AFTER THE STORM

Contents:
● Mosquito-Borne Illness
● Home Repair
● Home Clean-Up
● MOLD
● Heat Exhaustion
● Hand Washing can Help Prevent Illness
● Boil Water Notices
    o Disinfecting Water
● Flooding
● Sewer or Sewage Backup
● Disinfecting Your Well
● Submitting Water for Testing
● Preventing Illness from Food
● Removing Contaminated Foods
● Dehydration
● Conserving Water
● Tetanus
● Carbon Monoxide Poisoning
● Warning Signs of Heart Attack
● Fire

MOSQUITO-BORNE ILLNESS
Heavy rains & flooding lead to an increase in the mosquito population. Take precautions to minimize your exposure:
      ● Dusk and Dawn -- Avoid being outdoors when mosquitoes are
        seeking blood, for many species this is during the dusk and dawn
        hours.
      ● Dress -- Wear clothing that covers the skin.
      ● DEET -- When the potential exists for exposure to mosquitoes,
         repellents containing DEET (N,N-diethyl-meta-toluamide, or N,N-
         diethyl-3-methylbenzamide) are recommended. Products with
         concentrations up to 30% DEET are generally recommended for
         most situations. (It is not recommended to use DEET on children|
         less than 2 months old. Instead, infants should be kept indoors or
         mosquito netting used over carriers when mosquitoes are present).
         Apply repellent to exposed skin, or onto clothing, but not under
        clothing. Do not apply repellent to children's hands. Always read
        the manufacturer's directions carefully before you put on a repellent.
      ● Drainage -- Check your home to rid it of standing water in which
         mosquitoes can lay their eggs.

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HOME REPAIR
The danger of a storm does not end when it passes. As you return to your home and begin repairs, the Gadsden County Health Department suggests taking the following safety precautions to prevent personal injury:
     ● If possible, work in pairs or groups.
     ● Take short breaks and work during the cooler hours of the day.
     ● Wear goggles, heavy gloves and steel-toed boots.
     ● Immediately clean all open wounds and cuts with soap and clean
       water. Cuts beyond minor scratches may require medical attention.
     ● Never assume that water-damaged structures are safe; leave
        immediately if shifting or unusual noises occur.
     ● Avoid lifting more than 50 pounds of debris or building materials.
       Two or more people should move bulky objects.
     ● Avoid heat stroke and heat exhaustion by wearing light-colored,
        loose-fitting clothing and drinking a glass of fluid every 15 to 20
        minutes.
     ● Only experienced individuals should use chain saws and specialized
        equipment. When using chain saws or other heavy equipment, wear
        earplugs.
     ● To prevent electrocution in wet areas, turn power off at the main
        breaker.
     ● Never handle a downed power line.
     ● Never bring gasoline- or diesel-powered pumps, generators or
       pressure washers indoors as they release carbon monoxide ? a
       deadly, colorless, odorless gas.
     ● Set priorities for clean-up tasks and pace the work over several
       days or weeks.
     ● Avoid exhaustion by taking frequent rest breaks and resuming a
        normal sleep schedule as soon as possible.
     ● Take advantage of disaster relief programs and services in your
        community.

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HOME CLEAN-UP
After a hurricane has passed, failure to remove contaminated materials can cause health risks. If there is flooding along with a hurricane, water must be removed as quickly as possible since it may contain material from overflowing sewage systems.
If there has been a backflow of sewage into the house, the following measures should be taken to ensure proper clean-up:
     ● Walls, hard-surfaced floors and many other household surfaces must
       be cleaned with soap and water and disinfected with a solution of 1
       cup of bleach to five gallons of water.
     ● Thoroughly disinfect surfaces that come in contact with food and
       children's play areas.
     ● Wash all linens and clothing in hot water or dry-clean.
     ● Items that cannot be washed or dry-cleaned, such as mattresses and
       upholstered furniture, must be air dried in the sun and sprayed
       thoroughly with a disinfectant.
     ● Steam-clean all carpeting.
     ● Fiberboard, fibrous insulation and disposable filters that have
      contacted floodwater or sewage should be replaced in your heating
      and air conditioning system.
     ● Wear rubber boots and waterproof gloves during clean-up.

