FEDERAL GOVERNMENTDHS

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HHSCDCUSDADODNORTHCOM ARNORTH U.S. Army Corps of Engineers - Team New Orleans National Hurricane CenterNational Weather Service - Jackson Office, MS National Weather Service – New Orleans/Baton Rouge

LOUISIANALouisiana Governor’s Office of Homeland Security and Preparedness

WEATHER

NURSING HOMES

CURRENT SITUATION

PREVENT ILLNESS AFTER A DISASTER

YALE/TULANE ESF-8 PLANNING AND RESPONSE PROGRAM SPECIAL REPORT

Hurricane IsaacKEY LINKS

BACKGROUND

Louisiana State Police Louisiana Dept of Wildlife and FisheriesLouisiana Dept of CorrectionsLouisiana Dept of Health and HospitalsLouisiana Dept of Social ServicesLouisiana Work Force CommissionLouisiana Dept of Natural ResourcesLouisiana National GuardGovernor’s Office of Coastal ActivitiesLouisiana Dept of Environmental QualityLouisiana Attorney General’s OfficeLouisiana Economic DevelopmentLouisiana Dept of Transportation and DevelopmentDivision of AdministrationLouisiana Dept of Agriculture & Forestry

DIALYSIS

5 SEPTEMBER 2012

Severe Thunderstorm Flash Flood WatchSevere WeatherFlood Warning

Heat AdvisoryHazardous Weather Outlook

RIVER CONDITIONS

ENVIRONMENTAL

TODAY AND TONIGHT A HEAT ADVISORY IS IN EFFECT FOR THE LOUISIANA SOUTH SHORE PARISHES THROUGH THIS EVENING FOR HEAT INDEX READINGS REACHING 100 TO 106. THERE IS A CHANCE OF THUNDERSTORMS TODAY MAINLY OVER THE EASTERN PORTIONS OF THE OUTLOOK AREA. WHILE ORGANIZED SEVERE THUNDERSTORMS ARE NOT EXPECTED...A FEW MAY PRODUCE WET MICROBURST GUSTS TO 40 MPH...OCCASIONAL LIGHTNING AND BRIEF TORRENTIAL RAINFALL. WATERSPOUTS MAY OCCUR IN THE COASTAL WATERS EAST OF THE MISSISSIPPI RIVER TODAY.

DISASTER SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM

WATER

ELECTRICAL

TIME LINE• On the evening of Tuesday, August 28, 2012 Hurricane Isaac made landfall in Louisiana,

seven years after Katrina. • Wednesday, August 29, 2012, as Hurricane Isaac continued to batter the area,

emergency responders rescued close to 3,500 residents from flooded homes in River Forest, Palmetto, Palmetto Lakes, Palmetto South, Cambridge, Riverlands Subdivision, Live Oak Landing, River Oak Landing, Old 51, Carmel Valley, Canterbury's, Summerlin Estates, the Ascension of Our Lord school area, Country Club and LaPlace Park.

• Thursday, August 30, 2012 the tropical storm was down graded to a tropical depression but rains drenched a large swath of the Gulf Coast.

Louisiana announced mandatory evacuations for all low-lying areas along the Tangipahoa River. The river was observed at more than 17 feet Thursday morning -- more than two feet above flood level. The National Weather Service predicted that the river level would rise as high as 19.5 feet by Friday. Average rainfall totals around New Orleans was in the range of 9-12”. New Orleans International Airport officially received 9.69” setting a daily rainfall record shattering the 4.5” mark established during Katrina in 2005. And it’s more than the city’s averages (5.98”) for an entire month.

• Friday, Aug 31 – Tuesday 4 September

Recovery efforts continued throughout the state. At least 47% of the state's energy users lost power in Louisiana, most has been restored.

Low level flooding continues and do flash floods as a result of the rain that Isaac deposited as it moved inland.

It will likely take weeks to bring Louisiana back to normal after last week’s visit from Hurricane Isaac, an unusually wet storm that caused serious flooding in 10 parishes and damaged more than 13,000 homes.

