Our Latest Perspectives Posts

A Fun Holiday Hand-washing Activity for Kids

As our families and friends gather to celebrate the holidays, we look forward to enjoying good company, delicious food and exchanging gifts. One aspect of the holidays we don’t enjoy, however, is exchanging the germ du jour.

Many adults are aware that frequent hand-washing—and hand sanitizer use in a pinch–can help avoid the “re-gifted” germs that cause colds, flu, the stomach bug (norovirus) and more. The Centers for Disease Control and Prevention tell us that hand-washing is one of the most important steps we can take to avoid getting sick and spreading germs to others, so how can we help the children in our lives practice proper hand hygiene?

The American Cleaning Institute offers a fun resource for children to “Create a colorful holiday!” with its “Clean Your Paws for Santa Claus Coloring Page.” The image caption clarifies that handwashing “with soap and warm water for 20 seconds” precedes the reward of reaching for a cookie. Why not print out a few copies and share them with the children at your holiday gathering?

Here’s wishing you Happy, Healthy Holidays!

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Handkerchief or Tissues? That is the Question!

Whether you use a handkerchief or tissues when you are sick, leaving them out on a common surface only helps spread your germs.

Whether you use a handkerchief or tissues when you are sick, leaving them out on a common surface only helps spread your germs.

Ah-choo! How do you handle sneezes and a runny nose? Do you reach for a handkerchief or tissues? Which option is more sanitary? Which option is most environmentally responsible? How do affordability, comfort and convenience factor into your decision? More men than women may prefer handkerchiefs, but that may be changing. Rather than endorse one option over another, we provide the following analysis for your consideration.



Comparing Handkerchiefs and Tissues

Handkerchief Tissues
How Sanitary? Handkerchiefs are adequately sanitary if stored away immediately after use (e.g., in a pocket or purse), followed by the user washing his or her hands. (Exposure risk remains for the person laundering handkerchiefs.) Tissues are adequately sanitary if disposed of immediately after use, followed by the user washing his or her hands. (Exposure risk remains for the person removing trash.)
How Environmentally Responsible? Laundered handkerchiefs can be reused many times. Laundering and ironing require energy, water, detergent and sanitizer (see directions below for sanitizing with bleach). Tissues are manufactured from a renewable resource using energy, water and chemicals. Used tissues can be composted, or they enter the general waste stream.
How Comfortable and Convenient? Handkerchiefs can be purchased to please the user’s preferences in fabric and size. They can be laundered to enhance softness (e.g., with fabric softener). Portable tissue packets are available as well as a range of tissue box shapes and sizes. Tissues pre-moistened with aloe and other products are also available to help soothe irritated skin.


How to Launder Cotton or Poly/cotton Handkerchiefs

According to the Clorox website, soak chlorine-bleachable laundry in ¼ cup regular bleach per gallon of water or 3 tablespoons of concentrated bleach per gallon of water for up to 5 minutes. Rinse. Follow-up with a hot water machine wash using detergent and bleach.

Our advice is to choose the option you prefer based on the factors that mean the most to you. Whichever choice you make, help reduce the likelihood of spreading germs by staying mindful that germs go wherever nasal mucous goes. For example, blowing your nose and leaving the handkerchief or tissues in the open may infect others in your living or work space. Not washing your hands (or at least using a hand sanitizer) after blowing your nose is another way to spread your illness to others through commonly touched surfaces. What is the “life cycle” of the item used to wipe your nose? How can you minimize the risk of spreading germs through that item? It’s not rocket science, but it is worth some thought.