Be careful about mixing household cleaners and disinfectants as combining certain types of products can produce toxic fumes and result in injury or death.
It can be difficult to throw away items in a home, particularly those with sentimental value. However, keeping certain items soaked by sewage or floodwater may be unhealthy. In general, materials that cannot be thoroughly cleaned and dried within 24-48 hours should be discarded.

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MOLD
Moisture that enters buildings from leaks or flooding accelerates mold growth. Molds can cause disease, trigger allergic reactions and continue to damage materials long after the storm. Failure to control moisture and mold can present short and long- term health risks. To protect against health risks associated with mold:
     ● Remove standing water from your home or office.
     ● Remove wet materials.
     ● If mold growth has already occurred, carefully remove or clean the
        moldy material.
     ● Consider using personal protective equipment when cleaning or
        removing mold ? gloves, goggles and an N-95 particle respirator
        (found at most local hardware stores). Check with a health care
        provider before wearing a respirator. Do not use a respirator if you
        have heart disease or chronic lung disease such as asthma or
        emphysema.
     ● Individuals with known mold allergies or asthma should not clean or
        remove moldy materials.
Remember to not mix cleaners and disinfectants, as hazardous gases may produce hazardous chemical reactions. Read and follow label instructions carefully. Open windows and doors to provide plenty of fresh air. Do not mix bleach with any other cleaners, especially ammonia.

For more information about indoor air quality and mold growth, contact the Gadsden County Health Department or the Florida Department of Health's Indoor Air Toxics Hotline at 800-543-8279.

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HEAT EXHAUSTION
Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids. Signs of heat exhaustion include:
     ● Heavy sweating
     ● Paleness
     ● Muscle cramps
     ● Tiredness
     ● Weakness
     ● Dizziness
     ● Headache
     ● Nausea or vomiting
     ● Fainting
     ● Skin: may be cool and moist
     ● Pulse rate: fast and weak
     ● Breathing: fast and shallow
If heat exhaustion is untreated, it may progress to heat stroke. Seek medical attention immediately if any of the following occurs:
     ● Symptoms are severe.
     ● The victim has heart problems or high blood pressure.
     ● Otherwise, help the victim cool off and seek medical attention if  
       symptoms worsen or last longer than one hour. Cooling measures
       that may be effective include the following:
     ● Drinking cool, nonalcoholic beverages, as directed by your physician
     ● Resting in an air-conditioned environment
     ● Taking a cool shower, bath, or sponge bath
     ● Wearing lightweight clothing
     ● Preventing sun burn, which damages the skin's ability to dissipate
       heat by wearing sunscreen with SPF 30.

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HAND WASHING CAN HELP PREVENT ILLNESS
To help prevent the spread of disease that can cause illness, it is important to wash your hands often. Germs are spread when people forget to wash their hands, or don't wash their hands correctly.
Basic hygiene is very important during an emergency period. Always wash your hands with soap and water that has been boiled or disinfected and cooled.
When Should You Wash Your Hands?
Before:
     ● preparing or eating food
     ● treat a cut or wound
     ● insert of remove contact lenses
After:
     ● using the bathroom or changing a diaper
     ● handling uncooked food
     ● playing with a pet
     ● handling garbage
     ● tending to someone who is sick or injured
     ● blowing your nose
     ● coughing or sneezing
     ● participating in flood cleanup activities
     ● handling articles contaminated by floodwater or sewage
How Should You Wash Your Hands?
How you wash your hands is just as important as when you wash them. Just rinsing them quickly is not enough.
     ● Use soap and warm running water or boiled, disinfected, or bottled
       water
     ● Wash all surfaces thoroughly, including wrists, palms, back of hands,
        fingers and under fingernails
     ● Rub hands together for at least 10-15 seconds and then rinse
     ● Dry with a clean and/or disposable towel
     ● Use the towel to turn off the water faucet
     ● If soap and water are not available, alcohol-based hand sanitizers
       can be used; however, they do not kill all germs.

