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The simple steps you can take now to be prepared for a public health emergency.

Brought to you by the Iowa Department of Public Health

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CIESA Message for All Iowans

Since the first meeting of the state board of healthin 1880, Iowa’s organized public health systemhas continually addressed ways to protect thehealth of Iowans. For nearly 125 years, publichealth has defended against smallpox, whoopingcough, influenza, and most recently theemergence of the West Nile Virus. However,since the tragic events of 9/11, new public healththreats have emerged to include bioterrorism orother health threats.

The Iowa Department of Public Health works withlocal, state and federal partners in developingplans and creating systems to increase the state’s ability to respond to bioterrorism, infectious disease outbreaks and other public health emergencies.

We invite you to be a part of our preparednesseffort. In this publication, you’ll find information onhow to make a plan for communicating with yourloved ones and coordinating their actions if apublic health emergency occurs. There’s alsoinformation on making an emergency kit to assureyour safety during a public health emergency.

Please take the time to read this guide and sharethis information with your friends and relatives.Taking action now will help make sure you areready for the unexpected.

Mary Mincer Hansen, R.N., Ph.D.DirectorIowa Department of Public Health

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“You never think it could happen to you, but I’m glad that I’m prepared.”

NOTES

As individuals, we must be aware of our healthand safety risks and recognize we have a largemeasure of control over our own lives. Iowans canrely on public health officials to bring expertise tothe front line when dealing with potential publichealth emergencies.

Any of us could find our health, safety or both in jeopardy during a public health threat or emergency.

There are four important steps to take during apublic health emergency:

Remain calm and have patience

Use your personal communication plan

Follow the advice of local and state publichealth officials

Listen to your radio or television foradditional information

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Facing the Possibilities

The purpose of this guide is not to frighten you;however, the variety of threats in our everydaylives has increased. Recent incidents show ourworld has become more dangerous and we needto take the best actions to be prepared for anypotential danger.

There are many types of emergencies that canaffect the public’s health. Public healthemergencies range from man-made threats suchas bioterrorism to natural disasters like floods and tornadoes.

Since 9/11, the Iowa Department of Public Health,local public health officials and hospitals haveworked to improve the state’s response to a publichealth emergency. Some examples include:• Expanded public health and hospital laboratory

capacity for testing• Enhanced public health and hospitals’ ability

to communicate with each other throughthe Health Alert Network and an 800 MHzradio system

• Established Public Health ResponseTeams that can help communities duringan emergency

• Trained public health, healthcare andEMS professionals

• Implemented decontamination systems atall hospitals

• Established clinic locations for vaccination andmedication dispensing during an emergency

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Nuclear or Radiation

Although a radiological incident is unlikely,everyone should educate themselves on thesepotential threats and how to deal with them. “Dirtybombs” or radiological dispersal devices mixexplosives, such as dynamite, with radioactivematerials. “Dirty bombs” are not nuclear weaponsand would not create a nuclear explosion.Radiation spread in this manner is likely to bequickly dispersed and reduced to relativelylow concentrations.

A nuclear blast is an explosion with intense lightand heat, a damaging pressure wave, andwidespread radioactive material that cancontaminate the air, water and ground surfaces for miles.

Chemical Agents

A chemical emergency occurs when a hazardouschemical is released in the air.

Chemical agents are poisonous vapors, aerosols,liquids or solids that have toxic effects on people,animals and plants.

If public health officials detect a biological,nuclear, radiation or chemical threat, they willprovide the public with information based on thespecific incident. In the meantime, begin usingyour personal communication plan andemergency kit as necessary.

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Public Health Emergencies

While the spread of many infectious diseases hasbeen controlled through vaccination and otherpublic health efforts, terrorist acts worldwide haveraised concerns about the possibility of abiological attack. It is important to understandwhat can and would be done to protect the publicfrom the spread of infectious diseases.

The public can be infected with diseases inthree ways: • Passed from animals or insects to humans• Passed from human to human• Passed from contaminated water or food to

humans

Diseases spread from human to human are calledcontagious and generally pose the greatest risk tothe public’s health.

Biological

Biological agents are bacteria, viruses or toxinsthat can cause deadly diseases in people,livestock and crops.

It is important to know that only a small numberof biological agents could be used as terroristweapons. Most potential agents cannot surviveoutside of narrow temperature ranges, and aretoo rare or hard to grow.

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“Our mommy took us to get shots so that we wouldn’t get sick.

She said it’s good to plan ahead.”