HURRICANE ISAACBackground

Source: New Orleans Times-Picayune CNN Washington Post

Melanie Martinez stands in the front yard as family members salvage items from their flooded home in Plaquemines Parish in Braithwaite, La. (Mario Tama / Getty Images / September 3, 2012)

man carries an armload of food, ice and water at a Hurricane Isaac aid distribution site in Metairie- The Times-Picayune A

CURRENT SITUATION:• LA EOC activated at Level II (Partial Activation)

• The Incident Command Post established to monitor the level of the Pearl River and initial search and rescue operations ceased operation and closed at 6:30 p.m. CDT on September 4.

• Officials remain cognizant of flooding but are no longer concerned with a threat of major flooding.

• 5 DRCs are operating in Plaquemines, St. John the Baptist, St. Tammany, St. Bernard, and Orleans Parishes

• 15 PODs open across LA

• IA valid registrations: 125,022; Total IHP Approved $11,028,439

• Housing Inspections: 69,545 issued; 17,188 completed

RIVERS

• River flooding on Pearl River continues

• No roads are flooded

• All other rivers have crested and should be below flood stage in the next day or so

CURRENT SITUATION FATALITIES: 5 DESTRUCTION: Assessments is on going but AIR Worldwide put insured losses

between 700 million – 2 billion in USD UTILITIES: 11,014 without power 94% of wireless and cellular transmitters are fully operational. SHELTERS: 616 STATE DECLARATION: 8/27/12 FEDERAL DECLARATIONS: 8/28/12 Resistance Assistance: To date, more than 35,000 Louisianans registered for

assistance, with roughly $400,000 approved, so far, for housing assistance and other needs.

LINKS

Louisiana Health and Hospitals Department of Public Health

http://www.dhh.louisiana.gov/

Louisiana Governor's Office Homeland Security and Emergency Preparedness

http://gohsep.la.gov/

Twitter http://twitter.com/#!/GOHSEP

Flickr http://www.flickr.com/photos/lagohsep/

Facebookhttp://www.facebook.com/gohsep

NOAA Weather Radio for LAhttp://www.nws.noaa.gov/nwr/Maps/PHP/Louisiana.php

National Weather Service Watches, Warnings and Advisories

http://www.weather.gov/alerts-beta/la.php?x=1

SOURCE: FEMA DAILY SITREP

MAJOR DISASTER DECLARATIONS

NUMBER DATE STATE INCIDENT DESCRIPTION

4080 08/29 Louisiana Hurricane Isaac

4081 08/29 Mississippi Hurricane Isaac

EMERGENCY DECLARATION3347 08/27 Louisiana Tropical Storm Isaac

3348 08/28 Mississippi Tropical Storm Isaac

CURRENT SITUATIONESF-8 - MEDICAL AND PUBLIC HEALTH

DEPLOYED AMBULANCES

REGION STATE STATE SPT VEHICLES

1 29 1

2 2 1

3 10

6 2

9 6

TOTAL DISPATCHED 49 2

TOTAL AVAILABLE 16 32

AMBULANCES

MSSN: 1 MSNS at convention center in New Orleans, 21 pts and 4 caregivers last night . AS OF 4:30 CDT 5 SEP 2012 the MSNS at the Convention Center is closed. ALL MSNS Operations are closed from Isaac response.

As of 0700 hrs 5 SEP 2012 Region 1

Total Capacity of the MSNS 250Available Slots in Shelter Currently Total in the Medical Special Needs Shelter: Number of shelterees 7Number of caregivers 1

PERMANENT SUPPORTIVE HOUSING Teams are continuing efforts to follow up with recipients. The services they are providing include– assisting people to get basic needs, food, water, temporary assistance, etc.

PERMANENT SUPPORTIVE HOUSING LATEST FOLLOW UP ON HOUSEHOLDS BY REGION

HOUSEHOLDS ATTEMPTED TO REACH

HOUSEHOLDS SUCCESSFULLY

REACHED

HOUSEHOLDS IN UNITS

HOUSEHOLDS STILL AT

EVACUATION SITE

Region I 1524 1175 1058 120CAHSD 162 129 119 10Region III 89 85 71 14Region IV/V JPHSA FPHSA 194 174 174 18

HOSPITALS: • Hospital are all operational• Across the state, 60 hospitals lost power. Power has been restored at all

hospitals, no hospitals are running on generators.

ASSISTED LIVING FACILITIESDHH is monitoring the status of Assisted Living Facilities. In the affected areas, ALF’s 24 ALF’s evacuated. As of 5 SEP 2012 - All have repatriated. All have power.