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What Cooking Shows Don’t Teach

Want to know how to prepare a delicious recipe? Tune in to a TV cooking show. Just don’t expect to view some of the most important cooking steps! According to a new study1 in the Journal of Nutrition Education and Behavior (abstract), today’s cooking shows are missing “an opportunity to model and teach good food safety practices for millions of viewers.” In fact, the researchers found in 39 episodes from 10 television cooking shows, the majority of episodes failed to demonstrate:

  • Proper use of utensils and gloves
  • Protection from contamination
  • Maintaining time and temperature rules

Foodborne Illness: Learn from “Maria”

How to Sanitize Kitchen Surfaces with Chlorine Bleach Solution

  1. Clean: Wash hard surfaces with hot, soapy water, then rinse with clear water.
  2. Sanitize: Apply a solution made by adding ½ tablespoon of chlorine bleach2 to ½ gallon of water. Air dry.
Bleach solutions break down over time, turning into salty water, so prepare bleach solutions daily. Never mix ammonia-containing cleaners with bleach.

Each year there are 48 million cases of foodborne illness in the US, including 128,000 hospitalizations and 3,000 deaths. Foodborne illnesses, most of which are infections caused by bacteria, viruses and parasites, can even have long-term health consequences, according to the Centers for Disease Control and Prevention (CDC). To highlight some of the most common food safety mistakes, CDC developed a series of short cooking show style videos called “Recipes for Disaster.” Viewers are invited to learn the right steps in food preparation as the fictional cook “Maria” does everything wrong. In “Contaminated Carbo Load,” for example, Maria chops vegetables on an unwashed and unsanitized cutting board that previously held raw chicken and bacon. In “Bacteria BBQ,” Maria leaves steaks marinating on the counter overnight, “just as her Nanna did.” Maria’s family and friends enjoy her cooking but hours later suffer the consequences of her cooking mistakes.

Missed Opportunities

The new study by Cohen and Olson cites a recent Harris Poll that finds “50% of consumers reported watching many of the hundreds of television cooking shows very often or occasionally.” Unfortunately, the researchers found that the percentage of shows in conformance with recommended food safety practices was much lower than that observed in restaurant employees and consumers. For example, as the authors note, fruits and vegetables are the leading sources of foodborne illness in the US, yet less than 10% of the food shows they viewed demonstrated handling produce properly. Additionally, in only 13% of episodes were food safety practices even mentioned.

Recommendations of the study authors include:

  • Food safety training for chefs and food show contestants
  • Modifying TV kitchen sets to support food safety actions, such as incorporating sinks to use for hand-washing and featuring different colored cutting boards for separate use when handling raw meats and vegetables
  • Adding food safety as a criterion in TV cooking competitions
  • Discussing food safety in cooking show scripts, such as demonstrating the proper use of food thermometers and when to change gloves or wash hands

TV cooking shows have a wonderful but underutilized opportunity to demonstrate more than the latest and greatest ways to stuff zucchini or roast a chicken. Modeling good food safety practices for millions of viewers could go a long way toward reducing foodborne illness.


Barbara M. Soule, R.N. MPA, CIC, FSHEA, FAPIC is an Infection Preventionist and a member of the Water Quality & Health Council.

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1 Cohen, N.L. and Olson, R.B. (2016). “Compliance with Recommended Food Safety Practices in Television Cooking Shows,” Journal of Nutrition Education and Behavior, Vol. 48, pp. 730-735.

2 Directions are for 5.25% bleach. Decrease amount of bleach to 1 teaspoon per half-gallon if using 8.25% bleach.



The Black Friday Shoppers’ Health and Safety Survival Guide

Determined to brave the traffic, crowds and general madness of Black Friday, many shoppers strike out to take advantage of deep discounts on holiday goods. We offer tips to help ensure shoppers return home from these shopping adventures safely and in good health.

Safety First

  • As exciting as it is to get to the sales early, don’t compromise safety when driving or walking to the shops. Obey traffic and pedestrian rules—arrive alive and unharmed. Exercise extra caution driving and walking in packed parking lots.
  • Reduce your chances of being caught and injured in a stampede at “door buster” sales. It’s better to hang back or off to the side than to risk injury in a rushing crowd.

