General Information Flu terms defined — Seasonal flu_ avian flu by gabyion

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									General Information

Flu terms defined — Seasonal flu, avian flu, and pandemic flu are
not the same.

Topics on this Page
What's Happening Now?                               What would be the Impact of a
Avian Influenza Viruses                             Pandemic?
Avian Influenza in Birds                            How are We Preparing?
Human Infection with Avian Influenza Viruses        Factsheets
Vaccination and Treatment for H5N1 Virus in         Frequently Asked Questions (FAQs)
Humans                                              History of Pandemics

What's Happening Now?
A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza
virus emerges for which people have little or no immunity, and for which there is no
vaccine. The disease spreads easily person-to-person, causes serious illness, and can
sweep across the country and around the world in very short time.

It is difficult to predict when the next influenza pandemic will occur or how severe it will
be. Wherever and whenever a pandemic starts, everyone around the world is at risk.
Countries might, through measures such as border closures and travel restrictions,
delay arrival of the virus, but cannot stop it.

Health professionals are concerned that the continued spread of a highly pathogenic
avian H5N1 virus across eastern Asia and other countries represents a significant threat
to human health. The H5N1 virus has raised concerns about a potential human
pandemic because:
     It is especially virulent
     It is being spread by migratory birds
     It can be transmitted from birds to mammals and in some limited circumstances
      to humans, and
     Like other influenza viruses, it continues to evolve.

Since 2003, a growing number of human H5N1 cases have been reported in
Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey, and
Vietnam. More than half of the people infected with the H5N1 virus have died. Most of
these cases are all believed to have been caused by exposure to infected poultry. There
has been no sustained human-to-human transmission of the disease, but the concern is
that H5N1 will evolve into a virus capable of human-to-human transmission.


http://www.pandemicflu.gov/general

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Avian Influenza Viruses
Avian (bird) flu is caused by influenza A viruses that occur naturally among birds. There
are different subtypes of these viruses because of changes in certain proteins
(hemagglutinin [HA] and neuraminidase [NA]) on the surface of the influenza A virus
and the way the proteins combine.

Each combination represents a different subtype. All known subtypes of influenza A
viruses can be found in birds. The avian flu currently of concern is the H5N1 subtype.

Avian Influenza in Birds
Wild birds worldwide carry avian influenza viruses in their intestines, but usually do not
get sick from them. Avian influenza is very contagious among birds and can make some
domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.

Infected birds shed influenza virus in their saliva, nasal secretions, and feces.
Domesticated birds may become infected with avian influenza virus through direct
contact with infected waterfowl or other infected poultry, or through contact with
surfaces (such as dirt or cages) or materials (such as water or feed) that have been
contaminated with the virus.

Avian influenza infection in domestic poultry causes two main forms of disease that are
distinguished by low and high extremes of virulence. The "low pathogenic" form may go
undetected and usually causes only mild symptoms (such as ruffled feathers and a drop
in egg production). However, the highly pathogenic form spreads more rapidly through
flocks of poultry. This form may cause disease that affects multiple internal organs and
has a mortality rate that can reach 90-100%, often within 48 hours. The H5N1 virus is
highly pathogenic.

Human Infection with Avian Influenza Viruses
"Human influenza virus" usually refers to those subtypes that spread widely among
humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and
H3N2) currently circulating among humans. It is likely that some genetic parts of current
human influenza A viruses originally came from birds. Influenza A viruses are constantly
changing, and other strains might adapt over time to infect and spread among humans.

The risk from avian influenza is generally low to most people, because the viruses do
not usually infect humans. H5N1 is one of the few avian influenza viruses to have
crossed the species barrier to infect humans, and it is the most deadly of those that
have crossed the barrier.

Most cases of H5N1 influenza infection in humans have resulted from contact with
infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces
contaminated with secretion/excretions from infected birds.