ICF/DD FACILITIES (GROUP HOMES) 

97% of Group Homes have repatriated. There are only 5 remaining evacuated, 2 in Region 1 and 3 in Region 3.

DISASTER SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (DNSAP)

The Louisiana Department of Children and Family Services (DCFS) today announced locations where residents of nine parishes can finalize their application for Disaster Supplemental Nutrition Assistance Program (DNSAP) benefits. Additional sites will be announced as the need arises or as additional parishes are approved for DSNAP. DSNAP provides food assistance for eligible households who do not receive regular SNAP benefits and who need help buying groceries due to lost income or damages following a disaster. The following locations will be open Wednesday, September 5 through Tuesday, September 11 from 8 a.m. to 6 p.m.

• Ascension Parish - Lamar Dixon Expo Center, 9039 St. Landry Rd., Gonzales• Jefferson Parish - Alario Center, 2000 Segnette Blvd., Westwego• Lafourche Parish - Peltier Park, 151 Peltier Park, Thibodaux• Livingston Parish - Amvets, 26890 Hwy. 42, Springfield• Orleans Parish - University of New Orleans, 6801 Franklin Ave., New Orleans• St. John - New Wine Christian Church, 1929 W. Airline Hwy., LaPlace

In Lafourche Parish, DCFS will open a second site on Friday, September 7 at South Lafourche Parish Library, 16241 East Main, Cutoff, now that electrical services have been restored

For the above locations, applicants should go on the following designated days based on their last name.

• Wednesday, September 5 - A through C• Thursday, September 6 - D through G• Friday, September 7 - H through L• Saturday, September 8 - M through R• Sunday, September 9 - S through Z• Monday, September 10 - All applicants unable to make prior scheduled day • Tuesday, September 11 - All applicants unable to make prior scheduled day

For a quicker process, residents of those parishes should pre-apply for DSNAP before going to a DSNAP site. Pre-apply online at WW.DCFS.LA.GOV/PREAPPLY or call 1-888-LAHELP-U (888-524-3578) 24 hours a day, seven days a week. Callers should select the appropriate language and then select options 3 and 3.

FOR FURTHER INFORMATION: http://www.dcfs.louisiana.gov/index.cfm?md=newsroom&tmp=detail&articleID=451

The following locations will be open Wednesday, September 5 to Wednesday, September 12 from 8 a.m. to 6 p.m., but will be CLOSED for the day on Sunday, September 9.

• Plaquemines - Exceleration Church, 202 Woodland Hwy., Belle Chasse• St. Bernard - Christian Fellowship Church, 5816 E. Judge Perez Dr., Violet• St. Tammany - YMCA, 71256 Francis Road, Covington• St. Tammany - First Baptist Church, 16333 Hwy. 1085, Covington• The above sites will follow the following schedule:• Wednesday, September 5 - A through C• Thursday, September 6 - D through G• Friday, September 7 - H through L• Saturday, September 8 - M through R• Sunday, September 9 – CLOSED• Monday, September 10 - S through Z• Tuesday, September 11 - All applicants unable to make prior scheduled day • Wednesday, September 12 -- All applicants unable to make prior scheduled

day

DSNAP applicants MUST go to a specified DSNAP site to apply and receive benefits. DCFS offices will not accept DSNAP applications. Applicants may name an Authorized Representative to go to a DSNAP site on their behalf. Accommodations will be made for the elderly and those with disabilities to reduce on-site wait times.

WATER

HEALTH DEPARTMENT ADVISES RESIDENTS USING PRIVATE WELLS IN HURRICANE-AFFECTED AREAS OF RISKS, TESTING OPTIONS

The Louisiana Department of Health and Hospitals advises Louisiana residents in the parishes affected by Hurricane Isaac who use private wells for their drinking water systems to take water safety precautions if their wells flooded during the storm.

If a homeowner's water well was flooded during Hurricane Isaac, the well owner should disinfect the well using a chlorine bleach solution following recommended Environmental Protection Agency guidelines. The owner should then flush the well.

If well owners wish to have their water tested for contamination, there are private laboratories throughout the state that are certified to test drinking water samples and will perform this service for a fee. DHH has a list of state-certified drinking water laboratories available online at www.dhh.louisiana.gov. Owners should wait to submit water samples for testing until they have disinfected and flushed the well.

