How to Prepare for Disasters and Emergencies

The information found within this document was taken from various websites including ready.gov, nationalterroralert.com, the University of Colorado, and crimanljusticeusa.com. This information is assembled for reference and convenience within one usable document. Version 1.0

Table of Contents How to Prepare for Disasters and Emergencies.......................................................................................................1 Preparedness Guides..............................................................................................................................................10 How to Prepare......................................................................................................................................................10 Introductions..................................................................................................................................................10 What You Can Do to Prepare........................................................................................................................10 If Disaster Strikes...........................................................................................................................................11 A Word on What Could Happen....................................................................................................................12 Evacuation......................................................................................................................................................12 If youre sure you have time: ........................................................................................................................12 Additional Positive Steps You Can Take.......................................................................................................13 Quick Reference.....................................................................................................................................................14 National Security Emergencies......................................................................................................................14 Terrorism........................................................................................................................................................14 Preparing for terrorism...................................................................................................................................14 Protection against cyber attacks.....................................................................................................................15 Preparing for a building explosion.................................................................................................................15 Bomb Threats.................................................................................................................................................15 Suspicious parcels and letters .......................................................................................................................16 What to do if there is an explosion ...............................................................................................................17 Chemical and Biological Weapons ...............................................................................................................17 Chemical........................................................................................................................................................17 There are six types of agents: ........................................................................................................................18 Biological.......................................................................................................................................................18 What to do to prepare for a chemical or biological attack ............................................................................19 What to do during a chemical or biological attack .......................................................................................19 What to do after a chemical attack ................................................................................................................20 What to do after a biological attack ..............................................................................................................20 Nuclear and Radiological Attack ..................................................................................................................20 In general, potential targets include: .............................................................................................................21 Electromagnetic pulse ...................................................................................................................................22 What to do during a nuclear or radiological attack .......................................................................................23 What to do after a nuclear or radiological attack ..........................................................................................24 Returning to your home ................................................................................................................................24 Homeland Security Advisory System ...........................................................................................................25 Threat Conditions and Associated Protective Measures ...............................................................................26 Biological Attack...................................................................................................................................................28 Protect Yourself.............................................................................................................................................29 Symptoms and Hygiene.................................................................................................................................29 Responding To an Attack...............................................................................................................................29 Warning Signs of an Attack or Incident........................................................................................................30 What to Do In Case of Attack........................................................................................................................30 Choosing a Safe-Haven Room.......................................................................................................................31 Chemical Attack.....................................................................................................................................................31 Possible Signs of Chemical Threat................................................................................................................32 Responding To an Attack...............................................................................................................................32 Warning Signs of a Chemical Attack or Incident..........................................................................................33 What to Do In Case of Attack........................................................................................................................34 Preparing a Safe room....................................................................................................................................35 Hijacking Survival Guidelines...............................................................................................................................35 What to Do In A Hijacking............................................................................................................................35

Explosive Attack....................................................................................................................................................38 If There is an Explosion.................................................................................................................................38 If There is a Fire.............................................................................................................................................38 If You Are Trapped in Debris........................................................................................................................38 Family Disaster Plan..............................................................................................................................................38 4 Steps to Safety:...........................................................................................................................................39 Neighbors Helping Neighbors:......................................................................................................................40 Home Hazard Hunt:.......................................................................................................................................40 Evacuation:....................................................................................................................................................40 Emergency Supplies:.....................................................................................................................................41 UTILITIES ....................................................................................................................................................41 If Disaster Strikes:..........................................................................................................................................41 72 Hour Kit............................................................................................................................................................42 72 Hour Kit List of Items...............................................................................................................................42 72 Hour Kit Info You Need To Know ..........................................................................................................43 Emergency Evacuation Plan..................................................................................................................................43 Preparing an Emergency Evacuation Plan ....................................................................................................43 Emergency Evacuation Inventory..................................................................................................................43 Evacuation Steps............................................................................................................................................44 Household Emergency Evacuation Plan .......................................................................................................44 Choosing an Out-of-Area Contact:................................................................................................................44 Choosing A Place to Meet:............................................................................................................................44 Emergency Water Storage.....................................................................................................................................45 Amount of Emergency Water to Store...........................................................................................................46 Use the following guidelines when storing water:.........................................................................................46 Containers That Can be Used for Water Storage...........................................................................................46 Do I Need to Treat Water?.............................................................................................................................47 Where to Store Water.....................................................................................................................................47 Emergency Sources of Water.........................................................................................................................47 Emergency Outdoor Water Sources...............................................................................................................48 Hidden Water Sources in Your Home...........................................................................................................48 Using Swimming Pool Water........................................................................................................................48 When and How to Treat Water for Storage...................................................................................................48 Food Storage and Preparedness.............................................................................................................................50 When Food Supplies Are Low.......................................................................................................................50 Special Considerations...................................................................................................................................50 How to Cook If the Power Goes Out.............................................................................................................50 Short-Term Food Supplies ............................................................................................................................51 Storage Tips...................................................................................................................................................51 Nutrition Tips.................................................................................................................................................51 So remember: ................................................................................................................................................51 How long can food supplies be stored?.........................................................................................................51 What kinds of food supplies are recommended to store in case of a disaster?..............................................52 Recommended foods include:........................................................................................................................52 Food Options to Avoid:.................................................................................................................................52 Shelf-life of Foods for Storage......................................................................................................................53 Use within six months:...................................................................................................................................53 Use within one year:......................................................................................................................................53 First Aid in an Emergency.....................................................................................................................................53 First Aid Kit List............................................................................................................................................55 Sanitation and Hygiene In An Emergency.............................................................................................................56 Tips for Staying Clean in an Emergency Situation........................................................................................57

Keep Basic Hygiene Supplies Handy............................................................................................................57 Emergency Sewage Disposal.........................................................................................................................58 Temporary Toilet Provisions.........................................................................................................................58 Emergency Sewage Storage ..........................................................................................................................58 Solutions for Apartment Dwellers.................................................................................................................59 Controlling Odors and Insects.......................................................................................................................59 Other Supplies................................................................................................................................................59 Babies.............................................................................................................................................................59 Heat, Light and Cooking In An Emergency..........................................................................................................59 Matches..........................................................................................................................................................60 Sterno ............................................................................................................................................................60 Sterno Stove...................................................................................................................................................60 Coleman fuel (white gas)...............................................................................................................................60 Charcoal.........................................................................................................................................................60 Emergency Communications.................................................................................................................................62 Here are some criteria for setting up an emergency communications system: .............................................62 Cell Phones....................................................................................................................................................62 CB Radio........................................................................................................................................................62 49MHz Personal Communicators..................................................................................................................63 Family Radio Service.....................................................................................................................................64 General Mobile Radio Service.......................................................................................................................64 Amateur Radio...............................................................................................................................................65 Final Points....................................................................................................................................................65 911 Calls........................................................................................................................................................66 Public Safety Answering Point and Call Dispatch........................................................................................66 Wireless and E911.........................................................................................................................................66 VoIP and E911...............................................................................................................................................67 Network Damage and Black-outs..................................................................................................................67 E-mail May Work When Phone Lines Dont During a Terrorist Attack, Natural Disaster or State of Emergency.....................................................................................................................................................68 The Emergency Alert System Radio and Television Updates.......................................................................68 Accessibility of Emergency Information.......................................................................................................69 Wind Up Radios.............................................................................................................................................69 Important documentation in an emergency............................................................................................................70 Shelter-in-Place......................................................................................................................................................72 At School:......................................................................................................................................................74 In Your Vehicle:............................................................................................................................................75 Safe Room..............................................................................................................................................................75 Sealing a Safe Room......................................................................................................................................75 How to Prepare the Sealed Room..................................................................................................................75 Risk Factors for a Bio-Chemical Attack:.......................................................................................................76 Potassium Iodide KI...............................................................................................................................................78 Potassium Iodide (KI) Information................................................................................................................78 When to take KI.............................................................................................................................................78 Who should or should not take KI when the public is told to do so..............................................................79 Medical conditions that make it dangerous to take KI..................................................................................80 Gas Masks..............................................................................................................................................................80 Let the Buyer Beware ...................................................................................................................................81 Suspicious Activity................................................................................................................................................85 What to Do If You Spot Suspicious Terrorist Activity..................................................................................85 Unusual Interest in High Risk or Symbolic Targets......................................................................................86 The following should cause a heightened sense of suspicion:.......................................................................86

Fraudulent Identification................................................................................................................................87 Fraudulent IDs include:................................................................................................................................87 Some signs that may raise your suspicions....................................................................................................87 Unusual Purchases or Thefts..........................................................................................................................88 Additional suspicious activity may include:..................................................................................................88 Emergency Evacuation Plan..................................................................................................................................89 Preparing an Emergency Evacuation Plan ....................................................................................................89 Emergency Evacuation Inventory..................................................................................................................89 Evacuation Steps............................................................................................................................................89 Household Emergency Evacuation Plan .......................................................................................................89 Choosing an Out-of-Area Contact:................................................................................................................90 Choosing a Place to Meet:.............................................................................................................................90 Emergency Preparedness.......................................................................................................................................91 Emergency Preparedness.......................................................................................................................................91 Create an emergency communications plan..................................................................................................91 Establish meeting places................................................................................................................................92 Assemble a disaster supplies or 72 hour emergency preparedness kit..........................................................92 Evacuation in an emergency..........................................................................................................................93 If youre sure you have time additional emergency preparedness actions................................................94 Additional Steps You Can Take....................................................................................................................94 Explosive Devices and Weapons...........................................................................................................................95 Dirty Bomb............................................................................................................................................................95 What is a Dirty Bomb....................................................................................................................................95 Dirty bomb versus atomic bombs in Hiroshima and Nagasaki......................................................................95 How much expertise does it take to make a dirty bomb?..............................................................................95 Is a dirty bomb a nuclear weapon?................................................................................................................96 Is a dirty bomb a weapon of mass destruction?.............................................................................................96 Sources of the radioactive material in Dirty Bombs......................................................................................96 Dangers of a dirty bomb................................................................................................................................96 Past use of dirty bombs..................................................................................................................................97 What people should do following the explosion of a dirty bomb..................................................................97 Taking potassium iodide (KI)........................................................................................................................97 If radioactive materials were involved...........................................................................................................97 Risk of cancer from a dirty bomb..................................................................................................................98 Nuclear...................................................................................................................................................................98 Explosive Blast..............................................................................................................................................98 Direct Nuclear Radiation...............................................................................................................................98 Thermal Radiation.........................................................................................................................................99 Fallout............................................................................................................................................................99 1 Megaton Surface Blast: Pressure Damage..................................................................................................99 1 Megaton Surface Blast: Fallout................................................................................................................100 25 Megaton Air Blast: Pressure Damage.....................................................................................................101 What Types of Terrorist Events Might Involve Radiation?.................................................................................102 How Can I Protect Myself During a Radiation Emergency? ......................................................................102 What is Radiation? ......................................................................................................................................103 How Can Exposure Occur? .........................................................................................................................103 Health Effects of Radiation Exposure .........................................................................................................104 Suitcase Nukes.....................................................................................................................................................105 Effects..........................................................................................................................................................105 Symptoms....................................................................................................................................................106 Treatment.....................................................................................................................................................106 What To Do In A Bombing.................................................................................................................................107

What should I do if I think someone is going to set off a bomb?................................................................107 What should I do during a terrorist bombing?.............................................................................................107 Chemical and Biological Weapons......................................................................................................................108 Anthrax................................................................................................................................................................108 What are the signs and symptoms of anthrax?.............................................................................................108 What specific symptoms should I watch for?..............................................................................................109 Is there a way to distinguish between early inhalational anthrax and flu?..................................................109 Is anthrax contagious?..................................................................................................................................110 What are the case fatality rates for the various forms of anthrax?...............................................................110 Can the presence of Bacillus anthracis spores be detected by a characteristic appearance, odor, or taste? 110 What would be the approximate size of enough Bacillus anthracis spores to cause infection?..................110 How can I know my cold or flu this season is not anthrax?........................................................................110 If I have the flu, can I still get anthrax?.......................................................................................................111 How is anthrax diagnosed? .........................................................................................................................111 Preventative Therapy...................................................................................................................................111 What is the therapy for preventing inhalational anthrax?............................................................................111 What is cipro (ciprofloxacin)?.....................................................................................................................111 Does ciprofloxacin have an expiration date?...............................................................................................111 What are the side effects of cipro?...............................................................................................................111 What are the guidelines for changing from ciprofloxacin to another antibiotic?........................................112 Should people buy and store antibiotics?.....................................................................................................112 Will antibiotics protect me from a bioterrorist event? Should I stockpile them?........................................112 Who should receive antibiotics for 60 days?...............................................................................................112 When is a 60-day prescription of prophylactic antibiotics not needed?......................................................113 Anthrax Treatment...............................................................................................................................................113 What if I develop side effects from the antibiotic?......................................................................................113 Has CDC tested the anthrax isolates for sensitivity to different antibiotics?..............................................113 What are the risks of using tetracyclines and fluoroquinolones in children; are alternatives available?....113 Are there special instructions for taking ciprofloxacin or doxycycline?.....................................................113 After I have started taking ciprofloxacin to protect me from developing anthrax, what side effects could I get from taking this antibiotic?....................................................................................................................113 After I have started taking doxycycline to protect me from developing anthrax, what side effects could I get from taking this antibiotic?....................................................................................................................114 Why is CDC recommending doxycycline instead of ciprofloxacin for the treatment and prevention of anthrax?........................................................................................................................................................114 Why are people who have been exposed to B. anthracis being given antibiotics for different amounts of time?.............................................................................................................................................................115 Are there different strains of B. anthracis? Do they all respond to antibiotics?..........................................115 What is the FDA telling physicians and other health professionals about prescriptions for ciprofloxacin? ......................................................................................................................................................................115 Can other fluoroquinolones be used instead of ciprofloxacin for post exposure prophylaxis (PEP)/treatment?..........................................................................................................................................115 Why do I need 60 days of antibiotics?.........................................................................................................116 What happens if I take ciprofloxacin, doxycycline, or amoxicillin for a few days, stop, and then restart the antibiotics?...................................................................................................................................................116 The ciprofloxacin I am taking gives me headaches. Is there anything I can do to help this?......................116 The ciprofloxacin, doxycycline, or amoxicillin I am taking makes me feel sick to my stomach. Is there anything I can do to help this?.....................................................................................................................116 The ciprofloxacin, doxycycline, or amoxicillin I am taking gives me diarrhea. Is there anything I can do to help this?......................................................................................................................................................116 If taking one of the recommended antibiotics makes me feel terrible, can I switch to another of these antibiotics?...................................................................................................................................................116

I am having terrible yeast infections while taking ciprofloxacin, doxycycline, or amoxicillin. Is there anything I can take for this?.........................................................................................................................117 I feel much better if I take only one pill of ciprofloxacin, doxycycline, or amoxicillin each day. Is that okay?............................................................................................................................................................117 My prescription says to take one pill every 12 hours. If 15 hours have passed since my last dose, is it still okay to take the pill?....................................................................................................................................117 What side effects are serious enough that I should go to a doctor?.............................................................117 Can I drink alcohol if I am taking ciprofloxacin, doxycycline, or amoxicillin?..........................................117 The ciprofloxacin, doxycycline, or amoxicillin I am taking makes me feel itchy all over. Is there anything I can do to help this?......................................................................................................................................117 The ciprofloxacin, doxycycline, or amoxicillin gave me an allergic reaction and I stopped taking it. What should I do?..................................................................................................................................................118 Why cant I take a shot, wear a patch, or take one large dose of the medicine instead of taking it for 60 days?............................................................................................................................................................118 Ciprofloxacin and doxycycline look different and come in different doses. Is one better than the other?. 118 Should all patients who have flu-like symptoms be treated with antibiotics?.............................................118 Does a patient have immunity after recovering from anthrax infection?....................................................118 How do doctors treat inhalational anthrax to reduce the risk of death in patients?.....................................118 I was told that I had been exposed to Bacillus anthracis and prescribed antibiotics. I took the medicine for a couple weeks. Wouldnt that weaken any anthrax thats in my body?........................................................119 Why was ciprofloxacin ever publicized as the best drug for anthrax? How can we know which antibiotic is best?.............................................................................................................................................................119 Besides anthrax, what else is ciprofloxacin prescribed for? Has there been resistance to ciprofloxacin when used in other instances (historically)?..........................................................................................................119 Is there a generic form of ciprofloxacin?.....................................................................................................119 CBRN...................................................................................................................................................................119 Cyanide................................................................................................................................................................120 What cyanide is:...........................................................................................................................................120 Where cyanide is found and how it is used..................................................................................................120 How people can be exposed to cyanide.......................................................................................................121 How cyanide works......................................................................................................................................121 Immediate signs and symptoms of cyanide exposure..................................................................................121 How cyanide poisoning is treated................................................................................................................122 How people can get more information about cyanide.................................................................................122 Sulfur Mustard.....................................................................................................................................................123 What sulfur mustard is: ...............................................................................................................................123 Where sulfur mustard is found and how it is used.......................................................................................123 How people are exposed to sulfur mustard..................................................................................................123 How sulfur mustard works...........................................................................................................................123 Immediate signs and symptoms of sulfur mustard exposure.......................................................................123 What the long-term health effects may be...................................................................................................124 How people can protect themselves and what they should do if they are exposed to sulfur mustard.........124 How sulfur mustard exposure is treated.......................................................................................................125 Where people can get more information about sulfur mustard....................................................................125 Pneumonic Plague................................................................................................................................................125 Ricin.....................................................................................................................................................................127 What Is Ricin?..............................................................................................................................................127 Where Is Ricin Found, and How Is It Used?...............................................................................................127 How Can People Be Exposed to Ricin?.......................................................................................................127 How Does Ricin Work? ..............................................................................................................................128 What Are the Signs and Symptoms of Ricin Exposure? ............................................................................128 How Is Ricin Poisoning Treated?................................................................................................................128

How Do We Know for Sure Whether People Have Been Exposed to Ricin?.............................................129 What Can People Do If They Think They May Have Been Exposed to Ricin?...........................................................................................................................................................129 Sarin.....................................................................................................................................................................129 What Sarin is:...............................................................................................................................................129 Where sarin is found and how it is used?....................................................................................................129 How people can be exposed to sarin?..........................................................................................................129 How sarin works?........................................................................................................................................130 Immediate signs and symptoms of sarin exposure......................................................................................130 How people can protect themselves and what they should do if they are exposed to sarin?.......................131 How sarin poisoning is treated?...................................................................................................................132 Smallpox vaccine.................................................................................................................................................132 Should you get the smallpox vaccine if you have a weakened immune system (e.g., you are immuno compromised)?.............................................................................................................................................133 Pregnant women are discouraged from getting the vaccine. Is there a danger to them (or to an unborn child) if broader vaccination occurs, increasing the potential for contact with vaccinated people?..............................................................................................133 Is there any way to treat bad reactions to the vaccine?................................................................................133 Is a child under the age of 1 year in the household a contraindication to vaccination? ..............................133 Are there any eye conditions that would preclude vaccination?..................................................................134 Soman..................................................................................................................................................................135 What soman is:.............................................................................................................................................135 Where soman is found and how it is used?..................................................................................................135 How people can be exposed to soman?.......................................................................................................135 How soman works:......................................................................................................................................135 Immediate signs and symptoms of soman exposure....................................................................................136 How people can protect themselves and what they should do if they are exposed to soman?....................137 How soman poisoning is treated..................................................................................................................138 Tabun...................................................................................................................................................................138 What tabun is:..............................................................................................................................................138 Where tabun is found and how it is used.....................................................................................................138 How people can be exposed to tabun...........................................................................................................138 How tabun works.........................................................................................................................................138 Immediate signs and symptoms of tabun exposure.....................................................................................139 What the long-term health effects are..........................................................................................................140 How people can protect themselves and what they should do if they are exposed to tabun ......................140 How tabun poisoning is treated....................................................................................................................140 Tularemia.............................................................................................................................................................140 How Soon Do Infected People Get Sick?....................................................................................................141 What Should I Do if I Think I Have Tularemia?.........................................................................................141 How Is Tularemia Treated?.........................................................................................................................141 What Can I Do To Prevent Becoming Infected with Tularemia?................................................................141 Can Tularemia Be Used As a Weapon?.......................................................................................................142 More Questions & Answers.........................................................................................................................142 Viral Hemorrhagic Fever.....................................................................................................................................144 What is VHF?..............................................................................................................................................144 How Is It Spread?.........................................................................................................................................144 What Are the Symptoms of Exposure?........................................................................................................144 How Is It Treated?.......................................................................................................................................144 Who Has It/Where Can It Be Found?..........................................................................................................145 Supplies for a Recession .....................................................................................................................................145

Have a supply of bottled water....................................................................................................................145

Preparedness Guides
HOW TO PREPARE Introductions Devastating acts, such as the terrorist attacks on the World Trade Center and the Pentagon, have left many concerned about the possibility of future incidents in the United States and their potential impact. They have raised uncertainty about what might happen next, increasing stress levels. Nevertheless, there are things you can do to prepare for the unexpected and reduce the stress that you may feel now and later should another emergency arise. Taking preparatory action can reassure you and your children that you can exert a measure of control even in the face of such events. What You Can Do to Prepare Finding out what can happen is the first step. Once you have determined the events possible and their potential in your community, it is important that you discuss them with your family or household. Develop a disaster plan together. 1. Create an emergency communications plan. Choose an out-of-town contact your family or household will call or e-mail to check on each other should a disaster occur. Your selected contact should live far enough away that they would be unlikely to be directly affected by the same event, and they should know they are the chosen contact. Make sure every household member has that contacts, and each others, e-mail addresses and telephone numbers (home, work, pager and cell). Leave these contact numbers at your childrens schools, if you have children, and at your workplace. Your family should know that if telephones are not working, they need to be patient and try again later or try e-mail. Many people flood the telephone lines when emergencies happen but e-mail can sometimes get through when calls dont. 2. Establish a meeting place. Having a predetermined meeting place away from your home will save time and minimize confusion should your home be affected or the area evacuated. You may even want to make arrangements to stay with a family member or friend in case of an emergency. Be sure to include any pets in these plans, since pets are not permitted in shelters and some hotels will not accept them. 3. Assemble a disaster supplies kit. If you need to evacuate your home or are asked to shelter in place, having some essential supplies on hand will make you and your family more comfortable. Prepare a disaster supplies kit in an easy-to-carry container such as a duffel bag or small plastic trash can. Include special needs items for any member of your household (infant formula or items for people with disabilities or older people), first aid supplies (including prescription medications), a change of clothing for each household member, a sleeping

bag or bedroll for each, a battery powered radio or television and extra batteries, food, bottled water and tools. It is also a good idea to include some cash and copies of important family documents (birth certificates, passports and licenses) in your kit. Copies of essential documents-like powers of attorney, birth and marriage certificates, insurance policies, life insurance beneficiary designations and a copy of your will-should also be kept in a safe location outside your home. A safe deposit box or the home of a friend or family member who lives out of town is a good choice. For more complete instructions, ask your local Red Cross chapter for the brochure titled Your Family Disaster Supplies Kit 4. Check on the school emergency plan of any school-age children you may have. You need to know if they will they keep children at school until a parent or designated adult can pick them up or send them home on their own. Be sure that the school has updated information about how to reach parents and responsible caregivers to arrange for pickup. And, ask what type of authorization the school may require to release a child to someone you designate, if you are not able to pick up your child. During times of emergency the school telephones may be overwhelmed with calls. For more information on putting together a disaster plan, request a copy of the brochure titled Your Family Disaster Plan from your local American Red Cross chapter. You may also want to request a copy of Before Disaster Strikes . . . How to Make Sure Youre Financially Prepared for specific information on what you can do now to protect your assets. If Disaster Strikes

Remain calm and be patient. Follow the advice of local emergency officials. Listen to your radio or television for news and instructions. If the disaster occurs near you, check for injuries. Give first aid and get help for seriously injured people. If the disaster occurs near your home while you are there, check for damage using a flashlight. Do not light matches or candles or turn on electrical switches. Check for fires, fire hazards and other household hazards. Sniff for gas leaks, starting at the water heater. If you smell gas or suspect a leak, turn off the main gas valve, open windows, and get everyone outside quickly. Shut off any other damaged utilities. Confine or secure your pets. Call your family contactdo not use the telephone again unless it is a lifethreatening emergency. Check on your neighbors, especially those who are elderly or disabled.

A Word on What Could Happen As we learned from the events of September 11, 2001, the following things can happen after a terrorist attack:

There can be significant numbers of casualties and/or damage to buildings and the infrastructure. So employers need up-to-date information about any medical needs you may have and on how to contact your designated beneficiaries. Heavy law enforcement involvement at local, state and federal levels follows a terrorist attack due to the events criminal nature. Health and mental health resources in the affected communities can be strained to their limits, maybe even overwhelmed. Extensive media coverage, strong public fear and international implications and consequences can continue for a prolonged period. Workplaces and schools may be closed, and there may be restrictions on domestic and international travel. You and your family or household may have to evacuate an area, avoiding roads blocked for your safety. Clean-up may take many months.

Evacuation If local authorities ask you to leave your home, they have a good reason to make this request, and you should heed the advice immediately. Listen to your radio or television and follow the instructions of local emergency officials and keep these simple tips in mind.

Wear long-sleeved shirts, long pants and sturdy shoes so you can be protected as much as possible. Take your disaster supplies kit. Take your pets with you; do not leave them behind. Because pets are not permitted in public shelters, follow your plan to go to a relatives or friends home, or find a pet-friendly hotel. Lock your home. >Use travel routes specified by local authoritiesdont use shortcuts because certain areas may be impassable or dangerous. Stay away from downed power lines. Listen to local authorities. Your local authorities will provide you with the most accurate information specific to an event in your area. Staying tuned to local radio and television, and following their instructions is your safest choice.

