car emergency kit.
• If you have time, tum off the gas, electricity, and water. Also unplug your appliances.
• Follow the roads that emergency workers recommend even if there's traffic. Other routes might be blocked.

WHAT TO DO AFTER A HURRICANE OR SEVERE FLOODING

Flood water safety

Emergency management officials have requested that people escaping flood waters as a last resort do not stay in the attic of their house. If the highest floor of your home becomes dangerous, get on the roof. Call 911 for help and stay on the line until the call is answered.

Follow local flood watches, warnings and instructions.

Flood water poses drowning risks for everyone, regardless of their ability to swim. Swiftly moving shallow water can be deadly, and even shallow standing water can be dangerous for small children.

Vehicles do not provide adequate protection from flood waters. They can be swept away or may stall in moving water.

If flooding occurs, get to higher ground. Get out of areas subject to flooding. This includes dips, low spots, canyons, washes, etc.

If you are in an area that is in danger of flooding or you are under a flood watch or warning:

• Gather the emergency supplies, including prescription medications, you previously stocked in your home and stay tuned to your local radio or television station for updates.
• Turn off all utilities at the main power switch and close the main gas valve if evacuation appears necessary.
• Have your immunization records handy or be aware of your last tetanus shot, in case you receive a puncture wound or a wound becomes infected during or after the flood.
• Immunization records should be stored in a waterproof container.
• Fill bathtubs, sinks and containers with clean water. Sanitize the sinks and tubs first by using bleach. Rinse and fill with clean water.

Avoid driving through flooded areas and standing water. As little as six inches of water can cause you to lose control of your vehicle, and two feet of water can cause your car to be swept away. Turn around, don't drown.

Stay safe in extreme heat

Be aware of yours and others' risk for heat stroke, heat exhaustion, heat cramps and fainting.

Some people are more at risk of developing a heat-related illness than others. Be sure to check on people in these groups and follow tips to keep them safe:

• Older adults (aged 65+)
• People with diabetes
• People with other chronic medical conditions
• Outdoor workers
• Infants and children
• Low income households or households without air conditioning
• Athletes
• Pets

Heat stroke is the most serious heat illness. It happens when the body can't

control its own temperature and its temperature rises rapidly Sweating fails and the body cannot cool down. Body temperature may rise to 106°F or higher within

10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency care is not given.

Personal hygiene and hand washing

Keeping hands clean during an emergency helps prevent the spread of germs. If your tap  water  is not  safe to  use, wash  your  hands with  soap  and  water  that has  been boiled  or  disinfected.   Follow these   steps to make sure   you wash   your   hands properly:

• Wet your hands with clean, running water (warm or cold) and apply soap.
• Rub your hands together to make lather and scrub them well; be sure to scrub the backs of your hands, between your fingers, and under your nails.
• Continue rubbing your hands for at least 20 seconds.  Need a timer? Hum the "Happy Birthday" song from beginning to end twice.
• Rinse your hands well under running water.
• Dry your hands using a clean towel or air dry them.

A temporary hand washing station can be created by using a large water jug that contains clean water (for example, boiled or disinfected).

Washing hands with soap and water is the best way to reduce the number of germs on them. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.

Hand sanitizers are not effective when hands are visibly dirty.

Bathing or showering after a water-related emergency should only be done with clean, safe water. Sometimes water that is not safe to drink can be used for bathing, but be careful not to swallow any water or get it in your eyes. Do not bathe in water that may be contaminated with sewage or toxic chemicals. This includes rivers, streams, or lakes that are contaminated by flood water.

If you have a drinking water well, listen to your local health authorities for advice on using your well water for showering and bathing.  If extensive flooding has occurred or you suspect that your well water may be contaminated, contact your local, state, or tribal health department for specific advice on well testing and disinfection.

Diarrheal diseases

Eating or drinking anything contaminated by flood water can cause diarrheal disease (such as E. coli or Salmonella infection). To protect yourself and your family:

• Practice good hygiene (hand washing with soap and water) after contact with flood waters.
• Do not allow children to play in flood water areas.
• Wash children’s hands with soap and water frequently (always before meals).
• Do not allow children to play with toys that have been contaminated by flood water and have not been disinfected.