So far, the spread of H5N1 virus from person to person has been limited and has not
continued beyond one person. Nonetheless, because all influenza viruses have the
ability to change, scientists are concerned that H5N1 virus one day could be able to
infect humans and spread easily from one person to another.
http://www.pandemicflu.gov/general


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In the current outbreaks in Asia, Europe, and Africa, more than half of those infected
with the H5N1 virus have died. Most cases have occurred in previously healthy children
and young adults. However, it is possible that the only cases currently being reported
are those in the most severely ill people, and that the full range of illness caused by the
H5N1 virus has not yet been defined.

Symptoms of avian influenza in humans have ranged from typical human influenza-like
symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections,
pneumonia, severe respiratory diseases (such as acute respiratory distress), and other
severe and life-threatening complications. The symptoms of avian influenza may
depend on which virus caused the infection.

Because these viruses do not commonly infect humans, there is little or no immune
protection against them in the human population. If H5N1 virus were to gain the
capacity to spread easily from person to person, a pandemic (worldwide outbreak of
disease) could begin. No one can predict when a pandemic might occur. However,
experts from around the world are watching the H5N1 situation very closely and are
preparing for the possibility that the virus may begin to spread more easily and widely
from person to person.

For the most current information about avian influenza and cumulative case numbers,
see the on this site's home page.

For more information about human infection, see http://www.cdc.gov/flu/avian/gen-
info/avian-flu-humans.htm

Vaccination and Treatment for H5N1 Virus in Humans
There currently is no commercially available vaccine to protect humans against H5N1
virus that is being seen in Asia, Europe, and Africa. A pandemic vaccine cannot be
produced until a new pandemic influenza virus emerges and is identified.

The U.S. Department of Health and Human Services (HHS), through its National
Institute of Allergy and Infectious Diseases (NIAID), is addressing the problem in a
number of ways. These include the development of pre-pandemic vaccines based on
current lethal strains of H5N1, collaboration with industry to increase the Nation's
vaccine production capacity, and seeking ways to expand or extend the existing supply.
We are also doing research in the development of new types of influenza vaccines.




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                               Factsheets
Pandemics Death                What is an Influenza Pandemic? Read what an influenza
Toll Since 1900                pandemic is-learn about its characteristics & challenges.
1918-1919                      How Does Seasonal Flu Differ From Pandemic Flu?
                               Pandemic flu should not be confused with seasonal flu.
U.S....        675,000+        Learn the differences.
Worldwide... 50,000,000+       Avian Influenza (Bird Flu)
                               Read this short fact sheet about bird flu.
This as per the CDC.
                               Low-Pathogenicity H5N1 vs. High-Pathogenicity
1957-1958                      H5N1 (U.S. Department of Agriculture)
                               Find information on the differences between low-
U.S....        70,000+         pathogenicity and high-pathogenicity H5N1.
                               Frequently Asked Questions (FAQs)
Worldwide... 1-2,000,000       FAQs About Avian and Pandemic Flu
                               Find answers to questions about both avian and
1968-1969
                               pandemic influenza, including vaccines and antivirals.
U.S....        34,000+         History of Pandemics
                            Timeline of Human Flu Pandemics (National Institute of
Worldwide... 700,000+       Allergy and Infectious Diseases) See a chronology of
                            significant dates in pandemic influenza history.
Pandemics and Pandemic Threats since 1900
Learn about the three pandemics and several "pandemic threats" that have occurred.
The Deadly Virus: The Influenza Epidemic of 1918 (National Archives and Records
Administration) View archival documents and photos from the era of the Great
Pandemic of 1918.
The Great Pandemic of 1918: State by State
Read stories and anecdotes of the impact of the Great Pandemic in individual states.
Pandemic Influenza--Past, Present, Future: Communicating Today Based on the
Lessons from the 1918-1919 Influenza Pandemic These workshops provide a historical
retrospective review of the impact of the 1918–1919 influenza pandemic. A panel of
experts discusses how the 1918–1919 pandemic affected daily life in the United States,
and what lessons can be learned and applied to planning today.
The American Experience, Influenza 1918 (Public Broadcasting Service) Read the
history of "the worst epidemic the U.S. has ever known"
Influenza Pandemics of the 20th Century (Centers for Disease Control and Prevention)
Read the history of "the worst epidemic the U.S. has ever known"
Swine Influenza A Outbreak, Fort Dix, New Jersey, 1976 (Centers for Disease Control
and Prevention) Find out how the Swine Influenza A Outbreak affected the health of the
Fort Dix soldiers in 1976.
The Swine Flu Episode and the Fog of Epidemics (Centers for Disease Control and
Prevention) Read about the lessons learned from previous epidemics.
http://www.pandemicflu.gov/general                        Last revised: December 29, 2006