If youre sure you have time:

Call your family contact to tell them where you are going and when you expect to arrive. Shut off water and electricity before leaving, if instructed to do so. Leave natural gas service ON unless local officials advise you otherwise. You may need gas for heating and cooking, and only a professional can restore gas service in your home

once its been turned off. In a disaster situation it could take weeks for a professional to respond. Devastating acts, such as the terrorist attacks on the World Trade Center and the Pentagon, have left many concerned about the possibility of future incidents in the United States and their potential impact. They have raised uncertainty about what might happen next, increasing stress levels. Nevertheless, there are things you can do to prepare for the unexpected and reduce the stress that you may feel now and later should another emergency arise. Taking preparatory action can reassure you and your children that you can exert a measure of control even in the face of such events. If you are advised by local officials to shelter in place, what they mean is for you to remain inside your home or office and protect yourself there. Close and lock all windows and exterior doors. Turn off all fans, heating and air conditioning systems. Close the fireplace damper. Get your disaster supplies kit, and make sure the radio is working. Go to an interior room without windows thats above ground level. In the case of a chemical threat, an above-ground location is preferable because some chemicals are heavier than air, and may seep into basements even if the windows are closed. Using duct tape, seal all cracks around the door and any vents into the room. Keep listening to your radio or television until you are told all is safe or you are told to evacuate. Local officials may call for evacuation in specific areas at greatest risk in your community. Additional Positive Steps You Can Take Raw, unedited footage of terrorism events and peoples reaction to those events can be very upsetting, especially to children. We do not recommend that children watch television news reports about such events, especially if the news reports show images over and over again about the same incident. Young children do not realize that it is repeated video footage, and think the event is happening again and again. Adults may also need to give themselves a break from watching disturbing footage. However, listening to local radio and television reports will provide you with the most accurate information from responsible governmental authorities on whats happening and what actions you will need to take. So you may want to make some arrangements to take turns listening to the news with other adult members of your household. Another useful preparation includes learning some basic first aid. To enroll in a first aid and AED/CPR course, contact your local American Red Cross chapter. In an emergency situation, you need to tend to your own well-being first and then consider first aid for others immediately around you, including possibly assisting injured people to evacuate a building if necessary. People who may have come into contact with a biological or chemical agent may need to go through a decontamination procedure and receive medical attention. Listen to the advice of local officials on the radio or television to determine what steps you will need to take to protect yourself and your family. As emergency services will likely be overwhelmed, only call 9-1-1 about life-threatening emergencies.

QUICK REFERENCE National Security Emergencies In addition to the natural and technological hazards described in this publication, Americans face threats posed by hostile governments or extremist groups. These threats to national security include acts of terrorism and acts of war. The following is general information about national security emergencies. Terrorism Terrorism is the use of force or violence against persons or property in violation of the criminal laws of the United States for purposes of intimidation, coercion or ransom. Terrorists often use threats to create fear among the public, to try to convince citizens that their government is powerless to prevent terrorism, and to get immediate publicity for their causes. Acts of terrorism range from threats of terrorism, assassinations, kidnappings, hijackings, bomb scares and bombings, cyber attacks (computer-based), to the use of chemical, biological and nuclear weapons. High-risk targets include military and civilian government facilities, international airports, large cities and high-profile landmarks. Terrorists might also target large public gatherings, water and food supplies, utilities, and corporate centers. Further, they are capable of spreading fear by sending explosives or chemical and biological agents through the mail. In the immediate area of a terrorist event, you would need to rely on police, fire and other officials for instructions. However, you can prepare in much the same way you would prepare for other crisis events. Preparing for terrorism 1. Wherever you are, be aware of your surroundings. The very nature of terrorism suggests there may be little or no warning. 2. Take precautions when traveling. Be aware of conspicuous or unusual behavior. Do not accept packages from strangers. Do not leave luggage unattended. Unusual behavior, suspicious packages and strange devices should be promptly reported to the police or security personnel. 3. Do not be afraid to move or leave if you feel uncomfortable or if something does not seem right. 4. Learn where emergency exits are located in buildings you frequent. Notice where exits are when you enter unfamiliar buildings. Plan how to get 5. Out of a building, subway or congested public area or traffic. Note where staircases are located. Notice heavy or breakable objects that could move, fall or break in an explosion. 6. Assemble a disaster supply kit at home and learn first aid. Separate the supplies you would take if you had to evacuate quickly, and put them in a backpack 7. or container, ready to go. 8. Be familiar with different types of fire extinguishers and how to locate them. Know the location and availability of hard hats in buildings in which you spend a lot of time.

Protection against cyber attacks Cyber attacks target computer or telecommunication networks of critical infrastructures such as power systems, traffic control systems, or financial systems. Cyber attacks target information technologies (IT) in three different ways. First, is a direct attack against an information system through the wires alone (hacking). Second, the attack can be a physical assault against a critical IT element. Third, the attack can be from the inside as a result of compromising a trusted party with access to the system. Be prepared to do without services you normally depend on that could be disrupted electricity, telephone, natural gas, gasoline pumps, cash registers, ATM machines, and internet transactions. Be prepared to respond to official instructions if a cyber attack triggers other hazards, for example, general evacuation, evacuation to shelter, or shelter-in-place, because of hazardous materials releases, nuclear power plant incident, dam or flood control system failures. Preparing for a building explosion Explosions can collapse buildings and cause fires. People who live or work in a multilevel building can do the following: 1. Review emergency evacuation procedures. Know where emergency exits are located. 2. Keep fire extinguishers in working order. Know where they are located, and learn how to use them. 3. Learn first aid. Contact the local chapter of the American Red Cross for information and training. 4. Building owners should keep the following items in a designated place on each floor of the building. * Portable, battery-operated radio and extra batteries * Several flashlights and extra batteries * First aid kit and manual * Several hard hats * Fluorescent tape to rope off dangerous areas Bomb Threats If you receive a bomb threat, get as much information from the caller as possible. Keep the caller on the line and record everything that is said. Then notify the police and the building management.

If you are notified of a bomb threat, do not touch any suspicious packages. Clear the area around suspicious packages and notify the police immediately. In evacuating a building, dont stand in front of windows, glass doors or other potentially hazardous areas. Do not block sidewalk or streets to be used by emergency officials or others still exiting the building. Suspicious parcels and letters Be wary of suspicious packages and letters. They can contain explosives, chemical or biological agents. Be particularly cautious at your place of employment. Some typical characteristics postal inspectors have detected over the years, which ought to trigger suspicion, include parcels that

Are unexpected or from someone unfamiliar to you. Have no return address, or have one that cant be verified as legitimate. Are marked with restrictive endorsements, such as Personal, Confidential or Do not x-ray. Have protruding wires or aluminum foil, strange odors or stains. Show a city or state in the postmark that doesnt match the return address. Are of unusual weight, given their size, or are lopsided or oddly shaped. Are marked with any threatening language. Have inappropriate or unusual labeling. Have excessive postage or excessive packaging material such as masking tape and string. Have misspellings of common words. Are addressed to someone no longer with your organization or are otherwise outdated. Have incorrect titles or title without a name. Are not addressed to a specific person. Have handwritten or poorly typed addresses.

With suspicious envelopes and packages other than those that might contain explosives, take these additional steps against possible biological and chemical agents.

Refrain from eating or drinking in a designated mail handling area. Place suspicious envelopes or packages in a plastic bag or some other type of container to prevent leakage of contents. Never sniff or smell suspect mail. If you do not have a container, then cover the envelope or package with anything available (e.g., clothing, paper, trash can, etc.) and do not remove the cover. Leave the room and close the door, or section off the area to prevent other from entering. Wash your hands with soap and water to prevent spreading any powder to your face. If you are at work, report the incident to your building security official or an available supervisor, who should notify police and other authorities without delay. List all people who were in the room or area when this suspicious letter or package was recognized. Give a copy of this list to both the local public health authorities and law enforcement officials for follow-up investigations and advice.

If you are at home, report the incident to local police.

What to do if there is an explosion Leave the building as quickly as possible. Do not stop to retrieve personal possessions or make phone calls. If things are falling around you, get under a sturdy table or desk until they stop falling. Then leave quickly, watching for weakened floors and stairs and falling debris as you exit. 1. If there is a fire: o Stay low to the floor and exit the building as quickly as possible. o Cover your nose and mouth with a wet cloth. o When approaching a closed door, use the back of your hand to feel the lower, middle and upper parts of the door. Never use the palm of your hand or fingers to test for heat: burning those areas could impair your ability to escape a fire (i.e., ladders and crawling). If the door is NOT hot, open slowly and ensure fire and/or smoke is not blocking your escape route. If your escape route is blocked, shut the door immediately and use an alternate escape route, such as a window. If clear, leave immediately through the door. Be prepared to crawl. Smoke and heat rise. The air is clearer and cooler near the floor. If the door is hot, do not open it. Escape through a window. If you cannot escape, hang a white or light-colored sheet outside the window, alerting fire fighters to your presence. o Heavy smoke and poisonous gases collect first along the ceiling. Stay below the smoke at all times. 2. If you are trapped in debris: o Do not light a match. o Do not move about or kick up dust. Cover your mouth with a handkerchief for clothing. o Rhythmically tap on a pipe or wall so that rescuers can hear where you are. Use a whistle if one is available. Shout only as a last resort when you hear sounds and think someone will hear youshouting can cause a person to inhale dangerous amounts of dust. Chemical and Biological Weapons In case of a chemical or biological weapon attack near you, authorities will instruct you on the best course of action. This may be to evacuate the area immediately, to seek shelter at a designated location, or to take immediate shelter where you are and seal the premises. The best way to protect yourself is to take emergency preparedness measures ahead of time and to get medical attention as soon as possible, if needed. Chemical Chemical warfare agents are poisonous vapors, aerosols, liquids or solids that have toxic effects on people, animals or plants. They can be released by bombs, sprayed from aircraft, boats, or vehicles, or used as a liquid to create a hazard to people and the

environment. Some chemical agents may be odorless and tasteless. They can have an immediate effect (a few seconds to a few minutes) or a delayed effect (several hours to several days). While potentially lethal, chemical agents are difficult to deliver in lethal concentrations. Outdoors, the agents often dissipate rapidly. Chemical agents are also difficult to produce. There are six types of agents:

Lung-damaging (pulmonary) agents such as phosgene, Cyanide, Vesicants or blister agents such as mustard, Nerve agents such as GA (tabun), GB (sarin), GD (soman), GF, and VX, Incapacitating agents such as BZ, and Riot-control agents (similar to MACE).

Biological Biological agents are organisms or toxins that can kill or incapacitate people, livestock and crops. The three basic groups of biological agents which would likely be used as weapons are bacteria, viruses, and toxins. 1. Bacteria. Bacteria are small free-living organisms that reproduce by simple division and are easy to grow. The diseases they produce often respond to treatment with antibiotics. 2. Viruses. Viruses are organisms which require living cells in which to reproduce and are intimately dependent upon the body they infect. Viruses produce diseases which generally do not respond to antibiotics. However, antiviral drugs are sometimes effective. 3. Toxins. Toxins are poisonous substances found in, and extracted from, living plants, animals, or microorganisms; some toxins can be produced or altered by chemical means. Some toxins can be treated with specific antitoxins and selected drugs. Most biological agents are difficult to grow and maintain. Many break down quickly when exposed to sunlight and other environmental factors, while others such as anthrax spores are very long lived. They can be dispersed by spraying them in the air, or infecting animals which carry the disease to humans as well through food and water contamination.

AerosolsBiological agents are dispersed into the air, forming a fine mist that may drift for miles. Inhaling the agent may cause disease in people or animals.

AnimalsSome diseases are spread by insects and animals, such as fleas, mice, flies, and mosquitoes. Deliberately spreading diseases through livestock is also referred to as agro-terrorism. Food and water contaminationsome pathogenic organisms and toxins may persist in food and water supplies. Most microbes can be killed, and toxins deactivated, by cooking food and boiling water.

Anthrax spores formulated as a white powder were mailed to individuals in the government and media in the fall of 2001. Postal sorting machines and the opening of letters dispersed the spores as aerosols. Several deaths resulted. The effect was to disrupt mail service and to cause a widespread fear of handling delivered mail among the public. Person-to-person spread of a few infectious agents is also possible. Humans have been the source of infection for smallpox, plague, and the Lassa viruses. What to do to prepare for a chemical or biological attack

Assemble a disaster supply kit (see the Emergency Planning and Disaster Supplies chapter for more information) and be sure to include: Battery-powered commercial radio with extra batteries. Non-perishable food and drinking water. Roll of duct tape and scissors. Plastic for doors, windows and vents for the room in which you will shelter in place this should be an internal room where you can block out air that may contain hazardous chemical or biological agents. To save critical time during an emergency, sheeting should be pre-measured and cut for each opening. First aid kit. Sanitation supplies including soap, water and bleach.

What to do during a chemical or biological attack 1. Listen to your radio for instructions from authorities such as whether to remain inside or to evacuate. 2. If you are instructed to remain in your home, the building where you are, or other shelter during a chemical or biological attack: o Turn off all ventilation, including furnaces, air conditioners, vent sand fans. o Seek shelter in an internal room, preferably one without windows. Seal the room with duct tape and plastic sheeting. Ten square feet of floor space per person will provide sufficient air to prevent carbon dioxide build-up for up to five hours. (See Shelter chapter.) o Remain in protected areas where toxic vapors are reduced or eliminated, and be sure to take your battery-operated radio with you. 3. If you are caught in an unprotected area, you should: o Attempt to get up-wind of the contaminated area. o Attempt to find shelter as quickly as possible. o Listen to your radio for official instructions.

What to do after a chemical attack Immediate symptoms of exposure to chemical agents may include blurred vision, eye irritation, difficulty breathing and nausea. A person affected by a chemical or biological agent requires immediate attention by professional medical personnel. If medical help is not immediately available, decontaminate yourself and assist in decontaminating others. Decontamination is needed within minutes of exposure to minimize health consequences. (However, you should not leave the safety of a shelter to go outdoors to help others until authorities announce it is safe to do so.) 1. Use extreme caution when helping others who have been exposed to chemical agents: o Remove all clothing and other items in contact with the body. Contaminated clothing normally removed over the head should be cut off to avoid contact with the eyes, nose, and mouth. Put into a plastic bag if possible. Decontaminate hands using soap and water. Remove eyeglasses or contact lenses. Put glasses in a pan of household bleach to decontaminate. 2. Remove all items in contact with the body. 3. Flush eyes with lots of water. 4. Gently wash face and hair with soap and water; then thoroughly rinse with water. 5. Decontaminate other body areas likely to have been contaminated. Blot (do not swab or scrape) with a cloth soaked in soapy water and rinse with clear water. 6. Change into uncontaminated clothes. Clothing stored in drawers or closets is likely to be uncontaminated. 7. If possible, proceed to a medical facility for screening. What to do after a biological attack In many biological attacks, people will not know they have been exposed to an agent. In such situations, the first evidence of an attack may be when you notice symptoms of the disease caused by an agent exposure, and you should seek immediate medical attention for treatment. In some situations, like the anthrax letters sent in 2001, people may be alerted to a potential exposure. If this is the case, pay close attention to all official warnings and instructions on how to proceed. The delivery of medical services for a biological event may be handled differently to respond to increased demand. Again, it will be important for you to pay attention to official instructions via radio, television, and emergency alert systems. If your skin or clothing comes in contact with a visible, potentially infectious substance, you should remove and bag your clothes and personal items and wash yourself with warm soapy water immediately. Put on clean clothes and seek medical assistance. For more information, visit the website for the Centers for Disease Control and Prevention, www.bt.cdc.gov. Nuclear and Radiological Attack Nuclear explosions can cause deadly effectsblinding light, intense heat (thermal radiation), initial nuclear radiation, blast, fires started by the heat pulse, and secondary

fires caused by the destruction. They also produce radioactive particles called fallout that can be carried by wind for hundreds of miles. Terrorist use of a radiological dispersion device (RDD)often called dirty nuke or dirty bombis considered far more likely than use of a nuclear device. These radiological weapons are a combination of conventional explosives and radioactive material designed to scatter dangerous and sub-lethal amounts of radioactive material over a general area. Such radiological weapons appeal to terrorists because they require very little technical knowledge to build and deploy compared to that of a nuclear device. Also, these radioactive materials, used widely in medicine, agriculture, industry and research, are much more readily available and easy to obtain compared to weapons grade uranium or plutonium. Terrorist use of a nuclear device would probably be limited to a single smaller suitcase weapon. The strength of such a weapon would be in the range of the bombs used during World War II. The nature of the effects would be the same as a weapon delivered by an inter-continental missile, but the area and severity of the effects would be significantly more limited. There is no way of knowing how much warning time there would be before an attack by a terrorist using a nuclear or radiological weapon. A surprise attack remains a possibility. The danger of a massive strategic nuclear attack on the United States involving many weapons receded with the end of the Cold War. However, some terrorists have been supported by nations that have nuclear weapons programs. If there were threat of an attack from a hostile nation, people living near potential targets could be advised to evacuate or they could decide on their own to evacuate to an area not considered a likely target. Protection from radioactive fallout would require taking shelter in an underground area, or in the middle of a large building. In general, potential targets include:

Strategic missile sites and military bases. Centers of government such as Washington, D.C., and state capitals. Important transportation and communication centers. Manufacturing, industrial, technology and financial centers. Petroleum refineries, electrical power plants and chemical plants. Major ports and airfields.

Taking shelter during a nuclear attack is absolutely necessary. There are two kinds of sheltersblast and fallout. Blast shelters offer some protection against blast pressure, initial radiation, heat and fire, but even a blast shelter could not withstand a direct hit from a nuclear detonation. Fallout shelters do not need to be specially constructed for that purpose. They can be any protected space, provided that the walls and roof are thick and dense enough to

absorb the radiation given off by fallout particles. The three protective factors of a fallout shelter are shielding, distance, and time.

Shielding. The more heavy, dense materialsthick walls, concrete, bricks, books and earthbetween you and the fallout particles, the better. Distance. The more distance between you and the fallout particles, the better. An underground area, such as a home or office building basement, offers more protection than the first floor of a building. A floor near the middle of a high-rise may be better, depending on what is nearby at that level on which significant fallout particles would collect. Flat roofs collect fallout particles so the top floor is not a good choice, nor is a floor adjacent to a neighboring flat roof. Time. Fallout radiation loses its intensity fairly rapidly. In time, you will be able to leave the fallout shelter. Radioactive fallout poses the greatest threat to people during the first two weeks, by which time it has declined to about 1% of its initial radiation level.

Remember that any protection, however temporary, is better than none at all, and the more shielding, distance and time you can take advantage of, the better. Electromagnetic pulse In addition to other effects, a nuclear weapon detonated in or above the earths atmosphere can create an electromagnetic pulse (EMP), a high-density electrical field. EMP acts like a stroke of lightning but is stronger, faster and briefer. EMP can seriously damage electronic devices connected to power sources or antennas. This include communication systems, computers, electrical appliances, and automobile or aircraft ignition systems. The damage could range from a minor interruption to actual burnout of components. Most electronic equipment within 1,000 miles of a high-altitude nuclear detonation could be affected. Battery powered radios with short antennas generally would not be affected. Although EMP is unlikely to harm most people, it could harm those with pacemakers or other implanted electronic devices. What to do before a nuclear or radiological attack 1. Learn the warning signals and all sources of warning used in your community. Make sure you know what the signals are, what they mean, how they will be used, and what you should do if you hear them. 2. Assemble and maintain a disaster supply kit with food, water, medications, fuel and personal items adequate for up to 2 weeksthe more the better. (Seethe Emergency Planning and Disaster Supplies chapter for more information). 3. Find out what public buildings in your community may have been designated as fallout shelters. It may have been years ago, but start there, and learn which buildings are still in use and could be designated as shelters again. o Call your local emergency management office. o Look for yellow and black fallout shelter signs on public buildings. Note: With the end of the Cold War, many of the signs have been removed from the buildings previously designated.

If no noticeable or official designations have been made, make your own list of potential shelters near your home, workplace and school: basements, or the windowless center area of middle floors in high-rise buildings, as well as subways and tunnels. o Give your household clear instructions about where fallout shelters are located and what actions to take in case of attack. 4. If you live in an apartment building or high-rise, talk to the manager about the safest place in the building for sheltering, and about providing for building occupants until it is safe to go out. 5. There are few public shelters in many suburban and rural areas. If you are considering building a fallout shelter at home, keep the following in mind. o A basement, or any underground area, is the best place to shelter from fallout. Often, few major changes are needed, especially if the structure has two or more stories and its basementor one corner of itis below ground. o Fallout shelters can be used for storage during non-emergency periods, but only store things there that can be very quickly removed. (When they are removed, dense, heavy items may be used to add to the shielding.) o See the Tornadoes section in the Thunderstorms chapter for information on the Wind Safe Room, which could be used as shelter in the event of a nuclear detonation or for fallout protection, especially in a home without a basement. o All the items you will need for your stay need not be stocked inside the shelter itself but can be stored elsewhere, as long as you can move them quickly to the shelter. 6. Learn about your communitys evacuation plans. Such plans may include evacuation routes, relocation sites, how the public will be notified and transportation options for people who do not own cars and those who have special needs.
o

See the Evacuation chapter for more information. 7. Acquire other emergency preparedness booklets that you may need. See the For More Information chapter at the end of this guide. What to do during a nuclear or radiological attack 1. Do not look at the flash or fireballit can blind you. If you hear an attack warning: 1.
o o

Take cover as quickly as you can, BELOW GROUND IF POSSIBLE, and stay there unless instructed to do otherwise. If you are caught outside, unable to get inside immediately, take cover behind anything that might offer protection. Lie flat on the ground and cover your head. If the explosion is some distance away, it could take 30 seconds or more for the blast wave to hit.

2. Protect yourself from radioactive fallout. If you are close enough to see the brilliant flash of a nuclear explosion, the fallout will arrive in about20 minutes. Take shelter, even if you are many miles from ground zeroradioactive fallout can be carried by the winds for hundreds of miles. Remember the three protective factors: shielding, distance and time. 3. Keep a battery-powered radio with you, and listen for official information. Follow the instructions given. Local instructions should always take precedence: officials on the ground know the local situation best. What to do after a nuclear or radiological attack In a public or home shelter: 1. Do not leave the shelter until officials say it is safe. Follow their instructions when leaving. 2. If in a fallout shelter, stay in your shelter until local authorities tell you it is permissible or advisable to leave. The length of your stay can range from a day or two to four weeks. o Contamination from a radiological dispersion device could affect a wide area, depending on the amount of conventional explosives used, the quantity of radioactive material and atmospheric conditions. o A suitcase terrorist nuclear device detonated at or near ground level would produce heavy fallout from the dirt and debris sucked up into the mushroom cloud. o A missile-delivered nuclear weapon from a hostile nation would probably cause an explosion many times more powerful than a suitcase bomb, and provide a greater cloud of radioactive fallout. o The decay rate of the radioactive fallout would be the same, making it necessary for those in the areas with highest radiation levels to remain in shelter for up to a month. o The heaviest fallout would be limited to the area at or downwind from the explosion, and 80% of the fallout would occur during the first24 hours. o Because of these facts and the very limited number of weapons terrorists could detonate, most of the country would not be affected by fallout. o People in most of the areas that would be affected could be allowed to come out of shelter and, if necessary, evacuate to unaffected areas within a few days. 3. Although it may be difficult, make every effort to maintain sanitary conditions in your shelter space. 4. Water and food may be scarce. Use them prudently but do not impose sever rationing, especially for children, the ill or elderly. 5. Cooperate with shelter managers. Living with many people in confined space can be difficult and unpleasant. Returning to your home 1. Keep listening to the radio for news about what to do, where to go, and places to avoid.

2. If your home was within the range of a bombs shock wave, or you live in a highrise or other apartment building that experienced a non-nuclear explosion, check first for any sign of collapse or damage, such as: o Toppling chimneys, falling bricks, collapsing walls, plaster falling from ceilings. o Fallen light fixtures, pictures and mirrors. o Broken glass from windows. o Overturned bookcases, wall units or other fixtures. o Fires from broken chimneys. o Ruptured gas and electric lines. 3. Immediately clean up spilled medicines, drugs, flammable liquids, and other potentially hazardous materials. 4. Listen to your battery-powered radio for instructions and information about community services. 5. Monitor the radio and your television for information on assistance that maybe provided. Local, state and federal governments and other organizations will help meet emergency needs and help you recover from damage and losses. 6. The danger may be aggravated by broken water mains and fallen power lines. 7. If you turned gas, water and electricity off at the main valves and switch before you went to shelter: o Do not turn the gas back on. The gas company will turn it back on for you or you will receive other instructions. o Turn the water back on at the main valve only after you know the water system is working and water is not contaminated. o Turn electricity back on at the main switch only after you know the wiring is undamaged in your home and the community electrical system is functioning. o Check to see that sewage lines are intact before using sanitary facilities. 8. Stay away from damaged areas. 9. Stay away from areas marked radiation hazard or HAZMAT. Homeland Security Advisory System The Homeland Security Advisory System was designed to provide a comprehensive means to disseminate information regarding the risk of terrorist acts to federal, state, and local authorities and to the American people. This system provides warnings in the form of a set of graduated Threat Conditions that increase as the risk of the threat increases. At each threat condition, federal departments and agencies would implement a corresponding set of Protective Measures to further reduce vulnerability or increase response capability during a period of heightened alert. Although the Homeland Security Advisory System is binding on the executive branch, it is voluntary to other levels of government and the private sector. There are five threat conditions, each identified by a description and corresponding color. The greater the risk of a terrorist attack, the higher the threat condition. Risk includes both the probability of an attack occurring and its potential gravity.

Threat conditions are assigned by the Attorney General in consultation with the Assistant to the President for Homeland Security. Threat conditions may be assigned for the entire nation, or they may be set for a particular geographic area or industrial sector. Assigned threat conditions will be reviewed at regular intervals to determine whether adjustments are warranted. Threat Conditions and Associated Protective Measures There is always a risk of a terrorist threat. Each threat condition assigns a level of alert appropriate to the increasing risk of terrorist attacks. Beneath each threat condition are some suggested protective measures that the government and the public can take, recognizing that the heads of federal departments and agencies are responsible for developing and implementing appropriate agency-specific Protective Measures: Low Condition (Green). This condition is declared when there is a low risk of terrorist attacks. Federal departments and agencies will consider the following protective measures. Refine and exercise prearranged protective measures; Ensure personnel receive proper training on the Homeland Security Advisory System and specific prearranged department or agency protective measures; and Institute a process to assure that all facilities and regulated sectors are regularly assessed for vulnerabilities to terrorist attacks, and all reasonable measures are taken to mitigate these vulnerabilities.

Members of the public can:

Develop a household disaster plan and assemble a disaster supply kit. (see Emergency Planning and Disaster Supplies chapter).

Guarded Condition (Blue). This condition is declared when there is a general risk of terrorist attacks. In addition to the measures taken in the previous threat condition, federal departments and agencies will consider the following protective measures:

Check communications with designated emergency response or command locations; Review and update emergency response procedures; and Provide the public with any information that would strengthen its ability to act appropriately.

Members of the public, in addition to the actions taken for the previous threat condition, can:

Update their disaster supply kit; Review their household disaster plan; Hold a household meeting to discuss what members would do and how they would communicate in the event of an incident; Develop a more detailed household communication plan;

Apartment residents should discuss with building managers steps to be taken during an emergency; and People with special needs should discuss their emergency plans with friends, family or employers.

Elevated Condition (Yellow). An Elevated Condition is declared when there is a significant risk of terrorist attacks. In addition to the measures taken in the previous threat conditions, federal departments and agencies will consider the following protective measures:

Increase surveillance of critical locations; Coordinate emergency plans with nearby jurisdictions as appropriate; Assess whether the precise characteristics of the threat require the further refinement of prearranged protective measures; and Implement, as appropriate, contingency and emergency response plans.

Members of the public, in addition to the actions taken for the previous threat condition, can:

Be observant of any suspicious activity and report it to authorities; Contact neighbors to discuss their plans and needs; Check with school officials to determine their plans for an emergency and procedures to reunite children with parents and caregivers; and Update the household communication plan.