If the lab tests are positive for contaminants, the well owner will be advised not to consume the water (e.g. drinking, brushing teeth, cooking with it) until the water has been boiled or chemically disinfected.

For more information on private well water testing, see DHH's brochure on this process or contact DHH's Safe Drinking Water Program at 225-342-7499.

To contact your parish sanitarian about submitting well samples to your local health unit, call 225-342-7643, or visit DHH's list of parish health units throughout the State to find the contact information for your local health unitSOURCES:http://new.dhh.louisiana.gov/index.cfm/newsroom/detail/2621

The Louisiana Department of Health and Hospitals' Safe Drinking Water Program issued its most comprehensive water system boil advisory list following Hurricane Isaac.

The DHH Office of Public Health staff contacted water systems around the State to assess whether their systems experienced any of these issues and would need a precautionary boil advisory. See DHH's list of public water systems in Louisiana under a boil advisory. DHH also has a list of water systems safe to drink.

Customers of a water system that is under a boil advisory should disinfect it prior to consumption until notified the system is restored and the advisory is lifted. People whose water system is under a boil advisory should disinfect water prior to drinking it, cooking with it, brushing teeth or preparing food using one of the following methods:

• Boil water for one full minute in a clean container. The one-minute boil time begins after the water has been brought to a rolling boil. (The flat taste that sometimes results from this process can be eliminated by shaking the water in a bottle or pouring it from one container to another.)

• If the water is clear coming from the tap, mix 1/8 teaspoon of unscented, liquid chlorine laundry bleach with one gallon of water and let it stand for at least 30 minutes prior to consumption. If the water is cloudy or colored, use 1/4 teaspoon per gallon of water. Be sure to mix thoroughly. If the treated water has too strong a chlorine taste, it can be made more palatable by allowing the water to stand exposed to the air for a few hours or by pouring it from one clean container to another several times.

• Boiling is the most effective method of disinfecting drinking water, and is particularly important for people have compromised immune systems (e.g. those who have HIV/AIDS or cancer, and organ transplant patients who are taking immunosuppressive drugs.) This is also recommended for infants and the elderly.

People who obtain their water from these systems must continue disinfecting their drinking water by one of the above listed methods until the Department of Health and Hospitals issues a public notice that the water has been tested and is now safe to drink.

HEALTH DEPARTMENT ISSUES COMPREHENSIVE LIST OF WATER SYSTEMS UNDER BOIL ADVISORY FOLLOWING HURRICANE ISAAC (4 SEPT 12)

http://www.dhh.louisiana.gov/assets/docs/Isaac/WaterNotSafeToDrinkReport.pdf

WATER OUTAGES

ENVIRONMENTAL

Law enforcement officials ordered the evacuation of homes within a half-mile of storm-damaged Stolthaven chemical plant in Braithwaite to guard against possible contamination or fire on 3 September.

Teams with the U.S. Environmental protection agency and the state department of environmental quality were evaluating the Stolthaven New Orleans plant, which has been without power since Hurricane Isaac struck last week.

Air monitoring continued but no off-site impacts have been detected.

The Coast Guard, State Police and other local and state agencies are joining the effort and Stolthaven contractors are working to manage any releases,

DEQ responders are assessing orphaned containers in the area, some from the Stolthaven facility and are overseeing all sampling plans and reviewing all data for air monitoring, air and water sampling, Mallett said.

A boom surrounds flooded railcars as a chemical plant in Braithwaite, La.

The Louisiana Department of Environmental Quality is reminding people in the impacted area of Hurricane Isaac and the flooding aftermath to be cautious around orphaned containers and sheens on the water.

State and federal officials, such as the U.S. Coast Guard, are asking residents to avoid any contact with chemicals or pollution they come across, and to report it to the Coast Guard New Orleans Operations Center at 504-365-2200, the National Response Center at 800-424-8802 or the DEQ hotline at 225-219-3640, during working hours or 225-342-1234 or 888-763-5424 after hours. Also, if there is an emergency situation, call local 911 or closest local emergency responder.

DEQ, along with its state, federal and local partners, continue to conduct assessments in the impacted area. There have been several small sheens found. Agencies are working with possible responsible parties to clean up any spills.