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Massachusetts State Summit History Supplement                   February 7, 2006
http://www.pandemicflu.gov/general/greatpandemic2.html#massachusetts
Opening Remarks Prepared for Delivery
By the Honorable Mike Leavitt, Secretary of Health and Human Services
The Great Pandemic also touched Massachusetts.
It first came here, to Boston. On August 27th, 1918, two sailors at Commonwealth Pier
reported in sick with influenza. The next day, there were eight. By the third day,
influenza had struck nearly 60 people.
That fire soon became an inferno, and within two weeks, 2,000 officers and men had
been struck.
On September 8th, a spark of influenza touched Camp Devens, a military camp near
Boston with about 50,000 soldiers. The conflagration that erupted is difficult to
comprehend.
A physician - known only as Roy - described the situation as it appeared in late
September. He wrote: "This epidemic started about four weeks ago, and has developed
so rapidly that the camp is demoralized and all ordinary work is held up till it has
passed....These men start with what appears to be an ordinary attack of . . . Influenza,
and when brought to the Hospital they very rapidly develop the most viscous type of
Pneumonia that has ever been seen.
Two hours after admission they have the Mahogany spots over the cheek bones, and a
few hours later you can begin to see the Cyanosis (pronounce "Cy-an-no-sis")
extending from their ears and spreading all over the face, until it is hard to distinguish
the colored men from the white.
It is only a matter of a few hours then until death comes, and it is simply a struggle for
air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die,
but to see these poor devils dropping like flies sort of gets on your nerves. We have
been averaging about 100 deaths per day, and still keeping it up."
The pandemic was just as dreadful for civilians. Scarcely six weeks after it touched the
first sailor on Commonwealth Pier, the pandemic was raging all across the state. By
October 1st, the Public Health Service estimated that there were at least 75,000 cases
in the state, excluding those from the military camps.
At that point, nearly 800 people had already died from influenza here in Boston. Another
200 had perished from pneumonia. By the time the next week ended, nearly 1,300 more
Bostonians had died.
By the time the pandemic finally passed, an estimated 45,000 people had perished in
Massachusetts. That is about two-thirds of a sellout crowd at a Patriots game, or more
than two consecutive sell-outs at Boston Garden.
When it comes to pandemics, there is no rational basis to believe that the early years of
the 21st century will be different than the past. If a pandemic strikes, it will come to
Massachusetts.

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What Is an Influenza
Pandemic?
A pandemic is a global disease outbreak. An influenza pandemic occurs when
a new influenza A virus emerges for which there is little or no immunity in
the human population, begins to cause serious illness and then spreads
easily person-to-person worldwide.

Historically, the 20th century saw 3 pandemics of influenza:

   1918 influenza pandemic caused at least 675,000 U.S. deaths and up to
    50 million deaths worldwide
   1957 influenza pandemic caused at least 70,000 U.S. deaths and 1-2
    million deaths worldwide
   1968 influenza pandemic caused about 34,000 U.S. deaths and 700,000
    deaths worldwide

Characteristics and challenges of a pandemic

    1. Rapid Worldwide Spread

      o When a pandemic influenza virus emerges, its global spread is
        considered inevitable.
      o Preparedness activities should assume that the entire world
        population would be susceptible.
      o Countries might, through measures such as border closures and
        travel restrictions, delay arrival of the virus, but cannot stop it.