Be a Healthy Shopper

  • Be mindful that frequently touched surfaces such as door handles and electronic key pads are drop off and pick-up points for germs. Keep your hands away from your face while shopping, and make frequent use of portable hand sanitizer.
  • Use your knuckle instead of the pad of your finger to depress elevator keys or automatic door openers.
  • Using a public restroom? Use a clean tissue or paper towel to act as a barrier between you and the restroom door handle as you enter and exit. Wash your hands thoroughly after using the restroom.
  • Cough and sneeze into a tissue or into the crook of your elbow to prevent germs spreading to your fellow shoppers.
  • Did you remember to get a flu shot? The flu vaccine is recommended for all people over the age of six months, with rare exception. It’s not too late to get one now, but next year remember, “Vaccine by Halloween” for the timeliest protection against the seasonal flu. See your doctor if you have questions about the flu vaccine.
  • Stay home on Black Friday if you are sick. Considering how many people you could potentially infect in mobbed shopping centers, online bargain shopping just might be the kinder, gentler option when you are under the weather. And remember: Cyber Monday is only three days after Black Friday.
  • Recognizing that some of the best sales begin very early in the day, consider putting your egg nog down on Thanksgiving night and getting a good night’s sleep.

Happy Bargain Hunting!

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Holiday Food Safety and the Foodkeeper App

A beautifully arranged holiday dinner table is a feast for the senses. Occasionally, however, festive fare that looks perfectly delectable can sicken unsuspecting diners. There are many ways in which the “perfect” holiday dinner can go horribly wrong. Fortunately, most foodborne illness can be avoided when cooks maintain and apply a keen awareness of the basics of food safety. Add to that a new “app” issued by the US Department of Agriculture (USDA), and safe food storage and preparation can be a snap this holiday season.

Food Safety Basics

“Clean” starts with the cooks washing their hands with soap and warm water before and after handling any food item (not just raw animal or vegetable products). Food preparation surfaces, such as cutting boards and countertops, should be thoroughly washed with soap and hot water, followed by sanitizing with a solution of one tablespoon of unscented, liquid chlorine bleach per gallon of water. Air-dry.

“Separate” foods so that juices from raw meats, poultry and seafood, which can contain harmful bacteria, do not contact ready-to-eat food. Place raw meats, poultry and seafood in plastic bags in the refrigerator to prevent their juices from dripping onto other food. To lower the risk of accidental dripping, place those plastic bags on the lowest shelves of the refrigerator.

Designate one cutting board for raw fruits and vegetables and another for raw meats, poultry and seafood.

Never place cooked food back on the same plate that previously held raw food unless the plate has first been washed in hot, soapy water.

“Cook” foods to safe minimum internal temperatures to destroy harmful bacteria. The food thermometer should be placed in the thickest part of the food, away from bone, fat or gristle. According to the Foodsafety.gov website, poultry, including chicken, turkey, duck and goose, should be cooked to a minimum internal temperature of 165 degrees F.

“Chill” foods that should be refrigerated at 40 degrees F or below. Defrost frozen foods in the refrigerator, microwave or cold water. Do not leave food at room temperature for more than 2 hours (or 1 hour when the air temperature is 90 degrees F or more). Meat defrosted in the refrigerator is safe to re-freeze before or after cooking. Foods defrosted in the microwave or cold water must be cooked before freezing. Store eggs in the refrigerator in their original carton and use within three to five weeks.

An App for the Kitchen

The new “Foodkeeper” app, developed by the USDA’s Food Safety and Inspection Service, with Cornell University and the Food Marketing Institute, was designed to help consumers understand and optimize food and beverage storage. The app is available for Android and Apple devices.

Here is a sampling of the type of information available through the Foodkeeper app:

  • Cooked poultry dishes (e.g., turkey and chicken) last 3 to 4 days when stored in the refrigerator and 4 to 6 months if stored frozen. Poultry should be cooked in an oven to a safe minimum temperature of 165 degrees F.
  • Fresh potatoes last 1 to 2 months in the pantry (the recommended storage method for whole potatoes) and 1 to 2 weeks in the refrigerator (refrigerating potatoes is not recommended as potatoes may darken during cooking and develop an unpleasantly sweet taste1 )
  • Bagged greens, such as spinach and lettuce, last 3 to 5 days after the date on the bag when stored in the refrigerator, and 2 days if refrigerated after opening. Freezing bagged greens is not recommended.
  • Hard cheeses such as cheddar, Swiss and block parmesan last 6 months in the refrigerator before opening, and 3 to 4 weeks in the refrigerator after opening, but 6 months if stored frozen.
  • Ready to Bake Pie Crust should be used by the date indicated on the package when stored in the refrigerator, but can last up to 2 months if stored in the freezer.
  • Whipped, sweetened cream lasts 1 day when stored in the refrigerator and 1 to 2 months if stored frozen.
  • Fruit juice and punch in cartons last 3 weeks in the pantry, 7 to 12 days in the pantry if stored after opening, and 8 to 12 days if refrigerated after opening.

Keep the four food safety basics in mind as you gear up for holiday cooking. And remember the Foodkeeper app, which can help you decide on the usability of ingredients. Finally, trust your instincts: If a food or drink looks suspect, follow the old adage, “When in doubt, throw it out.”

Here’s wishing you a happy and safe Holiday Season!

Linda F. Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality and Health Council.

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1 The recommendation not to refrigerate potatoes comes from the United States Potato Board.



Five Tips for Getting through Flu Season

The 2016–2017 flu season is off to a slow start, but the Centers for Disease Control and Prevention (CDC) predicts an uptick in flu activity in the coming weeks and months. Here are some tips to help prepare and inform you as flu appears in your community:
Flu Season Ahead

  1. Get a Flu Shot: CDC recommends a flu shot for everyone six months old and older. Flu vaccines protect against the three or four flu viruses most likely to spread in a given season. What segments of the population are most vulnerable to flu-related complications? The very young, people aged 65 and older, pregnant women, and people with chronic health conditions such as asthma, diabetes or heart and lung disease are most at risk for complications.

To help avoid spreading the flu to those in their care, health care workers and people who care for vulnerable populations, including families of babies under the age of six months, should be sure to get their flu shot.

Maximum immune system protection against the flu takes about two weeks from the time of vaccination. CDC advises people to get their flu shots each year by the end of October. Some health departments are proclaiming: “Vaccine before Halloween!”1 This year’s breaking news on flu is that the nasal spray is not recommended by CDC because its effectiveness is in question.

  1. Wash Your Hands: Washing your hands frequently and thoroughly is one of the most important ways to elude the flu. Flu virus particles are very good at hitching a ride from contaminated surfaces (door knobs and hand rails, for example)—where they gather like airline passengers at a departure gate—to your hands and then for the “flight” to your eyes, nose and mouth. Viruses can only spread by infecting new hosts, and they appreciate not being washed down the drain. Give them the slip with thorough hand washing (use alcohol-based hand rub if soap and water are unavailable), and keep your hands away from your face.
  1. Disinfect Frequently Touched Surfaces: Destroy flu virus particles where they lurk to lower your odds of picking them up and becoming infected. Clean surfaces first with detergent and water and then sanitize using two teaspoons of high strength household bleach (8.25%) per gallon of water. Alternatively, wipe down surfaces with disposable pre-moistened wipes containing chlorine bleach.
  1. Maintain a Healthy Lifestyle: Get adequate sleep, maintain a healthy diet, stay hydrated and exercise regularly to keep your immune system on alert against flu and other infections.
  1. Be Kind to Others: If you do get the flu, stay home and limit your contact with others. Cover your coughs and sneezes with a disposable tissue and wash your hands after using tissues. Tissues not available? Cough or sneeze into your elbow to help prevent projecting thousands of infected mucous droplets into the air that others breathe! Finally, keep your distance from those who appear to have flu symptoms but have opted to be out and about anyway.

Not sure if you have the flu or a cold? Use this chart to help you decide. For more information on the seasonal flu, please see this CDC website.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

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1 See, for example, this WJHG.com video.