High Condition (Orange). A High Condition is declared when there is a high risk of terrorist attacks. In addition to the measures taken in the previous threat conditions, federal departments and agencies will consider the following protective measures:

Coordinate necessary security efforts with federal, state, and local law enforcement agencies, National Guard or other security and armed forces; Take additional precautions at public events, possibly considering alternative venues or even cancellation; Prepare to execute contingency procedures, such as moving to an alternate site or dispersing the workforce; and Restrict access to a threatened facility to essential personnel only.

Members of the public, in addition to the actions taken for the previous threat conditions, can:

Review preparedness measures (including evacuation and sheltering) for potential terrorist actions including chemical, biological, and radiological attacks; Avoid high profile or symbolic locations; and Exercise caution when traveling.

Severe Condition (Red). A Severe Condition reflects a severe risk of terrorist attacks. Under most circumstances, the protective measures for a Severe Condition are not intended to be sustained for substantial periods of time. In addition to the protective

measures in the previous threat conditions, federal departments and agencies also will consider the following general measures:

Increase or redirect personnel to address critical emergency needs; Assign emergency response personnel and pre-position and mobilize specially trained teams or resources; Monitor, redirect, or constrain transportation systems; and Close public and government facilities not critical for continuity of essential operations, especially public safety.

Members of the public, in addition to the actions taken for the previous threat conditions, can:

Avoid public gathering places such as sports arenas, holiday gatherings, or other high risk locations; Follow official instructions about restrictions to normal activities; Contact employer to determine status of work; Listen to the radio and TV for possible advisories or warnings; and Prepare to take protective actions such as sheltering-in-place or evacuation if instructed to do so by public officials.

BIOLOGICAL ATTACK Biological weapons and the use of bio terror is one of the greatest terrorist threats we face. A biological attack is the deliberate release of germs or other biological substances that can make you sick. Many agents must be inhaled, enter through a cut in the skin or be eaten to make you sick. Some biological agents, such as anthrax, do not cause contagious diseases. Others, like the smallpox virus, can result in diseases you can catch from other people. If There Is A Biological Threat Unlike an explosion, a biological attack may or may not be immediately obvious. While it is possible that you will see signs of a biological attack, as was sometimes the case with the anthrax mailings, it is perhaps more likely that local health care workers will report a pattern of unusual illness or there will be a wave of sick people seeking emergency medical attention. You will probably learn of the danger through an emergency radio or TV broadcast, or some other signal used in your community. You might get a telephone call or emergency response workers may come to your door. In the event of a biological attack, public health officials may not immediately be able to provide information on what you should do. It will take time to determine exactly what the illness is, how it should be treated, and who is in danger. However, you should watch TV, listen to the radio, or check the Internet for official news including the following:

Are you in the group or area authorities consider in danger? What are the signs and symptoms of the disease? Are medications or vaccines being distributed? Where? Who should get them?

Where should you seek emergency medical care if you become sick?

Protect Yourself If you become aware of an unusual and suspicious release of an unknown substance nearby, it doesnt hurt to protect yourself. Quickly get away. Cover your mouth and nose with layers of fabric that can filter the air but still allow breathing. Examples include two to three layers of cotton such as a t-shirt, handkerchief or towel. Otherwise, several layers of tissue or paper towels may help. Wash with soap and water and contact authorities. Symptoms and Hygiene At the time of a declared biological emergency, if a family member becomes sick, it is important to be suspicious. Do not automatically assume, however, that you should go to a hospital emergency room or that any illness is the result of the biological attack. Symptoms of many common illnesses may overlap. Use common sense, practice good hygiene and cleanliness to avoid spreading germs, and seek medical advice. Responding To an Attack Aside from their common lethality, there is no one size fits all when it comes to describing the types and effects of possible chemical or biological agents. Chemical agents are generally liquids, often aerosolized, and most have immediate effects or are delayed for a few hours. Many chemical agents have a unique odor and color. Biological agents differ in that the effects are delayed, often for days. The effects of toxins, such as botulism toxin, occur typically in less than a day. Living biological agents, such as anthrax or plague, generally take 2-5 days for symptoms to appear. Biological agents have no odor or color and can be in either liquid or powder form. There are many different potential chemical and biological agents that a terrorist could use as a weapon, but we can make the following broad generalizations:

Although food or water contamination or absorption through the skin are possible attack routes, most experts agree that inhalation of chemical or biological agents is the most likely and effective means. Protection of breathing airways is therefore the single most important factor in a situation where chemical or biological agents may be present. Many likely agents are heavier than air and would tend to stay close to the ground. This dictates an upward safe-haven strategy.

Basic decontamination procedures are generally the same no matter what the agent. Thorough scrubbing with large amounts of warm soapy water or a mixture of 10 parts water to 1 part bleach (10:1) will greatly reduce the possibility of absorbing an agent through the skin.

If water is not available, talcum powder or flour are also excellent means of decontamination of liquid agents. Sprinkle the flour or powder liberally over the affected skin area, wait 30 seconds, and brush off with a rag or gauze pad. (Note: the powder absorbs the agent so it must be brushed off thoroughly. If available, rubber gloves should be sued when carrying out this procedure.) Generally, chemical agents tend to present an immediately noticeable effect, whereas many biological agents will take days before symptoms appear. In either case, medical attention should be sought immediately, even if exposure is thought to be limited. Most chemical and biological agents that present an inhalation hazard will break down fairly rapidly when exposed to the sun, diluted with water, or dissipated in high winds. No matter what the agent is or its concentration, evacuation from the area of attack is always advisable unless you are properly equipped with an appropriate breathing device and protective clothing or have access to collective protection. Warning Signs of an Attack or Incident A chemical or biological attack or incident wont always be immediately apparent given the fact that many agents are odorless and colorless and some cause no immediately noticeable effects or symptoms. Be alert to the possible presence of agents. Indicators of such an attack include:

Droplets of oily film on surfaces Unusual dead or dying animals in the area Unusual liquid sprays or vapors Unexplained odors (smell of bitter almonds, peach kernels, newly mown hay or green grass) Unusual or unauthorized spraying in the area Victims displaying symptoms of nausea, difficulty breathing, convulsions, disorientation, or patterns of illness inconsistent with natural disease. Low-lying clouds or fog unrelated to weather; clouds of dust; or suspended, possibly colored, particles. People dressed unusually (long-sleeved shirts or overcoats in the summertime) or wearing breathing protection particularly in areas where large numbers of people tend to congregate, such as subways or stadiums

What to Do In Case of Attack Protection of breathing airways is the single most important thing a person can do in the event of a chemical or biological incident or attack. In most cases, absent a handy gas mask, the only sure way to protect an airway is to put distance between you and the source of the agent. While evacuating the area, cover your mouth and nose with a handkerchief, coat sleeve or any piece of cloth to provide some moderate means of protection. Other basic steps one can take to avoid or mitigate exposure to chemical or biological agents include:

Stay alert for attack warning signs. Early detection enhances survival. Move upwind from the source of the attack. If evacuation from the immediate area is impossible, move indoors (if outside) and upward to an interior room on a higher floor. Remember many agents are heavier than air and will tend to stay close to the ground. Once indoors, close all windows and exterior doors and shut down air conditioning or heating systems to prevent circulation of air. Cover your mouth and nose. If gas masks are not available, use a surgical mask or a handkerchief. An improvised mask can be made by soaking a clean cloth in a solution of 1 tablespoon of baking soda in a cup of water. While this is not highly effective, it may provide some protection. Cover bare arms and legs and make sure any cuts or abrasions are covered or bandaged. If splashed with an agent, immediately wash it off using copious amounts of warm soapy water or a diluted 10:1 bleach solution. Letters from unknown sources should first be screened by security personnel. If opened, letters allegedly containing anthrax or another toxin should be handled carefully. Note if there was a puff of dust or particles from the envelope when it was opened and be sure to report that when assistance arrives. Carefully place such a letter and its envelope in a sealed plastic pouch. Thoroughly wash face and hands with warm soapy water before calling for assistance. If circumstances dictate, plan and prepare a chemical/biological safe-haven in your residence using guidelines listed in this guide. At the office, familiarize yourself in advance with established emergency procedures and equipment at your post. See your regional or post security officer for details. If in a car, shut off outside air intake vents and roll up windows if no gas has entered the vehicle. Late model cars may provide some protection from toxic agents. In any case of suspected exposure to chemical or biological agents, no matter what the origin, medical assistance should be sought as soon as possible, even if no symptoms are immediately evident. Preparing a Safe-Haven In some remote but possible scenarios, an entire city or neighborhood could become endangered by lethal gas. If conditions at your post make this a possibility, you may want to plan and prepare a sealed chemical/biological safe-haven at your residence as follows:

Choosing a Safe-Haven Room

Select an inner room on an upstairs floor with the least number of windows and doors. Choose a large room with access to a bathroom and preferably with a telephone. Avoid choosing rooms with window or wall air conditioners; they are more difficult to seal. Shut down all window and central air and heating units. Seal The Room.

CHEMICAL ATTACK

A chemical attack is the deliberate release of a toxic gas, liquid or solid that can poison people and the environment Possible Signs of Chemical Threat Many people suffering from watery eyes, twitching, choking, having trouble breathing or losing coordination. Many sick or dead birds, fish or small animals are also cause for suspicion.

Quickly try to define the impacted area or where the chemical is coming from, if possible. Take immediate action to get away. If the chemical is inside a building where you are, get out of the building without passing through the contaminated area, if possible. Otherwise, it may be better to move as far away from where you suspect the chemical release is and shelter-in-place. If you are outside, quickly decide what is the fastest escape from the chemical threat. Consider if you can get out of the area, or if you should follow plans to shelter-in-place. If You Think You Have Been Exposed to a Chemical If your eyes are watering, your skin is stinging, and you are having trouble breathing, you may have been exposed to a chemical. If you think you may have been exposed to a chemical, strip immediately and wash. Look for a hose, fountain, or any source of water, and wash with soap if possible, being sure not to scrub the chemical into your skin. Seek emergency medical attention.

Responding To an Attack Aside from their common lethality, there is no one size fits all when it comes to describing the types and effects of possible chemical or biological agents. Chemical agents are generally liquids, often aerosolized, and most have immediate effects or are delayed for a few hours. Many chemical agents have a unique odor and color. Biological agents differ in that the effects are delayed, often for days. The effects of toxins, such as botulism toxin, occur typically in less than a day. Living biological agents, such as anthrax or plague, generally take 2-5 days for symptoms to appear. Biological agents have no odor or color and can be in either liquid or powder form.

There are many different potential chemical and biological agents that a terrorist could use as a weapon, but we can make the following broad generalizations: Although food or water contamination or absorption through the skin are possible attack routes, most experts agree that inhalation of chemical or biological agents is the most likely and effective means. Protection of breathing airways is therefore the single most important factor in a situation where chemical or biological agents may be present. Many likely agents are heavier than air and would tend to stay close to the ground. This dictates an upward safe-haven strategy.

Basic decontamination procedures are generally the same no matter what the agent. Thorough scrubbing with large amounts of warm soapy water or a mixture of 10 parts water to 1 part bleach (10:1) will greatly reduce the possibility of absorbing an agent through the skin. If water is not available, talcum powder or flour are also excellent means of decontamination of liquid agents. Sprinkle the flour or powder liberally over the affected skin area, wait 30 seconds, and brush off with a rag or gauze pad. (Note: the powder absorbs the agent so it must be brushed off thoroughly. If available, rubber gloves should be sued when carrying out this procedure.) Generally, chemical agents tend to present an immediately noticeable effect, whereas many biological agents will take days before symptoms appear. In either case, medical attention should be sought immediately, even if exposure is thought to be limited. Most chemical and biological agents that present an inhalation hazard will break down fairly rapidly when exposed to the sun, diluted with water, or dissipated in high winds. No matter what the agent is or its concentration, evacuation from the area of attack is always advisable unless you are properly equipped with an appropriate breathing device and protective clothing or have access to collective protection.

Warning Signs of a Chemical Attack or Incident

A chemical or biological attack or incident wont always be immediately apparent given the fact that many agents are odorless and colorless and some cause no immediately noticeable effects or symptoms. Be alert to the possible presence of agents. Indicators of such an attack include: Droplets of oily film on surfaces Unusual dead or dying animals in the area Unusual liquid sprays or vapors

Unexplained odors (smell of bitter almonds, peach kernels, newly mown hay or green grass) Unusual or unauthorized spraying in the area Victims displaying symptoms of nausea, difficulty breathing, convulsions, disorientation, or patterns of illness inconsistent with natural disease Low-lying clouds or fog unrelated to weather; clouds of dust; or suspended, possibly colored, particles People dressed unusually (long-sleeved shirts or overcoats in the summertime) or wearing breathing protection particularly in areas where large numbers of people tend to congregate, such as subways or stadiums

What to Do In Case of Attack Protection of breathing airways is the single most important thing a person can do in the event of a chemical or biological incident or attack. In most cases, absent a handy gas mask, the only sure way to protect an airway is to put distance between you and the source of the agent. While evacuating the area, cover your mouth and nose with a handkerchief, coat sleeve or any piece of cloth to provide some moderate means of protection. Other basic steps one can take to avoid or mitigate exposure to chemical or biological agents include:

Stay alert for attack warning signs. Early detection enhances survival. Move upwind from the source of the attack. If evacuation from the immediate area is impossible, move indoors (if outside) and upward to an interior room on a higher floor. Remember many agents are heavier than air and will tend to stay close to the ground. Once indoors, close all windows and exterior doors and shut down air conditioning or heating systems to prevent circulation of air. Cover your mouth and nose. If gas masks are not available, use a surgical mask or a handkerchief. An improvised mask can be made by soaking a clean cloth in a solution of 1 tablespoon of baking soda in a cup of water. While this is not highly effective, it may provide some protection. Cover bare arms and legs and make sure any cuts or abrasions are covered or bandaged. If splashed with an agent, immediately wash it off using copious amounts of warm soapy water or a diluted 10:1 bleach solution. Letters from unknown sources should first be screened by security personnel. If opened, letters allegedly containing anthrax or another toxin should be handled

carefully. Note if there was a puff of dust or particles from the envelope when it was opened and be sure to report that when assistance arrives. Carefully place such a letter and its envelope in a sealed plastic pouch. Thoroughly wash face and hands with warm soapy water before calling for assistance.

If circumstances dictate, plan and prepare a chemical/biological safe-haven in your residence At the office, familiarize yourself in advance with established emergency procedures and equipment at your post. See your regional or post security officer for details. If in a car, shut off outside air intake vents and roll up windows if no gas has entered the vehicle. Late model cars may provide some protection from toxic agents. In any case of suspected exposure to chemical or biological agents, no matter what the origin, medical assistance should be sought as soon as possible, even if no symptoms are immediately evident.

Preparing a Safe room In some remote but possible scenarios, an entire city or neighborhood could become endangered by lethal gas. If conditions at your post make this a possibility, you may want to plan and prepare a sealed chemical/biological safe-haven at your residence as follows: Choosing a Safe room

Select an inner room on an upstairs floor with the least number of windows and doors. Choose a large room with access to a bathroom and preferably with a telephone. Avoid choosing rooms with window or wall air conditioners; they are more difficult to seal. Shut down all window and central air and heating units.

HIJACKING SURVIVAL GUIDELINES What to Do In A Hijacking Hijacking is extremely rare, but it does happen. It is well to consider how you should react if you end up being in the wrong place at the wrong time. The physical takeover of the aircraft by the hijackers may be accompanied by noise, commotion, and possibly shooting and yelling, or it may be quiet and methodical with little more than an announcement by a crew member. Either way, how you and others react during these first few minutes of the hijacking may be crucial to the outcome.

The guidance below focuses on avoiding violence and achieving a peaceful resolution to a hijacking. This guidance was developed prior to September 11, 2001 when two hijacked airliners were flown into the World Trade Center and one into the Pentagon. Since then, there has been considerable public discussion of a more active and aggressive reaction to the initial announcement that a plane is being hijacked. As of this writing, the U.S. Government has not developed new guidelines for how to react to a hijacking. The appropriate reaction may depend upon the presumed purpose of the hijacking the hijackers goal a suicide mission to use the airplane itself as a bomb, take hostages to gain publicity for a political movement, or a simple desire to escape to another country. Remember that the hijackers will be extremely nervous and probably as scared as you are. Although they may appear calm, they cannot be trusted to behave reasonably or rationally. Fear can trigger a disaster. One wrong move by either a victim or a hijacker could easily set off a defensive spate of violence. To promote a peaceful resolution of the situation, follow these guidelines. * Stay calm and encourage others around you to do the same. * Do not challenge the hijackers physically or verbally. Comply with their instructions. Do not struggle or try to escape unless you are absolutely certain of success. * If shooting occurs, keep your head down or drop to the floor. Once the takeover of the aircraft has occurred, passengers may be separated by citizenship, sex, race, etc. Your passport may be confiscated and your carry-on luggage ransacked. The aircraft may be diverted to another country. The hijackers may enter into a negotiation phase which could last indefinitely and/or the crew may be forced to fly the aircraft to a different destination. During this phase passengers may be used as a bargaining tool in negotiations, lives may be threatened, or a number of passengers may be released in exchange for fuel, landing/departure rights, food, etc. This will be the longest phase of the hijacking * If you are told to keep your head down or maintain another body position, talk yourself into relaxing into the position. You may need to stay that way for some time. * Be aware that all hijackers may not reveal themselves at the same time. A lone hijacker may be used to draw out security personnel for neutralization by other hijackers. * Prepare yourself mentally and emotionally for a long ordeal with possible verbal or physical abuse, lack of food and drink, and unsanitary conditions. * Blend in with the other airline passengers. Avoid eye contact with your captors. Dont draw attention to yourself with sudden body movements, verbal remarks, or hostile looks. * If addressed by the hijackers, respond in a calm tone of voice. If interrogated, keep answers short and limited to nonpolitical topics. Minimize the importance of your job. Give innocuous reasons for traveling. Never admit to any accusations.

* Do not attempt to hide your passport or belongings. If you are carrying both an official passport and a tourist passport, give your tourist passport in response to a general demand for identification. Confirm your military status if directly confronted with the fact. In that case, be prepared to explain that you always travel on your personal passport and that no deceit was intended. * Use your time wisely by observing the characteristics and behavior of the hijackers, mentally attach nicknames to each one and notice their dress, facial features and temperaments. Occupy your mind by memorizing this information so that you can report it after your release. * If you or a nearby passenger is in need of assistance due to illness or discomfort, solicit the assistance of a crew member first do not attempt to approach a hijacker unless similar assistance has been rendered by them for other passengers. * If you are singled out by the hijackers, be responsive but do not volunteer information. The last phase of the hijacking is resolution, either by a hostage rescue team or through negotiation. In the latter instance, the hijackers may simply surrender to authorities or abandon the aircraft, crew and passengers. The following guidelines apply in the case of a rescue operation. The rescue may be similar to the hijackers takeover noisy, chaotic, and possibly with shooting. The rescue force is re-taking control of the aircraft. The termination of any hijacking incident is extremely tense. If an assault force attempts a rescue, it is imperative that you remain calm and out of the way. Make no sudden moves or take any action by which you could be mistaken for a terrorist and risk being injured or killed. * If you hear shots fired inside or outside the aircraft, immediately take a protective position; put your head down or drop to the floor. * If instructed by a rescue force to move, do so quickly, putting your hands up in the air or behind your head. * If fire or smoke appears, attempt to get emergency exits open and use the inflatable slides or exit onto the wing. * Once you are on the tarmac, follow the instructions of the rescue force or local authorities. If neither is there to guide you, move as quickly as possible away from the aircraft and eventually move towards the terminal or control tower area. * Initially, the rescue force may have no way of knowing whether you are a hijacker or a victim. They may treat you as a hijacker or co-conspirator until they can determine that you are not part of the hijacking team. * Cooperate with local authorities and members of the U.S. Embassy, Consulate or other U.S. agencies in relating information about the hijacking.

EXPLOSIVE ATTACK If There is an Explosion

Take shelter against your desk or a sturdy table. Exit the building ASAP. Do not use elevators. Check for fire and other hazards. Take your emergency supply kit if time allows.

If There is a Fire

Exit the building ASAP. Crawl low if there is smoke Use a wet cloth, if possible, to cover your nose and mouth. Use the back of your hand to feel the upper, lower, and middle parts of closed doors. If the door is not hot, brace yourself against it and open slowly. If the door is hot, do not open it. Look for another way out. Do not use elevators If you catch fire, do not run. Stop-drop-and-roll to put out the fire. If you are at home, go to a previously designated meeting place. Account for your family members and carefully supervise small children. Never go back into a burning building.

If You Are Trapped in Debris

If possible, use a flashlight to signal your location to rescuers. Avoid unnecessary movement so that you dont kick up dust. Cover your nose and mouth with anything you have on hand. (Dense-weave cotton material can act as a good filter. Try to breathe through the material.) Tap on a pipe or wall so that rescuers can hear where you are. If possible, use a whistle to signal rescuers. Shout only as a last resort. Shouting can cause a person to inhale dangerous amounts of dust.

FAMILY DISASTER PLAN Disaster can strike quickly and without warning. It can force you to evacuate your neighborhood or confine you to your home. What would you do if basic serviceswater, gas, electricity or telephoneswere cut off? Local officials and relief workers will be on the scene after a disaster, but they cannot reach everyone right away. Families canand docope with disaster by preparing in advance and working together as a team. Follow the steps listed in this brochure to create your familys disaster plan. Knowing what to do is your best protection and your responsibility.

4 Steps to Safety: I. Find Out What Could Happen to You: 1. Contact your local Red Cross chapter or emergency management officebe prepared to take notes. 2. Ask what types of disasters are most likely to happen. Request information on how to prepare for each. 3. Learn about your communitys warning signals: what they sound like and what you should do when you hear them. 4. Ask about animal care after a disaster. Animals are not allowed inside emergency shelters because of health regulations. 5. Find out how to help elderly or disabled persons, if needed. 6. Find out about the disaster plans at your workplace, your childrens school or day care center, and other places where your family spends time. II. Create a Disaster Plan: 1. Meet with your family and discuss why you need to prepare for disaster. Explain the dangers of fire, severe weather, and earthquake preparedness to children. Plan to share responsibilities and work together as a team. 2. Discuss the types of disasters that are most likely to happen. Explain what to do in each case. 3. Pick two places to meet: Right outside your home in case of a sudden emergency, like a fire, and another location outside your neighborhood in case you cant return home. Remember, everyone must know the address and phone number. 4. Ask an out-of-state friend to be your "family contact." After a disaster, its often easier to call long distance. Other family members should call this person and tell them where they are. Everyone must know your contacts phone number. 5. Discuss what to do in an evacuation. Plan how to take care of your pets. III. Complete

This Checklist: Post emergency telephone numbers by phones (fire, police, ambulance, etc.). Teach children how and when to call 9-1-1 or your local Emergency Medical Services number for emergency help. Show each family member how and when to turn off the water, gas, and electricity at the main switches. Check if you have adequate insurance coverage. Get training from the fire department for each family member on how to use the fire extinguisher (ABC type), and show them where its kept. Install smoke detectors on each level of your home, especially near bedrooms. Conduct a home hazard hunt. Stock emergency supplies and assemble a Disaster Supplies Kit. Take a Red Cross first aid and CPR class.

 IV. 1. 2. 3. 4.

Determine the best escape routes from your home. Find two ways out of each room. Determine the safest places in your home or office for each type of disaster. Practice and Maintain Your Plan:

Quiz your family every six months or so. Conduct fire and emergency evacuation drills. Replace stored water every six months and stored food every six months. Test and recharge your fire extinguisher(s) according to manufacturers instructions. 5. Test your smoke detectors monthly and change the batteries at least once a year. Neighbors Helping Neighbors: Working with neighbors can save lives and property. Meet with your neighbors to plan how the neighborhood could work together after a disaster until help arrives. If youre a member of a neighborhood organization, such as a home association or crime watch group, introduce disaster preparedness as a new activity. Know your neighbors special skills (e.g., medical, technical) and consider how you could help neighbors who have special needs, such as disabled and elderly persons. Make plans for child care in case parents cant get home. Home Hazard Hunt: During a disaster, ordinary objects in your home can cause injury or damage. Anything that can move, fall, break, or cause a fire is a home hazard. For example, a hot water heater or a bookshelf can fall. Inspect your home at least once a year and fix potential hazards. Also, it would be a good idea to contact your local fire department to learn about home fire hazards. Evacuation:

Evacuate immediately if told to do so: Listen to your battery-powered radio and follow the instructions of local emergency officials. Wear protective clothing and sturdy shoes. Take your Disaster Supplies Kit with you. Lock your home. Use travel routes specified by local authoritiesdont use shortcuts because certain areas may be impassable or dangerous.

If youre sure you have time:

Shut off your water, gas, and electricity before leaving, if instructed to do so. Make arrangements for your pets.

Emergency Supplies: Keep enough supplies in your home to meet your needs for at least three days. Assemble a Disaster Supplies Kit with items you may need in an evacuation. Store these supplies in sturdy, easy-to-carry containers such as back-packs, duffle bags, or covered trash containers. Include:

A three-day supply of water (one gallon per person per day) and food that wont spoil. One change of clothing and footwear per person, and one blanket or sleeping bag per person. A first aid kit that includes your familys prescription medications. Emergency tools including a battery-powered radio, flashlight, and plenty of extra batteries. An extra set of car keys and a credit card, cash or travelers checks. Sanitation supplies. Special items for infant, elderly, or disabled family members. An extra pair of glasses. Keep important family documents in a waterproof container. Keep a smaller version of this kit in the trunk of your car.

UTILITIES

Locate the main electric fuse box, water service main, and natural gas main. Learn how and when to turn these utilities off. Teach all responsible family members. Keep necessary tools near gas and water shut-off valves. Remember; turn off the utilities only if you suspect the lines are damaged or if you are instructed to do so. If you turn the gas off, you will need a professional to turn it back on.

If Disaster Strikes:

Remain calm and patient. Put your plan into action. Check for Injuries Give first aid and get help for seriously injured people. Listen to Your Battery-Powered Radio for News and Instructions Evacuate, if advised to do so. Wear protective clothing and sturdy shoes. Check for Damage in Your Home Use flashlights. Do not light matches or turn on electrical switches, if you suspect damage. Sniff for gas leaks, starting at the water heater. If you smell gas or suspect a leak, turn off the main gas valve, open windows, and get everyone outside quickly. Shut off any other damaged utilities. (You will need a professional to turn gas back on.) Clean up spilled medicines, bleaches, gasoline, and other flammable liquids immediately. Remember to o Confine or secure your pets. o Call your family contactdo not use the telephone again unless it is a lifethreatening emergency. o Check on your neighbors, especially elderly or disabled persons.

o o

Make sure you have an adequate water supply in case service is cut off. Stay away from downed power lines.