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BOIL WATER NOTICES
Boil water notices are issued when wells have been flooded, lose electricity and pressure, or a water lines break. It's important to know what to do when a boil water notice has been issued so you don't consume potentially contaminated water. If a boil-water notice has been issued, use bottled water for drinking. If bottled water is not available, you can disinfect your water using these methods.
Disinfecting Water
     ● The preferred method of treatment is boiling. Boiling water kills harmful bacteria and parasites (freezing will not disinfect water). Bring water to a full rolling boil for at least 1 minute before using it for drinking, washing, cooking, etc.
     ● For areas without power add 8 drops, about 1/8 teaspoon (this would form a puddle about the size of a dime), of plain unscented household beach per gallon of water and then let it stand for 30 minutes. If the water is cloudy after 30 minutes, repeat the procedure.
Washing Dishes & Clothes
     ● You can wash dishes during a boil-water notice if you rinse hand-washed dishes for a minute in a bleach solution (1 tablespoon bleach per gallon of water). Allow dishes to completely air dry. Most household dishwashers do not reach the proper temperature to sanitize dishes.
     ● It is safe to wash clothes in tap water.
Bathing & Shaving
     ● The water may be used for showering, baths, shaving and washing, so long as care is taken not to swallow or allow water in eyes or nose or mouth. Children and disabled individuals should have their bath supervised to ensure water is not ingested. The time spent bathing should be minimized. Though the risk of illness is minimal, individuals who have recent surgical wounds, are immunosuppressed, or have a chronic illness may want to consider using bottled or boiled water for cleansing until the advisory is lifted.
Washing Fruits & Vegetables and Making Ice
     ● Fruits and vegetables should be washed with boiled (then cooled water) or bottled water or water sanitized with 8 drops (about 1/8 teaspoon) of unscented household bleach per gallon of water.
     ● Ice should be made with boiled water, bottled water or sanitized water.
Consuming Potentially Contaminated Water
     ● Even if someone has consumed potentially contaminated water from either a public water system or a private well before they were aware of the boil water advisory, the likelihood of becoming ill is low. Anyone experiencing symptoms such as diarrhea, nausea, vomiting, abdominal cramps, with or without fever, should seek medical attention.
Infectious Organisms Present in Contaminated Water
     ● Disease transmission from contaminated water occurs principally by  ingesting water. The major organisms of concern are protozoa such as Giardia and Cryptosporidium, and bacteria, such as Shigella, E. coli and  viruses. These organisms primarily affect the gastrointestinal system, causing diarrhea, abdominal cramps, nausea, and vomiting with or without fever. Most of these illnesses are not usually serious or life threatening except in the elderly, the very young or those who are immunocompromised.