    2. Health Care Systems Overloaded

      o Most people have little or no immunity to a pandemic virus.
        Infection and illness rates soar. A substantial percentage of the
        world’s population will require some form of medical care.
      o Nations unlikely to have the staff, facilities, equipment and hospital
        beds needed to cope with large numbers of people who suddenly
        fall ill.

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      o Death rates are high, largely determined by four factors: the
        number of people who become infected, the virulence of the virus,
        the underlying characteristics and vulnerability of affected
        populations and the effectiveness of preventive measures.
      o Past pandemics have spread globally in two and sometimes three
        waves.

   3. Medical Supplies Inadequate

      o The need for vaccine is likely to outstrip supply.
      o The need for antiviral drugs is also likely to be inadequate early in a
        pandemic.
      o A pandemic can create a shortage of hospital beds, ventilators and
        other supplies. Surge capacity at non-traditional sites such as
        schools may be created to cope with demand
      o Difficult decisions will need to be made regarding who gets antiviral
        drugs and vaccines.

   4. Economic and Social Disruption

      o Travel bans, closings of schools and businesses and cancellations of
        events could have major impact on communities and citizens.
      o Care for sick family members and fear of exposure can result in
        significant worker absenteeism.

Communications and Information are Critical Components of
Pandemic Response

Education and outreach are critical to preparing for a pandemic.
Understanding what a pandemic is, what needs to be done at all levels to
prepare for pandemic influenza, and what could happen during a pandemic
helps us make informed decisions both as individuals and as a nation.
Should a pandemic occur the public must be able to depend on its
government to provide scientifically sound public health information quickly,
openly and dependably. For additional information on pandemic influenza
visit: www.pandemicflu.gov.




http://www.pandemicflu.gov/general/whatis.html

Last revised: September 13, 2006




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Pandemic Planning Assumptions

1.1. Planning Assumptions

1.1.1. Susceptibility to the pandemic influenza virus will be universal.
1.1.2. Efficient and sustained person-to-person transmission signals an imminent
pandemic.
1.1.3. The clinical disease attack rate will likely be 30% or higher in the overall
population during the pandemic. Illness rates will be highest among school-aged
children (about 40%) and decline with age. Among working adults, an average of 20%
will become ill during a community outbreak.
       1.1.3.1. Some persons will become infected but not develop clinically significant
       symptoms. Asymptomatic or minimally symptomatic individuals can transmit
       infection and develop immunity to subsequent infection.
1.1.4. Of those who become ill with influenza, 50% will seek outpatient medical care.
       1.1.4.1. With the availability of effective antiviral drugs for treatment, this
       proportion may be higher in the next pandemic.
1.1.5. The number of hospitalizations and deaths will depend on the virulence of the
pandemic virus. Estimates differ about 10-fold between more and less severe
scenarios. Two scenarios are presented based on extrapolation of past pandemic
experience (Table 1). Planning should include the more severe scenario.
       1.1.5.1. Risk groups for severe and fatal infection cannot be predicted with
       certainty but are likely to include infants, the elderly, pregnant women, and
       persons with chronic medical conditions.
1.1.6. Rates of absenteeism will depend on the severity of the pandemic.
       1.1.6.1. In a severe pandemic, absenteeism attributable to illness, the need to
       care for ill family members, and fear of infection may reach 40% during the peak
       weeks of a community outbreak, with lower rates of absenteeism during the
       weeks before and after the peak.
       1.1.6.2. Certain public health measures (closing schools, quarantining household
       contacts of infected individuals, ―snow days‖) are likely to increase rates of
       absenteeism.
1.1.7. The typical incubation period (interval between infection and onset of symptoms)
for influenza is approximately 2 days.



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                      Emergency Water and Food Supplies
http://www.fema.gov/pdf/library/f&web.pdf

If an earthquake, hurricane, winter storm, or other disaster strikes your community, you
might not have access to food, water, and electricity for days or even weeks. By taking
some time now to store emergency food and water supplies, you can provide for your
entire family.

EMERGENCY WATER SUPPLIES
Having an ample supply of clean water is a top priority in an emergency. A normally
active person needs to drink at least two quarts (half gallon) of water each day. People
in hot environments, children, nursing mothers, and ill people will require even more.