Floodwaters could also contain bacteria from a variety of sources. Avoid contact with floodwater whenever possible. Sometimes after storm events, drums or others types of containers get displaced. These containers may contain hazardous waste and may need special type of disposal method.

The public should not handle these containers.

SOURCE: http://www.labeoc.org/labeoc/alerts/Alert_Details.aspx?id=729

LDWF CLOSES A PORTION OF COASTAL WATERS DUE TO THE EMERGENCE OF OIL ON ADJACENT BEACHES

EFFECTIVE IMMEDIATELY - (4 SEP 2012) Louisiana Department of Wildlife and Fisheries Secretary Robert Barham announced an emergency closure of a portion of coastal waters due to the emergence of a large tar mat and concentrations of tar balls on adjacent beaches.

This action is taken in coordination with the Louisiana Department of Environmental Quality, who will assist with the investigation to determine the extent, source, and impacts of the oil in the environment.

The area affected by this emergency closure includes the portion of state outside waters seaward a distance of one mile from the shoreline from the eastern shore of Belle Pass at 90 degrees 13 minutes 30 seconds west longitude eastward to the western shore of Caminada Pass at 90 degrees 02 minutes 46.6 seconds west longitude.

All commercial and recreational fishing is prohibited within these waters except for recreational and charter boat angling. The harvest of live bait by wholesale/retail seafood dealers who hold a special bait dealers permit and who harvest live bait for sale to recreational fishermen exclusively is also permitted.

In addition to this closure, certain areas are still closed to recreational and commercial fishing due to the 2010 Deepwater Horizon oil spill. Maps of the areas still closed to recreational and commercial fishing are posted on the LDWF website at www.wlf.louisiana.gov/oilspill.

Tar balls photographed by Louisiana state response teams on Elmer’s Island in Jefferson Parish on September 1, 2012.Photo credit: Louisiana Department of Wildlife and Fisheries

ELECTRICAL OUTAGESELECTRICAL – 3 SEPTEMBERENTERGY workers have reduced the number of Hurricane Isaac outages by more than 645,000, or 84 percent, from the 769,000 system wide peak.

In Louisiana, the slowly-receding flood waters have prevented ENTERGY from making repairs in Plaquemines Parish, but they will start today when they will convoy workers and equipment on the levee, set up a staging site in Buras and begin airlifting material to it.

Outages at 9:30 p.m.Entergy Gulf States Louisiana: 509Entergy Louisiana: 10,481Entergy New Orleans: 24Total System wide: 11,014 (excludes customers with storm damage or flooding who cannot take service.)

Percent of customers restored:Entergy Gulf States Louisiana: 100 percent.Entergy Louisiana: 98 percent.Entergy New Orleans: 100 percent.Total System wide: 99 percent

http://stormcenter.entergy.com/default.aspx

WEATHER CONDITIONSAS OF 5 SEPTEMBER 2012

6 – 11 September Thursday through Tuesday there will be a chance of thunderstorms each day Thursday through Saturday. Some thunderstorms may become strong to marginally severe Saturday along a strong cold front. Heat index readings will be in the 100 to 110 range each afternoon through Saturday. Less humid conditions are expected after frontal passage Sunday through Tuesday. An large area of disturbed weather was moving offshore into the northeast Gulf of Mexico. There is a slight chance of this system developing further into a tropical depression over the next few days. At this time...It appears impacts to coastal Louisiana and coastal Mississippi will be minimal though tide levels will have to be monitored closely through Sunday.

http://www.wunderground.com/weather-forecast/US/LA/New_Orleans.html

http://forecast.weather.gov/showsigwx.php?warnzone=LAZ062&warncounty=LAC071&firewxzone=LAZ062&local_place1=&product1=Hazardous+Weather+Outlook

Heat advisory remains in effect until 7 PM CDT this evening

A HEAT ADVISORY is in effect primarily for areas still without power and adequate climate control. Heat index readings should reach 100 to 106 range this afternoon. Stay out of the sun for prolonged periods of time and drink plenty of liquids.

A heat advisory is in effect for the Louisiana South Shore Parishes through this evening for heat index readings reaching 100 to 106. There is a chance of thunderstorms today mainly over the eastern portions of the outlook area. While organized severe thunderstorms are not expected...A few may produce wet microburst gusts to 40 mph. Occasional lightning and brief torrential rainfall. Waterspouts may occur in the coastal waters east of the Mississippi river today.