72 HOUR KIT A 72 Hour Kit is essential for any emergency. Your 72 Hour Kit could mean the difference between life and death. We recommend purchasing your 72 Hour Kit only through an established and reputable company. There are many types of disasters and emergencies: floods, fires, earthquakes, hurricanes and tornadoes. In many cases, a 72 hour kit could mean the difference between life and death. It is estimated that after a major disaster, it may take up to three days for relief workers to reach some areas. It would be wise to consider a 72 hour kit that you could live on for 7-10 days. In such a case, If you live in a disaster prone area a 72-hour kit is the minimum you should have available. Plan your 72 hour kit according to your familys size. 72 Hour Kit List of Items

72 Hour Kit Info You Need To Know

Your 72 hour kit should be in a portable container located near an exit of your house or better, sheltered in your backyard. Each family member should have their own 72 hour kit with food, clothing and water. Distribute heavy items between kits. Enclose the extra clothing, matches, personal documents, and other items damageable by smoke or water in plastic to protect them. Keep a light source in the top of your 72 hour kit, so you can find it quickly in the dark. Personalize your 72 hour kit. Make sure you fill the needs of each family member. Inspect your 72 hour kit at least twice a year. Rotate food and water every six months. Dont forget to check your medications. Check childrens clothing for proper fit. Adjust clothing for winter or summer needs. Check expiration dates on batteries, light sticks, warm packs, food and water. Consider the needs of elderly people as well as those with handicaps or other special needs when building your 72 hour kit. For example: for babies, store diapers, washcloth, ointment, bottles and pacifiers, and other special supplies.

EMERGENCY EVACUATION PLAN Preparing an Emergency Evacuation Plan An emergency evacuation plan has two parts: evacuation from your house and evacuation from your neighborhood. An evacuation plan for your home is useful not only for disasters, but also for fires or other incidents in your home. Important points to remember when creating an evacuation plan for your home are:

You should have at least two (2) escape routes from each room. You should mark the locations of any escape ladders, or other special equipment. You should mark the locations of fire extinguishers, smoke detectors, first aid kits, disaster 72 hour kit. You should mark the locations of the shutoffs for gas, water, and electricity. For people with medical conditions or disabilities, mark their location as well as the location of any special equipment they will immediately need.

Emergency Evacuation Inventory If you have to evacuate your house, you may have as little as 10 minutes. Under these circumstances, trying to think of what to save is very difficult. Take some time now to think about what items you would try to take with you. Write down a list of the high priority items you would take if you only had 10 minutes to evacuate your house. Remember, you may have to carry everything.

Evacuation Steps If you have time during an evacuation, you may want to take steps to secure your house. Give some thought to what things you need to do to secure your house. Write down your plans and keep the paper in a safe and accessible location. Household Emergency Evacuation Plan

Draw your buildings floor plan. Draw your evacuation routes and a meeting place. Make one drawing for each story of the building. Keep in a safe place and review often with your family. Have maps ready for the following: Closest evacuation centers. Main and Alternative routes for leaving the city in North, South, East and West directions. Meet up spots outside the affected areas. For example: I live approximately 50 miles east of a nuclear power plant. Should there be an accident or an attack and the wind is blowing in an Easterly direction, our plan is to head north and meet up in a town approximately 60 miles north of my home.

Choosing an Out-of-Area Contact: During an emergency local phone service may be limited, so you should arrange with someone outside your area to be your family contact. Your contact person should have voice mail or an answering machine. Ensure that every family member knows that they should listen to the radio or TV for telephone use instructions, and then phone your out-of-area contact person to say how and where they are and what their plans are. Keep calls short, and if possible, arrange to call the contact person back at a specified time for another check-in. Choosing A Place to Meet: At the time of an emergency, your family may not be together. It is important to choose family meeting places. Remember that bridges may be out and roads may be blocked by debris, so choose your meeting places carefully with access in mind. Pick places that are easy to identify, that can be reached on foot if necessary, and that are in an accessible, open area. Take into account where each of you will likely be at different times and on different days.

The emergency evacuation plan for your neighborhood can be handy in a large disaster. By plotting out potential routes on a city map before the disaster, you will save yourself from having to figure something out while in a hurry. Things to think about when crafting your neighborhood evacuation plan include: You should plan two (2) routes for each direction. (North, South, East, West.) You should avoid routes with obvious hazards, or routes which are likely to be impassible in a disaster. (You probably will want to drive the routes before deciding.) And avoid common routes that may be congested during an emergency. Establish plans with other family members for meeting up outside of the evacuated area. Make sure each member knows the location of the established meeting points. You should have a phone list of 3 contacts, outside of your area. Each family member should carry a personal copy of this list. In an emergency, communications may be down in your area. Family members can contact the persons out of the emergency area to pass along messages and to check on the welfare of other family members. Be sure that each family member has a copy of the evacuation plan, maps and telephone numbers. You should also allow for an evacuation scenario, while at work. Keep your emergency evacuation plans in a safe location with your 72 hour kit. EMERGENCY WATER STORAGE Water storage is important. Having an ample supply of safe, clean water is a top priority in an emergency. A normally active person needs to drink at least two quarts of water each day. Hot environments can double that amount. Children, nursing mothers and ill people will need even more. You will also need water for food preparation and hygiene. Store a total of at least one gallon per person, per day. You should store at least a two-week supply of water for each member of your family. If supplies run low, never ration water. Drink the amount you need today, and try to find more for tomorrow. You can minimize the amount of water your body needs by reducing activity and staying cool. To ensure a safe supply of water in an emergency we recommend SteriPEN Water Purifiers. Read our recent review of the Steripen Hand-held Emergency Water Purifier here.

Amount of Emergency Water to Store Whereas a quart of water or other fluid daily will sustain life, according to the Department of Defense and the Office of Civil Defense, it is recommended that a gallon of water per day per person be stored for food preparation and drinking. A gallon provides added comfort and accommodates increased fluid needs at higher altitudes or warm climates. An additional one-half to 1 gallon per day is recommended for bathing and hygiene, and to wash dishes. How much water should I store? The rule of thumb is to store at least one gallon per person per day for at least 3 days (for earthquake preparedness). Thats 2 quarts for drinking and 2 quarts for food preparation and sanitation. A family of four should store a minimum of 12 gallons of water. Personally, I recommend at least a 10 day supply of water and a 30 day supply if it all possible. Use the following guidelines when storing water: 1. Store drinking water in carefully cleaned, non-corrosive, tightly covered containers. 2. Store containers in a cool dark place. DO NOT store in direct sunlight. Polyethylene plastics (prepackaged milk and water bottles) are somewhat permeable to hydrocarbon vapors. Keep away from stored gasoline, kerosene, pesticides, or similar substances. 3. Stored tap water should be rotated every 6 months. Prepackaged bottled water should be rotated once a year. Check the pull date on the container. Be sure it didnt sit on the stores shelf for a year before you purchased it. Self Serve Bottled Water should be rotated once a year, as long as the water treatment process includes ozonation. 4. Rotate your stored water with the water you use on a regular basis. This practice helps insure you dont have water stored longer than one year. Containers That Can be Used for Water Storage Food-grade plastic or glass containers are suitable for storing water. One-, three- and five-gallon water containers can be purchased from most outdoor or hardware stores. Any plastic or glass container that previously held food or beverages such as 2-liter soda bottles or water, juice, punch or milk jugs, also may be used. Stainless steel can be used to store water which has not been or will not be treated with chlorine; chlorine is corrosive to most metals. 55 gal drums, designed specifically for water storage can be difficult to transport, if the need arises, but are of a tremendous value in an emergency .When looking for additional food grade containers, the bottom will be stamped with HDPE (High Density PolyEthylene) and coded with the recycle symbol and a 2 inside. HDPE containers are FDA-approved for food. Containers without these designations arent OK because of possible chemical interactions between the water and the plastic. Use clean used containers and lids with hot soapy water. Once the containers have been thoroughly cleaned, rinse them with water and sanitize the containers and lids by rinsing

them with a solution of 1 tablespoon chlorine bleach per gallon of water. Leave the containers wet for two minutes, and then rinse them again with water. Remember to remove the paper or plastic lid liners before washing the lids. It is very difficult to effectively remove all residues from many containers, so carefully clean hard-to-reach places like the handles of milk jugs. To sanitize stainless steel containers, place the container in boiling water for 10 minutes. Never use containers that previously held chemicals. Do I Need to Treat Water? Once you properly clean containers, fill them with potable, or safe, drinking water. All public water supplies are already treated and should be free of harmful bacteria. However, as an additional precaution, it is recommended that you add 5-7 drops, about 1/8 teaspoon, of chlorine bleach per gallon of water stored. This precaution protects you against any lingering organisms in storage containers that may have been inadvertently missed during the cleaning process. Where to Store Water Clearly label all water containers drinking water with the current date. Store the water in a cool, dry place away from direct sunlight and heat sources. Do not store it near gasoline, kerosene, pesticides or similar substances. When potable water is properly stored, it should have an indefinite shelf life; however, its a good idea to use and replace the stored water every 6 12 months. Rotating water this way provides you with an opportunity to experiment and check the amount of stored water against what you require. It also serves as an additional precaution against bacteria or viruses growing in containers which may not have been thoroughly or properly cleaned and sanitized. If you have freezer space, storing some water in the freezer is a good idea. If you lose electricity, the frozen water will help keep foods in your freezer frozen until the power is restored. Make sure you leave 2 to 3 inches of space in containers because water expands as it freezes. Emergency Sources of Water In an emergency, if you have not previously stored water and commercial or public sources of water are not available, drain water from your plumbing system. Unless you are advised that the public water supply has been contaminated and is not safe, open the drain valve at the bottom of the water heater and salvage the water stored in the heater. A typical water heater holds 30-60 gallons of water. Discard the first few gallons if they contain rust or sediment. Let the water heater cool before draining it from the heater so it does not scald you. Turn off the electricity or gas to the water heater to prevent the heater from operating without water. Once water has been drained into clean, sanitized containers, add 5-7 drops of chlorine bleach* per gallon of water, and stir or shake the solution to mix it. Let it set 30 minutes before use.

Emergency Outdoor Water Sources If you need to find water outside your home, you can use these sources. Be sure to treat the water first. Additional sources include: Rainwater Streams, rivers and other moving bodies of water Ponds and lakes Natural springs. Try to avoid water with floating material, an odor or dark color. Use saltwater only if you distill it first. You should not drink flood water. Hidden Water Sources in Your Home If a disaster catches you without a stored supply of clean water, you can use the water in your hot-water tank, pipes and ice cubes. As a last resort, you can use water in the reservoir tank of your toilet (not the bowl). Do you know the location of your incoming water valve? Youll need to shut it off to stop contaminated water from entering your home if you hear reports of broken water or sewage lines. To use the water in your pipes, let air into the plumbing by turning on the faucet in your house at the highest level. A small amount of water will trickle out. Then obtain water from the lowest faucet in the house. To use the water in your hot-water tank, be sure the electricity or gas is off, and open the drain at the bottom of the tank. Start the water flowing by turning off the water intake valve and turning on a hot-water faucet. Do not turn on the gas or electricity when the tank is empty. Using Swimming Pool Water You should always view your pool as backup water; keep the water treated; you never know when it will be needed! The maintenance of the free chlorine residual will prevent establishment of any microorganisms. The maintenance level should be kept about 3-5ppm free chlorine. (See Water Purification for detailed information on purifying pool water.) If other stored water stocks are not available, remove the necessary pool water and boil it or just treat with chlorine to the normal 5ppm. It is best to err on the side of caution. Covering the pool at all times when not in use is a very good idea. Try to keep the cover clean and wash the area you put it on when removing it from the pool. When and How to Treat Water for Storage In an emergency, if you do not have water that you know is safe, its possible to purify water for drinking. Start with the cleanest water you can find and treat with one of the following methods:

Boiling and chlorinating: Water can be purified by boiling. Boiling times may vary from state to state, depending on altitude. In Colorado, the water is safe to

use once after it has been boiled for three to five minutes and has cooled. If you plan to store boiled water, pour it into clean, sanitized containers and let it cool to room temperature. Then add 5-7 drops, or 1/8 teaspoon, of chlorine bleach* per gallon of water (1/2 teaspoon per 5 gallons). Stir or shake the solution to mix it. Cap the containers and store them in a cool, dry place. Filtering and chlorinating: You can filter water if you have a commercial or backpack filter that filters to 1 micron. These are available in sporting good stores and are recommended for use when back-packing. They are not recommended to clean large volumes of water. Filtering eliminates parasites such as giardia and cryptosporidium, but it may not eliminate all bacteria and viruses. Therefore, its recommended that 5-7 drops (1/8 teaspoon) of chlorine bleach* be added per gallon of filtered water (1/2 teaspoon for 5 gallons). Stir or shake the solution to mix it. Wait 30 minutes before using the water, or cap the containers and store them in a cool, dry place.

*Use liquid household bleach that contains 5.25 percent hypochlorite. Do not use bleaches with fresheners or scents as they may not be safe to consume. The above treatment methods use a two-step approach so less bleach is needed, yet giardia and cryptosporidium are destroyed through boiling or eliminated by filtering. Chlorine may not be effective against these parasites. Since adding too much chlorine to water can be harmful, its important to be as accurate as possible when measuring.

Distillation involves boiling water and then collecting the vapor that condenses back to water. The condensed vapor will not include salt and other impurities. To distill, fill a pot halfway with water. Tie a cup to the handle on the pots lid so that the cup will hang right-side-up when the lid is upside-down (make sure the cup is not dangling into the water) and boil the water for 20 minutes. The water that drips from the lid into the cup is distilled.

Most water filtration devices are designed for use on microbiologically safe water. Dont assume they are safe to use on contaminated water. Check with the manufacturer to be sure. Use the following guidelines to determine if filtration equipment is adequate to use with microbiologically contaminated water: Filtration Equipment Carbon Filter Reverse Osmosis Deionization Filter Pitcher Filter Faucet Mount Filter Steam Distiller UV Sterilizer No No No No No Yes but requires electricity Yes but requires electricity Safe on Microbiologically Contaminated Water?

Ceramic Filter

Some but only if rated for bacteriological protection

Equipment that is safe to use on contaminated water is often slow, costly, inconvenient and/or high maintenance. It makes the most sense to use the filtration equipment that best meets your normal daily needs and shift to water storage or alternative methods of water treatment in times of emergencies. FOOD STORAGE AND PREPAREDNESS When Food Supplies Are Low If activity is reduced, healthy people can survive on half their usual food intake for an extended period and without any food for many days. Food, unlike water, may be rationed safely, except for children and pregnant women. If your water supply is limited, try to avoid foods that are high in fat and protein, and dont stock salty foods, since they will make you thirsty. Try to eat salt-free crackers, whole grain cereals and canned foods with high liquid content. You dont need to go out and buy unfamiliar foods to prepare an emergency food supply. You can use the canned foods, dry mixes and other staples on your cupboard shelves. In fact, familiar foods are important. They can lift morale and give a feeling of security in time of stress. Also, canned foods wont require cooking, water or special preparation. Following are recommended short-term food storage plans. Special Considerations As you stock food, take into account your familys unique needs and tastes. Try to include foods that they will enjoy and that are also high in calories and nutrition. Foods that require no refrigeration, preparation or cooking are best. Individuals with special diets and allergies will need particular attention, as will babies, toddlers and elderly people. Nursing mothers may need liquid formula, in case they are unable to nurse. Canned dietetic foods, juices and soups may be helpful for ill or elderly people. Make sure you have a manual can opener and disposable utensils. And dont forget nonperishable foods for your pets. How to Cook If the Power Goes Out For emergency cooking you can use a fireplace, or a charcoal grill or camp stove can be used outdoors. You can also heat food with candle warmers, chafing dishes and fondue pots. Canned food can be eaten right out of the can. If you heat it in the can, be sure to open the can and remove the label first.

Short-Term Food Supplies Even though it is unlikely that an emergency would cut off your food supply for two weeks, you should prepare a supply that will last that long. The easiest way to develop a two-week stockpile is to increase the amount of basic foods you normally keep on your shelves. Storage Tips

Keep food in a dry, cool spot a dark area if possible. Keep food covered at all times. Open food boxes or cans care-fully so that you can close them tightly after each use. Wrap cookies and crackers in plastic bags, and keep them in tight containers. Empty opened packages of sugar, dried fruits and nuts into screw-top jars or airtight cans to protect them from pests. Inspect all food for signs of spoilage before use. Use foods before they go bad, and replace them with fresh supplies, dated with ink or marker. Place new items at the back of the storage area and older ones in front. Consider building a special storage unit for your supplies. There are numerous, DIY prefab garage kits available that are sturdy and would work well.

Nutrition Tips

During and right after a disaster, it will be vital that you maintain your strength.

So remember:

Eat at least one well-balanced meal each day. Drink enough liquid to enable your body to function properly (two quarts a day). Take in enough calories to enable you to do any necessary work. Include vitamin, mineral and protein supplements in your stockpile to assure adequate nutrition.

How long can food supplies be stored? To judge how long you can store food supplies, look for an expiration date or best if used by date on the product. If you can not find a date on the product, then the general recommendation is to store food products for six months and then replace them. Some households find it helpful to pull food products for their regular meals from their disaster supplies kit and replace them immediately on an ongoing basis, so the food supplies are always fresh.

What kinds of food supplies are recommended to store in case of a disaster? Try to avoid foods that are high in fat and protein, and dont stock salty foods, since they will make you thirsty. Familiar foods can lift morale and give a feeling of security in time of stress. Also, canned foods wont require cooking, water or special preparation. Take into account your familys unique needs and tastes. Try to include foods that they will enjoy and that are also high in calories and nutrition. Store supplies of non-perishable foods and water in a handy place. You need to have these items packed and ready in case there is no time to gather food from the kitchen when disaster strikes. Sufficient supplies to last several days to a week are recommended. Select foods that require no refrigeration, preparation or cooking, and little or no water. Foods that are compact and lightweight are easy to store and carry. Try to eat salt-free crackers, whole grain cereals and canned food with high liquid content. Recommended foods include:

Ready-to-eat canned meats, fruits and vegetables. (Be sure to include a manual can opener) Canned juices, milk and soup (if powdered, store extra water). High energy foods, such as peanut butter, jelly, crackers, granola bars and trail mix. Comfort foods, such as hard candy, sweetened cereals, candy bars and cookies. Instant coffee, tea bags. Foods for infants, elderly persons or persons on special diets, if necessary. Compressed food bars. They store well, are lightweight, taste good and are nutritious. Trail mix. It is available as a prepackaged product or you can assemble it on your own. Dried foods. They can be nutritious and satisfying, but have some have a lot of salt content, which promotes thirst. Read the label. Freeze-dried foods. They are tasty and lightweight, but will need water for reconstitution. Instant Meals. Cups of noodles or cups of soup are a good addition, although they need water for reconstitution. Snack-sized canned goods. Good because they generally have pull-top lids or twist-open keys. Prepackaged beverages. Those in foil packets and foil-lined boxes are suitable because they are tightly sealed and will keep for a long time.

Food Options to Avoid:

Commercially dehydrated foods. They can require a great deal of water for reconstitution and extra effort in preparation. Bottled foods. They are generally too heavy and bulky, and break easily.

Meal-sized canned foods. They are usually bulky and heavy. Whole grains, beans, pasta. Preparation could be complicated under the circumstances of a disaster.

Shelf-life of Foods for Storage Here are some general guidelines for rotating common emergency foods. Use within six months:

Powdered milk (boxed) Dried fruit (in metal container) Dry, crisp crackers (in metal container) Potatoes

Use within one year:

Canned condensed meat and vegetable soups Canned fruits, fruit juices and vegetables Ready-to-eat cereals and uncooked instant cereals (in metal containers) Peanut butter Jelly Hard candy and canned nuts Vitamin C

May be stored indefinitely (in proper containers and conditions):

Wheat Vegetable oils Dried corn Baking powder Soybeans Instant coffee, tea and cocoa Salt Noncarbonated soft drinks White rice Bouillon products Dry pasta Powdered milk (in nitrogen-packed cans)

FIRST AID IN AN EMERGENCY First Aid Resources and Information.

Knowing what to do ahead of time will potentially prevent an emergency, possibly even save a life.

Every emergency can be handled by remembering four things: prevent, prepare, recognize, act. Quick action can save a life, and the initial minutes after an injury or medical crisis are frequently the most important. The key is knowing what to do, remaining calm, and making a decision to act. Calling 9-1-1 is one of the most important things you can do. Have a complete First Aid Kit available at all times and know how to use it. For details and examples of what to include, please refer to our First Aid Checklist.

Q. What steps can I take to prevent emergencies? A. Preventing emergencies means getting yearly doctors exams and regular exercise. Protect your health by determining whether youre at risk for any life-threatening conditions, and follow your doctors suggestions to reduce any risk factors that can be dangerous to your health. For example, if you dont smoke, dont start. If you do smoke, quit. Were all busy people, and theres never enough time, but is it easier to handle a heart attack in progress or to prevent it in the first place with regular exercise and visits to the doctor? If we dont prevent now, well pay later. Q. How can I prepare for an emergency? A. After doing everything we can to prevent an emergency, the next step is to prepare for one. While it may seem negative to prepare for the worst, preparation takes prevention one step further. It means that if an emergency does occur, we can handle it calmly, quickly, and effectively to minimize its impact. Being prepared means keeping a list of emergency numbers by the phone. The police, fire department, poison control center, local hospital, ambulance service, and your family doctors office should all be included. Being prepared means making a list of all the medications you and your family take and their dosages. In an emergency, you might not be able to speak for yourself, so carry it with you. This list could help prevent serious drug interactions. Also make a list of allergies, especially drug allergies or those with severe reactions. This list will help ensure that the care you receive wont make matters worse. Take a first-aid class. A basic class will teach CPR and proper methods for treating burns, wrapping sprains, applying splints, and performing the Heimlich maneuver. Firstaid classes also will help you learn how to remain calm and how to calm others in an emergency. Q. How do I recognize an emergency? A. Recognize the difference between a minor crisis and a life-threatening emergency. For example, upper abdominal pain can be indigestion, ulcers, or an early sign of a heart attack. A toddler who falls down in the yard unconscious may have tripped or he could

have been stung by an insect and be having an allergic reaction. Not every cut needs stitches, nor does every burn require advanced medical treatment. Part of handling an emergency is being able to evaluate warning signs and make a fast decision. But its always best to err on the side of caution. In an emergency, always call 9-1-1 or the local hospital for assistance. When should you call an ambulance instead of driving to the emergency department? Ask yourself the following questions:

Is the victims condition life-threatening? Could the victims condition worsen and become life-threatening on the way to the hospital? Could moving the victim need the skills or equipment of paramedics or emergency medical technicians? Would distance or traffic conditions cause a delay in getting the victim to the hospital?

If the answer to any of these questions is yes, or if you are unsure, its best to call an ambulance. First Aid Kit List
1 2 4 2 1 2 3 1 1 1 1 1 1 1 1 2 4 1 1 1 1 1 1 1 each Basic First Aid Book, in plain language each Bandages (Ace) elastic, 4" each Bandages, gauze, 2" x 2" each Bandages, gauze, 3" x 3" and 4" x 4" each Bandages, gauze, 18" x 36" each Bandages for burns (Second Skin) 3" x 3-1/2" each Triangular Bandages box Band-Aids in assorted sizes, flexible and moisture resistant best box Bicarbonate of Soda box Butterfly sutures or Leukostrips each Cold/heat Pack, reusable box Cotton Swabs box Dental Floss box Epsom Salts each Eyedropper rolls First Aid Tape, 1/2" x 10 yards and 1" x 5 yards pair Gloves, lightweight rubber, (for medical and hygiene purposes) tube Insect Repellent bottle Isopropyl Alcohol box Moistened Towelettes each Nail Clipper box Razor Blades, single edge box Safety Pins, assorted sizes each SAM splint

1 1 1 1 6 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

each Scalpel each Scissors, Surgical pointed each Snake bite kit bottle Soap, liquid, antibacterial each Tongue Depressors each Thermometers, disposal OR 1 digital, (no breakables with mercury) each Tweezers tube Analgesic Cream (Camphophenique, Paraderm Plus) box Antacid (Mylanta, Tums, Pepto-Bismal) series Antibiotic (Tetracycline for general infections) box Anti-Diarrheal (Imodium, Diasorb, Lomotil) box Anti-fungal (Desenex, Micatin, Tinactin, Lotrimin) box Antihistamine (Benadryl, Claratyne) tube Antiseptic Ointment (Neosporin, Dettol) each Anti-toxin (DMSO) 1 tube Burns (Hydrocortisone, Derm-Aid) box Cold/Flu Tablets (Nyquil, Repetabs) box Constipation (Ex-Lax, Dulcolax, Durolax) bottle Cough Syrup (Robitussen, Dimetap) box Decongestant (Actifed, Sudafed, Repetabs) bottle Eye Drops (Visine) tube Hemorrhoid Relief (Preparation H, Anusol) box Ibuprofen (Advil, Nurofen, Paracetamol) bottle Itching, Insect/Rash (Caladril, Calamine) tube Itching (Dibucaine, Paraderm, Lanacane) tube Lip Balm (ChapStick, Blistex) tube Lubricant, Water Soluble (K-Y Jelly) bottle Nasal Decongestant (Sinex, Ornex) box Nausea, Motion Sickness (Kwells, Dramamine, Travacalm, Meclizine) box Non-Aspirin Pain Reliever (Tylenol) box Pain, Fever Reducer (Panadeine, Mobigesic) box Pain Reliever with Codeine (Panamax, Tylenol 3) Prescription (A supply of any you are taking) jar Petroleum Jelly (Vaseline) bottle Poison Ivy/Oak packet Poison Absorber (Activated Charcoal) bottle Radiation Protection (Potassium Iodide-[KI] or Potassium Iodate-[KIO3] either is fine) can Sunburn Relief (Solarcaine, Paxyl) bottle Sunscreen (SPF 15 at least) bottle Vomit Inducer (Ipecac, Activated charcoal) tube Yeast Infection Treatment (Gyne-Lotrimin, Monistat

SANITATION AND HYGIENE IN AN EMERGENCY The lack of sanitation facilities following major disaster can quickly create secondary problems unless basic guidelines are followed. If the water lines are damaged or if damage is suspected, do not flush the toilet. Avoid digging holes in the ground and using these. Untreated raw sewage can pollute fresh round water supplies. It also attracts flies and promotes the spread of diseases.

Store a large supply of heavy-duty plastic bags, twist ties, disinfectant, and toilet paper A good disinfectant that is easy to use is a solution of 1 part liquid bleach to 10 parts water. Dry bleach is caustic and not safe for this type of use. If the toilet is NOT able to be flushed, it can still be used. This is less stressful for most people than using some other container. Remove all the bowl water. Line it with a heavy-duty plastic bag. When finished, add a small amount of deodorant or disinfectant, securely tie the bag, and dispose of it in a large trash can with a tight fitting lid. This large trash can should also be lined with a sturdy trash bag. Eventually, the city will provide a means to dispose of these bags. Portable camp toilets, small trash cans or sturdy buckets lined with heavy-duty plastic bags can also be used. Those with tight fitting lids are best.