Norovirus and Chlorine Bleach: The Perfect Pathogen Meets its Match

Colorized transmission electron micrograph of norovirus particles

Colorized transmission electron micrograph of norovirus particles

Courtesy of CDC/ Charles D. Humphrey


Is there such a thing as a “perfect” human pathogen? If by perfect we mean a disease-causing microorganism that is highly contagious; quickly and profusely shed in the environment by its hosts; and able to evolve rapidly to both avoid widespread human immunity and ensure a large pool of susceptible hosts, then norovirus comes very close. Norovirus expert Dr. Aron Hall of the Centers for Disease Control and Prevention’s (CDC’s) Division of Viral Diseases cleverly entertained the notion that noroviruses could be the perfect human pathogens in a 2012 editorial commentary.1

Notorious Norovirus

Sometimes referred to as “the stomach bug,” and infamous for spreading through cruise ships, norovirus is responsible for some 19-21 million cases of gastrointestinal illness in the US annually.2 The very young, the very old and the immunocompromised are especially vulnerable to norovirus. It is the most common cause of foodborne illness in the US—responsible for at least 50,000 hospitalizations and between 570 and 800 deaths annually.3 But norovirus respects no borders. It is a global player. Found in both developed and developing countries, it is the main cause of half of all gastroenteritis outbreaks worldwide. A 2016 analysis4 estimated the virus’ global economic burden at $60 billion, the largest share of which ($56 billion) is lost productivity.

Means of Transmission

Norovirus is spread in three main ways: (1) close personal contact with an infected individual; (2) ingesting contaminated food or water; and (3) contact with contaminated surfaces. Norovirus can be transmitted by ingesting food contaminated at the source (e.g., fruits and vegetables) or by infected food handlers. (Food handlers who return to work sooner than 48 hours after they no longer have symptoms can still spread norovirus.5 ) Norovirus has remarkable staying power on environmental surfaces where it can persist for up to two weeks. It can survive freezing and withstand heating to 140 degrees. To destroy norovirus in drinking water, CDC recommends6 bringing water to a rolling boil (212 degrees Fahrenheit) for one minute. Astonishingly, only 18 norovirus particles are required to infect a human host. For perspective, there are billions of particles in the stool and vomit of infected individuals.

Outsmarting Norovirus

Efforts to develop a vaccine for norovirus are still in their infancy,7 so proper hygiene and surface disinfection practices must be employed to control the spread of the perfect pathogen. People infected with norovirus are advised to limit their contact with others for at least two days after symptoms have ended. Disinfecting surfaces contaminated with the persistent norovirus can go a long way to curtailing outbreaks. Properly prepared chlorine bleach solutions (see below) destroy norovirus on surfaces. Simply cleaning surfaces with soap and water or other cleaning product can actually spread virus particles. In the City of Albuquerque, for example, restaurant staff are encouraged to switch from quaternary ammonium disinfectants to chlorine bleach disinfectants when a norovirus outbreak occurs.8

Communicating a Disinfection Strategy

In 2012, the Water Quality and Health Council participated in a partnership with public health experts, including the New Jersey Somerset County Department of Health, the CDC, the National Environmental Health Association and others, to develop a series of downloadable posters featuring directions for preparing bleach solutions to destroy noroviruses on surfaces. For example, the posters include detailed directions on how to clean and disinfect an area affected by a vomiting or diarrhea incident. Posters are available in English, Spanish and French and can be found at http://www.disinfect-for-health.org/tools-reduce-spread-norovirus.

So when it comes to combatting the nearly perfect pathogen norovirus, remember:

  • the right way to wash your hands;
  • do not prepare food or care for others when you are sick;
  • wash fruits and vegetables and cook seafood thoroughly;
  • clean and disinfect contaminated surfaces using chlorine bleach or other disinfectant registered as effective against norovirus by the EPA; and
  • launder clothes thoroughly.

Linda F. Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality and Health Council.

Click here to download this article.

1 Hall, A.J. (2012). Noroviruses: The Perfect Human Pathogens? Journal of Infectious Diseases, 205: 1622-1624. http://jid.oxfordjournals.org/content/205/11/1622.full.