RIVER CONDITIONS

THE FLOOD WARNING CONTINUES FOR THE FOLLOWING RIVERS:

BOGUE CHITTO RIVER NEAR BUSH AFFECTING ST. TAMMANY PARISH At 10:15 am Wednesday the stage was 12.1 feet. Minor flooding is occurring and minor flooding is forecasted (The flood stage is 11.0 feet.) FORECAST: The river is expected to continue to fall to below flood stage by Friday morning. IMPACT: At 11.0 feet...The access road upstream of the bridge will flood. The river will leave the main channel on the left bank below the bridge flooding woodlands on either side of Louisiana highway

PEARL RIVER NEAR BOGALUSA AFFECTING ST. TAMMANY AND WASHINGTON PARISHES IN LOUISIANA At 10:00 am Wednesday the stage was 20.8 feet. \Minor flooding is occurring and minor flooding is forecast. ( The flood stage is 18.0 feet) FORECAST: the river will continue to slowly fall to a stage of 20.7 feet by tomorrow morning.IMPACT: At 20.0 feet - .Woodlands and crop acreage along the river will be flooded. The Bogue Chitto wildlife management area will be inundated with water in recreational camps and over access roads.

SOURCE http://www.srh.noaa.gov/lmrfc/?n=fop http://www.srh.noaa.gov/lmrfc/

FLOODING

• Bogue Chitto River - Water levels have crested and are now falling on the Bogue Chitto River.

• Pearl River - There is major flooding on the Pearl River for the next few days .

SOURCE http://www.srh.noaa.gov/lmrfc/?n=fop http://www.srh.noaa.gov/lmrfc/

Jesse Shaffer Sr. checks on the water level inside the Braithwaite levee Wednesday September 5, 2012. An intentional breach helps drain the area. PHOTO DAVID GRUNFELD / THE TIMES-PICAYUNE

NURSING HOMES

NURSING HOME REPATRIATION

NUMBER OF NURSING HOMES THAT MOVED RESIDENTS PRE-STORM

NURSING HOME REPATRIATION

9

Bayside Health Care (Gretna) ReturnedLuling Living Center (Luling) ReturnedOrmond Nursing and Care Center ReturnedMaison DeVille Nursing Home (Houma) ReturnedLafon Nursing Facility of Holy Family ReturnedMaison DeVille Nursing Home (Harvey) ReturnedRaceland Manor Nursing Home ReturnedWest Jefferson Health Care Center in Harvey ReturnedRiverbend Nursing and Rehabilitation Center Returned

NUMBER OF NURSING HOMES THAT MOVED RESIDENTS DUE TO THE QUINCY DAM

NURSING HOME

REPATRIATION

2Tangi Pines Nursing Home Returned

Poydras Home Returned

• Eleven nursing homes conducted patient movement prior to the storm or as a result of subsequent flooding. All have repatriated their residents

• Across the state, 80 nursing homes lost power. Power has been restored at 74 nursing homes and two nursing homes are running on generators. All of the homes currently running on generator have HVAC.

DIALYSIS

As a result of Isaac, Louisiana’s dialysis patients are particularly vulnerable, since they typically need treatment every 2-3 days, and any substantial delay can be life threatening. Dialysis patients impacted by Tropical Storm Isaac should call 1-800-626-1297 (Fresenius) or 1-800-400-8331 (DaVita) to find the nearest open dialysis clinic to schedule their treatments. WAFB Baton Rouge and The following are some disaster preparedness tips for dialysis patients:

• Keep your emergency phone numbers handy. When bad weather threatens, contact your local facility and follow instructions they may provide. In a disaster, Fresenius Medical Care offers a patient hotline at 1-800-626-1297 for patients who need help finding the nearest open dialysis facility. The hotline is staffed by customer service specialists who can provide locations and contact numbers for alternate facilities, if necessary.

• Carry your up-to-date personal information with you at all times (ID, medication and allergy lists, insurance, emergency contact information, type of dialysis treatment).

• Talk to your doctor and family about your evacuation plan — what you should do and where you should go if a disaster strikes. Keep track of local weather forecasts.