Tips for Staying Clean in an Emergency Situation As much as possible, continue regular hygiene habits such as brushing your teeth, washing your face, combing your hair and even washing your body with a wet washcloth. This will help prevent the spread of disease and irritation as well as help relieve stress.

Keep your fingers out of your mouth. Avoid handling food with your hands. Purify your drinking water. Use chlorine bleach, purification tablets (check bottle for expiration dates), or by boiling for 10 minutes. Sterilize your eating utensils by heat. You can also rinse dishes in purified water that has additional chlorine bleach added to it. (Use 2 1/2 teaspoons bleach per gallon of purified water.) Keep your clothing as clean and dry as possible, especially under-clothing and socks.

If, during an emergency situation, you develop vomiting or diarrhea, rest and stop eating solid foods until the symptoms ease up. Take fluids, particularly water, in small amounts at frequent intervals. As soon as can be tolerated, resume eating semi-solid foods. Normal salt intake should be maintained. Keep Basic Hygiene Supplies Handy These basic supplies should be kept in your Safe Room, Go Pack and Car.

Cornstarch Fingernail clippers and files Sanitary napkins Insect repellent Toilet paper Moistened Towelettes or Baby Wipes

A few bath towels Small hand-held mirror Liquid all-purpose soap Vaseline Petroleum Jelly Liquid Chlorine Bleach Ammonia (disinfecting aid)

Emergency Sewage Disposal Water flush toilets cannot be used when water service is interrupted. The water remaining in the fixture is not sufficient to flush the wastes down the sewer. Clogging may result and your living conditions then become just that much more uncomfortable. Even if water is available, local authorities may ask you not to use flush toilets, wash basins, and other fixtures connected with soil pipes. The sewer mains may be broken or clogged, which would make it impossible to carry off such waste; or water may be needed for fire fighting or other emergencies. It is necessary for every family to know emergency methods of waste disposal in case such conditions arise. Failure to properly dispose of human wastes can lead to epidemics of such diseases as typhoid, dysentery, and diarrhea. At the same time, sewage must be disposed of in ways that will prevent contamination of water supplies used for drinking, cooking, bathing, laundering, and other domestic purposes. Here are simple steps that any family can take to prevent such dangers and discomforts. Temporary Toilet Provisions Right after an emergency, or during one, you will probably not have the time and tools to prepare a complex emergency sanitation system. If there is a delay of several days in restoring sewage service to your neighborhood, you may find that disposal is a big problem. Your first task is to make some temporary toilet provision for your family, especially the children. Almost any covered metal or plastic container will do. You can use a covered pail, a 5-gallon bucket, or a small kitchen garbage container with a foot operated cover for an emergency toilet. Anything that has a cover and will hold the contents until you can dispose of them will serve for sanitary purposes at first. Emergency Sewage Storage Keep on the premises at least one extra 10-gallon garbage can or other waterproof container with a tight fitting cover. This should be lined with paper and/or a plastic bag. And the lid should be fastened to the can to prevent its loss. Such a can may be used for the emergency storage of body wastes until the public sewage system can be put back into action, or until other arrangements can be made. Empty your emergency toilet into this storage can as often as necessary. A small amount of household disinfectant should be added after each use. If you live in an apartment, you may not have a large garbage can or room to keep one. In that case, two smaller covered pails or other containers will do just as well.

Solutions for Apartment Dwellers Persons in city apartments, office buildings, or homes without yards should keep a supply of waterproof paper containers on hand for emergency waste disposal. Where flush toilets cannot be used and open ground is not available for the construction of privies, such disposable containers offer a practical method of emergency waste collection and disposal. Building managers should plan for the collection of such containers and for their final disposal. Before collection, the used containers may be stored in tightly covered garbage cans or other water tight containers fitted with lids. Homemade soil bags for this purpose can be prepared very easily by putting one large grocery bag inside another, and a layer of shredded newspaper or other absorbent material between. You should have sufficient grocery bags on hand for possible emergencies. A supply of old newspapers will come in handy for other sanitary uses also, such as wrapping garbage and lining larger containers. Controlling Odors and Insects Insecticides and deodorants should be used when necessary to control odors and insects breeding in containers that cannot be emptied immediately. At least 2 pints of household bleach solution should be kept on hand for disinfecting purposes. Other Supplies Keep on hand an extra supply of toilet tissue, plus a supply of sanitary napkins. If there is illness in the house that requires rubber sheeting or other special sanitary equipment, make sure that adequate supplies are available. At least a weeks accumulation of daily newspapers will come in handy for insulating bedding from floors, and lining clothes against cold, as well as for the sanitary uses already mentioned. Babies If you have a baby in your home, you may find diaper laundering a problem under emergency conditions. It is best to keep an ample supply of disposable diapers on hand for emergency use. Or, any moisture resistant material can be cut and folded to diaper size and lined with absorbent material. HEAT, LIGHT AND COOKING IN AN EMERGENCY To conserve your cooking fuel storage needs always do your emergency cooking in the most efficient manner possible. Dont boil more water than you need, extinguish the fire as soon as you finished, plan your meals ahead of time to consolidate as much cooking as possible, during the winter cook on top of your heating unit while heating your home, and cook in a pressure cooker or other fuel efficient container as much as possible. Keep enough fuel to provide outdoor cooking for at least 7-10 days. It is even possible to cook without using fuel at all. For example, to cook dry beans you can place them inside a pressure cooker with the proper amount of water and other ingredients needed and place it on your heat source until it comes up to pressure. Then turn off the heat, remove the pressure cooker and place inside a large box filled with

newspapers, blankets, or other insulating materials. Leave it for two and a half hours and then open it, your meal will be done, having cooked for two and a half hours with no heat. If you dont have a large box in which to place the pressure cooker, simply wrap it in several blankets and place it in the corner. Matches Store matches in a waterproof airtight tin with each piece of equipment that must be lit with a flame. Sterno Sterno Fuel a jellied petroleum product is an excellent source of fuel for inclusion in your back pack as part of your 72 hour kit. Sterno is very light weight and easily ignited with a match or a spark from flint and steel but is not explosive. It is also safe for use indoors. Sterno Stove A Sterno Stove can be purchased at any sporting goods store and will retail between $3 and $8, depending upon the model you choose. They fold up into a very small, compact unit ideal for carrying in a pack. The fuel is readily available at all sporting goods stores and many drug stores. One can of Sterno fuel, about the diameter of a can of tuna fish and twice as high, will allow you to cook six meals if used frugally. Chafing dishes and fondue pots can also be used with Sterno. Sterno is not without some problems. It will evaporate very easily, even when the lid is securely fastened. If you use Sterno in your 72 hour kit you should check it every six to eight months to insure that it has not evaporated beyond the point of usage. Because of this problem it is not a good fuel for long-term storage. It is a very expensive fuel to use compared to others fuel available, but is extremely convenient and portable. Coleman fuel (white gas) When used with a Coleman stove, this is another excellent and convenient fuel for cooking. It is not as portable or as lightweight as Sterno, but produces a much greater BTU value. Like Sterno, Coleman fuel has a tendency to evaporate even when the container is tightly sealed so it is not a good fuel for long-term storage. Unlike Sterno, however, it is highly volatile; it will explode under the right conditions and should therefore never be stored in the home. Because of its highly flammable nature great care should always be exercised when lighting stoves and lanterns that use Coleman fuel. Many serious burns have been caused by carelessness with this product. Always store Coleman fuel in the garage or shed, out of doors. Charcoal Charcoal is the least expensive fuel per BTU that the average family can store. Remember that it must always be used out of doors because of the vast amounts of poisonous carbon monoxide it produces. Charcoal will store for extended period of time

if it is stored in air tight containers. It readily absorbs moisture from the surrounding air so do not store it in the paper bags it comes in for more than a few months or it may be difficult to light. Transfer it to airtight metal or plastic containers and it will keep almost forever. Fifty or sixty dollars worth of charcoal will provide all the cooking fuel a family will need for an entire year if used sparingly. The best time to buy briquettes inexpensively is at the end of the summer. Broken or torn bags of briquettes are usually sold at a big discount. You will also want to store a small amount of charcoal lighter fluid (or kerosene). Newspapers will also provide an excellent ignition source for charcoal when used in a funnel type of lighting device. To light charcoal using newspapers use two or three sheets, crumpled up, and a #10 tin can. Cut both ends out of the can. Punch holes every two inches around the lower edge of the can with a punch-type can opener (for opening juice cans). Set the can down so the punches holes are on the bottom. Place the crumpled newspaper in the bottom of the can and place the charcoal briquettes on top of the newspaper. Lift the can slightly and light the newspaper. Prop a small rock under the bottom edge of the can to create a good draft. The briquettes will be ready to use in about 20-30 minutes. When the coals are ready remove the chimney and place them in your cooker. Never place burning charcoal directly on concrete or cement because the heat will crack it. A wheelbarrow or old metal garbage can lid makes an excellent container for this type of fire. One of the nice things about charcoal is that you can regulate the heat you will receive from them. Each briquette will produce about 40 degrees of heat. If you are baking bread, for example, and need 400 degrees of heat for your oven, simply use ten briquettes. To conserve heat and thereby get the maximum heat value from your charcoal you must learn to funnel the heat where you want it rather than letting it dissipate into the air around you. One excellent way to do this is to cook inside a cardboard oven. Take a cardboard box, about the size of an orange crate, and cover it with aluminum foil inside and out. Be sure that the shiny side is visible so that maximum reflectivity is achieved. Turn the box on its side so that the opening is no longer on the top but is on the side. Place some small bricks or other noncombustible material inside upon which you can rest a cookie sheet about two or three inches above the bottom of the box. Place ten burning charcoal briquettes between the bricks (if you need 400 degrees), place the support for your cooking vessels, and then place your bread pans or whatever else you are using on top of the cookie sheet. Prop a foil-covered cardboard lid over the open side, leaving a large crack for air to get in (charcoal needs a lot of air to burn) and bake your bread, cake, cookies, etc. just like you would in your regular oven. Your results will amaze you. To make your own charcoal, select twigs, limbs, and branches of fruit, nut and other hardwood trees; black walnuts and peach or apricot pits may also be used. Cut wood into desired size, place in a large can which has a few holes punched in it, put a lid on the can and place the can in a hot fire. When the flames from the holes in the can turn yellow-red, remove the can from the fire and allow it to cool. Store the briquettes in a moisture-proof container. Burn charcoal only in a well-ventilated area.

EMERGENCY COMMUNICATIONS Emergency communications information. During emergencies local, state, and national the importance of our countrys communications system, including telecommunications, broadcast, cable, and satellite systems, becomes clear. We use our phones to call 911 or to call our family members to make sure they are safe. We turn on our televisions and radios to get information updates. While there is no doubt that our country has one of the worlds most extensive and dependable communications systems, unusual conditions can put a strain on it. The following information will help you better understand what happens with our communications system during an emergency and how best to use the various components of our communications system during a crisis or disaster. When the power is off, phones go out and the internet is down, when police, fire, and hospital services are overwhelmed, amateur radio operators are there to take up the slack as emergency communications volunteers. They have, in fact, been there in virtually all disasters in recent memory. Hurricanes, fires, ice storms, earthquakes, floods and so on. With a little forethought and a few bucks, you can prepare yourself for similar events in the future and avoid being incommunicado when you need it the most. Here are some criteria for setting up an emergency communications system: 1) 2) 3) 4) 5) 6) It should be easy to operate have effective range have a modest amount of protection against interference be inexpensive (i.e. low initial cost, low maintenance and no monthly fees) be readily available be able to operate off the grid

There are at least five communications systems that more or less meet these criteria. Some have big drawbacks, others minor ones. In making your choice, you should examine your own needs and match them with the appropriate system. Cell Phones CB Radio In the late 50s, the FCC took a set of frequencies from the Amateur Radio service and designated it as the Citizens Band. The rules were simple: a rubber stamp license, low power, ease of operation and channelized tuning. But the service was a relative sleeper til the 70s when movies like Smokey and the Bandit and popular tunes like Convoy, with their rachet jawin, truck drivin cowboys, captured the American imagination. That sent a stampede of otherwise respectable Americans onto the airwaves and the

Interstate and overwhelmed the sluggish FCC which promptly abandoned the band to the mayhem that ensued. The Commissions only response to the millions of yahoos yelling at each other over CB was to expand the band to 40 channels. If you havent used a CB in the last 20 years, a few things may surprise you: 1) The units themselves are virtually unchanged (which leads one to wonder if theyre still selling off excess inventory from the initial craze). 2) Prices for complete systems are cheap. 3) In many areas, the CB channels are relatively quiet. Advantages of using CB radios for emergency communications are considerable. Aside from the low price tag, lack of licensing and fees, they are operated on your cars 12v. electrical system and can be easily operated from home using a small, cheap motorcycle battery. Their range, depending on antenna type and placement, can be anywhere from one to fifteen miles. Disadvantages of CBs are few, but persistent. Antennas tend to be large (4 to 8 on vehicles and larger for base or home stations). While much smaller antennas are sold, their effective range is drastically reduced. Transmissions tend to leak into all kinds of other electronic devices. In the home, CBers will often be heard on TV speakers, corded telephones, electronic keyboard speakers, etc. This was an aspect the FCC came to regret as the Commission was faced with hundreds of thousands of complaints from frustrated neighbors. Another problem is that sometimes, during favorable atmospheric propagation, range can be as great as several thousand miles. Thousands of people all hitting their mike buttons at the same time sets up an unearthly squeal and nobody gets through. Prices for CB radios range from US$50 to $150 for full-sized mobile-mount radios to $230 for handheld portable units with AM/Single Side Band (SSB) capabilities. I recommend units with built-in Weather Radio receivers. Antennas are sold separately and range from $28 to $75 and usually have attached cables and connectors to simply plug into the back of the unit. 49MHz Personal Communicators After the CB fiasco and before the Family Radio Service was established, manufacturers took advantage of FCC rules regarding transmissions in the 49MHz band. They built small, lightweight, self-contained, low power systems which featured a single headset with boom mike attached to the transmitter/controller which could be clipped onto the users belt or pants pocket. Usually single channel operation only, some models are sold with as many as five frequency channels. All feature PTT (push-to-talk) mikes as well as VOX (voice operated) transmitters. The VOX feature makes them ideal hands free systems for cyclists, joggers or motorcyclists. Without speakers, the audio is heard only through the earphone. Early cordless phones, baby monitors and a few other devices share this band. The advantage of this system is the extremely low power drain. Most sets are powered by only 2 or 3 AA batteries and can be in service for months. Their size makes them perfect for traveling light and taking up very little space. The big disadvantage is limited range. Expect under a quarter mile coverage with these systems. This can be seen as an advantage when you dont want to battle hundreds of other people on your frequency.

Prices for 49MHz Personal Communicators range from $30 to $50 each. Family Radio Service Once again, the FCC has tried to give the average citizen a chance to use the airwaves with a new scheme they call the Family Radio Service (FRS). Here the Commission sought to re-dress the problems of the first citizens band. They assigned the band frequencies in the UHF region (around 462MHz) which limits the propagation-induced range. They also limited the output to one-half watt and transmissions use Frequency Modulation (FM). All are small, battery-powered handi-talkies which can easily fit into a pocket. The Commission has again chosen channelized operation and this time has allowed 14 channels for use. Advantages of FRS units are that they are very compact (typically 4 h x 2.5 w x 1.5 d) and weighing 6-10 ounces. The UHF frequency means they have very short antennas (typically only a few inches). Some units also have such useful features as optional headset/boom mikes for VOX operation, audible low battery alert and transmit LED. Some units feature 38 interference eliminator codes which are subaudible tones which let your unit respond only to other units transmitting a designated tone. Other notable features include a programmable scan feature and automatic power off (shuts down if not used after a certain period of time). The main disadvantage of these units is the relatively short range. While manufacturers claim up to two miles, dont expect more than a mile. Expect to pay $50 each for basic FRS models, $90-$190 for higher-end models with additional features. General Mobile Radio Service The General Mobile Radio Service (GMRS) is like the FRS in that it operates in the 460MHz region, uses small handi-talkies and is intended to be used by individuals to communicate with immediate family members. The big differences are that GMRS requires an FCC license with a fee and users must be 18 years or older. In addition, the output of these units is considerably greater (1 to 5 watts), allowing a range of coverage from 5 to 25 miles, depending on terrain and antenna position. There are 23 GMRS channels used on an unassigned basis and dependent on the cooperation of all users. The channels are split up for base, mobile relay and fixed station or mobile station use. Each license is assigned one or two of eight possible channels or pairs as requested by the license applicants. In order to avoid interference or conflicts in use, the FCC recommends monitoring existing frequencies in your area before making your application and requesting your channels. The advantage of the GMRS is that this is the most useful of the previously listed services, but brings with it disadvantages of government oversight and stringent frequency assignment. GMRS radios are bigger than FRS units and have more features. Higher power means more batteries (as many as 6 AAs) and a higher price. Expect to pay $200 for handheld 2 watt units and considerably more for 5 watt base station transceiver.

Amateur Radio The great grand pappy of the two way radio scene is the Amateur Radio service whose operators are known as Hams and who have pioneered radio communications since the first decade of this century. AR is also the most regulated of the non-commercial services, it can end up being the most expensive, but it can also be the most versatile and powerful. All hams and their stations must be licensed by the FCC, and in order to receive a license, you must pass a written exam. Any license above the entry level also requires a proficiency in Morse Code. Theres no fee for the license (which is good for ten years), no age requirement and operators are allowed to use any frequency for which their license qualifies them. A nationwide system of repeaters on the 144MHz and 440MHz bands allows nearly seamless communications as hams travel around the country. These repeaters are built, installed and maintained by active and well-populated local amateur radio clubs. Traditional amateur frequencies in the shortwave bands provide excellent coverage for local, regional, national, and even international, communications. Unfortunately, theres not one radio for all of these capabilities which is why hams typically have three or four separate radios and antennas. The easiest way into ham radio is via the Technician class license which requires a written test based on a text available through many sources. This class allows the user to operate (among others) in the 2 meter band (144MHz). Small handi-talkies for 2 meters are relatively cheap and give a range of 20-50 miles depending on terrain, power and whether or not youre using a repeater. Many repeaters provide access to 911 services through the handi-talkie. Expect to pay $200-$500 for 2 meter transceivers depending on features. If youre planning to use Amateur Radio for your family, each member needs a Technician license and their own handi-talkie. Final Points The FCC has made it illegal to modify any of these radios to operate in any band other than the one for which they were intended or to make it possible to place telephone calls from the radios. Despite what sales people might tell you, or manufacturers claims, none of these services offer privacy. Anyone with a similar unit or a scanner can tune into your conversations. You dont need to buy any of these transceivers to find out whats happening in your area in an emergency. Any scanner capable of tuning the VHF or UHF bands can tune in. Any shortwave radio capable of tuning as high as 27MHz can monitor the Citizens Band. This is particularly useful in winter when you need to know about road conditions in your immediate area.

911 Calls Emergency personnel and others often learn about emergencies through 911 calls. 911 is the official national emergency number in the United States and Canada. Dialing 911 quickly connects you to a PSAP dispatcher trained to route your call to local emergency medical, fire, and law enforcement agencies. The 911 network is a vital part of our nations emergency response and disaster preparedness system. This network is constantly being upgraded to provide emergency help more quickly and effectively. For example, most traditional wire line 911 systems now automatically report to the PSAP the telephone number and location of calls, a capability called Enhanced 911 or E911. By receiving the telephone number of the caller, the PSAP is able to call back in the event the call gets disconnected. The PSAP is also able to determine the location of the caller by cross-referencing the telephone number against a location database. Traditional wire line E911 is available in most parts of the country. Public Safety Answering Point and Call Dispatch The emergency dispatcher uses location information to direct public safety personnel responding to the emergency to ensure the shortest possible emergency response time. At the PSAP, the operator verifies the callers location, determines the nature of the emergency, and decides which emergency response teams should be notified. Sometimes, a single primary PSAP will answer for an entire region. In most cases, the caller is then transferred to a secondary PSAP from which help will be sent. Secondary PSAPs are sometimes located at fire dispatch offices, municipal police headquarters, or ambulance dispatch centers. Communities that dont have PSAPs rely on public safety emergency operators and communications centers to process emergency calls. Once the call is processed, the PSAP operator or dispatch center alerts the appropriate emergency response team. During emergencies, radio systems frequently are used by emergency units and officers at the scene to coordinate activities among all emergency personnel fire, rescue, police, dispatchers, etc. with the emergency units on their way and with dispatchers at command bases. Wireless and E911 While new telecommunications technologies can be important tools for public safety, they sometimes create special challenges for public safety personnel. For example, the mobility of wireless telephone service makes determining a wireless users location more complicated than is true for traditional wireline services, which are associated with a fixed location or address. In an effort to increase the ability of emergency personnel to respond to wireless 911 calls, the Federal Communications Commission (FCC) has adopted rules requiring wireless telephone carriers to provide Enhanced 911 (E911).

Wireless carriers have begun to deploy technologies to meet the FCCs E911 rules. When fully implemented, wireless E911 will provide PSAPs with information about the location of consumers dialing 911 from mobile phones. However, since wireless E911 will not be available everywhere immediately, it is important for consumers to follow a few basic steps when calling 911 from their mobile phones:

Tell the emergency operator the location of the emergency right away. Give the emergency operator your wireless phone number so that if the call gets disconnected, the operator can call you back. If your wireless phone is not initialized (i.e., you do not have a contract for service with a wireless service provider) and your emergency call gets disconnected, you must call the emergency operator back because he or she does not automatically receive your telephone number and therefore cannot contact you.

VoIP and E911 The FCC also has imposed E911 obligations on providers of interconnected Voice over Internet Protocol (VoIP) services. Interconnected VoIP service allows you to make and receive calls to and from traditional wireline phone numbers using any high-speed (broadband) Internet connection (i.e., DSL, Cable Modem). VoIP can be used in place of traditional phone service. Typically, interconnected VoIP technology works by either placing an adapter between a traditional phone and a broadband connection, or by using a special VoIP phone that connects directly to your computer or Internet connection. While you may choose to use interconnected VoIP service from a single location, like a residence, interconnected VoIP services can be used wherever you travel as long as a broadband Internet connection is available. By the end of 2005, all interconnected VoIP providers must automatically provide E911 services to all customers as a standard, mandatory feature without customers having to specifically request this service. VoIP providers may not allow their customers to optout of E911 service. Before interconnected VoIP service providers can activate a new customers service, providers must obtain from the customer the physical location at which the service will first be used so that emergency services personnel will be able to locate callers who dial 911. Interconnected VoIP providers must also provide one or more easy ways for all customers to update the physical location they have registered with the provider, if it changes. Network Damage and Black-outs If the telecommunications network is damaged in a disaster, your traditional wireline, wireless, or VoIP phone and text pager may not work. If only your electricity goes out (a black-out), your traditional telephone may still work. In a black-out, you still may be able to use your traditional wire line phone because electricity and telephone transmissions travel on different wires. If you keep the battery on your wireless phone and text pager fully charged, you should be able to use these, too, in a black-out. Unless

you have a backup power supply, your VoIP phone will not work if your broadband connection is down or in a black-out. Text pagers have a built-in radio transmitter/ receiver. Messages are transmitted over the wireless network, a nationwide network of radio towers that transmit data. Some text pagers can subscribe to the National Oceanic and Atmospheric Administrations (NOAA) National Weather Service for any weather alerts. E-mail May Work When Phone Lines Dont During a Terrorist Attack, Natural Disaster or State of Emergency When a telephone call is completed on the public telephone network, transmission circuits are assigned and dedicated between the two users for the length of the call. The telephone network is engineered so that during normal usage there are adequate facilities that can be assigned and dedicated to handle the number of calls during the peak period. However, if during a disaster or emergency the number of calls exceeds that peak (or if the network transmission capacity is reduced), then some calls will be blocked. And, of course, if the phone being called is already in use, the call will be blocked. The Internet backbone uses shared rather than dedicated transmission facilities so that even during heavy usage the Internet will work, albeit perhaps more slowly. However, if Internet traffic is heavy enough, VoIP phones may not work. Cable modem and DSL users who have dedicated Internet access can generally get through to their e-mail systems, although dial-up Internet users may experience some blocking when they try to dial their Internet Service Provider (ISP), either because the local telephone system is congested or all ISPs lines are busy. E-mail itself is an Internet application which has the additional characteristic that the recipient doesnt have to be available at the same time as the sender, and instead can connect to his or her own mail system at his or her convenience to retrieve messages that have been delivered there. The Emergency Alert System Radio and Television Updates In the event of an emergency, many people rely on local radio and/or television stations to receive updates on what is happening and what to do. There is a nationwide broadcast system in place for national disaster or other large-scale disasters. The Emergency Alert System (EAS) currently provides not only the President, but national, state, and local authorities with the ability to give emergency information to the general public via broadcast, cable, and wireless cable systems. All broadcast stations and cable systems currently are required to broadcast emergency alerts and messages for national security emergencies initiated by the President. In October, 2005, the FCC expanded its rules to require EAS participation by digital television (DTV) broadcasters, digital cable television providers, digital broadcast radio, Digital Audio Radio Service (DARS), and Direct Broadcast Satellite (DBS) systems. These rules are effective as of December 31, 2006, except for DBS, whose effective date is

May 31, 2007. The FCC continues to consider ways to enhance the EAS to ensure that all Americans, including those with hearing and vision disabilities and those who speak languages other than English, receive EAS alerts. EAS participants are not required to broadcast EAS alerts and messages initiated by state and local authorities, but the FCC encourages them to transmit emergency alerts as a public service. Information about local natural disasters is often broadcast via EAS. All EAS alerts should be accessible by audio and visual means, or simple visual means, including closed-captioning, open-captioning, crawls or scrolls. Exception: If your local television/radio tower or studio is damaged during a natural disaster like a tornado, you may not receive the signal. EAS was designed, however, so that if one link in the dissemination of alert information is broken, the public has multiple alternate sources of warning. Accessibility of Emergency Information The FCC has separate requirements to meet the needs of persons with disabilities in cases of local emergencies. The FCC requires that any information that is intended to further the protection of life, health, safety, or property, such as immediate weather situations, civil disorder, evacuation orders, school closings, relief assistance, etc., be accessible to persons with disabilities. These rules apply to all local broadcasters, cable operators, and satellite television service providers. Critical details about the emergency must be provided in a visual format, such as open captions, scrolls, or even handlettered signs. The critical details must also be provided in an aural format. If crawls or scrolls are provided during regular programming, an aural tone is required to indicate to persons who are blind or who have low vision that emergency information is being provided. Wind Up Radios Wind up radios are available through a variety of sources however the quality in wind up radios varies. If you dont have a radio that works during a power failure.. youll wish you had a Freeplay wind up radio. Its the one we use and recommend. The Baygen Freeplay wind up radio is the best alternative power, AM/FM, Shortwave you can buy and is the only one we recommend. Simply stated there is no better choice for a dependable radio of any type in an emergency. The Baygen Freeplay wind up radio can be charged with the built-in NiMH battery pack through the wind-up generator, the solar cells, or the optional AC adapter. A fully charged battery will run the Freeplay Plus wind up radio for over 40 hours, and when the battery gets low, you can always wind it up.