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FLOODING
Tropical storms and hurricanes often produce enough rain to cause flooding in some areas. It is important to be prepared for issues related to flooding.
Moving Flood Water
During flooding, the greatest threat comes from moving water. The deeper the moving water, the greater the threat. People should avoid driving in moving water, regardless of the size of their vehicle or the depth of the water.
Pooling Flood Water
Heavy rain causes flood waters to rise and pool on streets and throughout neighborhoods. In these situations, be aware of the following:
     ● Road surfaces become obscured, and drivers can unknowingly steer into a deep body of water, such as a canal or pond.
     ● Electricity from streetlights and power poles may be conducted through standing water, causing a deadly shock to anyone coming in contact with it.
     ● Children playing in contaminated standing water can become sick or be bitten by snakes or floating insects.
     ● People coming into contact with floodwater should thoroughly rinse any exposed body parts with soap and clean water.
Contaminated Water Supply
     ● Drinking contaminated water may cause illness. You cannot assume that the water in the hurricane-affected area is safe to drink. Listen to local announcements on safety of the water supply.
     ● If your public water system loses pressure, a boil water notice will likely be issued for your area. People in these areas should take precautions to avoid contaminated water, especially individuals with private wells. If your well is in a flooded area, your water may contain disease-causing organisms and may not be safe to drink.
DOH Recommends Boiling or Sanitizing Your Water:
     ● Boil the water before drinking, holding it at a rolling boil for one minute;
     ● Disinfect it by adding 8 drops (about 1/8 tsp ? this would form a puddle about the size of a dime) of unscented household bleach per gallon of water, and then let it stand for 30 minutes. If the water is cloudy after 30 minutes, repeat the procedure; or
     ● Use only bottled water for mixing baby formula.
After the Flooding Subsides:
     ● Disinfect your well.
     ● Have your water tested by the Health Department, or by a laboratory
       certified by the State to do drinking water analyses.
Contaminated Food
Do not eat any food that may have come into contact with flood water. Discard any food without a waterproof container if there is any chance that it has come into contact with floodwater. Undamaged, commercially canned foods can be saved if you remove the labels thoroughly, wash the cans, and then disinfect them with a solution consisting of 1/4 cup of bleach per gallon of water for clean surfaces. Re-label your cans, including the expiration date, with a marker. Food containers with screw-caps, snap lids, and home canned foods should be discarded if they have come in contact with flood water because they cannot be disinfected.
Contaminated Items
Discard wooden cutting boards, plastic utensils, baby bottle nipples and pacifiers. There is no way to safely clean them if they have come in contact with contaminated flood waters. Thoroughly wash metal pans, ceramic dishes, and utensils with soap and hot water and sanitize by boiling them in clean water or by immersing them for 15 minutes in a solution of 1/4 cup of household bleach per gallon of water.
Water Activity
In the aftermath of a natural disaster, bacterial contamination of our waters commonly occurs because of rain and sewage overflow. We advise no swimming in inland waters for at least one-week. Sewage contamination of waters can expose bathers to intestinal viruses, bacteria, and parasites.
Swimming in offshore and ocean waters is not recommended if they appear dirty after the storm. While these waters are less likely to be contaminated by bacteria, they may be dangerous due to strong rip tides, currents, and wave action. Also sharp metal or glass debris may be present in shallow waters after a storm, so use caution.
The Marine Patrol recommends no boating because of submerged and partially submerged obstructions and damage to the aids which assist navigation.
Hygiene
Basic hygiene is very important during an emergency period. Always wash your hands (with soap and water that has been boiled or disinfected and cooled) before eating, after toilet use, after participating in cleanup activities, and after handling articles contaminated by floodwater or sewage.
Animals Displaced by Flooding
Natural disasters can cause displacement of wild and domestic animals. Avoid contact with stray, injured, or aggressive animals and report them to the local animal control agency.
Many wild raccoons, foxes, and skunks living in Florida are infected with the rabies virus. Though you may feel sorry for an injured wild animal, these animals are not to be played with. Should you be bitten by a stray or a wild animal, report it to the Gadsden County Environmental Health Office at (850) 875-7223.  You may need to take Rabies vaccines, too. It is important to discuss animal bites with your doctor even if it is just a small puncture.