Tetanus

Guidance for tetanus-related questions in areas affected by hurricanes or flooding:

Protection against tetanus

• Vaccination prevents tetanus, however this does not last a lifetime. This means that if you were vaccinated before or had tetanus before, you still need to get vaccinated regularly to keep a high level of protection against this serious disease. Being up to date with your tetanus vaccine is the best tool to prevent tetanus.
• Tetanus vaccines are recommended for people of all ages. After a series of tetanus shots during childhood and adolescence, adults need a tetanus booster shot (Td) every 10 years. Td or the tetanus booster shot that  add protection against  pertussis, or whooping cough, (Tdap) can be used; getting Tdap instead  of Td  for one tetanus booster  during adulthood  is recommended to maintain protection  against  whooping cough.
• If you have wounds, you should be evaluated for a tetanus immunization. If you receive a puncture wound or a wound contaminated with feces, soil, or saliva, have a health care professional determine whether a tetanus booster is necessary based on individual records.

Risk of tetanus after exposure to flood water

• Exposure to flood waters does not increase the risk of tetanus. However, some people may have wounds such as punctures to the skin or nail sticks, cuts, bruises, lacerations, or scrapes (or other skin injuries) that become contaminated with flood waters, human or animal wastes, soil, dirt, or saliva. Besides treatment of these wounds, the vaccination status of such persons should be assessed and an age-appropriate tetanus vaccine given if needed. In some of these situations, the doctor or health care provider may decide that a tetanus vaccine is needed as early as 5 years since the last dose.
• Being up to date for tetanus vaccine can greatly simplify the treatment for any wound that might occur.

Food and water safety after a storm

Food may not be safe to eat during and after an emergency. Safe water for drinking, cooking, and personal hygiene includes bottled, boiled, or treated water. Your state, local, or tribal health  department can make specific recommendations for boiling or treating water in your area.

Throw away food that may have come in contact with flood or storm water, perishable foods, and those with an unusual odor, color, or texture. When in doubt, throw it out.

Do not use water you suspect or have been told is contaminated to wash dishes, brush your teeth, wash and prepare food, wash your hands, make ice, or make baby formula.

Food

Food-borne illness, or food poisoning, is a risk from food contaminated from flood water and from perishable food not held at a safe temperature due to power outages. If foods of animal origin, especially raw meat and poultry, have not been held at a safe temperature, germs already present can grow to high numbers.  Other foods not held at the right temperature can also spoil.

Do the following with food and containers that may have had contact with flood or storm water.

Throw away the following foods

• Food that has an unusual odor, color, or texture. When in doubt, throw it out.
• Perishable foods (including meat, poultry, fish, eggs and leftovers) in your refrigerator when the power has been off for 4 hours or more.
• Canned foods or food containers that are bulging, opened, or damaged. Throw away the food if the container spurts liquid or foam when you open it or the food inside is discolored, moldy, or smells bad.
• Food not in packages or cans.
• Packaged food: Throw away food containers with screw-caps, snap-lids, crimped caps, twist caps, flip tops, and snap-open  tops, as well as home- canned  foods because they cannot be disinfected. Throw away food in cardboard containers, including juice, milk, or baby formula boxes.

Thawed food that contains ice crystals can be refrozen or cooked. Freezers, if left unopened and full during a power outage, will keep food safe for 48 hours (24 hours if half full).

Store food safely

• While the power is out, keep the refrigerator and freezer doors closed as much as possible.

Feeding infants and young children

• Breastfed infants should continue breastfeeding. For formula-fed infants, use ready-to• feed formula if possible. If using ready- to-feed formula is not possible, it is best to use bottled water to prepare powdered or concentrated formula when your tap water is unsafe.  If bottled water is not available, check with local authorities to find the status of your drinking water to see if boiling it will make it safe to drink. Use treated water to prepare formula only if you do not have bottled or boiled water.
• If water is contaminated with a chemical, boiling it will not remove the chemical or make it safe to consume.
• If  you prepare formula with boiled water, let the formula cool sufficiently before giving it to an infant.  Put a couple drops of formula on the back of your hand to see if it is too hot.
• Clean feeding bottles with bottled, boiled, or treated water before each use.