The Freeplay Plus wind up radio comes with a detachable, 3-White LED light with a magnetic base; making it the perfect combination of essentials you need during a power failure. Regardless of the type of emergency, the Baygen Freeplay Plus wind up radio can go where you need it, when you want it, and without the need for any external power. Its superior AM, FM and Shortwave reception also make it an excellent everyday radio. Continuous coverage of 10 SW bands from 3.0 to 18.1 MHz. Built-in stereo headphone jack. Weight: 5 lbs. Size: 11 W x 8 H x 8 D. With four ways to power it, the Baygen Freeplay wind up radios are a must and thats why its the one we use. A wind up radio is a radio that is powered by clockwork wind-up mechanism driving an internal electrical generator. Like other self-powered equipment, a wind up radio it is intended for camping, emergencies and for use in areas of the world where there is no electrical grid and replacement batteries are hard to obtain. It is also useful when it will not be used on a regular basis, such as at a vacation house or cabin. Wind up radios sometimes incorporate a flashlight or other useful device and some models include alternative power sources including conventional supplies such as batteries. The wind up radio is a patented design by Trevor Baylis through Baygen. Dont purchase a knock-off or imitation wind up radio. Youll only be disappointed when you really need it. IMPORTANT DOCUMENTATION IN AN EMERGENCY Leave a copy of this list with a trusted contact. Update it periodically and carry it with you when moving from one locale to another.

Passport numbers and dates of issue. Bank account number Credit card number Insurance policy number Car registration, serial, and license number U.S. drivers license number Social Security numbers, including children Current prescriptions, including eyeglasses Contents and location of safe deposit box(es). Assets and debts Names and address book

Make copies of the following. Take one with you, leave the other in a secured deposit box.

Copy of will(s). Originals should be left with lawyer or executor, not in safe depository. School Records (yours and childrens) Medical/dental records, immunization cards Power of attorney (one of the originals Birth and marriage certificate Naturalization papers Deeds Mortgages Drivers license, auto insurance policies, auto registration, and title, if applicable Stocks (or leave with broker in case you want to sell) Bonds (or leave with broker in case you want to sell) Insurance papers life, car, house, medical, and household effects (HHE) School records, report cards, test scores, and current samples of work Current household effects inventory Personal checks, check registers, latest bank statement Execute a current power of attorney for each adult family member and have several originals made. Make several copies as well. These are needed to transact business on behalf of spouse or other adult. Give some thought to other important documentation that would be useful to you during or after an emergency.

Additional steps to consider.

Establish credit that will be adequate for emergencies. Obtain individual credit cards for spouse. Establish a joint checking account, or two joint checking accounts, enabling each spouse to work from either in the event they are separated for a period of time. Get an automatic teller machine (ATM) card for your bank account that can be used all over the country and internationally. Make sure both spouses know the personal identification number (PIN). Put checkbooks, bank books, credit cards, some travelers checks, and a small amount of cash in a safe (but easily accessible) place. Keep a list of regular billing dates for all recurring expenses insurance, mortgages, and taxes. Make and continually update an inventory of all your possessions, including jewelry and clothing. Decide what to take and what to leave. Consider putting items into storage that cant be replaced. Consider personal property insurance. Update scrapbook and photo albums. Consider leaving sentimental photos and negatives or duplicate photos in storage or with a relative. Put photos on CDs! Make duplicates of all personal address lists. Consolidate all personal records, financial documents, school records, etc. Prepare your house for evacuation secure valuables. Plan for pets. You may not be able to take them with you. Make advance arrangements for their care, food, etc. Keep the pets records updated and with you.

Decide how money will be handled. Who will pay bills? Will you continue to use the joint checking account?

Additional needs. Keep a small amount of cash set aside in a safe place. Allow for enough to sustain you through an emergency. SHELTER-IN-PLACE What Shelter-in-Place Means: One of the instructions you may be given in an emergency where hazardous materials may have been released into the atmosphere is to shelter-in-place. This is a precaution aimed to keep you safe while remaining indoors. (This is not the same thing as going to a shelter in case of a storm.) Shelter-in-place means selecting a small, interior room, with no or few windows, and taking refuge there. It does not mean sealing off your entire home or office building. If you are told to shelter-in-place, follow the instructions provided in this Fact Sheet. Why You Might Need to Shelter-in-Place: Chemical, biological, or radiological contaminants may be released accidentally or intentionally into the environment. Should this occur, information will be provided by local authorities on television and radio stations on how to protect you and your family. Because information will most likely be provided on television and radio, it is important to keep a TV or radio on, even during the workday. The important thing is for you to follow instructions of local authorities and know what to do if they advise you to shelter-in-place. At Home:

Close and lock all windows and exterior doors. If you are told there is danger of explosion, close the window shades, blinds, or curtains. Turn off all fans, heating and air conditioning systems. Close the fireplace damper. Get your family disaster supplies kit and make sure the radio is working. Go to an interior room without windows thats above ground level. In the case of a chemical threat, an above-ground location is preferable because some chemicals are heavier than air, and may seep into basements even if the windows are closed. Bring your pets with you, and be sure to bring additional food and water supplies for them. It is ideal to have a hard-wired telephone in the room you select. Call your emergency contact and have the phone available if you need to report a lifethreatening condition. Cellular telephone equipment may be overwhelmed or damaged during an emergency. Use duct tape and plastic sheeting (heavier than food wrap) to seal all cracks around the door and any vents into the room.

Keep listening to your radio or television until you are told all is safe or you are told to evacuate. Local officials may call for evacuation in specific areas at greatest risk in your community.

At Work:

Close the business. Bring everyone into the room(s). Shut and lock the door(s). If there are customers, clients, or visitors in the building, provide for their safety by asking them to stay not leave. When authorities provide directions to shelterin-place, they want everyone to take those steps now, where they are, and not drive or walk outdoors. Unless there is an imminent threat, ask employees, customers, clients, and visitors to call their emergency contact to let them know where they are and that they are safe. Turn on call-forwarding or alternative telephone answering systems or services. If the business has voice mail or an automated attendant, change the recording to indicate that the business is closed, and that staff and visitors are remaining in the building until authorities advise it is safe to leave. Close and lock all windows, exterior doors, and any other openings to the outside. If you are told there is danger of explosion, close the window shades, blinds, or curtains. Have employees familiar with your buildings mechanical systems turn off all fans, heating and air conditioning systems. Some systems automatically provide for exchange of inside air with outside air these systems, in particular, need to be turned off, sealed, or disabled. Gather essential disaster supplies, such as nonperishable food, bottled water, battery-powered radios, first aid supplies, flashlights, batteries, duct tape, plastic sheeting, and plastic garbage bags. Select interior room(s) above the ground floor, with the fewest windows or vents. The room(s) should have adequate space for everyone to be able to sit in. Avoid overcrowding by selecting several rooms if necessary. Large storage closets, utility rooms, pantries, copy and conference rooms without exterior windows will work well. Avoid selecting a room with mechanical equipment like ventilation blowers or pipes, because this equipment may not be able to be sealed from the outdoors. It is ideal to have a hard-wired telephone in the room(s) you select. Call emergency contacts and have the phone available if you need to report a lifethreatening condition. Cellular telephone equipment may be overwhelmed or damaged during an emergency. Use duct tape and plastic sheeting (heavier than food wrap) to seal all cracks around the door(s) and any vents into the room. Write down the names of everyone in the room, and call your business designated emergency contact to report who is in the room with you, and their affiliation with your business (employee, visitor, client, customer.) Keep listening to the radio or television until you are told all is safe or you are told to evacuate. Local officials may call for evacuation in specific areas at greatest risk in your community.

At School:

Close the school. Activate the schools emergency plan. Follow reverse evacuation procedures to bring students, faculty, and staff indoors. If there are visitors in the building, provide for their safety by asking them to stay not leave. When authorities provide directions to shelter-in-place, they want everyone to take those steps now, where they are, and not drive or walk outdoors. Provide for answering telephone inquiries from concerned parents by having at least one telephone with the schools listed telephone number available in the room selected to provide shelter for the school secretary, or person designated to answer these calls. This room should also be sealed. There should be a way to communicate among all rooms where people are sheltering-in-place in the school. Ideally, provide for a way to make announcements over the school-wide public address system from the room where the top school official takes shelter. If children have cell phones, allow them to use them to call a parent or guardian to let them know that they have been asked to remain in school until further notice, and that they are safe. If the school has voice mail or an automated attendant, change the recording to indicate that the school is closed, students and staff are remaining in the building until authorities advise that it is safe to leave. Provide directions to close and lock all windows, exterior doors, and any other openings to the outside. If you are told there is danger of explosion, direct that window shades, blinds, or curtains be closed. Have employees familiar with your buildings mechanical systems turn off all fans, heating and air conditioning systems. Some systems automatically provide for exchange of inside air with outside air these systems, in particular, need to be turned off, sealed, or disabled. Gather essential disaster supplies, such as nonperishable food, bottled water, battery-powered radios, first aid supplies, flashlights, batteries, duct tape, plastic sheeting, and plastic garbage bags. Select interior room(s) above the ground floor, with the fewest windows or vents. The room(s) should have adequate space for everyone to be able to sit in. Avoid overcrowding by selecting several rooms if necessary. Classrooms may be used if there are no windows or the windows are sealed and can not be opened. Large storage closets, utility rooms, meeting rooms, and even a gymnasium without exterior windows will also work well. It is ideal to have a hard-wired telephone in the room(s) you select. Call emergency contacts and have the phone available if you need to report a lifethreatening condition. Cellular telephone equipment may be overwhelmed or damaged during an emergency. Bring everyone into the room. Shut and lock the door. Use duct tape and plastic sheeting (heavier than food wrap) to seal all cracks around the door(s) and any vents into the room. Write down the names of everyone in the room, and call your schools designated emergency contact to report who is in the room with you. Listen for an official announcement from school officials via the public address system, and stay where you are until you are told all is safe or you are told to

evacuate. Local officials may call for evacuation in specific areas at greatest risk in your community. In Your Vehicle: If you are driving a vehicle and hear advice to shelter-in-place on the radio, take these steps:

If you are very close to home, your office, or a public building, go there immediately and go inside. Follow the shelter-in-place recommendations for the place you pick described above. If you are unable to get to a home or building quickly and safely, then pull over to the side of the road. Stop your vehicle in the safest place possible. If it is sunny outside, it is preferable to stop under a bridge or in a shady spot, to avoid being overheated. Turn off the engine. ? Close windows and vents. If possible, seal the heating/air conditioning vents with duct tape. Listen to the radio regularly for updated advice and instructions. Stay where you are until you are told it is safe to get back on the road. Be aware that some roads may be closed or traffic detoured. Follow the directions of law enforcement officials.

Local officials on the scene are the best source of information for your particular situation. Following their instructions during and after emergencies regarding sheltering, food, water, and clean up methods is your safest choice. Remember that instructions to shelter-in-place are usually provided for durations of a few hours, not days or weeks. There is little danger that the room in which you are taking shelter will run out of oxygen and you will suffocate. SAFE ROOM A safe room is an ultra-secure location within a residence. The concept of a safe room is simpleprepare a room within the interior of the home where the family can safely retreat during a home invasion or other terrorist threat and summon help. Sealing a Safe Room

Pick a room with few, or if possible, no windows. Higher stories are better because chemical agents sink. If possible, pick a room with water, toilet and a phone. Set aside plenty of duct tape for sealing, doors, windows and vents. Prepare a 72 hour Go Pack and keep it in the room. Keep inexpensive breathing filters in the room, rated at N95 or better for each family member.

How to Prepare the Sealed Room All supplies should already be in the room.

To seal a room in a bio-chemical emergency, first shut off all air intakes into the house (heat, air, attic fans, ceiling fans, etc.). If your home is heated with gas or uses gas appliances, shut off the gas. Get into the sealed room, and take your gas mask with you if you have one. In the selected room, run sturdy duct tape along any windows where the glass joins the sill, where the sill meets the frame, and over all window seams and joins. Entirely cover the windows with polyethylene sheeting, anchoring the sheeting on every side on the wall around the window, and seal the sheeting to the wall thoroughly with duct tape. When all the members of the family have entered the room, complete the sealing of the room by using adhesive tapes between the door and the frame and between the frame and the wall. The space between the door and the floor should be covered with a wet towel. Id pack that in firmly and seal it with duct tape as well. Leave the front door unlocked, so as to allow rescue units to get into the house if needed. Your room is still not perfectly air tight, but the air intake is quite diminished. Turn on the radio to get information. Everybody needs to sit absolutely still, against inner walls or with their backs towards the outer walls, heads down on their arms with knees drawn up. Wait for an All Clear from the radio or from local municipal rescue/defense., the wait could last for several hours. Ideally, a sealed room has its own emergency filter that blocks particles and purifies the air from toxins. I dont think you can buy any quick-install devices that you can simply hook into an open window and rely upon (and you would need one that can be manually powered as well as electrically powered). But if anybody knows of a manufacturer, please notify me and send me the information, and I will post it here. Risk Factors for a Bio-Chemical Attack: All biological weapons have a high failure rate in terrorist attacks because even though they are quite deadly dispersal/delivery of them in an effective way is difficult. Changes in ph of air quality, changes in temperature and humidity, changes in environment, and life span of the entity itself make efficient delivery of these bacteria and viruses difficult. For example, Anthrax is, for all intents and purposes, 100 percent deadly when it enters the lungs of human beings. The minimum fatal dose for a person is one Anthrax spore. Yet spores that are small enough to infiltrate the blood vessels of the human lungs also tend to be highly static. They clump together and adhere to dust and dirt particles, which then make them too big to infiltrate the lungs. This problem of Anthrax delivery means that any people at ground zero of an Anthrax attack would probably be infected if they were directly exposed to a cloud or vapor falling on them. But those who get a warning signal and retreat into sealed rooms would have a good chance of survival. Anthrax has a very small rate of secondary uptake, which means that once it hits the ground, it tends to end its delivery cycle. People who shelter in sealed rooms would have

the unpleasant task of waiting it out for hours (as long as 24 hours) before they could move, and then would have to wait for days to see if they were infected or not, but as long as they remained calm and secluded from sprayed or treated (i.e., infected) areas, they could escape infection. Smallpox is far more persistent than Anthrax, (though less fatal, with a mortality rate at about 33% 66%), and people at ground zero of an attack would fare the worst. But once it has been identified, people secure from the initial infection would have to be prepared to quarantine themselves to avoid contact from victims whose symptoms would not appear for several weeks. As difficult as this is, our society is better equipped to do this than its ever been before. Telecommuting is a fact of life. Dispersing biological agents in a crop dusting plane is currently the quickest, most effective scenario yet envisioned. But the plane would have to fly quite low to drop enough of a concentration in a stable medium. From the evidence of one would-be terrorist who was arrested on September 22, 2001, using crop dusting equipment has at least entered the minds of some terrorist planners. But as of this writing, it has not yet been attempted. The more likely and dangerous alternative is for a biological weapon to be entered into the water supply. Filtering and water purification in the home may hinder the effectiveness of such a plan, and certainly boiling water for six minutes would probably kill any biological entity. But poisoning could occur and last for several days before symptoms appear. Drinking bottled water or at least boiling all water that comes from the tap (for six minutes) before you drink it might be a good precautionary step, if you fear a biological attack. Chemical warfare terrorism is much more likely in terms of past successes with chemical agents. Mustard gas canisters can be opened and their vapors simply allowed to disperseno explosions, no bursts of munitions, just quiet vapors. Their damage would not be known for a couple days. An unsuspecting and crowded public could suffer catastrophic pain, injury, blindness, and loss of life two days after the fact of exposure. This, to me, is one of the most realistic and horrifying of scenarios. Yet it is one that an educated public can prevent. Do not stand in any area where vapors are escaping. Teach your children not to stand in plumes of smoke or run through any vaporous substance. Iraq used mustard gas in smoke bombs, thus enticing Iranian soldiers to run into the smoke to pursue supposedly retreating enemy soldiers. It was a highly successful ruse. People in crowded or enclosed places are in the greatest danger of a terrorist chemical agent attack. Granted, a city might just get bombed by chemical warheads, but that scenario is not nearly as likely as a crowded building being sealed off from the outside and a chemical agent introduced into the ventilation system or simply opened up in the corners. We know from the Tokyo subway attack that subways, terminals, even trains and planes are in the most danger of attacks like these. As are crowded buildingsespecially theaters, which have no windows and are dark.

People do buy gas masks (including me), but chemical-bio weapons can strike when a gas mask and bio-suit are out of range. And for the terrorist, thats the ideal situation. So the answer is to be smarter than terrorists. Avoid crowded and dark, enclosed building interiors that rely heavily on a ventilation system rather than open windows and fresh air. Visit enclosed buildings only when its necessary, in their off-peak hours. (Remember, as we learned on September 11, our enemies like to make grand displays in very public places.) For example, I go to the mall as soon as it opens or at around three in the afternoon on weekdays: NOT on Saturdays at noon. Dont go to movies. I dont. (But then, I hate the movies.) If you are in a crowded, enclosed building, always know where the exits are and your path to reach them. Dont linger; just complete your tasks and leave. Simply being very aware of your immediate environment has always been the first good defense against crime, and terrorists are just another version of criminals. POTASSIUM IODIDE KI Potassium Iodide (KI) Information Recent terrorist events have many people concerned about potential future attacks using radioactive materials. Taking potassium iodide (KI) tablets after an incident involving radioactive materials may or may not limit the risk of damage to a persons thyroid gland from ionizing radiation. The Centers for Disease Control and Prevention (CDC) has prepared this fact sheet to further explain when KI might be appropriate and what people should consider before making a decision to take KI. When to take KI Local emergency management officials will tell people when to take KI. If a nuclear incident occurs, officials will have to find out which radioactive substances are present before recommending that people take KI. If radioactive iodine is not present, then taking KI will not protect people. If radioactive iodine is present, then taking KI will help protect a persons thyroid gland from the radioactive iodine. Taking KI will not protect people from other radioactive substances that may be present along with the radioactive iodine. The Food and Drug Administration (FDA) recommends that KI be taken as soon as the radioactive cloud containing iodine from the explosion is close by. KI may still have some protective effect even if it is taken 3 to 4 hours after exposure to radioactive iodine. Because the radioactive iodine will be present in the initial blast and decays quickly, a single dose of KI may be all that is required. KI comes in tablets of 130 mg. A one-time dose at the levels recommended in this fact sheet is usually all that is required. However, if a person expects to be exposed to radioactive iodine for more than 24 hours, another dose should be taken every 24 hours. People should listen to emergency management officials for recommendations after an incident. According to the FDA,

Adults should take one 130-mg tablet.

Children between 3 and 18 years of age should take one-half of a 130-mg tablet (65 mg). Children between 1 month and 3 years of age should take one-fourth of a 130-mg tablet (32 mg). Infants from birth to 1 month of age should be given one-eighth of a 130-mg tablet (16 mg). Women who are breastfeeding should take the adult dose, and their infants should receive the recommended infant dose. Children who are approaching adult size (greater than or equal to 150 pounds) should take the adult dose regardless of their age.

KI tablets can be stored for at least 5 years without losing their potency. People should remember that taking a higher dose of KI, or taking KI more often than recommended, will not offer more protection and can cause severe illness and death due to allergic reaction. How a nuclear incident might cause thyroid damage Some types of radioactive incidents release radioactive iodine. The thyroid gland, which will use any iodine that is in a persons bloodstream, cannot tell the difference between radioactive and nonradioactive forms of iodine. Because of this, the thyroid would rapidly absorb radioactive iodine just as it does iodine from a persons diet. The radioactive iodine releases energy (radiation) that, in high concentrations, can damage the cells of the thyroid gland. In some people, especially young children, this damage can cause thyroid cancer or other diseases of the thyroid within a few years of the exposure. What KI is KI is a salt of iodine? It is one of several ingredients that can be added to table salt to make it iodized. KI has also been approved by the FDA as a nonprescription drug for use as a blocking agent to prevent the human thyroid gland from absorbing radioactive iodine. However, KI may not provide people with 100% protection against all radioactive iodine. Its effectiveness will depend on a variety of factors, including when a person takes it, how much iodine is already in the persons thyroid, how fast the persons body processes it, and the amount of radioactive iodine the person is exposed to. Iodized table salt will not provide enough iodine to protect the thyroid and should not be used as a substitute. Why KI would be important in the event of a nuclear incident. Because the thyroid will rapidly absorb any iodine that is in the body, people may need to take KI tablets soon after an incident that involves radioactive iodine. The KI will saturate the thyroid gland with iodine and help prevent it from absorbing radioactive iodine. However, KI does not prevent the effects of other radioactive elements. Using KI will only protect the thyroid gland from radioactive iodine. It will not protect other parts of the body from radioactive iodine, and it will not protect a person from other radioactive materials that may be released. Who should or should not take KI when the public is told to do so Children are the most susceptible to the dangerous effects of radioactive iodine. The FDA and the World Health Organization (WHO) recommend that children from newborn to 18 years of age all take KI unless they have a known allergy to iodine. Women who are breastfeeding should also take KI, according to the FDA and WHO, to protect both themselves and their breast milk. However, breastfeeding infants should still be given the recommended dosage of KI to protect them from any radioactive iodine that they may breathe in or drink in breast milk.

Young adults between the ages of 18 and 40 have a smaller chance of developing thyroid cancer or thyroid disease from exposure to radioactive iodine than do children. However, the FDA and WHO still recommend that people ages 18 to 40 take the recommended dose of KI. This includes pregnant and breast-feeding women, who should take the same dose as other young adults. Adults over the age of 40 have the smallest chance of developing thyroid cancer or thyroid disease after an exposure to radioactive iodine, but they have a greater chance of having an allergic reaction to the high dose of iodine in KI. Because of this, they are not recommended to take KI unless a very large dose of radioactive iodine is expected. People should listen to emergency management officials for recommendations after an incident. Medical conditions that make it dangerous to take KI The high concentration of iodine in KI can be harmful to some people. People should not take KI if they:

Have ever had thyroid disease (such as hyperthyroidism, thyroid nodules, or goiter). Know they are allergic to iodine (as in x-ray dye or shellfish). Have certain skin disorders (such as dermatitis herpetiformis or urticaria vasculitis).

People should consult their doctor if they are unsure whether or not to take KI. Facts about the thyroid gland The thyroid is a small gland located in a persons neck on either side of the breathing tube (trachea). The thyroid has two parts, a right lobe and a left lobe, that are connected by a small strip of tissue called the isthmus. The main function of the thyroid gland is to create, store, and release thyroid hormones. These hormones regulate the bodys metabolism. Why iodine is important to the thyroid gland? The thyroid gland takes iodine from the bloodstream and uses it to make thyroid hormones. Without the required amounts of iodine, the thyroid will not be able to make these hormones. Most of the iodine in peoples bodies comes from the food they eat. GAS MASKS Gas mask purchases are a personal decision each family must make. Educate yourself about gas masks to avoid a mistake that could cost you your life. Consider the following information before purchasing and purchase only from a recognized dealer or manufacturer. A gas mask would only protect you if you were wearing it at the exact moment a bioterrorist attack occurred. Unfortunately, a release of a biological agent is most likely to be done covertly, that is, without anyone knowing it. That means you would not know ahead of time to put on your gas mask. To wear a gas mask continuously or just in case a bioterrorist attack occurs is impractical, if not impossible. To work effectively, masks must be specially fitted to the wearer, and wearers must be trained in their use.

This is usually done for the military and for workers in industries and laboratories who face routine exposure to chemicals and germs on the job. Gas masks purchased at an Army surplus store or off the internet carry no guarantees that they will work. In fact, one national chain of surplus stores provides the following statement: (X) has been selling gas masks as a novelty item since 1948. We have never been able to warrant their effectiveness and we cannot do so at this time We do not know what each type of gas mask we sell might or might not be effective againstWe do not know the age of each gas mask In brief, no guarantees whatsoever are provided. More serious is the fact that the masks can be dangerous. There are reports of accidental suffocation when people have worn masks incorrectly, as happened to some Israeli civilians during the Persian Gulf War. Military personal goes through extensive training in the use of gas masks. If you purchase masks, be sure to get properly trained in their use. Become familiar with putting the mask on and using it correctly. If you are forced to use the gas mask in an attack, that would not be the best time to be donning it, for the first time. And again, KNOW what you are purchasing and understand that a gas mask that will actually work in an attack, will cost you upwards of $125.00 Let the Buyer Beware Information provided by Approved Gas Masks.com The truth about surplus gas masks: Many models of surplus masks & filters are available in nearly unlimited quantities at low prices. In most cases, these prices are low because the mask is obsolete, recalled or replaced due to design flaws or defective components. Before buying a surplus mask, do your homework, take time to review recalled gas mask models. Here are a few of the most widely advertised surplus masks that should be avoided:

Russian Gas Mask Unless you are assembling your Halloween costume, avoid this ineffective mask. Although the $19 price tag is enticing, this mask is 30+ years old & does NOT provide NBC protection.

EVAC-U-8 Hood Advertised by some unscrupulous vendors for protection against NBC agents, this mask is actually intended for smoke/fire protection. Over 27,400 have been recalled.

Canadian M69 C-3 The entire Canadian military has removed the C3 from service (replaced by a completely different model, designated as the C4) The C3 60mm filter port does not accept NATO threaded filters without plastic adapter.

GAS MASK: Russian/German M-10-M Protective Mask STATUS: INEFFECTIVE 100% obsolete DETAILS: Very old model. This type of protective mask should NEVER be used for protecting against any NBC warfare agents. USAGE: Designed ONLY for protection against tear-gas. (These will most likely not provide this protection as they are ALL more than 20 years expired)

GAS MASK: Russian M41 Aardvark Protective Mask STATUS: INEFFECTIVE 100% obsolete DETAILS: Complete waste of money. These Russian masks are a triumph in the world of completely useless gas masks, possibly the worst mask still being sold by unscrupulous surplus stores & internet vendors. USAGE: Russian / Outdated (over 20-30 years old) could be used as a Halloween costume or conversation piece but it will provide 0% protection.

GAS MASK: Russian SMS Snorkel Protective Mask STATUS: INEFFECTIVE 100% obsolete DETAILS: Complete waste of money. These Russian masks are another triumph in the world of completely useless gas masks, possibly the worst mask still being sold by unscrupulous surplus stores & Internet vendors. USAGE: Russian/ Outdated (over 20-30 years old) could be used as a Halloween costume or conversation piece but it will provide 0% protection.

