An epidemic is a greater than expected number of cases of a contagious disease. What counts as an epidemic depends on the disease. In the United States, a few cases of measles is an epidemic because we usually donít have any measles. In comparison, a winter with only ten thousand deaths from influenza would be a good year because this is much less than usual.

Diseases In Disasters

Infectious diseases can be a major problem in disaster situations. The water supply may be unreliable and food may become contaminated or spoiled. When people are living in crowded conditions like shelters, respiratory illnesses can spread very rapidly. During clean-up it is easy to get exposed to diseases that are spread by insects. Disease prevention should be part of your disaster planning. The chapters on food and water are intended to help you keep your family healthy.

What you usually get from bad water is some form of diarrhea. After a disaster, if you have a private water source like a well, you need to get it tested. If you have city water, listen to the news. If there is any question about the quality of the water in your pipes, boil it or treat it with chlorine before you drink it.


Bad food can be even more of a problem than bad water. The most common source of food poisoning in the United States is pot-luck suppers. People get sick from the chicken salad that wasnít refrigerated. We have millions of cases of food borne illness in this country every year, and most are from accidental poisoning by friends or family. In a disaster situation, where both heating and cooling food is difficult, the problem can be more severe. Remember to keep hot foods hot, cold foods cold, and throw away cooked food that has been at room temperature for more than two hours.

Respiratory diseases like colds or bronchitis are around all the time and can easily cause outbreaks during a disaster. We usually have outbreaks of these diseases every fall when children go back to school. They spend hours in small rooms with lots of other people. They cough and sneeze on each other. They share pencils and baseballs and sandwiches. Then they bring home all the germs they have shared at school. The same principles apply in shelters or crowded homes. To protect yourself, wash your hands or use alcohol gel hand sanitizer frequently and keep your hands out of your eyes, nose and mouth. To protect others, cover your mouth when you cough or sneeze.

Diseases that are spread by insects are generally rare but they can be a problem in a disaster area. Several different diseases are spread by mosquitoes or ticks, and a few are spread by fleas. You prevent these diseases by preventing the insect bites that transmit them. If you are outside in the morning or evening, wear long sleeves and mosquito repellant. If you are in high weeds or the woods, tuck you pant legs into your socks or boots, wear repellant and check for ticks frequently. Stay away from fleas by staying away from rodents and feral dogs and cats.

Diseases As Disasters

In rare circumstances, like bird flu or bioterrorism, an epidemic can be a disaster. This is unlikely except with diseases that are spread through person to person contact, ones that you can catch from someone on the subway or at a football game. Bird flu really isnít going to be a problem as long as the only people getting sick are chicken farmers. It is when their nurses get sick too that we are in trouble.

Most epidemic diseases spread through the air or from touching things that are contaminated. You prevent bird flu, smallpox, and pneumonic plague the same way you prevent the common cold. Keep your hands clean and avoid being coughed on. If the situation is more complicated than this, or an epidemic has started, you should listen to the advice of the Centers for Disease Control and your local health department.

All our national plans for responding to an epidemic include reducing the movement of people in order to slow the spread of the disease. This may include orders for people to stay at home or away from public places. If this occurs, your stores of food and water and other emergency supplies are going to be very useful. You simply follow the advice here for taking care of your family without leaving the house.


The best disease prevention available is immunization. There are about a dozen diseases that we can protect children against with routine immunizations. The childhood diseases like measles, mumps, rubella, chickenpox, polio, diphtheria and whooping cough are becoming almost unknown in this country along with the death and disability they caused. Now, we can also prevent several types of hepatitis, meningitis and pneumonia. It involves a lot of shots, especially for the babies but it keeps them alive and healthy. In a disaster situation, if children are up to date on their immunizations, they do not need any extra shots.


Most of us are conscientious about getting our children their shots, but it is easy to forget about the adults in the family. Some of the immunizations that we now give to all children were not available twenty years ago. Everyone should have a tetanus/diphtheria booster every ten years if they have not had an injury that requires one sooner. An adult who has not had chickenpox should get the vaccine. Any adult who is at higher risk for hepatitis, such as healthcare workers and emergency responders should have these immunizations. In a disaster situation, very few adults need anything except a routine tetanus shot to bring them up to date. People with special needs, such as nurses and police officers, should have had their shots already.

Disease control for disasters is easy. Make sure everyone in the family is up to date on their regular immunizations and keep their immunization records with your other important papers. If there is a disease outbreak, listen to your local health department and follow their instructions carefully. Stay home if you are told to do so. Donít ask for special immunizations unless you are one of the people at risk. And, donít go to a hospital or clinic unless you are sick.