• Create an Emergency Kit with emergency supplies and at least one extra three-day supply of medicines. Many patients find it convenient to keep medicines and medical supplies in an easy-to-carry fanny pack or backpack.

• Store a three-day supply of food based on your emergency meal plan. Speak with your healthcare team about when to begin following your emergency plan. Limit fluid intake to two cups per 24 hours and avoid fresh fruit and vegetables. Periodically check expiration dates of food items in the kit and replace when needed.

For more information on preparing for a disaster, visit www.ultracare-dialysis.com. Information regarding dialysis care after disasters, such as Tropical Storm Isaac, can be found via the Centers for Disease Control and Prevention

PREVENT ILLNESS AFTER A DISASTER Avoid wild or stray animals and biting or stinging insects.

Call local authorities to handle animals.

Get rid of dead animals, according to local guidelines, as soon as you can.

For more information, contact your local animal shelter or services, a veterinarian, or the humane society for advice on dealing with pets or stray or wild animals after an emergency.

For information on specific animal and insect issues, see protect yourself from animal- and insect-related hazards after a natural disaster.

PROTECT YOURSELF FROM ANIMAL - AND INSECT-RELATED HAZARDS

PREVENT CARBON MONOXIDE POISONING

Carbon monoxide (CO) is an odorless, colorless gas that can cause sudden illness and death if you breathe it. Never use generators, pressure washers, grills, camp stoves, or other gasoline, propane, natural gas, or charcoal-burning devices inside your home, basement, garage, or camper—or even outside near an open window, door, or vent.

Don't heat your house with a gas oven.

If you are too hot or too cold, or you need to prepare food, don't put yourself and your family at risk for co poisoning—look to friends, family, or a community shelter for help.

If your co detector sounds, leave your home immediately and call 911.

Seek prompt medical attention if you suspect co poisoning and are feeling dizzy, light-headed, or nauseated.

For further guidance on avoiding co poisoning, see protect yourself from carbon monoxideCLEAN UP SAFELY AFTER FLOODS

To prevent illness, disinfect and dry buildings and items in them. This will prevent growth of some bacteria, viruses, mold, and mildew that can cause illness.

For more information, see flood water after a disaster or emergency.

KEEP FOOD AND WATER SAFE Food may not be safe to eat during and after an emergency. Water may not be safe for cooking.

Water may not be safe to drink, clean with, or bathe in after an emergency, such as a hurricane or flood. During and after a disaster, water can become contaminated with microorganisms (for example, bacteria), sewage, agricultural or industrial waste, chemicals, and other substances that can cause illness or death.

Listen to and follow public announcements. Local authorities will tell you if water is safe to drink or to use for cooking or bathing. Follow local instructions to use bottled water or to boil or disinfect water for cooking, cleaning, or bathing.

For more information, see keep food and water safe after a natural disaster or power outage.

WASH YOUR HANDS

Always wash your hands with soap and boiled or disinfected water before preparing or eating food, after toilet use, after participating in cleanup activities, and after handling articles contaminated by floodwater or sewage. Use warm water when available. Wash children's hands frequently (always before meals).

Disinfect water for washing by mixing 1/8 teaspoon of household bleach per 1 gallon of water). Let it stand for 30 minutes. If the water is cloudy, use a solution of 1/4 teaspoon of household bleach per 1 gallon of water.

If water isn't available, use alcohol-based products made for washing hands.

For more tips on washing your hands, see hand hygiene after a disaster.

PROTECT MENTAL HEALTH

The days and weeks after an emergency are going to be rough. Some sleeplessness, anxiety, anger, hyperactivity, mild depression, or lethargy are normal and may go away with time. If you feel any of these symptoms acutely, seek counseling. Your state, local, tribal health departments will help you find local resources, including hospitals or health care providers that you may need.

Seek medical care if you are injured, feel sick, or have acute stress and anxiety.

Keep as many elements of your normal routine incorporated into the disaster plans as possible, including activities to calm children's fears.

Be aware that you may have fewer resources to attend to your day-to-day conflicts, so it is best to resolve what you can ahead of time.

Turn to family, friends, and important social or religious contacts to setup support networks to deal with the potential stressors.

Let your child know that it is okay to feel upset when something bad or scary happens. Encourage your child to express feelings and thoughts, without making judgments.

For additional resources, see disaster mental health resources.