Throw out bottle nipples or pacifiers that have been in contact with flood waters.

• Wash your hands before preparing formula and before feeding an infant. You can use alcohol-based hand sanitizer for sanitizing your hands if water is not available for hand washing.

Clean and sanitize food-contact surfaces

Throw out wooden cutting boards, baby bottle nipples, and pacifiers if they have come into contact with flood waters because they cannot be properly sanitized. Clean and sanitize food-contact surfaces in a four-step process:

1. Wash with soap and warm, clean water.

2. Rinse with clean water.

3. Sanitize by immersing for 1minute in a solution of 1cup (8 ounces or 250 milliliters) of chlorine bleach (5.25%, unscented) in 5 gallons of clean water.

4. Allow to air dry

Note: Do not use your fireplace for cooking until the chimney has been inspected for cracks and damage. Sparks may escape into your attic through an undetected crack and start a fire.

Water

Safe drinking water

• After an emergency, especially after flooding, drinking water may not be available or safe to drink for personal use.
• Do not use water you suspect or have been told is contaminated to wash dishes, brush your teeth, wash and prepare food, make ice, or make baby formula.
• Alcohol dehydrates the body, which increases the need for drinking water.
• Floods and other disasters can damage drinking water wells and lead to aquifer and well contamination. Flood waters can contaminate well water, rivers, streams, and lakes with livestock waste, human sewage, chemicals, and other contaminants which can lead to illness when used for drinking, bathing, and other hygiene activities.

Make water safe

Water often can be made safe to drink by boiling, adding disinfectants, or filtering.

IMPORTANT: Water contaminated with fuel or toxic chemicals will not be made safe by boiling or disinfection. Use a different source of water if you know or suspect that water might be contaminated with fuel or toxic chemicals.

Boil water

If you don't have safe bottled water, you should boil water to make it safe. Boiling is the surest method to make water safer to drink by killing disease-causing organisms, including viruses, bacteria, and parasites.

You can improve the flat taste of boiled water by pouring it from one clean, disinfected  container to another and then  allowing it to stand for a few hours, OR by adding a pinch of salt for each quart or liter of boiled water.

If the water is cloudy

• Filter it through a clean cloth, paper towel, or coffee filter OR allow it to settle.
• Draw off the clear water.
• Bring the clear water to a rolling boil for one minute (at elevations above 6,500 feet, boil for three minutes).
• Let the boiled water cool.
• Store the boiled water in clean sanitized containers with tight covers.

If the water is clear

• Bring the clear water to a rolling boil for one minute (at elevations above 6,500 feet, boil for three minutes).
• Let the boiled water cool.
• Store the boiled water in clean sanitized containers with tight covers.

Disinfectants

If you don't have clean, safe, bottled water and if boiling is not possible, you often can make water safer to drink by using a disinfectant, such as unscented household chlorine bleach, iodine, or chlorine dioxide tablets. These can kill most harmful organisms, such as viruses and bacteria. However, only chlorine dioxide tablets are effective in controlling more resistant organisms, such as the parasite Cryptosporidium. If the water is contaminated with a chemical, adding a disinfectant will not make it drinkable

Medications

Some drugs require refrigeration to keep their strength, including many liquid drugs.

• When the power is out for a day or more, throw away any medication that should be refrigerated, unless the drug's label says otherwise.
• If a life depends on the refrigerated drug, but the medications have been at room temperature, use them only until a new supply is available.
• Replace all refrigerated drugs as soon as possible.

HHS's Emergency Prescription Assistance Program (EPAP) is a free service that helps residents get medicine, medical supplies,  medical equipment and vaccines that

were lost, stolen,  or damaged  due to a disaster.  HHS activates this service after some natural disasters.

For more information about EPAP, visit

https://www.phe.gov/Preparedness/planning/epap/Pages/default.aspx.