GAS MASK: M9 or M9A1 Protective Masks STATUS: OBSOLETE/ineffective (made in the 50s) Details: Uses a 60 mm threaded filter which is very hard to find with a modern & effective filter. USAGE: Tear Gas, Not used since 1960s, these will provide NO protection, as they are 40+ years

GAS MASK FILTER: WEST GERMAN (various model #s) STATUS: EXPIRED, HEPA ONLY. DETAILS: This filter is rated at 99.9% HEPA filtration and prior to expiration would be effective against P100 (small particles) agents. Examples: Tear Gas, Unmodified Simple Anthrax & other other non-micronized biological agents. Ineffective against ALL chemical warfare agents. USAGE: German mfg. for riot & tear gas protection. Manufactured prior to 1980, all lots are EXPIRED.

GAS MASK FILTER: AMERICAN M-9 (circa 1940) 60 mm threaded filter STATUS: 100% EXPIRED DETAILS: Common American issue. (Most from the 50s) USAGE: US issue during prior to 1950. Use of this filter is highly discouraged, it provides 0% protection and may be toxic on its own

GAS MASK FILTER: AMERICAN C2 (check exp. date) & C2A1 STATUS: EXPIRED -If more than 10 years old ** (old filters are known to have Chromium Toxicity ** and are considered highly dangerous) DETAILS: To find out if your filter is expired, you must find the printed date of manufacture. Look for the serial number on the can:

For Example: RFT 920000CF24054 (sample serial #) (first 2 digits are the year of manufacture) In this example the mfg date: RFT [92] is 1992 These are 100% military surplus filters. The military discontinued use of the C2 in favor of the new/better C2A1 filters. But Caution: C2A1 filters provide no protection against ammonia based agents. USAGE: Obsolete/US Military Surplus only. It is recommended you upgrade to a MSA or M95 filter (the same threads/mask fitting). Both protect against all NBC agents and are 100% current issue / used in federal agencies, etc. SUSPICIOUS ACTIVITY What to Do If You Spot Suspicious Terrorist Activity Take note of the details: S Size (Jot down the number of people, gender, ages, and physical descriptions) A - Activity (Describe exactly what they are doing) L - Location (Provide exact location) U Uniform (Describe what they are wearing, including shoes) T Time (Provide date, time, and duration of activity) E - Equipment (Describe vehicle, make, color etc., license plate, camera, guns, etc) Suspicious activity is often recalled after an event. We must train ourselves to be on the lookout for things that are out of the ordinary and arouse suspicions. Keep in mind, those who commit terrorist acts: Usually live among us without appearing suspicious while planning and preparing for their attack. They may be your neighbor, student or friend. Often they will need training or equipment that will arouse suspicion. Need to conduct surveillance on possible targets and gather information on the planned attcak location. All of these things make terrorists vulnerable to detection, by those watching for certain characteristics. Learn to recognize the difference between normal and abnormal behavior. It can be a fine line. Stay alert in your daily travels and routines and get to know:

Who your neighbors are What cars are normally in your neighborhood

Who regularly makes deliveries at work and in your neighborhood

Staying alert is NOT about becoming paranoid. Staying alert is being aware of ones surroundings. Be alert to indications of possible trouble. They may include:

A local activity that could indicate problems in your community. One of the clues that led to the recent break-up of a terrorist plot was that several of the cell members were spotted celebrating in an apartment complex on the anniversary of 911. Previous activity or crimes. Controversial issues being debated. Suspicious thefts.

It is impossible to Identify a terrorist by

Appearance Nationality Language

You CAN only identify a terrorist threat by observing or hearing about suspicious activity that may lead to a criminal act. Identifying suspicious activity is not a difficult science. Rely on your judgment. Your suspicion of a threat could be confirmed with only one incident or it could take a series of incidents. Your suspicions will need to be based on:

Experience Judgment Common sense

Unusual Interest in High Risk or Symbolic Targets Maybe you are at a high profile location or, perhaps a National Monument and you notice a person nearby taking several photos. Thats not unusual. But then you notice that the person is only taking photos of the locations surveillance cameras, entrence crash barriers and access control procedures. Is that normal for a tourist? Not. The following should cause a heightened sense of suspicion:

suspicious or unusual interest surveillance (suspicious in nature) inappropriate photographs or videos note-taking drawing of diagrams annotating maps using binoculars or night vision devices

Unusual or suspicious activity does not necessarily mean that terrorist activity is happening, but be aware of the following suspicious behaviors:

Individuals acting furtively and suspiciously Individuals avoiding eye contact Individuals departing quickly when seen or approached Individuals in places they dont belong A strong odor coming from a building or vehicle An overloaded vehicle Fluid leaking from a vehicle, other than the engine or gas tank Over dressed for the type of weather

Fraudulent Identification Many of the 9/11 terrorists were in the country illegally and using fraudulent IDs. Altering or using false government identification in any way and for any purpose is against the law. Fraudulent IDs include:

drivers license social security card passport birth certificate INS identification

If you believe someone is using or has altered government identification, please notify the law enforcement authorities. Do NOT request to see another persons ID when not appropriate. Allow law enforcements to do the investigating. Terrorists, when not acting alone, need to meet with their conspirators and often times work within a cell. Pay attention to visitors and guests that

arrive and leave at unusual hours try not to be noticed act in a suspicious manner park an unusual distance from the meeting have an unusual number of unrelated people living together Not all people who maintain privacy are terrorists. But people intent on doing illegal acts want to be left alone.

Some signs that may raise your suspicions.

they they they they they they they

only let you into the apartment or house with plenty of prior notice change the locks often keep certain rooms off limits cover tables and other pieces of furniture never allow maid service in a hotel room only take hotel room service outside the door only accept deliveries at the hotels front desk or outside a closed door

Deliveries are a common method for terrorists to carry out their attacks. Be aware of:

a vehicle with hazardous material parked or driving in an inappropriate area unusual deliveries of chemicals or fertilizer unattended bags or boxes in a public access place fire extinguishers that may have been moved or tampered with unusual or unexpected mail

Unusual Purchases or Thefts Terrorists need supplies to carry out their attacks and accomplish their goals. Pay attention to purchases, rentals or thefts of:

police, security, public utility, mail carrier, or airline uniforms and equipment explosives weapons ammunition propane bottles toxic chemicals vehicles able to contain or haul hazardous materials

Additional suspicious activity may include:

Someone bragging or talking about plans to harm citizens in violent attacks or who claims membership in a terrorist organization that espouses killing innocent people. Suspicious packages, luggage, or mail that have been abandoned in a crowded place like an office building, an airport, a school, or a shopping center. Suspicious letter or package that arrives in your mailbox. (Stay away from the letter or package and dont shake, bump or sniff it; wash hands thoroughly with soap and water. Someone suspiciously exiting a secured, non-public area near a train or bus depot, airport, tunnel, bridge, government building, or tourist attraction. Any type of activity or circumstance that seems frightening or unusual within the normal routines of your neighborhood, community, and workplace. Someone unfamiliar loitering in a parking lot, government building, or around a school or playground. Anyone asking a lot of questions especially concerning routes or loads or drop-off times.

Recruiters should be alert for unusual employment applications. Dont assume it couldnt be an inside job. A trucker returning to his or her vehicle from a restaurant or truck stop should make sure no one is loitering around the truck. Watch out for walk-arounds.

Emergency Evacuation Plan Preparing an Emergency Evacuation Plan An emergency evacuation plan has two parts: evacuation from your house, and evacuation from your neighborhood. An evacuation plan for your home is useful not only for disasters, but also for fires or other incidents in your home. Important points to remember when creating an evacuation plan for your home are:

You should have at least two (2) escape routes from each room. You should mark the locations of any escape ladders, or other special equipment. You should mark the locations of fire extinguishers, smoke detectors, first aid kits, disaster 72 hour kit. You should mark the locations of the shutoffs for gas, water, and electricity. For people with medical conditions or disabilities, mark their location as well as the location of any special equipment they will immediately need.

Emergency Evacuation Inventory If you have to evacuate your house, you may have as little as 10 minutes. Under these circumstances, trying to think of what to save is very difficult. Take some time now to think about what items you would try to take with you. Write down a list of the high priority items you would take if you only had 10 minutes to evacuate your house. Remember, you may have to carry everything. Evacuation Steps If you have time during an evacuation, you may want to take steps to secure your house. Give some thought to what things you need to do to secure your house. Write down your plans and keep the paper in a safe and accessible location. Household Emergency Evacuation Plan

Draw your buildings floor plan, then draw your evacuation routes and a meeting place. Make one drawing for each story of the building. Keep in a safe place and review often with your family. Have maps ready for the following: Closest evacuation centers. Main and Alternative routes for leaving the city in North, South, East and West directions.

Meet up spots outside the affected areas. For example: I live approximately 50 miles east of a nuclear power plant. Should there be an accident or an attack and the wind is blowing in an Easterly direction, our plan is to head north and meet up in a town approximately 60 miles north of my home.

Choosing an Out-of-Area Contact: During an emergency local phone service may be limited, so you should arrange with someone outside your area to be your family contact. Your contact person should have voice mail or an answering machine. Ensure that every family member knows that they should listen to the radio or TV for telephone use instructions, then phone your out-of-area contact person to say how and where they are and what their plans are. Keep calls short, and if possible, arrange to call the contact person back at a specified time for another check-in. Choosing a Place to Meet: At the time of an emergency, your family may not be together. It is important to choose family meeting places. Remember that bridges may be out and roads may be blocked by debris, so choose your meeting places carefully with access in mind. Pick places that are easy to identify, that can be reached on foot if necessary, and that are in an accessible, open area. Take into account where each of you will likely be at different times and on different days. The emergency evacuation plan for your neighborhood can be handy in a large disaster. By plotting out potential routes on a city map before the disaster, you will save yourself from having to figure something out while in a hurry. Things to think about when crafting your neighborhood evacuation plan include: You should plan two (2) routes for each direction. (North, South, East, West.) You should avoid routes with obvious hazards, or routes which are likely to be impassible in a disaster. (You probably will want to drive the routes before deciding.) And avoid common routes that may be congested during an emergency. Establish plans with other family members for meeting up outside of the evacuated area. Make sure each member knows the location of the established meeting points.

You should have a phone list of 3 contacts, outside of your area. Each family member should carry a personal copy of this list. In an emergency, communications may be down in your area. Family members can contact the persons out of the emergency area to pass along messages and to check on the welfare of other family members. Be sure that each family member has a copy of the evacuation plan, maps and telephone numbers. You should also allow for an evacuation scenario, while at work. Keep your emergency evacuation plans in a safe location with your 72 hour kit. Emergency Preparedness

Emergency Preparedness Planning Ahead Preparing for an emergency now, provides you your best chance of survival, in the event of an actual attack. Emergency preparedness should always be considered in the home and workplace for any unexpected event. This site provides a step-by-step approach to emergency preparedness by walking the reader through emergency plans in a variety of scenarios. As you make your emergency plan, carefully consider the information youll find throughout this website. Introduction To Emergency Preparedness Devastating acts, such as 911 and the terrorist attacks on the World Trade Center and the Pentagon, have left many concerned about the possibility of future events and their potential impact. They have raised uncertainty and heightened our awareness of the importance of emergency preparedness. There are specific steps you can take to prepare for the unexpected and reduce the stress that you may feel now and later should another emergency arise. Taking preparatory action can reassure you, your family and co-workers n that you can exert a measure of control even in the face of such events. EMERGENCY PREPAREDNESS Finding out what can happen is the first step. Once you have determined the events possible and their potential in your community, it is important that you discuss them with your family or household. Develop a disaster/ emergency preparedness plan together. Create an emergency communications plan. Choose an out-of-town contact your family or household will call or e-mail to check on each other should a disaster occur. Your selected contact should live far enough away that they would be unlikely to be directly affected by the same event, and they should know they are the chosen contact.

Make sure every household member has that contacts, and each others, e-mail addresses and telephone numbers (home, work, pager and cell). Leave these contact numbers at your childrens schools, if you have children, and at your workplace. Your family should know that if telephones are not working, they need to be patient and try again later or try e-mail. Many people flood the telephone lines when emergencies happen but e-mail can sometimes get through when calls dont. Establish meeting places. Having predetermined meeting places away from your home will save time and minimize confusion should your home be affected or the area evacuated. You may even want to make arrangements to stay with a family member or friend in case of an emergency. Be sure to include any pets in these plans, since pets are not permitted in shelters and some hotels will not accept them. Have two emergency locations, each in opposite directions. You wont know, until an actual emergency, which direction you will need to evacuate. Assemble a disaster supplies or 72 hour emergency preparedness kit. If you need to evacuate your home or are asked to shelter in place, having some essential supplies on hand will make you and your family more comfortable. Prepare an emergency preparedness kit in an easy-to-carry container such as a duffel bag or small plastic trash can. Include special needs items for any member of your household (infant formula or items for people with disabilities or older people), first aid supplies (including prescription medications), a change of clothing for each household member, a sleeping bag or bedroll for each, a battery powered radio or television and extra batteries, food, bottled water and tools. It is also a good idea to include some cash and copies of important family documents (birth certificates, passports and licenses) in your kit. Copies of essential documents-like powers of attorney, birth and marriage certificates, insurance policies, life insurance beneficiary designations and a copy of your will-should also be kept in a safe location outside your home. A safe deposit box or the home of a friend or family member who lives out of town is a good choice. Check on the school emergency preparedness plan of any school-age children you may have. You need to know if they will they keep children at school until a parent or designated adult can pick them up or send them home on their own. Be sure that the school has updated information about how to reach parents and responsible caregivers to arrange for pickup. And, ask what type of authorization the school may require to release a child to someone you designate, if you are not able to pick up your child. During times of emergency the school telephones may be overwhelmed with calls.

Remain calm and be patient. Follow the advice of local emergency officials. Listen to your radio or television for news and instructions.

If the disaster occurs near you, check for injuries. Give first aid and get help for seriously injured people.

If the disaster occurs near your home while you are there, check for damage using a flashlight. Do not light matches or candles or turn on electrical switches. Check for fires, fire hazards and other household hazards. Sniff for gas leaks, starting at the water heater. If you smell gas or suspect a leak, turn off the main gas valve, open windows, and get everyone outside quickly.

Shut off any damaged utilities. Confine or secure your pets. Call your family contact; do not use the telephone again unless it is a lifethreatening emergency. Check on your neighbors, especially those who are elderly or disabled.

What Could Happen Emergency Planning As we learned from the events of September 11, 2001, the following things can happen after a terrorist attack:

There can be significant numbers of casualties and/or damage to buildings and the infrastructure. So employers need up-to-date information about any medical needs you may have and on how to contact your designated beneficiaries. Heavy law enforcement involvement at local, state and federal levels follows a terrorist attack due to the events criminal nature. Health and mental health resources in the affected communities can be strained to their limits, maybe even overwhelmed. Extensive media coverage, strong public fear and international implications and consequences can continue for a prolonged period. Workplaces and schools may be closed, and there may be restrictions on domestic and international travel. You and your family or household may have to evacuate an area, avoiding roads blocked for your safety.

Evacuation in an emergency If local authorities ask you to leave your home, they have a good reason to make this request, and you should heed the advice immediately. Listen to your radio or television and follow the instructions of local emergency officials and keep these simple tips in mind.

Wear long-sleeved shirts, long pants and sturdy shoes so you can be protected as much as possible. Take your disaster supplies kit. Take your pets with you; do not leave them behind. Because pets are not permitted in public shelters, follow your plan to go to a relatives or friends home, or find a pet-friendly hotel. Lock your home.

Use travel routes specified by local authorities, dont use shortcuts because certain areas may be impassable or dangerous. Have planned routes out of any possible danger areas. Plane for leaving in any direction, North, South, East or West. Stay away from downed power lines. Listen to local authorities. Your local authorities will provide you with the most accurate information specific to an event in your area. Staying tuned to local radio and television, and following their instructions is your safest choice.

If youre sure you have time additional emergency preparedness actions

Call your family contact to tell them where you are going and when you expect to arrive. Shut off water and electricity before leaving, if instructed to do so. Leave natural gas service ON unless local officials advise you otherwise. You may need gas for heating and cooking, and only a professional can restore gas service in your home once its been turned off. In a disaster situation it could take weeks for a professional to respond. Close and lock all windows and exterior doors. Turn off all fans, heating and air conditioning systems. Close the fireplace damper. Get your disaster supplies kit, and make sure the radio is working. Go to an interior room without windows thats above ground level. In the case of a chemical threat, an above-ground location is preferable because some chemicals are heavier than air, and may seep into basements even if the windows are closed. Using duct tape, seal all cracks around the door and any vents into the room. Keep listening to your radio or television until you are told all is safe or you are told to evacuate. Local officials may call for evacuation in specific areas at greatest risk in your community.

Additional Steps You Can Take Raw, unedited footage of terrorism events and peoples reaction to those events can be very upsetting, especially to children. We do not recommend that children watch television news reports about such events, especially if the news reports show images over and over again about the same incident. Young children do not realize that it is repeated video footage, and think the event is happening again and again. Adults may also need to give themselves a break from watching disturbing footage. However, listening to local radio and television reports will provide you with the most accurate information from responsible governmental authorities on whats happening and what actions you will need to take. So you may want to make some arrangements to take turns listening to the news with other adult members of your household. Another useful preparation includes learning some basic first aid. To enroll in a first aid and AED/CPR course, contact your local American Red Cross chapter. In an emergency situation, you need to tend to your own well-being first and then consider first aid for others immediately around you, including possibly assisting injured people to evacuate a building if necessary.

People who may have come into contact with a biological or chemical agent may need to go through a decontamination procedure and receive medical attention. Listen to the advice of local officials on the radio or television to determine what steps you will need to take to protect yourself and your family. As emergency services will likely be overwhelmed, only call 9-1-1 about life-threatening emergencies. Emergency preparedness Each Persons Responsibility Dont wait until disaster strikes to realize the benefits of a good emergency preparedness plan. Begin gathering the items you will need and going over your plan with all family members, at regular intervals.

Explosive Devices and Weapons

DIRTY BOMB Because of recent terrorist events, people have expressed concern about the possibility of a terrorist attack involving radioactive materials, possibly through the use of a dirty bomb, and the harmful effects of radiation from such an event. This fact sheet was prepared to help people understand what a dirty bomb is and how it may affect their health. What is a Dirty Bomb A dirty bomb, or radiological dispersion device, is a bomb that combines conventional explosives, such as dynamite, with radioactive materials in the form of powder or pellets. The idea behind a dirty bomb is to blast radioactive material into the area around the explosion. This could possibly cause buildings and people to be exposed to radioactive material. The main purpose of a dirty bomb is to frighten people and make buildings or land unusable for a long period of time. Dirty bomb versus atomic bombs in Hiroshima and Nagasaki The atomic explosions that occurred in Hiroshima and Nagasaki were conventional nuclear weapons involving a fission reaction. A dirty bomb is designed to spread radioactive material and contaminate a small area. It does not include the fission products necessary to create a large blast like those seen in Hiroshima and Nagasaki. How much expertise does it take to make a dirty bomb? Not much more than it takes to make a conventional bomb. No special assembly is required; the regular explosive would simply disperse the radioactive material packed into the bomb. The hard part is acquiring the radioactive material, not building the bomb. The Washington Post reported in March 2002 that the Bush administrations consensus view was that Osama bin Ladens al Qaeda terrorist network probably had such often-stolen radioactive contaminants as strontium 90 and cesium 137, which could be used to make a dirty bomb. In January 2003, British officials found documents in the Afghan city of Herat that led them to conclude that al Qaeda had successfully built a small dirty bomb. In late December 2003, homeland security officials worried that al

Qaeda would detonate a dirty bomb during New Years Eve celebrations or college football bowl games, according to The Washington Post. The Department of Energy sent scores of undercover nuclear scientists with radiation detection equipment to key locations in five major U.S. cities, the Post reported. The relative ease of constructing such weapons makes them a particularly worrisome threat, counterterrorism experts say. Even so, expertise matters. Not all dirty bombs are equally dangerous: the cruder the weapon, the less damage caused. We dont know if terrorists could handle and detonate high-grade radioactive material without fatally injuring themselves first. Is a dirty bomb a nuclear weapon? No. Nuclear weapons involve a complex nuclear-fission reaction and are thousands of times more devastating. Is a dirty bomb a weapon of mass destruction? Yes, but more because of its capacity to cause terror and disruption than its ability to inflict heavy casualties, experts say. Depending on the sophistication of the bomb, wind conditions, and the speed with which the area of the attack was evacuated, the number of deaths and injuries from a dirty bomb explosion might not be substantially greater than from a conventional bomb explosion. But panic over radioactivity and evacuation measures could snarl a city. Moreover, the area struck would be off-limits for at least several monthspossibly yearsduring cleanup efforts, which could paralyze a local economy and reinforce public fears about being near a radioactive area. Sources of the radioactive material in Dirty Bombs There has been a lot of speculation about where terrorists could get radioactive material to place in a dirty bomb. The most harmful radioactive materials are found in nuclear power plants and nuclear weapons sites. However, increased security at these facilities makes obtaining materials from them more difficult. Because of the dangerous and difficult aspects of obtaining high-level radioactive materials from a nuclear facility, there is a greater chance that the radioactive materials used in a dirty bomb would come from low-level radioactive sources. Low-level radioactive sources are found in hospitals, on construction sites, and at food irradiation plants. The sources in these areas are used to diagnose and treat illnesses, sterilize equipment, inspect welding seams, and irradiate food to kill harmful microbes. Dangers of a dirty bomb If low-level radioactive sources were to be used, the primary danger from a dirty bomb would be the blast itself. Gauging how much radiation might be present is difficult when the source of the radiation is unknown. However, at the levels created by most probable sources, not enough radiation would be present in a dirty bomb to cause severe illness from exposure to radiation.

Past use of dirty bombs According to a United Nations report, Iraq tested a dirty bomb device in 1987 but found that the radiation levels were too low to cause significant damage. Thus, Iraq abandoned any further use of the device. What people should do following the explosion of a dirty bomb * Radiation cannot be seen, smelled, felt, or tasted by humans. Therefore, if people are present at the scene of an explosion from a suspected dirty bomb, they will not know whether radioactive materials were involved at the time of the explosion. If people are not too severely injured by the initial blast, they should: * Leave the immediate area on foot. Do not panic. Do not take public or private transportation such as buses, subways, or cars because if radioactive materials were involved, they may contaminate cars or the public transportation system. * Go inside the nearest building. Staying inside will reduce peoples exposure to any radioactive material from a dirty bomb that may be on dust at the scene. * Remove their clothes as soon as possible, place them in a plastic bag, and seal it. Removing clothing will remove most of the contamination caused by external exposure to radioactive materials. Saving the contaminated clothing would allow testing for exposure without invasive sampling. * Take a shower or wash themselves as best they can. Washing will reduce the amount of radioactive contamination on the body and will effectively reduce total exposure. * Be on the lookout for information. Once emergency personnel can assess the scene and the damage, they will be able to tell people whether radiation was involved. * Even if people do not know whether radioactive materials were present, following these simple steps can help reduce their injury from other chemicals that might have been present in the blast. Taking potassium iodide (KI) Potassium iodide, also called KI, only protects a persons thyroid gland from exposure to radioactive iodine. KI will not protect a person from other radioactive materials or protect other parts of the body from exposure to radiation. It must be taken prior to exposure (for example, if people hear that a radioactive cloud is coming their way) or immediately after exposure to be effective. Since there is no way to know at the time of an incident whether radioactive iodine was used in the explosive device, taking KI would probably not be beneficial. Also, KI can be dangerous to some people. Taking KI is not recommended unless there is a risk of exposure to radioactive iodine. If radioactive materials were involved Keep televisions or radios tuned to local news networks. If a radioactive material was released, people will be told where to report for radiation monitoring and blood tests to determine whether they were exposed to the radiation as well as what steps to take to protect their health.

Risk of cancer from a dirty bomb Some cancers can be caused by exposure to radiation. Being at the site where a dirty bomb exploded does not guarantee that people were exposed to the radioactive material. Until doctors are able to check peoples skin with sensitive radiation detection devices, it will not be clear whether they were exposed. Just because people are near a radioactive source for a short time or get a small amount of radioactive material on them does not mean that they will get cancer. Doctors will be able to assess risks after the exposure level has been determined. NUCLEAR Effects of a Nuclear Explosion Damage caused by nuclear explosions can vary greatly, depending on the weapons yield (measured in kilotons or megatons), the type of nuclear fuel used, the design of the device, whether its exploded in the air or at earths surface, the geography surrounding the target, whether its winter or summer, hazy or clear, night or day, windy or calm. Whatever the factors, though, the explosion will release several distinct forms of energy. One form is the explosive blast. Other forms are direct nuclear radiation and thermal radiation. And then theres radioactive fallout not exactly energy released by the explosion, but still a destructive result. Explosive Blast Much of the damage inflicted by a nuclear explosion is the result of its shock wave. There are two components to a blasts shock wave. First, theres the wall of pressure that expands outward from the explosion. It is this pressure, measured in psi (pounds per square inch), that blows away the walls from buildings. A typical two-story house subjected to 5 psi would feel the force of 180 tons on the side facing the blast. (Download the QuickTime movie entitled house to see an example of a building subjected to this type of pressure.) Additionally, the blast creates a 160 mile-an-hour wind. And thats only at 5 psi. The wind speed following a 20 psi blast would be 500 mph! Direct Nuclear Radiation A nuclear detonation creates several forms of nuclear, or ionizing, radiation. The nuclear fission (atom splitting) and nuclear fusion (atom combining) that occur to produce the explosion release, either directly or indirectly, neutrons, gamma rays, beta particles, and alpha particles. Neutrons are heavy particles that are released from atoms nuclei. These tiny missiles can easily penetrate solid objects. Another penetrating form of radiation is gamma rays, which are energetic photons. Both of these types of radiation can be deadly. Beta and alpha particles are less dangerous, having ranges of several meters and several centimeters, respectively. Alpha particles can cause harm only if they are ingested.

Thermal Radiation You dont have to be close to ground zero to view the bright flash created by the exploding bomb. The flash from a bomb has been viewed from hundreds of miles away. In addition to being intensely bright, this radiation is intensely hot (hence the name thermal). If youre seven miles away from a one megaton explosion, the heat emanating from the fireball will cause a first-degree burn (equivalent to a bad sunburn) to any exposed skin facing the light. If youre six miles away, it will cause second-degree burns. And if youre five miles away, the thermal radiation will cause third-degree burns a much more serious injury that would require prompt medical attention. The intense heat would also ignite a mass fire i.e., a fire that could cause large areas to simultaneously burst into flames. Fallout Youve seen the image: a mushroom cloud created by a nuclear explosion. Produced with a detonation at or near the earths surface, this type of explosion results in farranging radioactive fallout. Earth and debris made radioactive by the nuclear explosion rises up, forming the mushroom clouds stem. Much of this material falls directly back down close to ground zero within several minutes after the explosion, but some travels high into the atmosphere. This material will be dispersed over the earth during the following hours, days, months. In fact, some of the particles rising up through the mushroom will enter the stratosphere, where they could remain for tens of years. Obviously, if a thermonuclear bomb exploded close to your home, youd have little hope of surviving the blast. But what if one exploded 5 miles away, or 20 miles away? And what about radioactive fallout? Learn about a nuclear weapons zones of destruction choose between a relatively small detonation at earths surface, which will produce substantial fallout, and an especially destructive large detonation at high altitude. 1 Megaton Surface Blast: Pressure Damage The fission bomb detonated over Hiroshima had an explosive blast equivalent to 12,500 tons of TNT. A 1 megaton hydrogen bomb, hypothetically detonated on the earths surface, has about 80 times the blast power of that 1945 explosion. Radius of destructive circle: 1.7 miles 12 pounds per square inch At the center lies a crater 200 feet deep and 1000 feet in diameter. The rim of this crater is 1,000 feet wide and is composed of highly radioactive soil and debris. Nothing recognizable remains within about 3,200 feet (0.6 miles) from the center, except, perhaps, the remains of some buildings foundations. At 1.7 miles, only some of the strongest buildings those made of reinforced, poured concrete are still standing. Ninety-eight percent of the population in this area are dead.