2 CDC (2015). Norovirus: U.S. Trends and Outbreaks, http://www.cdc.gov/norovirus/trends-outbreaks.html.

3 CDC (2015). Prevent the Spread of Norovirus, http://www.cdc.gov/features/norovirus/.

4 Bartsch, S.M., Lopman, B.A., Ozawa, S., Hall, A.J., and Lee, B.Y. (2016). Global Economic Burden of Norovirus Gastroenteritis, PLOS ONE, DOI:10.1371/journal.pone.0151219. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151219.

5 CDC (2014). Norovirus and Working with Food, http://www.cdc.gov/norovirus/food-handlers/work-with-food.html.

6 CDC (2015). Noroviruses and Drinking Water from Private Wells, http://www.cdc.gov/healthywater/drinking/private/wells/disease/norovirus.html.

7 CDC (205). Making a Norovirus Vaccine a Reality, https://blogs.cdc.gov/publichealthmatters/2015/03/making-a-norovirus-vaccine-a-reality/.

8 “Norovirus Kitchen/Dining Room Response Procedures, City of Albuquerque Environmental Health Department handout at 4th Annual Norovirus Conference, August 4, 2016.



The Right Way to Wash Your Hands
Written by Barbara Soule, RN, MPA, CIC, FSAHEA

Wash your hands! The parental command echoes in my memory. It is also the public health message we hear most often when the subject is preventing the spread of infectious illness. Hand washing may be one of the easiest things we can do to ward off sickness, but the casual observer in any public restroom can attest to the slap-dash ritual practiced by many. Running water over the hands for a few seconds may be better than nothing, but consciously washing hands correctly is a learned behavior that can pay dividends.

The “Why” of Handwashing

The simple fact is that washing hands removes germs that can make you and others sick. Human hands, which perform countless useful activities, are also the prime vehicles for moving germs from person to person.  As the Centers for Disease Control and Prevention (CDC) website notes, people can infect themselves by touching their eyes, nose and mouth.  Germ-laden hands can make others sick when they prepare food or drinks. And frequently touched surfaces, such as hand rails and publicly used electronic touch pads, are essentially “drop-off” and “pick-up” points for the germ du jour.

According to CDC, teaching people about handwashing benefits the community in which they live. Studies cited by CDC1 show handwashing reduces:

  • The number of people who get sick with diarrhea by 31%
  • Diarrheal illness in people with weakened immune systems by 58%
  • Respiratory illnesses in the general population by 16-21%

The “How” of Handwashing

A downloadable World Health Organization poster recommends following the steps below to wash your hands correctly.  Practice (and review the chart) until the steps become routine.  You will know you have washed long enough if you can hum the “Happy Birthday” song twice.  By the way, “handrub” is another way of denoting “hand sanitizer.”

At a recent public health conference I attended, a presenter guided the audience through a lively “dry run” handwashing exercise from their seats in the auditorium. Shortly afterwards, during a scheduled break in the agenda, the restrooms filled with people who had been through the exercise. It was obvious that attendees at the sinks were self-consciously attempting to replicate the handwashing steps properly. No one wanted to be that slap-dash hand washer, and a few commented that they were trying hard to get it right. I like to think that those conference attendees are now modeling great handwashing for others, spreading a good habit, and—most importantly—not spreading germs!

You might want to try it yourself and teach it to your children to instill good habits early.

Barbara M. Soule, R.N. MPA, CIC, FSHEA, FAPIC is an Infection Preventionist and a member of the Water Quality & Health Council.

Click here to download this article.

Studies cited by CDC on its Handwashing:  Clean Hands Save Lives website include:

  1.  Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev. 2008;1:CD004265.
  2. Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis.Am J Public Health. 2008;98(8):1372-81.
  3. Huang DB, Zhou J. Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study. J Med Microbiol. 2007;56(5):659-63.
  4. Rabie T and Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic review.Trop Med Int Health. 2006 Mar;11(3):258-67.

Are You Ready for an Emergency?