PREVENT ILLNESS AFTER A DISASTERAVOID MOSQUITOES

PREVENT ILLNESS FROM SEWAGE

PREVENT TEMPERATURE-RELATED ILLNESS

PREVENT OR TREAT WOUNDS

AVOID WILD OR STRAY ANIMALS

Rain and flooding in a hurricane area may lead to an increase in mosquitoes, which can carry diseases like west nile virus. In most cases, the mosquitoes will be pests but will not carry communicable diseases.

To protect yourself from mosquitoes, use screens on dwellings, and wear long pants, socks, and long-sleeved shirts and use insect repellents that contain deet or picaridin. Care must be taken when using DEET on small children. More information about these and other recommended repellents can be found in the fact sheet updated information regarding insect repellents.

To control mosquito populations, drain all standing water left in open containers, such as flower pots, tires, pet dishes, or buckets, outside your home.

If there is flooding along with a hurricane, the waters may contain fecal material from overflowing sewage systems and agricultural and industrial waste. Although skin contact with floodwater does not, by itself, pose a serious health risk, there is risk of disease from eating or drinking anything contaminated with floodwater.

If there has been a backflow of sewage into your house, wear rubber boots and waterproof gloves during cleanup. Remove and discard contaminated household materials that cannot be disinfected, such as wall coverings, cloth, rugs, and drywall.

If you have any open cuts or sores that will be exposed to floodwater, keep them as clean as possible by washing them with soap and applying an antibiotic ointment to discourage infection.

Wash clothes contaminated with flood or sewage water in hot water and detergent and separately from uncontaminated clothes and linens.

Do not allow children to play in floodwater areas and do not allow children to play with floodwater-contaminated toys that have not been disinfected. Disinfect toys by using a solution of one cup of bleach in five gallons of water. Some toys, such as stuffed animals and baby toys, cannot be disinfected; they should be discarded.

When standing or working in water that is cooler than 75 f (24°c): Wear rubber boots.

Ensure that clothing and boots have adequate insulation.

Take frequent breaks out of the water.

Change into dry clothing when possible.

Immediately clean out all open wounds and cuts with soap and clean water. Keep wounds covered with clean, dry bandages that are large enough to cover the wound and contain any pus or drainage.

Change bandages as needed and when drainage can be seen through the bandage. Contact a doctor to find out whether more treatment is needed (such as a tetanus shot).

If a wound gets red, swells, or drains, seek immediate medical attention.

If you are bitten by any animal, seek immediate medical attention. If you are bitten by a snake, try to identify it, so that if it is poisonous, you can be given the correct anti-venom.

Do not cut the wound or attempt to suck the venom out. (See also the CDC rabies website, rat-bite fever: frequently asked questions, and medical problems and treatment considerations for the red imported fire ant)

CONTACT WITH HAZARDOUS MATERIAL If your skin or eyes may have come in contact with hazardous materials, such as acid from a car

battery, wash thoroughly with decontaminated water and seek medical attention as needed.

If you have wounds, you should be evaluated for a tetanus immunization, just as you would at any other time of injury.

If you receive a puncture wound or a wound contaminated with feces, soil, or saliva, have a doctor or health department determine whether a tetanus booster is necessary based on individual records.

For further guidance, see emergency wound care after a natural disaster.

TETANUS IMMUNIZATION

Prevent heat–related illness: Stay in air-conditioned buildings.

Take breaks in shaded areas or in cool rooms.

Drink water and nonalcoholic fluids often.

Wear lightweight, light-colored, loose-fitting clothing.

Do outdoor activities during cooler hours.

For further guidance, visit the cdc extreme heat website.

Short bouts of diarrhea and upset stomach and colds or other breathing diseases sometimes occur in developed countries, such as the united states, after a natural disaster, particularly among large groups of people in a shelter. Basic hygiene measures like frequent hand washing or use of an alcohol hand gel, especially after using the restroom or changing diapers and before eating, can help prevent these diseases.

Diseases like cholera or typhoid are rare in developed countries and do not typically occur after a natural disaster.

For information on infectious disease, see infectious disease after a disaster.

INFECTIOUS DISEASE

IMMUNIZATIONS

For information on immunizations for evacuees, relief workers, emergency responders and travelers, see immunization after a natural disaster.