You will also need water for food preparation and hygiene. Store at least one gallon per
person, per day. Consider storing at least a two-week supply of water for each member
of your family. If you are unable to store this quantity, store as much as you can.

If supplies run low, never ration water. Drink the amount you need today, and try to find
more for tomorrow. You can minimize the amount of water your body needs by reducing
activity and staying cool.

PREPARE AND STORE AN EMERGENCY SUPPLY OF WATER
To prepare the safest and most reliable emergency supply of water, it is recommended
that you purchase commercially bottled water. Keep bottled water in its original
container, and do not open it until you need to use it. Store bottled water in the original
sealed container, and observe the expiration or ―use by‖ date.

If You Are Preparing Your Own Containers of Water...
It is recommended to purchase food-grade water storage containers from surplus or
camping supplies stores to use for water storage.

If you decide to re-use storage containers, choose two-liter plastic soft drink bottles –
not plastic jugs or cardboard containers that have had milk or fruit juice in them. The
reason is that milk protein and fruit sugars cannot be adequately removed from these
containers and provide an environment for bacterial growth when water is stored in
them. Cardboard containers leak easily and are not designed for long-term storage of
liquids. Also, do not use glass containers, because they are heavy and may break.

Preparing Water Containers
 Thoroughly clean the bottles with dishwashing soap and water, and rinse completely
   so there is no residual soap.

   Additionally, for plastic soft drink bottles, sanitize the bottles by adding a solution of 1
    teaspoon of non-scented liquid household chlorine bleach to a quart (1/4 gallon) of
    water. Swish the sanitizing solution in the bottle so that it touches all surfaces. After
    sanitizing the bottle, thoroughly rinse out the sanitizing solution with clean water.


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Filling Water Containers
 Fill the bottle to the top with regular tap water. (If your water utility company treats
    your tap water with chlorine, you do not need to add anything else to the water to
    keep it clean.) If the water you are using comes from a well or water source that is
    not treated with chlorine, add two drops of non-scented liquid household chlorine
    bleach to each gallon of water.

   Tightly close the container using the original cap. Be careful not to contaminate the
    cap by touching the inside of it with your fingers. Write the date on the outside of the
    container so that you know when you filled it. Store in a cool, dark place.

   Replace the water every six months if not using commercially bottled water.

HIDDEN WATER SOURCES IN YOUR HOME
Safe water sources in your home include the water in your hot- water tank, pipes, and
ice cubes. You should not use water from toilet flush tanks or bowls, radiators,
waterbeds, or swimming pools/spas.

You will need to protect the water sources already in your home from contamination if
you hear reports of broken water or sewage lines, or if local officials advise you of a
problem. To shut off incoming water, locate the main valve and turn it to the closed
position. Be sure you and other family members know beforehand how to perform this
important procedure.

To use the water in your pipes, let air into the plumbing by turning on the faucet in your
home at the highest level. A small amount of water will trickle out. Then obtain water
from the lowest faucet in the home.

To use the water in your hot-water tank, be sure the electricity or gas is off, and open
the drain at the bottom of the tank. Start the water flowing by turning off the water intake
valve at the tank and turning on a hot-water faucet. Refill the tank before turning the gas
or electricity back on. If the gas is turned off, a professional will be needed to turn it
back on.

EMERGENCY OUTDOOR WATER SOURCES
If you need to find water outside your home, you can use these sources. Be sure to
treat the water according to the instructions in the next section before drinking it.

   Rainwater
   Streams, rivers, and other moving bodies of water
   Ponds and lakes
   Natural springs

Avoid water with floating material, an odor, or dark color. Use saltwater only if you distill
it first. You should not drink flood water.



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WAYS TO TREAT WATER
The instructions below are for treating water of uncertain quality in rare emergency
situations in the absence of instructions from local authorities when no other reliable
clean water source is available and you have used all of your stored water. If you store
enough water in advance, you will not need to treat water using these or other methods.