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Prevention

Vaccines have reduced or eliminated manyinfectious diseases that once killed or harmedinfants, children and adults. If we stop or do notkeep up with recommended vaccinations, there isa potential for diseases that have been reduced oreven eliminated to come back. More people couldget sick and potentially die.

Vaccinations are one of the best ways to put anend to the serious effects of certain diseases.

You can also decrease the spread of disease bytaking these six easy steps: • Update your immunization records• Wash your hands often with warm water

and soap • Cover your mouth and nose when you cough

or sneeze• Stay home and avoid close contact with others

if you are sick• Use bug spray with DEET to repel insects• Report suspicious activity to law enforcement

Disease Monitoring and Detection

An important link in public health officials’ ability todetect and respond to emergencies is monitoringdisease cases and obtaining laboratory results.

Healthcare professionals report infectiousdiseases to public health officials. Infectiousdiseases are defined as those spread by ablood-borne route or skin-to-skin contact.

Public health officials monitor health events in thestate and track potentially exposed individuals todetect early symptoms.

Monitoring infectious disease is critical to reducinga public health emergency. The purpose formonitoring is to identify the disease and prevent it from spreading.

An important part of detecting an infectiousdisease is the testing done by our state publichealth laboratory. During the past three years,Iowa has expanded and improved public healthand hospital laboratory testing capabilities.

Investigations

Once an infectious disease is detected, publichealth officials are responsible for investigating.The investigation is done to identify those whomay have been exposed in order to prevent andcontrol the spread of the infectious disease.

Control

Decontamination

If individuals are exposed to biological or chemicalagents or radioactive material, they may need tobe decontaminated. Decontamination is like takinga shower, washing from head to toe with soap andwater. Almost 90% of the contamination can beremoved by simply taking your clothes off.Decontamination is an easy, three-step process:

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• Remove contaminated clothing• Wash body • Cover body with replacement clothing

Quarantine and Isolation

Two ways that may be used by public healthofficials to control the spread of infectious diseaseare quarantine and isolation. • Quarantine may be used for those who may

have been exposed to an infectious diseasebut may or may not be ill.

• Isolation may be used for those who areknown to be ill with an infectious disease.

When someone is exposed to an infectiousdisease and it is not known if they have caught it,they may be quarantined or separated fromothers not exposed to the disease. For example,the individual(s) may be asked to stay home(home quarantine) to stop potential spread of the infectious disease. They receive specialinstructions to watch for early symptomsof disease.

When someone is known to be ill with an infectiousdisease, they may be placed in isolation andreceive special care (such as in a hospital).Precautions are taken to protect uninfected peoplefrom exposure to the infectious disease.

Medications and Vaccines

During a public health emergency such as aterrorist attack or an infectious disease outbreak,Iowa may need access to large amounts of

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medicine and medical supplies. Few states orlocal governments have the resources to createstockpiles of these supplies; therefore, theCenters for Disease Control and Prevention(CDC) created the Strategic National Stockpile(SNS). The SNS is a large collection of medicineand medical supplies. If SNS supplies are neededin Iowa, they should be delivered within one day.

State and local public health agencies have plansto receive and distribute SNS supplies tocommunities as quickly as possible. If medicationor a vaccine is necessary for preventing orcontrolling the spread of an infectious disease,you may get information from public healthofficials on how to protect you and your lovedones—by watching TV, listening to the radio,reading the newspaper, or checking thecommunity web site.

Are there people in my community who canrespond quickly?

People in an affected community will be the first tofeel the effect of a public health emergency. Yourlocal health department, hospital or doctor may bethe first to recognize the problem and will respond.

In addition to local resources, the state createdPublic Health Response Teams (PHRT) toprovide medical, public health and environmentalhealth expertise.

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There are two teams of expertise:• Disaster Medical Assistance Teams (IA-DMAT)• Environmental Health Emergency Response

Team (EHERT)

The IA-DMAT provides medical care and publichealth services to public health emergency victimsduring the first 24–72 hours after an incident.IA-DMAT members are volunteer doctors, nurses,physician assistants, paramedics and pharmacytechnicians who can help overburdened localmedical/public health personnel at or nearthe emergency.

The Environmental Health Emergency ResponseTeam (EHERT) is a partnership between local andstate organizations to provide volunteerenvironmental health services. EHERT is able toassist in areas such as private/public watersupplies, wastewater treatment, food safety, airquality, solid waste and mass shelter.

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NOTES

“My dad and I made a plan so we’d know whereto meet if a public health emergency strikes

when he’s at work and I’m at school. Now, noteven an emergency can keep us apart.”

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• Be prepared to use a landline phoneor a cell phone.

• Post emergency numbers by all phones inyour home.