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SEWER OR SEWAGE BACKUP
     Due to heavy rains associated with a tropical storm or hurricane, you may experience difficulties with your Septic System not functioning properly. If your system is operated by a dosing tank, it will not function without electricity. You should refrain from using water in your home as much as possible until electricity is restored. The tanks will fill up without dosing water to the drain field. This may cause backups of raw sewage in your home.
     If a sewage backup occurs in your home, secure the area affected from access. Keep children out of wet areas that are affected by sewage. If your entire home has been saturated, abandon the home until all affected areas, including but not limited to carpets, rugs, sheetrock, drywall, and baseboards, have been cleaned and decontaminated.
     If sewage overflows in open areas or streets, etc., avoid these areas and keep children out of these areas. Do not let children play in flood waters as these waters may be affected by sewage.
     If you live in a low-lying or flood-prone area, be advised that the ground in your area may be saturated due to the heavy rainfalls during and after the storm. You should use household water as little as possible to prevent sewage backups in your home.
     If there has been a backflow of sewage into the house, the following measures should be taken to ensure proper clean-up:
     ● Walls, hard-surfaced floors and many other household surfaces must be cleaned with soap and water and disinfected with a solution of 1 cup of bleach to five gallons of water.
     ● Thoroughly disinfect surfaces that come in contact with food and children's play areas.
     ● Wash all linens and clothing in hot water or dry-clean.
     ● Items that cannot be washed or dry-cleaned, such as mattresses and  
       upholstered furniture, must be air dried in the sun and sprayed thoroughly with a disinfectant.
     ● Steam-clean all carpeting.
     ● Fiberboard, fibrous insulation and disposable filters that have contacted floodwater or sewage should be replaced in your heating and air conditioning system.
     ● Wear rubber boots and waterproof gloves during clean-up.
     Be careful about mixing household cleaners and disinfectants, as combining certain types of products can produce toxic fumes and result in injury or death.
     It can be difficult to throw away items in a home, particularly those with sentimental value. However, keeping certain items soaked by sewage or floodwaters may be unhealthy. In general, materials that cannot be thoroughly cleaned and dried within 24-48 hours should be discarded.
     If you are having problems in areas served by sewer systems, please contact your utility company to insure they are aware of problems in your area.
     If you have questions, please call the Health Department's Environmental Health office at 892-8021.

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DISINFECTING YOUR WELL
After the flooding subsides, disinfect your well, following these procedures:
     ● If the water is discolored, run the water until it is clear.
     ● Turn off, then drain your hot water heater? chlorine bleach is not as
       effective in water above 105º.
     ● Bleed the air from pressure tanks so that chlorinated water can completely fill and sanitize them. Water softeners, sand filters, and iron removal filters should be backwashed with chlorinated water. Remove and replace charcoal filters after the chlorination process is completed.
     ● To avoid adding further contamination to the well during the disinfection procedure, first clean up the work area around the top of the well. Remove grease, mineral deposits, and other encrustation from accessible parts of well interior and flush these surfaces with 1/2 cup of laundry bleach in 5 gallons of water.
     ● Turn off the well pump. Remove the cap on a two-inch well, or the well plug on the rubber seal of a four-inch well. There are many types of well caps and plugs? if you have questions, you should contact a licensed well driller. If you have a submersible pump, you may also wan to contact a licensed well driller for advice on disinfection procedures.
     ● Consult Chart A and pour in the recommended amount of bleach solution. Try to coat the sides of the casing as you pour. If you get chlorine on the pump or wiring, flush it thoroughly with fresh water to prevent later  corrosion.
     ● Re-cap or plug the well opening and wait 30 minutes.
     ● Turn on and, if needed, re-prime the pump. Open all the faucets on the system one by one. Allow the water to run until there is a noticeable smell of chlorine. You may also want to flush the toilets. If you have outside faucets, you may want to direct the water away from sensitive plants. If you cannot detect a chlorine odor, re-chlorinate the system.
     ● Turn off all the faucets and allow the chlorine to remain in the system for at least eight (8) hours, preferable 10-12 hours.
     ● Again open all of the faucets and run the water until there is no chlorine smell.  Although chlorine bleach is effective against microorganisms, it will not remove chemical contamination that may have gotten into your well. The only way to verify that the water is now safe to drink is to have it tested at the Health Department or a licensed lab.