In addition to having a bad odor and taste, contaminated water can contain
microorganisms (germs, bacteria, and viruses) that cause diseases such as dysentery,
typhoid, and hepatitis. You should treat all water of uncertain quality before using it for
drinking, food preparation, or hygiene.

There are many ways to treat water, though none are perfect. Often the best solution is
a combination of methods.

Boiling or chlorination will kill most microorganisms but will not remove other
contaminants such as heavy metals, salts, and most other chemicals. Before treating,
let any suspended particles settle to the bottom, or strain them through layers of paper
towel, clean cloth, or coffee filter.

Boiling
Boiling is the safest method of treating water. In a large pot or kettle, bring water to a
rolling boil for 1 full minute, keeping in mind that some water will evaporate. Let the
water cool before drinking.

Boiled water will taste better if you put oxygen back into it by pouring the water back
and forth between two clean containers. This will also improve the taste of stored water.

Chlorination
You can use household liquid bleach to kill microorganisms. Use only regular household
liquid bleach that contains 5.25 to 6.0 percent sodium hypochlorite. Do not use scented
bleaches, colorsafe bleaches, or bleaches with added cleaners. Because the potency of
bleach diminishes with time, use bleach from a newly opened or unopened bottle.

Add 16 drops (1/8 teaspoon) of bleach per gallon of water, stir and let stand for 30
minutes. The water should have a slight bleach odor. If it doesn’t, then repeat the
dosage and let stand another 15 minutes. If it still does not smell of bleach, discard it
and find another source of water.

Other chemicals, such as iodine or water treatment products (sold in camping or surplus
stores) that do not contain 5.25 to 6.0 percent sodium hypochlorite as the only active
ingredient, are not recommended and should not be used.

Distillation
While the two methods described above will kill most microorganisms in water,
distillation will remove microorganisms that resist these methods, as well as heavy
metals, salts, and most other chemicals.

Distillation involves boiling water and then collecting the vapor that condenses back to
water. The condensed vapor will not include salt or most other impurities. To distill, fill a
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pot halfway with water. Tie a cup to the handle on the pot’s lid so that the cup will hang
right-side-up when the lid is upside-down (make sure the cup is not dangling into the
water), and boil the water for 20 minutes. The water that drips from the lid into the cup is
distilled. (See illustration.)




EMERGENCY FOOD SUPPLIES
Even though it is unlikely that an emergency would cut off your food supply for two
weeks, consider maintaining a supply that will last that long.

You may not need to go out and buy foods to prepare an emergency food supply. You
can use the canned goods, dry mixes, and other staples on your cupboard shelves. Be
sure to check expiration dates and follow the practice of first-in, first-out.

PREPARING AN EMERGENCY FOOD SUPPLY
As you stock food, take into account your family’s unique needs and tastes. Familiar
foods are important. They lift morale and give a feeling of security in times of stress. Try
to include foods that they will enjoy and that are also high in calories and nutrition.
Foods that require no refrigeration, water, special preparation, or cooking are best.

Individuals with special diets and allergies will need particular attention, as will babies,
toddlers, and the elderly. Nursing mothers may need liquid formula, in case they are
unable to nurse. Canned dietetic foods, juices, and soups may be helpful for ill or elderly
people.

Make sure you have a manual can opener and disposable utensils. Don’t forget
nonperishable foods for your pets.

STORAGE TIPS
 Keep food in a dry, cool spot—a dark area if possible.
 Open food boxes and other re-sealable containers carefully so that you can close
  them tightly after each use.
 Wrap perishable foods, such as cookies and crackers, in plastic bags and keep them
  in sealed containers.


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   Empty open packages of sugar, dried fruits, and nuts into screw-top jars or air-tight
    canisters for protection from pests.
   Inspect all food for signs of spoilage before use.
   Throw out canned goods that become swollen, dented, or corroded.
   Use foods before they go bad, and replace them with fresh supplies, dated with ink
    or marker. Place new items at the back of the storage area and older ones in front.

SHELF-LIFE OF FOODS FOR STORAGE
The following provides some general guidelines for replacement of common emergency
foods.