• Teach all household members how and whento call 911 for emergency assistance.

• Ask an out-of-state friend or relative to bea contact. It’s sometimes easier to callout-of-state if local service is disrupted.

• Discuss what to do with your pets.

At school or work

Talk to your children’s schools about theiremergency preparedness plans. Find out how they will communicate with you during an emergency. • Make sure you authorize someone nearby to

pick up your children from school in case youare unable to do so yourself during or afteran emergency.

• Discuss with your neighbors how you canwork together and help each other if anemergency strikes.

• At work, find out what kind of emergencypreparedness and communication plans arein place.

Special considerations

Elderly or people with disabilities

An elderly person or someone with disabilitiesmay face special challenges if an emergency

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Taking Action

Taking action to help loved ones, friends and thecommunity after an emergency makes one feelbetter. Depending on the emergency, lending ahand is done in many ways such as donatingblood, filling sandbags or checking on the elderly.Listen to local and state officials about what helpthey need from the public.

Make a Plan

Being prepared can reduce fear, anxiety andlosses during a disaster. A key part is having aplan for what to do in case of an emergency. Youneed to be ready to react to any situation andtake the necessary steps to protect yourself andyour loved ones.

Meet with your loved ones to discuss why youneed to prepare for a public health emergency.Plan to work together as a team and shareresponsibilites. Practice and maintain your planthroughout the year.

Develop a communications plan

Your loved ones may not be together when anemergency strikes. So, you need to establish a plan of communication to keep in close touch, discuss your options and make decisions together.• Designate a primary place to meet and

then choose a backup location outsideyour neighborhood.

• Designate an emergency contact.

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strikes. Learning about the challenges and beingprepared ahead of time will enable you tobetter cope with an emergency and recovermore quickly.

• Establish a personal support network madeup of individuals who will check with youin an emergency.

• You and your personal support network shouldnotify each other when you are going out oftown and when you will return.

• Have emergency supplies packed and ready inone place before an emergency hits. Makesure you have enough supplies to last at leastthree days, including prescription medications.Store them in an easy-to-carry container suchas a backpack or duffel bag.

• Be sure your bag and any equipment youneed such as a wheelchair, cane or walkerhas an ID tag.

Make an Emergency Supply Kit

During or after an emergency, you won’t havetime to search for supplies. There’s also a chancestores may not be open to fill even basic needs.

An emergency supply kit, containing necessaryitems you would need for survival, should beprepared in advance. Keep the kit in anaccessible place where you can reach it quickly incase of an emergency—whether you remain athome or evacuate to a safe place. Recommendedsupplies to include in a basic emergency supply kit:

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Water, at least one gallon per person perday for at least three days, stored in aplastic container Food, at least a three-day supply ofnonperishable food TIP: Don’t forget those with special diets such as diabetics. A first-aid kitPrescription medications—watch forexpiration datesBattery-powered radio, flashlights andextra batteriesCan openerBedding for each personPersonal hygiene itemsDust mask or cotton T-shirt for each personto help filter the airA whistle to signal for helpA waterproof container—to store importantdocuments such as drivers license, birthcertificates, copies of medical prescriptions,insurance policies

AFTER ASSEMBLING YOUR KIT

• Store the kit in a place known to all household members.

• Review the contents of your kit periodically tomake sure food and water are fresh andprescription medicines are up-to-date.

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NOTES

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CO

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“Being able to work through the stress of an emergency together was great.

We encouraged each other to get back into our routines and move on.”

If you continue to experience stress symptoms—not sleeping regularly, nervousness, getting tiredeasily, and a lost interest in what you once feltwas important—seek medical help.

Helping children cope with an emergencyChildren are influenced by behaviors and willreact based on how they view parents and otheradults responding to the emergency.

Here are steps you can take to help children copewith an emergency:• Reduce their exposure to TV and radio

coverage of the situation.• Listen to their concerns and don’t deny what

is happening.• Briefly share facts about the event and use

language they understand.• Encourage them to express feelings by

painting or drawing.• Reestablish their daily routine; it brings stability

back to their lives. Children cope better if theyare back in school or in daily activities, sharingwith peers their experience instead of beingkept at home.

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Coping/Recovering from an emergency

Returning to “normal”: How to deal with stressand anxiety after an emergencyEveryone who knows about or directlyexperiences an emergency is touched by it. Evenif an emergency produces little physical damage,it can bring fear, confusion and uncertainty intoeveryday life.

People are usually able to recover quickly fromdifficult experiences. If you have problems gettingback to normal after an emergency, state andlocal resources will be available to help.