Chart A
 

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SUBMITTING WATER FOR TESTING
     The Health Department will provide approved water sample test kits, as well as additional information for having your water tested.
     ● Sample bags and bottles are sterile and contain a chlorine neutralizer (white tablet or powder). DO NOT TOUCH THE OPENING OR INSIDE SURFACES OF THE BAG. DO NOT REMOVE THE WHITE TABLET OR POWDER.
     ● Disinfect the faucet or tap at opening with alcohol. Try to spray alcohol up into the mouth of the tap or faucet.
     ● Flush line by running water for at least five minutes, or until service line is clear. It is important to flush the line of any bacterial growth since the water was last used.
     ● Adjust flow through tap to the diameter of a pencil. Fill sample bag/bottle to the upper fill line and seal bag/bottle. Samples with less than 100 ml cannot be tested.
     ● All bag samples collected should be stored in a cooler with an ice pack. DO NOT use ?wet? ice unless this is the only option, and if so, place the top of the sample bag above any water in the cooler.
     ● Samples are only valid for up to 30 hours after collection. This includes the time it takes the sample to get to the lab to be tested. Do not take the sample and wait 30 hours to submit it to the Health Department for testing.
     ● Fill out the required fields on the sample submission form:
          o System Name: the name of the business, property, owner
          o Address: system address, including the city, county, and zip code
          o Collector's name
          o Sample Site: Full address of the site sampled if different from
             above address
          o Supply Type: community system, limited use, private home
          o Date/Time Collected: required for sample acceptance
          o Sample identification on sample and submission form
          o Mailing Address: where the report is to be mailed
          o Phone number: to call you with results
          o Reason for sample
     ● Samples must be submitted to the Santa Rosa Beach office by
11:30 a.m.
       Samples will only be accepted on Wednesdays.
     ● Samples must be submitted to the DeFuniak Springs office by
11:30 a.m.
       Samples will only be accepted on Wednesdays.
If you have questions please call the Health Department's Environmental Health office at 892-8021.

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PREVENTING ILLNESS FROM FOOD
     The risk of food poisoning is heightened when refrigerators and ovens are inoperable; discard any food that has been at room temperature for two hours or more, and any food that has an unusual odor, color or texture.
                                 When in doubt, throw it out!
     ● Always keep a thermometer in your refrigerator. The temperature
       should read 41º or below.
     ● Do not eat any food that may have come in contact with dirty water
        from floods or tidal surges.
     ● Do not eat from cans that are bulging, or opened. Cans that are not
        opened can be saved if you remove the labels and then disinfect
        them. Use 1/4 cup bleach in one gallon of clean water, and let stand
        for at least 30 minutes. Re-label the cans? include expiration date
        and type of food. Assume that home-canned foods are unsafe and
        throw them out.
     ● Infants should be fed only ready-to-feed baby formula, or prepared
       powdered or concentrated liquid formula with sterilized water (see
       previous page for instructions on boiling and disinfecting water). Use
       only sanitized bottles and nipples. Unused prepared formula must be
       refrigerated. If you are breastfeeding, continue to breastfeed.
     ● Refrigerators and freezers that have been without power since the
       storm should be cleaned out. Those perishables are unsafe for eating.
     ● A full cooler will maintain its cold temperatures longer than one that is
       partially filled, so it is important to pack plenty of extra ice or freezer
       packs to insure a constant cold temperature. If available, twenty-five
       pounds of dry ice will keep a ten-cubic-foot freezer below freezing
       for 3-4 days. Use care when handling dry ice, and wear dry, heavy
       gloves to avoid injury.
     ● Thawed food can usually be eaten if it is still "refrigerator cold," or re-
        frozen if it still contains ice crystals.
     ● Eggs and other foods need to be stored in 40º Fahrenheit or slightly
       below.  Do not eat foods that may have spoiled.
     ● Wash your hands before preparing or eating food, after using the
        bathroom or changing a diaper, after handling uncooked food, after
        playing with a pet, after handling garbage, after tending to someone
        who is sick or injured, after blowing your nose, and after coughing or
        sneezing.
     ● Fight cross-contamination, the transfer of harmful bacteria to food
       from other foods, cutting boards or utensils. Never place any type of
       food on a plate that previously held raw meat, poultry or seafood.
     ● When grilling foods, preheat the coals on your grill for 20 ? 30
        minutes, or until the coals are lightly coated with ash.
     ● Use a meat thermometer to insure that food reaches a safe internal
        temperature.
          o Hamburgers and ground poultry: 160o F.
          o Poultry parts: 170° F.
          o Roasts, steaks and other large cuts of beef: 145° F. (rare) and
            160o F.(medium)
          o Fish ? should be cooked until the meat is opaque and flakes
             easily.
     ● Use sanitized food and water bowls for your pets and be sure they
        do not drink from flood-contaminated surfaces.