Use within six months:
 Powdered milk - boxed
 Dried fruit
 Dry, crisp crackers
 Potatoes

Use within one year, or before the date indicated on the label:
 Canned condensed meat and vegetable soups
 Canned fruits, fruit juices, and vegetables
 Ready-to-eat cereals and uncooked instant cereals
 Peanut butter
 Jelly
 Hard candy and canned nuts
 Vitamins

May be stored indefinitely (in proper containers and conditions):
 Wheat
 Vegetable oils
 Dried corn
 Baking powder
 Soybeans
 Instant coffee, tea, and cocoa
 Salt
 Noncarbonated soft drinks
 White rice
 Bouillon products
 Dry pasta
 Powdered milk – in nitrogen-packed cans




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IF THE ELECTRICITY GOES OFF …

   FIRST... Use perishable food from the refrigerator, pantry, garden, etc.

   THEN... Use the foods from the freezer. To limit the number of times you open the
    freezer door, post a list of freezer contents on it. In a well-filled, well-insulated
    freezer, foods will usually still have ice crystals in their centers (meaning foods are
    safe to eat) for at least two days. Check to make sure the seal on your freezer door
    is still in good condition.

   FINALLY... Begin to use non-perishable foods and staples.

HOW TO COOK IF THE POWER GOES OUT
For emergency cooking indoors, you can use a fireplace. A charcoal grill or camp stove
can be used outdoors. You can keep cooked food hot by using candle warmers, chafing
dishes, and fondue pots. Use only approved devices for warming food. Canned food
can be eaten right out of the can. If you heat it in the can, be sure to open the can and
remove the label before heating. Always make sure to extinguish open flames before
leaving the room.

WHEN FOOD SUPPLIES ARE LOW
If activity is reduced, healthy people can survive on half their usual food intake for an
extended period and without any food for many days. Food, unlike water, may be
rationed safely, except for children and pregnant women.

If your water supply is limited, don’t eat salty foods, since they will make you thirsty.
Instead, eat salt-free crackers, whole grain cereals, and canned foods with high liquid
content.

NUTRITION TIPS
During and after a disaster, it is vital that you maintain your strength. Remember the
following:

   Eat at least one well-balanced meal each day.
   Drink enough liquid to enable your body to function properly (two quarts or a half
    gallon per day).
   Take in enough calories to enable you to do any necessary work.
   Include vitamin, mineral, and protein supplements in your stockpile to ensure
    adequate nutrition.

DISASTER SUPPLIES KIT
In the event you need to evacuate at a moment’s notice and take essentials with you,
you probably will not have the opportunity to shop or search for the supplies you and
your family will need. Every household should assemble a disaster supplies kit and
keep it up to date.

A disaster supplies kit is a collection of basic items a family would probably need to stay
safe and be more comfortable during and after a disaster. Disaster supplies kit items

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should be stored in a portable container(s) near, or as close as possible to, the exit
door. Review the contents of your kit at least once per year or as your family needs
change. Also, consider having emergency supplies in each vehicle and at your place of
employment.

The following should be included in your basic disaster supplies kit:
 Three-day supply of nonperishable food and manual can opener.
 Three-day supply of water (one gallon of water per person, per day).
 Portable, battery-powered radio or television, and extra batteries.
 Flashlight and extra batteries.
 First aid kit and manual.
 Sanitation and hygiene items (hand sanitizer, moist towelettes, and toilet paper).
 Matches in waterproof container.
 Whistle.
 Extra clothing and blankets.
 Kitchen accessories and cooking utensils.
 Photocopies of identification and credit cards.
 Cash and coins.
 Special needs items such as prescription medications, eye glasses, contact lens
   solution, and hearing aid batteries.
 Items for infants, such as formula, diapers, bottles, and pacifiers.
 Tools, pet supplies, a map of the local area, and other items to meet your unique
   family needs.

Learn More
The Federal Emergency Management Agency’s Community and Family Preparedness
Program and American Red Cross Community Disaster Education are nationwide
efforts to help people prepare for disasters of all types.