Mold

After natural disasters such as hurricanes, tornadoes, and floods, excess moisture and standing water contribute to the growth of mold in homes and other buildings. When returning to a home that has been flooded, be aware that mold may be present and may be a health risk for your family

If there is mold growth in your home, you should clean up the mold and fix any water problem, such as leaks in roofs, walls, or plumbing.  Controlling moisture in your home is the most critical factor for preventing mold growth. Keep children and pets out of the affected area until cleanup has been completed.

People at greatest risk from mold

• People with asthma, allergies, or other breathing conditions may be more sensitive to mold.
• People  with   a   weakened   immune  system,  such  as   people   receiving treatment  for   cancer,   people   who   have   had  an   organ   or  stem     cell transplant,  and   people   taking   medicines    that   suppress  the   immune system, are more likely to get a serious  illness from mold.
• If you have a breathing problem like asthma, a weakened immune system, or are pregnant, try not to enter a building with mold damage.
• Children should not take part in disaster clean-up work.
• In some homes and schools it might be hard to get rid of all mold quickly, so children could be exposed to some mold.
• Children and adults with asthma or a weakened immune system should stay out of buildings with mold growth.
• For healthy children and adults mold exposure can lead to cough, wheeze, eye and skin irritation, and runny or stuffy nose.

Possible health effects of mold exposure

• People who are sensitive or allergic to mold may experience problems like asthma attacks, wheezing, stuffy nose, and irritated eyes and skin.
• Mold exposure can lead to severe infections in people with a weakened immune system.
• If you or your family members have health problems after exposure to mold, contact your doctor or other health care provider.

Recognizing mold

You may recognize mold by:

• Sight. Are the walls and ceiling discolored, or do they show signs of mold growth or water damage?
• Smell. Do you smell a bad odor, such as a musty, earthy smell or a foul stench?

Safely preventing mold growth

• Clean up and dry out the building as quickly as you can.
• Open doors and windows.
• Use fans to dry out the building. Position fans to blow air out doors or windows.
• When in doubt, take it out! Remove all porous items that have been wet for more than 48 hours and that cannot be thoroughly cleaned and dried. These items can remain a source of mold growth and should be removed from the home. Porous, non-cleanable items include carpeting and carpet  padding, upholstery,  wallpaper,  drywall, floor and ceiling tiles, insulation material, some clothing, leather,  paper, wood, and food.
• Removal and cleaning are important because even dead mold may cause allergic reactions in some people.
• To prevent mold growth, clean wet items and surfaces with detergent and water.
• Homeowners may want to temporarily store items outside of the home until insurance claims can be filed.

Cleaning up mold

To remove mold growth from hard surfaces use commercial products, soap and water, or a bleach solution of no more than 1 cup of household laundry bleach in

1 gallon of water. Follow the manufacturers' instructions for use (see product label). Use a stiff brush on rough surface materials such as concrete.

When removing mold

• Never mix bleach with ammonia or other household cleaners.

Mixing bleach with ammonia or other cleaning products will produce dangerous, toxic fumes.

• Open windows and doors to provide fresh air.
• Wear rubber boots, rubber gloves, and goggles during cleanup of affected area.
• If the area to be cleaned is more than 10 square feet, consult guidance by the U.S. Environmental Protection Agency (EPA).
• Always follow the manufacturer's instructions when using bleach or any other cleaning product.
• Protect your nose and mouth against breathing in mold.

Before you enter a building with mold damage, wear at least a NIOSH-approved N-

95 respirator, which you can buy at a home supply store. If you plan to spend  a lot of time removing moldy belongings or doing work like ripping out moldy drywall, wear a half-face or full-face  respirator. Make certain that you follow instructions on the package for fitting the mask respirator tightly to your face. N-95 respirators are only approved for filtering out dust in the air (for example, from sweeping, sawing, and mold removal). This type of respirator will not protect you against chemicals or gases in the air, such as cleaning products or carbon monoxide.

Clean-up safely outside the home

• Keep children and pets out of the affected area until cleanup has been completed.
• Have your onsite waste-water system professionally inspected and serviced if you suspect damage.
• Wash all clothes worn during the cleanup in hot water and detergent. These clothes should be washed separately from uncontaminated clothes and linens.
• After completing the cleanup, wash your hands with soap and clean water. Seek immediate medical attention if you become injured or ill.