Preparing for disease threats following a disaster
Hawaii is vulnerable to a number of natural disasters including hurricanes, tsunamis, flash flooding, and earthquakes. These disturbances can threaten existing infrastructure (e.g. water and power supplies) disrupting the balance between people and their environments, increasing the risk for infectious diseases. Advanced warning may be limited or non-existent, making preparation and knowledge essential to reducing the potential for these harmful effects.
The information below contains tips and resources on how to protect yourself from the most common infectious disease threats when natural disasters occur in Hawaii.
For general information and resources about preparing for disasters in Hawaii, visit the Office of Public Health Preparedness
1) Food safety precautions
Prevent gastrointestinal illness
When the power goes out, food can spoil as microorganisms begin to grow rapidly when the temperature rises above 40°F.
Follow these tips to remain safe from foodborne illnesses during situations where food is likely to become contaminated:
- If the power goes out, food stored in the refrigerator can usually remain at a safe temperature (under 40°F) up to 4 hours, if you do not open the refrigerator.
- Any refrigerated food item that is perishable (meat, poultry, fish, eggs, soft cheeses) that has been left at room temperature for more than 2 hours should be thrown away.
- If your home experiences flooding, store food items on higher shelves to prevent contamination from flood water.
For more information about keeping food safe during an emergency, visit:
- HDOH Foodborne Illnesses
- FoodSafety.gov has great tips from the Centers for Disease Control (CDC), the United States Department of Agriculture (USDA), and the Food and Drug Administration (FDA) on keeping food and water safe in an emergency.
2) When taking shelter
Prevent respiratory disease with simple personal hygiene
Crowded conditions may occur following a natural disaster as people shelter in place or in an evacuation center, increasing the risk of respiratory disease. These illnesses are caused when germs spread from person to person through small droplets of saliva or mucus. Healthy people can become sick when they touch surfaces harboring these germs and then touch their mouth, nose, or food. Highly contagious respiratory diseases such as influenza, meningitis, and measles can be easily transmitted from person to person during periods of crowding.
To prevent the spread of germs that cause respiratory illness:
- Cover your mouth and avoid close contact with other people when coughing or sneezing, and avoid sharing personal items such as eating utensils or drinking containers, toothbrushes, and towels.
- Frequently wash your hands with soap and water or use an alcohol-based gel and wipe down surrounding surfaces with a disinfectant.
- Make sure you are up to date on vaccines that may reduce your risk for respiratory illness, such as the seasonal flu vaccine, given each year.
For more information about hygiene and preventing respiratory illness, visit:
- Hawaii Vaccine Locator
- CDC Prevent the Spread of Respiratory Illnesses Following a Natural Disaster
- CDC Infection Control Guidance for Community Evacuation Centers Following Disasters
- CDC Respiratory Hygiene/Cough Etiquette
3) Avoiding environmental hazards
Be careful to remain as safe and healthy as possible as you navigate your surroundings following a disaster. Injuries may occur during or after a disaster as debris and other hazards are introduced into the environment. The skin serves as a protective barrier to infection, though injuries can allow germs to enter and infect wounds. A wound infection can be identified when the area becomes red, swollen, painful, and warm to the touch.
To prevent infection:
- Immediately clean all open wounds and cuts with soap and water.
- Keep wounds covered with clean, dry bandages, and get evaluated for a tetanus vaccine, if needed.
- If the wound appears to be infected, contact a healthcare provider immediately.
For more information about wound management, visit:
- CDC Emergency Wound Care After a Natural Disaster:
- CDC Emergency Wound Management for Health Care Professionals
- Association for Professionals in Infection Control (APIC) website
Being prepared for natural disasters includes staying up to date on immunizations that protect you from serious diseases, like tetanus. Tetanus is caused by bacteria found everywhere in the environment, including soil, dust, and manure, which can enter the body through a puncture, cut, or sore on the skin. Tetanus causes painful muscle stiffness and can be deadly if untreated.
To reduce your risk of tetanus:
- Be aware of your surroundings; avoid sharp objects and use good wound care if your skin becomes cut or punctured.
- Tetanus vaccines are recommended for people of all ages, with booster shots recommended at least every 10 years.
- Talk to your healthcare provider to find out if you should receive a booster dose of the tetanus vaccine following a cut or burn.
For more information about environmental hazards, including tetanus, visit:
4) Avoiding waterborne diseases
Direct sources of waterborne illness
Water systems can be contaminated during natural disasters, so it is important to use clean and safe water for drinking, cooking and bathing. Standing water may contain small quantities of animal or human waste which harbor bacteria and parasites. When these germs enter the body, they can cause severe diarrhea, vomiting, and dehydration. Floodwaters may also contain potentially dangerous chemicals from agricultural run-off.
Follow these tips to remain safe from waterborne illnesses during situations where water may be contaminated:
- Do not bathe or enter areas with standing water, especially if you have an open wound.
- Avoid allowing flood water or contaminated water to enter your mouth, or get in your eyes and nose.
- Only use water from a known safe source. Have an emergency supply of bottled water at your home in case the tap water becomes unsafe.
For more information about preventing waterborne illness, visit:
Mosquitos and rodents
Following heavy rain events, mosquito and rodent populations often swell. Buckets, tires and other trash and debris create places for mosquitos to lay their eggs. Rodents may relocate to new areas in search of food or shelter. Mosquito bites can transmit diseases to humans such as Zika, dengue, and chikungunya, while rodents can transmit leptospirosis through urine and murine typhus through flea bites.
To protect yourself from mosquito bites:
- Make sure to wear long-sleeved shirts and pants.
- Apply EPA-registered insect repellents.
- Remove or dump out sources of standing water around your home.
To prevent disease from rodents:
- Seal all gaps and holes that are greater than 1/4-inch in diameter, as rats and mice are able to enter buildings through holes as small as a quarter or dime.
- Cover and store food and water in rodent-proof containers, dispose of garbage frequently into rodent-proof bins, and remove debris around the home that can serve as a shelter for rodents
- Be sure to cover wounds and avoid wading into standing floodwater to prevent exposure to urine from rodents and other animals.
For more information about mosquitos and the diseases they transmit, visit:
For more information about rodents and the diseases they transmit, visit:
- HDOH Leptospirosis
- HDOH Murine Typhus
- CDC Hurricanes, Floods, and Leptospirosis
- CDC Rodent Control After a Disaster
Last reviewed March 2019