Earthquakes, hurricanes, tornadoes, floods, wildfires, pandemics1 , disease outbreaks, terrorist attacks… We may not like to think about the disasters that can befall us, but these potential events warrant our preparedness. September is National Preparedness Month, and a new infographic—The Power of Preparedness—from the Centers for Disease Control and Prevention (CDC) indicates that over 60 percent of Americans do not have an emergency plan that they have discussed with their household. Are you in that camp? According to the 2014 Federal Emergency Management Agency report, “Preparedness in America”, the percentage of people taking recommended preparedness actions in 2011 remains largely unchanged since 2007.

Taking the First Steps

Where you live determines the type of emergency you may be most at risk of experiencing. If you live in a coastal area, your greatest risk could be hurricanes. Flooding may be a serious risk if you live near water, in a flood zone, for example. You may live in a tectonically active area, in which case earthquakes are a concern. Residents in or near forested areas subject to drought may count wildfires among their greatest risks. Do you live in a metropolitan area and have close contact with many people on a daily basis in your commute to work or as part of your job? Diseases can spread quickly among people in close contact. Unfortunately, by their nature, terrorist attacks are random and unpredictable.

Once you have determined your greatest risk factors, preparedness activities become clearer. That said, every household could benefit by storing and regularly updating:

  • Water and food to last each person at least 3 days (more is likely appropriate for many emergencies; for example, a pandemic may require 6-8 weeks of supplies).
  • Fuel for cooking, e.g., propane or charcoal.
  • Medications and first aid supplies for each person to last at least 3 days (include prescription medications and over-the-counter medications for treating fever, flu, colds, etc.).
  • Unscented chlorine bleach or appropriate water treatment tablets for preparing safe drinking water after stored water supplies have been depleted.
  • Flashlights and radios (and the appropriate batteries to power them unless they are solar-powered or operated by a hand-crank).
  • Candles and matches.
  • Emergency cash (Think: What if ATMs were inoperable?).
  • A family plan previously discussed with family members including routes to take/not take to get home and meeting sites in case getting home is not possible.
  • A pet plan which includes identification tags, food, water, and a safe place for them in the event of an emergency.

Customizing Your Emergency Plan

Build on the basic recommendations above with your unique circumstances in mind.

  • If you take life-sustaining prescription medication, discuss with your doctor the possibility of storing an emergency supply of medication in your home.
  • If you anticipate that a forest fire or earthquake could force you to leave your home, have an emergency “go bag” ready that contains at least one change of clothing, medicines, personal hygiene and other items you will likely need to survive away from home, such as your cell phone charger.
  • A face mask can help protect you during dust storms and from volcanic ash or ash from wildfires.
  • Is your only means of transportation from your community by personal vehicle? Keep your vehicle in good repair and its gas tank at least 50 percent full. On the other hand, if it is unlikely that you will have to evacuate, but you know that losing power is a real risk, you might want to invest in a portable generator and plan how you will safely store propane or gasoline.
  • Long, insulated underwear is essential in extremely cold weather disasters when gas and electricity go out for extended periods of time.
  • How do elderly and incapacitated neighbors and relatives fit into your emergency plans?
  • How about a bad flu season? The Water Quality & Health Council developed “Dr. Ralph’s Flu Preparedness Closet” to list the items needed to stay healthy and secure during a pandemic flu outbreak.
Emergency Water

Water is one of the “non-negotiables” of our daily survival. According to www.ready.gov/water, each person in a household requires one gallon of safe water per day for drinking and sanitation.

Either purchase commercially bottled water to store, or prepare your own containers of water using food grade water storage containers (visit surplus or camping supply stores or their websites). Alternatively, use 2-liter plastic drink bottles that are thoroughly cleaned.

Sanitize plastic drink bottles with a solution made by adding 1 teaspoon of unscented chlorine bleach to one quart of water. Rinse well and fill each 2- liter bottle with tap water. If your tap water is treated by a water utility, nothing else is required. If the tap water comes from a well or other untreated source, add 2 drops of non-scented chlorine bleach to the water. Let the water stand for at least 30 minutes before using. Tightly close each bottle (don’t touch the inside of the cap), write the date on a label and store in a cool, dark place. Water that has not been commercially bottled should be replaced every 6 months.