For more information, please contact your local emergency management office or
American Red Cross chapter. This booklet and the preparedness materials listed below
are online at www.fema.gov and www.redcross.org. Other preparedness materials are
available at these sites, as well as at www.ready.gov.

These publications are also available by calling FEMA at 1-800-480-2520, or writing:
FEMA
P.O. Box 2012
Jessup, MD 20794-2012

Publications with an ―A‖ number are available from your local American Red Cross
chapter.
 Are You Ready? An In-depth Guide to Citizen Preparedness (IS-22)
 Preparing for Disaster (FEMA 475) (A4600)
 Preparing for Disaster for People with Disabilities & other Special Needs (FEMA
   476) (A4497)
 Helping Children Cope with Disaster (FEMA 478) (A4499)
http://www.fema.gov/pdf/library/f&web.pdf                Last updated August 2004

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Understanding Flu Terms
Flu terms defined- Seasonal - Avian - and Pandemic flus are not the same.
                      News                                       Resources
                Jan 02 — NIAID DNA Vaccine for
                         H5N1 Avian Influenza                     Federal Progress
                         Enters Human Trial News                  Report
                         Release >>
Analysis of     Dec 29 — Molecular Anatomy of                     Planning Checklists
avian influenza          Influenza Virus Detailed
                                                                  (En Español)
sampling.                More >>
 [Credit FWS] Dec 18 — Report Issued
                         Summarizing Federal                      *Planning Tools
                         Department/Agency
                         Pandemic Planning                       Pandemic Influenza
                         Actions to Date More >>                 Preparedness,
                Dec 11 — U.S. International Avian                Response, and
                         and Pandemic Influenza                  Recovery Guide for
                         Assistance Tops $434                    Critical Infrastructure
                         Million More >>                         and Key Resources
                                                                 (PDF - 3.91 MB)
                      News Archive >>      News
                      Releases    Site Updates
Nations With Confirmed                  Where you live
Cases H5N1 Avian Influenza
(July 7, 2006)




Click on map for larger image
                                        Selecting this map will take you to a page with
Confirmed Human Cases by Country
                                        links to state pandemic planning information, state
[Note: Numbers are confirmed by
                                        pandemic Web site information, and local state
World Health Organization and may not
                                        contacts.
reflect news or country reports.]
http://pandemicflu.gov

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Planning Tools
Pandemic planning requires understanding the actions and priorities required
to prepare for and respond to crisis. This page links to tools and software
programs to assist state and local agencies in that preparation.

       FluAid (Centers for Disease Control and Prevention)
        Software designed to assist state and local level planners in preparing
        for the next influenza pandemic by providing estimates of potential
        impact specific to their locality.
       FluSurge (Centers for Disease Control and Prevention)
        Spreadsheet-based model which provides hospital administrators and
        public health officials estimates of the surge in demand for hospital-
        based services during the next influenza pandemic.
       Instructions to Estimate the Potential Impact of the Next Influenza
        Pandemic Upon Locale Y (Centers for Disease Control and Prevention)
        Downloadable instructions for FluAid and FluSurge software; includes
        a template of a draft report.
       Tabletop Exercises for Pandemic Influenza Preparedness in Local
        Public Health Agencies (Office of Public Health Emergency
        Preparedness (OPHEP) Provides customizable tabletop exercises to
        test the relationships between local public health agencies and their
        local health care delivery and governmental partners in response to a
        pandemic flu emergency. Prepared under contract to OPHEP by the
        Rand Corporation.
       Facilitated Look Backs - A New Quality Improvement Tool for
        Management of Routine Annual and Pandemic Influenza (Office of
        Public Health Emergency Preparedness (OPHEP) Describes a tool that
        public health agencies can adopt to regularly "look back" at each
        routine annual influenza season and draw lessons from for pandemic
        influenza preparedness activities. Prepared under contract to OPHEP
        by the Rand Corporation.



http://pandemicflu.gov/plan/tools.html           Last revised: December 15, 2006




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