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REMOVING CONTAMINATED FOODS:
     ● Dispose of food in a closed, waterproof, heavy duty garbage bag or similar closed container and place in a closed dumpster or other closed waste receptacle. Make sure bags are securely fastened.
     ● If food is particularly odorous, liquid or decomposed, it is recommended that it be double bagged to prevent leakage and subsequent attraction of vermin.
     ● If a closed waste receptacle is not available, use double bags for all food disposals.
     ● Thoroughly sanitize all areas that have come in contact with contaminated foods. A solution of one cap full of bleach to one gallon of clean water is recommended. Using a straight concentration of bleach is discouraged as it could cause toxins on the household surfaces.
     ● County Officials will typically provide additional waste pick-up after a storm.

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DEHYDRATION
To avoid becoming dehydrated, it is important to drink plenty of fluids, especially water. This is particularly true on days when temperatures reach 90º Fahrenheit and higher. Do not wait until you get thirsty; drink to prevent thirst.
     ● Babies from birth ? 6 months: healthy infants normally do not need extra water. On hot days, a small amount of water may be needed. Check with your physician on how much to give.
     ● Babies from 6 ? 12 months: breast or formula-fed babies receive some foods and juices that contain water. They should also be receiving water.
     ● Children 12 months and older: should be reminded to drink fluids,  preferable water, throughout the day. They should be encouraged to drink more on hot days.
     ● Adults should drink: when exposed to temperatures reaching 90º F and higher, depending on physical activity level and heat exposure, adults should drink even more water. The minimum recommendation for adults is at least 64 ounces of water each day (½ gallon).
Help to avoid becoming dehydrated by staying out of the direct sun, wearing light-colored, loose-fitting clothing, limiting physical activity and using fans when available.

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CONSERVING WATER
Hurricanes, especially if accompanied by a tidal surge or flooding, can contaminate the public water supply. Drinking contaminated water may cause illness. You cannot assume that the water in a hurricane-affected area is safe to drink as water treatment plants may not be operating. Even if they are operating, storm damage and flooding can contaminate water lines. Listen for public announcements about the safety of your specific water supply.
     Until services are fully restored every effort should be made to conserve water usage.
     ● Minimize the use of washing machines and the flushing of toilets; use only as necessary.
     ● Utilize portable toilets where provided.
     ● Fix any plumbing leaks as soon as possible.
     ● While lift stations and sewage treatment plants are out of power, avoid adding water to sewer lines as it may stop the proper function.
Report any sewage spills to proper utility authorities for clean up and sanitation. Such spills may be stabilized with an application of lime (calcium oxide). Restrict access to such areas for 48 hours after cleanup.

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TETANUS
With the amount of debris left by Hurricanes, residents working on clean-up efforts could be at risk of sustaining injuries. Not everyone needs to get a tetanus shot. Tetanus boosters are recommended every 10 years, however, if it has been more than 5 years since you received your last Tetanus shot and you receive a deep puncture wound, a wound that is more serious than a minor wound, or a wound that is dirty, you need to obtain a Tetanus booster. Any time you sustain a wound or deep cut that concerns you, seek medical attention.