After an emergency, you and your loved ones areencouraged to take these steps to feel better byreducing stress:

• Avoid watching extended news coverageof the emergency. However, continue to keeptabs on announcements by public health officials.

• Increase physical activity; doing things liketalking walks, bike riding, or evenhousecleaning can help.

• Talk with friends, relatives, teachers or leadersof your faith community about your reaction tothe incident.

• Eat healthy foods and get plenty of rest.• Recognize that stress may make you want to

use or abuse tobacco, alcohol or drugs; don’t,as they will only make things worse.

• Return to daily routines as soon as possible,especially for children.

• Ask for help when you need it.

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“I keep the contact list on the fridge where it’s easy to find. Tiger and I like knowing

there are people out there waiting to help in an emergency.”

My Emergency Information

Use this guide to record your personalinformation:

My Name ______________________________

My Cell Phone Number ____________________

Date of Birth ____________________________

Height/Weight __________________________

Doctor Name & Number __________________

Allergies________________________________

Medications ____________________________

Past Medical History ______________________

______________________________________

Fill out the following information for eachhousehold member and keep it up-to-date:

Name __________________________________

Cell Phone Number ______________________

Date of Birth ____________________________

Height/Weight __________________________

Doctor Name & Number __________________

Allergies________________________________

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Contacts/Resources

Emergency Contact Numbers

Ambulance______________________________

Law Enforcement ________________________

Hospital ________________________________

Local Public Health ______________________

______________________________________

Iowa Department of Public Healthwww.idph.state.ia.us

Centers for Disease Control and Preventionwww.cdc.gov

U.S. Department of Health and HumanServiceswww.hhs.gov

Iowa Homeland Security and EmergencyManagementwww.iowahomelandsecurity.com

Disaster Helpwww.disasterhelp.gov

American Red Crosswww.redcross.org

U.S. Department of Homeland Securitywww.ready.gov

Complete the following based on the placeswhere your loved ones spend the most time:

Home Address __________________________

Phone Number __________________________

Neighborhood Meeting Place ______________

My Work ______________________________

Address ________________________________

Phone Number __________________________

Evacuation Location ______________________

Spouse’s Work Address __________________

Phone Number __________________________

Spouse’s Cell Phone Number ______________

Evacuation Location ______________________

School Address __________________________

Phone Number __________________________

Children’s Cell Phone Numbers ____________

______________________________________

Evacuation Location(s) ____________________

______________________________________

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Medications ____________________________

Past Medical History ______________________

Name __________________________________

Cell Phone Number ______________________

Date of Birth ____________________________

Height/Weight __________________________

Doctor Name & Number __________________

Allergies________________________________

Medications ____________________________

Past Medical History ______________________

______________________________________

Name __________________________________

Date of Birth ____________________________

Height/Weight __________________________

Doctor Name & Number __________________

Allergies________________________________

Medications ____________________________

Past Medical History ______________________

______________________________________

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Glossary

Aerosol: A gaseous suspension of fine solid orliquid particles.

Bacteria: Potentially harmful organisms that live in soil, water and the bodies of plants and animals.

Bioterrorism: Terrorist activities that usebiological agents to harm or kill victims.

Contagious: A disease that can be spread by contact.

Decontamination: To clean the area that is contaminated.

Immunization: To make immune or protectagainst a specific disease.

Infectious: Capable of causing infection.

Natural disaster: Widespread destruction causedby nature—floods, hurricanes, tornadoes.

Nonperishable: Food that does not spoil.

Nuclear: An atomic explosion.

Public health emergency: Anything that posesan urgent threat to the public’s health.

Radiation: The spreading of usually harmfulenergy waves—most often referring to nuclear energy.

Toxin: A poisonous substance.

Vaccine: A substance used for protecting humansagainst deadly diseases such as smallpox.

Vapor: Barely visible or cloudy diffused matter.

Virus: An infection that can cause illness inhumans and animals.

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Daycare Address ________________________

Phone Number __________________________

Evacuation Location ______________________

Other Place(s) You Frequent________________

Phone Number __________________________

Evacuation Location ______________________

Other Place(s) You Frequent________________

Phone Number __________________________

Evacuation Location ______________________

Other important information:

Pharmacy ______________________________

Homeowners/Renters Insurance ____________

Policy # ________________________________

Claims Phone Number ____________________

Vehicle Insurance ________________________

Policy # ________________________________

Claims Phone Number ____________________

Produced by the IOWA DEPARTMENT OF PUBLIC HEALTH

Acute Disease Prevention & Emergency Response

Lucas State Office Building321 East 12th Street

Des Moines, Iowa 50319-0075www.idph.state.ia.us