One easy way to get started on the path to preparedness is to download the FEMA App to your smart phone. You will receive weather alerts and be able to access critical information in the event of an emergency, including the locations of emergency shelters. Our hope this National Preparedness Month is that more Americans will see preparedness as a worthwhile and potentially life-saving activity.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

Click here to download this article.

1 A pandemic is a widespread disease outbreak, affecting large areas, such as an entire country, continent, or even the entire world.



What Are Zoonotic Diseases?
Written by Water Quality & Health Council

If you guessed that ZOOnotic diseases have something to do with animals, you are right.  According to the Centers for Disease Control and Prevention (CDC), a zoonotic disease is one that can spread between animals and humans under natural conditions—such as in homes, on farms, and at county fairs and petting zoos—and can be caused by viruses, bacteria, parasites and fungi.  Ironically, animals that can transmit zoonotic pathogens (disease-causing germs) to people often have no symptoms of disease and simply act as carriers.

Zoonotic, Emerging, and Waterborne Diseases

Zoonotic diseases are also very common:  At least six out of every 10 infectious diseases in humans are thought to be spread from animals.  Wildlife serves as a “reservoir” for many diseases common to domestic animals and humans.  Moreover, zoonotic pathogens are closely tied to so-called emerging (or reemerging) infectious diseases, and up to 75% of emerging pathogens are thought to be of zoonotic origin, including Ebola virus disease and Lassa fever.

Of course, people all over the world enjoy and work with animals on a daily basis.  But we also encounter very small animals unintentionally, such as ticks, fleas and mosquitoes (called disease “vectors”), which can transmit a wide variety of zoonotic diseases of tremendous global health importance.  In addition to Zika virus, mosquitoes can transmit West Nile virus, Dengue, malaria and chikungunya, and thrive in urban neighborhoods with standing, untreated water such as neglected or abandoned swimming pools.

Not surprisingly, many waterborne diseases, including outbreaks, result from ingesting zoonotic pathogens—whether of human or animal origin.  Well-known zoonotic diseases include cryptosporidiosis and giardiasis, particularly because both are caused by enteric protozoan parasites that are resistant to chlorination.  Cryptosporidium was responsible for the largest documented waterborne disease outbreak in US history, affecting over 400,000 people in Milwaukee in 1993! Bacterial zoonotic pathogens include Campylobacter from chickens, pathogenic E. coli from cattle (especially calves) and Salmonella from pet turtles and frogs.  Rotavirus and hepatitis E virus from swine can also be transmitted to persons through inadequately or untreated waters.  CDC maintains a list of diseases that can be spread from pets to people, many of which can be waterborne or rely on water-based vectors such as mosquitoes.

Preventing Zoonotic Diseases

It’s important to be aware of the different ways zoonotic diseases are transmitted to people, including:

  • Contact with the feces, saliva (such as when your dog licks your face or hands), blood and urine of an infected animal
  • Being bitten by an infected tick or mosquito
  • Consuming something unsafe, such as untreated water from a stream, undercooked meat or unwashed fruits and vegetables that are contaminated with feces from an infected person or animal

Source: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5805a3.htm

It’s also important to consider that some people are more at risk from developing serious or even life-threatening infections from zoonotic pathogens than others, including children, pregnant women, elderly and immunocompromised persons, such as someone with HIV or a chemotherapy patient.

 Fortunately, there are many over-lapping ways you can protect yourself from zoonotic diseases:

  • Wash hands frequently and follow proper hygiene
  • Always wash hands after being around animals, including pets
  • Take measures to prevent mosquito and tick bites

So remember, all creatures great and small can carry and transmit disease-causing germs, but an ounce of prevention (and disinfectant or bug spray) and frequent hand-washing can go a long way.

Additional information on healthy pets and people is available from CDC:


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