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CARBON MONOXIDE POISONING
Carbon monoxide (CO) is an invisible, odorless, tasteless gas and is highly poisonous. It can cause tiredness, weakness, chest pains for those with heart disease, shortness of breath, nausea, vomiting, headaches, confusion, impaired vision, loss of consciousness, and, in severe cases, death.
Prevent carbon monoxide poisoning:
     ● Do not burn charcoal or gas grills inside a house, garage, vehicle, tent or fireplace.
     ● NEVER use gas-powered generators indoors, including in homes, garages, basements, crawl spaces, and other enclosed or partially enclosed areas, even with ventilation. Opening doors and windows or using fans will not prevent CO build-up in the home.
     ● ALWAYS locate the unit outdoors on a dry surface, away from doors, windows, vents, and air conditioning equipment that could allow CO to come indoors.
     ● Follow the instructions that come with your generator. Locate the unit
       outdoors and away from doors, windows, vents, and air conditioning
       equipment that could allow CO to come indoors.
     ● Install battery-operated CO alarms or plug-in CO alarms with battery back- up in your home, according to the manufacturer's installation instructions. The CO alarms should be certified to the requirements of the latest safety standards for CO alarms (UL 2034, IAS 6-96, or CSA 6.19.01).
     ● Test your CO alarms frequently and replace dead batteries.
     ● Remember that you cannot see or smell CO and portable generators can  produce high levels of CO very quickly.
     ● If you start to feel sick, dizzy, or weak while using a generator, get to fresh air RIGHT AWAY. DO NOT DELAY.
     ● If you have a poisoning emergency, call your nearest Florida Poison
       Information Center at 1-800-222-1222. If the victim has collapsed or is not breathing, call 911 immediately.

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WARNING SIGNS OF HEART ATTACK
     As you begin the task of recovery from a hurricane, health officials ask individuals, especially those performing heavy physical activity, to be aware of the warning signs of heart attacks.
     While some heart attacks are sudden and intense, many heart attacks start slowly, with mild pain or discomfort. If you, or someone you are with begins to have chest discomfort, especially with one or more of the other signs of a heart attack, call 9-1-1 right away.
Warning Signs of Heart Attack Include the Following
     ● Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
     ● Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
     ● Shortness of breath. May occur before, with or without chest discomfort.
     ● Other signs: Breaking out in a cold sweat, nausea or light-headedness.

What to do?
     If you or someone you're with shows one or more of these signs, don't ignore them. Call 9-1-1 to get medical help right away. Don't wait longer than a few minutes before calling for help.
     Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive ? up to an hour sooner than if someone gets to the hospital by car. The staff are also trained to revive someone whose heart has stopped. You'll also get treated faster in the hospital if you come by ambulance.
Plan Ahead
     ● Learn the heart attack warning signs.
     ● Talk with your health care provider about your heart attack risk and what you can do to reduce it.
     ● Talk with family, friends and coworkers about warning signs and calling   9-1-1.

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FIRE
Use battery-powered lanterns and flashlights. If you must use candles, put them in safe holders away from curtains, paper, wood, or other flammable items.

NEED FURTHER INFORMATION ABOUT A TOPIC COVERED IN THIS BOOKLET?
The Gadsden County Health Department responds to disasters to help ensure the health and safety of our residents and visitors. If you have a question about a topic covered in this booklet, please call the Health Department at 892-8015. Our regular office hours are Monday through Friday, 8:00 a.m. to 5:00 p.m. However, we do have an Environmental Health Inspector on call who can help you after a disaster.

FOR MORE INFORMATION:
  ● http://www.doh.state.fl.us
  ● www.floridadisaster.org
  ● Florida Emergency Information Line: 1-800-342-3557
  ● Public Information Emergency Support Function (Tallahassee):
     850-921-0384
  ● Gadsden County Emergency Management:  850-875-8642

                    
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