Radius: 2.7 miles 5 psi Virtually everything is destroyed between the 12 and 5 psi rings. The walls of typical multi-story buildings, including apartment buildings, have been completely blown out. The bare, structural skeletons of more and more buildings rise above the debris as you approach the 5 psi ring. Single-family residences within this this area have been completely blown away only their foundations remain. Fifty percent of the population between the 12 and 5 psi rings are dead. Forty percent are injured. Radius: 4.7 miles 2 psi Any single-family residences that have not been completely destroyed are heavily damaged. The windows of office buildings have been blown away, as have some of their walls. The contents of these buildings upper floors, including the people who were working there, are scattered on the street. A substantial amount of debris clutters the entire area. Five percent of the population between the 5 and 2 psi rings are dead. Forty-five percent are injured. Radius: 7.4 miles 1 psi Residences are moderately damaged. Commercial buildings have sustained minimal damage. Twenty-five percent of the population between the 2 and 1 psi rings have been injured, mainly by flying glass and debris. Many others have been injured from thermal radiation the heat generated by the blast. The remaining seventy-five percent are unhurt. 1 Megaton Surface Blast: Fallout One of the effects of nuclear weapons detonated on or near the earths surface is the resulting radioactive fallout. Immediately after the detonation, a great deal of earth and debris, made radioactive by the blast, is carried high into the atmosphere, forming a mushroom cloud. The material drifts downwind and gradually falls back to earth, contaminating thousands of square miles. This page describes the fallout pattern over a seven-day period. Assumptions Wind speed: 15 mph Wind direction: due east Time frame: 7 days 3,000 Rem* Distance: 30 miles Much more than a lethal dose of radiation. Death can occur within hours of exposure. About 10 years will need to pass before levels of radioactivity in this area drop low enough to be considered safe, by U.S. peacetime standards.

900 Rem Distance: 90 miles A lethal dose of radiation. Death occurs from two to fourteen days. 300 Rem Distance: 160 miles Causes extensive internal damage, including harm to nerve cells and the cells that line the digestive tract, and results in a loss of white blood cells. Temporary hair loss is another result. 90 Rem Distance: 250 miles Causes a temporary decrease in white blood cells, although there are no immediate harmful effects. Two to three years will need to pass before radioactivity levels in this area drop low enough to be considered safe, by U.S. peacetime standards. *Rem: Stands for roentgen equivalent man. This is a measurement used to quantify the amount of radiation that will produce certain biological effects. 25 Megaton Air Blast: Pressure Damage Radius of destructive circle: 6.5 miles 12 pounds per square inch The remains of some buildings foundations are visible. Some of the strongest buildings those made of reinforced, poured concrete are still standing. Ninety-eight percent of the population within this area are dead. Radius: 10.7 miles 5 psi Virtually everything is destroyed between the 12 and 5 psi rings. The walls of typical multi-story buildings, including apartment buildings, are completely blown out. As you move from the center toward the 5 psi ring there are more structural skeletons of buildings standing. Single-family residences within this this area have been completely blown away only their foundations remain. Fifty percent of the population between the 12 and 5 psi rings are dead. Forty percent are injured. Radius: 20 miles 2 psi Any single-family residences that are not completely destroyed are heavily damaged. The windows of office buildings have been blown away, as have some of their walls. The contents of these buildings upper floors, including the people who were working there, are scattered on the street. A substantial amount of debris clutters the entire area. Five percent of the population between the 5 and 2 psi rings are dead. Forty-five percent are injured.

Radius: 30.4 miles 1 psi Residences are moderately damaged. Commercial buildings have sustained minimal damage. Twenty-five percent of the population between the 2 and 1 psi rings are injured, mainly by flying glass and debris. Many others have been injured from thermal radiation the heat generated by the blast. The remaining seventy-five percent are unhurt. NOTE: This information has been drawn mainly from The Effects of Nuclear War (Washington: Office of Technology Assessment, Congress of the United States, 1979) and the PBS Special Race For The Super bomb The zones of destruction described on this page are broad generalizations and do not take into account factors such as weather and geography of the target. WHAT TYPES OF TERRORIST EVENTS MIGHT INVOLVE RADIATION?

Possible terrorist events could involve introducing radioactive material into the food or water supply, using explosives (like dynamite) to scatter radioactive materials (called a dirty bomb), bombing or destroying a nuclear facility, or exploding a small nuclear device. Although introducing radioactive material into the food or water supply most likely would cause great concern or fear, it probably would not cause much contamination or increase the danger of adverse health effects. Although a dirty bomb could cause serious injuries from the explosion, it most likely would not have enough radioactive material in a form that would cause serious radiation sickness among large numbers of people. However, people who were exposed to radiation scattered by the bomb could have a greater risk of developing cancer later in life, depending on their dose. A meltdown or explosion at a nuclear facility could cause a large amount of radioactive material to be released. People at the facility would probably be contaminated with radioactive material and possibly be injured if there was an explosion. Those people who received a large dose might develop acute radiation syndrome. People in the surrounding area could be exposed or contaminated. Clearly, an exploded nuclear device could result in a lot of property damage. People would be killed or injured from the blast and might be contaminated by radioactive material. Many people could have symptoms of acute radiation syndrome. After a nuclear explosion, radioactive fallout would extend over a large region far from the point of impact, potentially increasing peoples risk of developing cancer over time.

How Can I Protect Myself During a Radiation Emergency? After a release of radioactive materials, local authorities will monitor the levels of radiation and determine what protective actions to take.

The most appropriate action will depend on the situation. Tune to the local emergency response network or news station for information and instructions during any emergency. If a radiation emergency involves the release of large amounts of radioactive materials, you may be advised to shelter in place, which means to stay in your home or office; or you may be advised to move to another location. If you are advised to shelter in place, you should do the following: o Close and lock all doors and windows. o Turn off fans, air conditioners, and forced-air heating units that bring in fresh air from the outside. Only use units to recirculate air that is already in the building. o Close fireplace dampers. o If possible, bring pets inside. o Move to an sealed room or basement. o Keep your radio tuned to the emergency response network or local news to find out what else you need to do. If you are advised to evacuate, follow the directions that your local officials provide. Leave the area as quickly and orderly as possible. In addition o Take your Go Pack. o Take pets only if you are using your own vehicle and going to a place you know will accept animals. Emergency vehicles and shelters usually will not accept animals.

What is Radiation?

Radiation is a form of energy that is present all around us. Different types of radiation exist, some of which have more energy than others. Amounts of radiation released into the environment are measured in units called curies. However, the dose of radiation that a person receives is measured in units called rem.

For more information about radiation, check the following Web sites: www.epa.gov/radiation, www.orau.gov/reacts/define.htm How Can Exposure Occur?

People are exposed to small amounts of radiation every day, both from naturally occurring sources (such as elements in the soil or cosmic rays from the sun), and man-made sources. Man-made sources include some electronic equipment (such as microwave ovens and television sets), medical sources (such as x-rays, certain diagnostic tests, and treatments), and from nuclear weapons testing. The amount of radiation from natural or man-made sources to which people are exposed is usually small; a radiation emergency (such as a nuclear power plant accident or a terrorist event) could expose people to small or large doses of radiation, depending on the situation.

Scientists estimate that the average person in the United States receives a dose of about one-third of a rem per year. About 80% of human exposure comes from natural sources and the remaining 20% comes from man-made radiation sources mainly medical x-rays. Internal exposure refers to radioactive material that is taken into the body through breathing, eating, or drinking. External exposure refers to an exposure to a radioactive source outside of our bodies. Contamination refers to particles of radioactive material that are deposited anywhere that they are not supposed to be, such as on an object or on a persons skin.

Health Effects of Radiation Exposure

Radiation affects the body in different ways, but the adverse health consequences of exposure may not be seen for many years. Adverse health effects range from mild effects, such as skin reddening, to serious effect such as cancer and death. These adverse health effects are determined by the amount of radiation absorbed by the body (the dose), the type of radiation, the route of exposure, and the length of time a person is exposed. Acute radiation syndrome (ARS), or radiation sickness, is usually caused when a person receives a high dose of radiation to much of the body in a matter of minutes. Survivors of the Hiroshima and Nagasaki atomic bombs and firefighters responding to the Chernobyl nuclear power plant event in 1986 experienced ARS. The immediate symptoms of ARS are nausea, vomiting, and diarrhea; later, bone marrow depletion may lead to weight loss, loss of appetite, feeling like you have the flu, infection, and bleeding. The survival rate depends on the radiation dose. For those who do survive, full recovery takes from a few weeks to 2 years. Children exposed to radiation may be more at risk than adults. Radiation exposure to the unborn child is of special concern because the human embryo or fetus is extremely sensitive to radiation. Radiation exposure, like exposure to the sun, is cumulative.

Protecting Against Radiation Exposure The three basic ways to reduce radiation exposure are through: TIME

Decrease the amount of time you spend near the source of radiation.

DISTANCE

Increase your distance from a radiation source.

SHIELDING

Increase the shielding between you and the radiation source. Shielding is anything that creates a barrier between people and the radiation source.

Depending on the type of radiation, the shielding can range from something as thin as a plate of window glass or as thick as several feet of concrete. Being inside a building or a vehicle can provide shielding from some kinds of radiation. SUITCASE NUKES

A suitcase nuke or suitcase bomb is a very compact and portable nuclear weapon and could have the dimensions of 60 x 40 x 20 centimeters or 24 x 16 x 8 inches. The smallest possible bomb-like object would be a single critical mass of plutonium (or U-233) at maximum density under normal conditions. The Pu-239 weighs 10.5 kg and is 10.1 cm across. It doesnt take much more than a single critical mass to cause significant explosions ranging from 10-20 tons. These types of weapons can also be as big as two footlockers. The warhead of a suitcase nuke or suitcase bomb consists of a tube with two pieces of uranium, which, when rammed together, would cause a blast. Some sort of firing unit and a device that would need to be decoded to cause detonation may be included in the suitcase. Another portable weapon is a backpack bomb. The Soviet nuclear backpack system was made in the 1960s for use against NATO targets in time of war and consists of three coffee can-sized aluminum canisters in a bag. All three must be connected to make a single unit in order to explode. The detonator is about 6 inches long. It has a 3-to-5 kiloton yield, depending on the efficiency of the explosion. Its kept powered during storage by a battery line connected to the canisters. Effects External radiation occurs when either part of or all of the body is exposed from an external source, such as when a person is standing near the site of where a radiological

device such as a suitcase bomb or suitcase nuke is set off and he or she is exposed to radiation, which can be absorbed by the body or can pass completely through it. Contamination occurs when radioactive materials in the form of solids, liquids or gases are released into the air and contaminate people externally, internally or both. This happens when body parts such as the skin become contaminated and/or if the harmful material gets inside the body via the lungs, gut or wounds. Incorporation of radioactive material occurs when body cells, tissues and organs such as bone, liver, thyroid or kidney, are contaminated. Gamma radiation can travel many meters in the air and many centimeters once in human tissue; therefore they represent a major external threat. Dense material is needed as a shield. Beta radiation can travel meters in air and can moderately penetrate human skin, but clothing and some protection can help. Alpha radiation travels a very short distance through the air and cant penetrate the skin, but can be harmful if inhaled, swallowed or absorbed through open wounds. Radiation in the first hour after an explosion is about 90 percent, with it going down to about 1 percent of the original level after two days. Radiation only drops to trace levels after 300 hours. Symptoms People in the immediate vicinity of a suitcase nuke or suitcase bomb detonation would likely die from the force of the conventional explosion itself. Some survivors of the blast might die of radiation poisoning in the weeks afterward. Those farther away from the explosion might suffer radiation sickness in the days and weeks afterward, but recover. Over time, risks of cancer in the affected area would rise, but perhaps only slightly. A mix of physical symptoms must be used to judge the seriousness of exposure. Impact of radiation poisoning also changes if the body has experienced burns or physical trauma. In the case of treatable victims, extensive medical treatment may be needed for more than two months after exposure. Some symptoms may include vomiting, headache, fatigue, weakness, diarrhea, thermal burn-like skin effects, secondary infections, reoccurring bleeding and hair loss. Treatment If detection and decontamination occurs soon after exposure, about 95 percent of external radioactive material can be removed by taking off the victims clothing and shoes and washing with water. Further decontamination may require the use of bleaches or other mild abrasives. Treatment of a victim within the first six weeks to two months after exposure is vital and is determined by what types of radioactive isotopes to which the victim was exposed.

Medical personnel will treat victims for hemorrhage and shock. Open wounds are usually irrigated to cleanse them of any radioactive traces. Amputation of limbs may occur if a wound is highly contaminated and functional recovery isnt likely. If radioactive material is ingested, treatment is given to reduce absorption and enhance excretion and elimination. It includes stomach pumping or giving the victim laxatives or aluminum antacids, among other things. If radioactive material has gotten into a victims internal organs and tissues, treatment includes giving the patient various blocking and diluting agents, such as potassium iodide, to decrease absorption. Mobilizing agents such as ammonium chloride, diuretics, expectorants and inhalants are given to a patient to force the tissues to release the harmful isotopes. Other treatments involve chelating agents. When ingested, these agents bind with some metals more strongly than others to form a stable complex that, when soluble, is more easily excreted through the kidneys. WHAT TO DO IN A BOMBING Although terrorists use a variety of methods to inflict harm and create fear, bombs are used most frequently. According to the U. S. Federal Bureau of Investigation, bombings accounted for nearly 70 percent of all terrorist attacks in the U.S. and its territories between 1980 and 2001. This document focuses on common sense principles that will be useful in a bombing event. What should I do if I think someone is going to set off a bomb? At Home Leave the area immediately. Call 9-1-1. Tell the operator what you saw or know (suspicious persons, packages, or vehicles). Follow directions from people in authority (police, fire, EMS, or military personnel, or from neighborhood leaders). Follow directions from people in authority (police, fire, EMS, or military personnel, or from workplace supervisors). Follow directions from people in authority (police, fire, EMS, or military personnel, or from school administrators). At Work Follow existing evacuation guidelines. At School Follow existing evacuation guidelines. In Public Leave the area immediately. Call 9-1-1. Tell the operator what you saw or know (suspicious persons, packages, or vehicles). Follow directions from people in authority (police, fire, EMS, or military personnel, or from community leaders).

What should I do during a terrorist bombing? If you are in a bombing event:

Leave the area immediately. Avoid crowds. Crowds of people may be targeted for a second attack. Avoid unattended cars and trucks. Unattended cars and trucks may contain explosives. Stay away from damaged buildings to avoid falling glass and bricks. Move at least 10 blocks or 200 yards away from damaged buildings. Follow directions from people in authority (police, fire, EMS, or military personnel, or from school or workplace supervisors). Call 9-1-1 once you are in a safe area, but only if police, fire, or EMS has not arrived. Help others who are hurt or need assistance to leave the area if you are able. If you see someone who is seriously injured, seek help. Do not try to manage the situation alone.

Chemical and Biological Weapons

ANTHRAX Anthrax infection is a disease that can be acquired following the intentional release of anthrax spores as a biological weapon. What are the signs and symptoms of anthrax? Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within 7 days. Cutaneous anthrax is the most common naturally occurring type of infection (>95%) and usually occurs after skin contact with contaminated meat, wool, hides, or leather from infected animals. The incubation period ranges from 1-12 days. The skin infection begins as a small papule, progresses to a vesicle in 1-2 days followed by a necrotic ulcer. The lesion is usually painless, but patients also may have fever, malaise, headache, and regional lymphadenopathy. Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the skin. Skin infection begins as a raised bump that resembles a spider bite, but (within 1-2 days) it develops into a vesicle and then a painless ulcer, usually 1-3 cm in diameter, with a characteristic black necrotic (dying) area in the center. Lymph glands in the adjacent area may swell. About 20% of untreated cases of cutaneous anthrax will result in death. Deaths are rare if patients are given appropriate antimicrobial therapy. Inhalational anthrax is the most lethal form of anthrax. Anthrax spores must be aerosolized in order to cause inhalational anthrax. The number of spores that cause human infection is unknown. The incubation period of inhalational anthrax among humans is unclear, but it is reported to range from 1 to 7 days, possibly ranging up to 60 days. It resembles a viral respiratory illness and initial symptoms include sore throat, mild fever, muscle aches and malaise. These symptoms may progress to respiratory failure and shock with meningitis frequently developing. Gastrointestinal anthrax usually follows the consumption of raw or undercooked contaminated meat and has an incubation period of 1-7 days. It is associated with

severe abdominal distress followed by fever and signs of septicemia. The disease can take an oropharyngeal or abdominal form. Involvement of the pharynx is usually characterized by lesions at the base of the tongue, sore throat, dysphagia, fever, and regional lymphadenopathy. Lower bowel inflammation usually causes nausea, loss of appetite, vomiting and fever, followed by abdominal pain, vomiting blood, and bloody diarrhea. What specific symptoms should I watch for? People should watch for the following symptoms:

Fever (temperature greater than 100 degrees F). The fever may be accompanied by chills or night sweats. Flu-like symptoms Cough, usually a non-productive cough, chest discomfort, shortness of breath, fatigue, muscle aches Sore throat, followed by difficulty swallowing, enlarged lymph nodes, headache, nausea, loss of appetite, abdominal distress, vomiting, or diarrhea A sore, especially on your face, arms or hands, that starts as a raised bump and develops into a painless ulcer with a black area in the center.

Influenza (flu) and inhalation anthrax can have similar symptoms. Does CDC recommend that I get a flu shot to help diagnose anthrax? You should get a flu shot only to prevent the flu. CDC does not recommend you get the flu shot so doctors can tell whether you have the flu or anthrax. Many illnesses (including anthrax) begin with flu-like symptoms, which include fever, body aches, tiredness, and headaches. In fact, most illnesses with flu-like symptoms are not either the flu or anthrax. The flu vaccine is the best protection you can get to prevent the flu and its severe complications, especially among those who are at the highest risk (e.g., people older than 65 years old or younger people with chronic disease such as diabetes or heart disease). The flu shot can prevent 70%-90% of flu infections, but it will not prevent illnesses with flu-like symptoms caused by anything other than influenza. Is there a way to distinguish between early inhalational anthrax and flu? Early inhalational anthrax symptoms can be similar to those of much more common infections. However, a runny nose is a rare feature of anthrax. This means that a person who has a runny nose along with other common influenza-like symptoms is by far more likely to have the common cold than to have anthrax. In addition, most people with inhalational anthrax have high white blood cell counts and no increase in the number of lymphocytes. On the other hand, people with infections such as flu usually have low white blood cell counts and an increase in the number of lymphocytes.

Chest X-rays are also critical diagnostic tools. Chest X-rays showed that all patients with inhalational anthrax have some abnormality, although for some patients, the abnormality was subtle. CT scans can confirm these abnormalities. Is there a quick test that doctors can do to tell whether I have anthrax or an illness like the flu? Some influenza detection tests give results fairly quickly. However, these tests are not perfect and are not appropriate for every patient. Rapid influenza tests can provide results within 24 hours; viral culture provides results in 3-10 days. However, as many as 30% of samples that test positive for influenza by viral culture may give a negative rapid test result. And, some rapid test results may indicate influenza when a person is not infected with influenza. Is anthrax contagious? No. Anthrax is not contagious; the illness cannot be transmitted from person to person. What are the case fatality rates for the various forms of anthrax? Early treatment of cutaneous anthrax is usually curative, and early treatment of all forms is important for recovery. Patients with cutaneous anthrax have reported case fatality rates of 20% without antibiotic treatment and less than 1% with it. Although case-fatality estimates for inhalational anthrax are based on incomplete information, the rate is extremely high, approximately 75%, even with all possible supportive care including appropriate antibiotics. Estimates of the impact of the delay in post exposure prophylaxis or treatment on survival are not known. For gastrointestinal anthrax, the case-fatality rate is estimated to be 25%-60% and the effect of early antibiotic treatment on that case-fatality rate is not defined. Can the presence of Bacillus anthracis spores be detected by a characteristic appearance, odor, or taste? Bacillus anthracis spores do not have a characteristic appearance (e.g., color), smell, or taste. Spores themselves are too small to be seen by the naked eye, but have been mixed with powder to transport them. The U.S. Postal Service advises that individuals be suspicious of letters or packages with any powdery substance on them, regardless of color. (See http://www.usps.gov/news/2001/press/pr01_1010tips.htm.) What would be the approximate size of enough Bacillus anthracis spores to cause infection? They could not be seen by the naked eye but could be seen under a microscope. How can I know my cold or flu this season is not anthrax? Many human illnesses begin with what are commonly referred to as flu-like symptoms, such as fever and muscle aches. However, in most cases anthrax can be distinguished from the flu because the flu has additional symptoms. In previous reports of anthrax

cases, early symptoms usually did not include a runny nose, which is typical of the flu and common cold. If I have the flu, can I still get anthrax? Yes, a person could theoretically get both the flu and anthrax, either at the same time or at different times. How is anthrax diagnosed? Anthrax is diagnosed by isolating B. anthracis from the blood, skin lesions, or respiratory secretions or by measuring specific antibodies in the blood of persons with suspected cases. In patients with symptoms compatible with anthrax, providers should confirm the diagnosis by obtaining the appropriate laboratory specimens based on the clinical form of anthrax that is suspected (i.e., cutaneous, inhalational, or gastrointestinal). Cutaneous vesicular fluid and blood Inhalational blood, cerebrospinal fluid (if meningeal signs are present) or chest X-ray Gastrointestinal blood Preventative Therapy What is the therapy for preventing inhalational anthrax? Interim recommendations for post exposure prophylaxis for prevention of inhalational anthrax after intentional exposure to B. anthracis may be found in the MMWR at http:// www.cdc.gov/mmwr/preview/mmwrhtml/mm5041a1.htm. What is cipro (ciprofloxacin)? Ciprofloxacin, or cipro as it is commonly known, is a broad-spectrum, synthetic antimicrobial agent active against several microorganisms. The use of ciprofloxacin is warranted only under the strict supervision of a physician. Does ciprofloxacin have an expiration date? Yes. Antibiotics, just like all medicines, have expiration dates. If you received your ciprofloxacin through a pharmacist, the expiration date should be listed on the bottle. If you cant find it or have questions about the expiration date, contact your pharmacist directly. What are the side effects of cipro? Adverse health effects include vomiting, diarrhea, headaches, dizziness, sun sensitivity, and rash. Hypertension, blurred vision, and other central nervous system effects occur in <1% of patients and may be accentuated by caffeine or medications containing theophylline.

What are the guidelines for changing from ciprofloxacin to another antibiotic? Considerations for choosing an antimicrobial agent include effectiveness, resistance, side effects, and cost. As a measure to preserve the effectiveness of ciprofloxacin against anthrax and other infections, use of doxycycline for preventive therapy may be preferable. As always, the selection of the antimicrobial agent for an individual patient should be based on side-effect profiles, history of reactions, and the clinical setting. For more information about possible adverse reactions from taking antimicrobial prophylaxis see Update: Investigation of Bioterrorism-Related Anthrax and Adverse Events from Antimicrobial Prophylaxis. Should people buy and store antibiotics? There is no need to buy or store antibiotics, and indeed, it can be detrimental to both the individual and to the community. First, only people who are exposed to anthrax should take antibiotics, and health authorities must make that determination. Second, individuals may not stockpile or store the correct antibiotics. Third, under emergency plans, the Federal government can ship appropriate antibiotics from its stockpile to wherever they are needed. Will antibiotics protect me from a bioterrorist event? Should I stockpile them? CDC does not recommend using antibiotics unless a specific disease has been identified. There are several different agents that could be used for bioterrorism, such as bacteria, viruses, and toxins. Not a single antibiotic (or vaccine) works for all of these agents. Antibiotics only kill bacteria, not viruses or other agents that could also be used in a bioterrorist event. Antibiotics are not harmless drugs. They can cause serious side effects and drug interactions. National and state public health officials have large supplies of needed drugs and vaccines if a bioterrorism event should occur. These supplies can be sent anywhere in the United States within 12 hours. Who should receive antibiotics for 60 days? People at risk for inhalational anthrax should receive 60 days of antibiotics. These people include the following: 1. People who have been exposed to an air space known to have been contaminated with aerosolized B. anthracis. 2. People who share the air space within a facility where others have acquired inhalational anthrax. 3. People who have been along the transit pathway of an envelope (or other vehicle) containing B. anthracis that may have been aerosolized. 4. Unvaccinated laboratory workers who have handled powder that has tested positive for B. anthracis and who may not have used appropriate bio-safety precautions. People who are unsure if they are at risk should discuss any concerns with their healthcare provider or local/state public health department.

When is a 60-day prescription of prophylactic antibiotics not needed? People who are determined not to be at risk for inhalational anthrax do not need to take the 60-day course of prophylactic antibiotics. Prophylactic antibiotics are not indicated for the prevention of cutaneous anthrax, for hospital personnel caring for patients with anthrax, or for persons who routinely open or handle mail if there has not been a credible threat. ANTHRAX TREATMENT What if I develop side effects from the antibiotic? If you develop side effects from the antibiotic, call your healthcare provider immediately. Depending on the type of side effects, you may be able to continue taking the medicine, or may be switched to an alternative antibiotic. If necessary, your physician may contact your State Department of Health for consultation on possible alternate antibiotics. Has CDC tested the anthrax isolates for sensitivity to different antibiotics? Yes. Antibiotic sensitivity testing performed at CDC has determined that the strain of anthrax was sensitive to a wide range of antibiotics, including penicillin and ciprofloxacin, giving public health officials important treatment information. What are the risks of using tetracyclines and fluoroquinolones in children; are alternatives available? Risks of using tetracyclines and fluoroquinolones in children must be weighed carefully against the risk for developing a life-threatening disease due to B. anthracis. Both agents can have adverse health reactions in children. If adverse reactions are suspected, therapy may be changed to amoxicillin or penicillin. Are there special instructions for taking ciprofloxacin or doxycycline? As with all antibiotics, take the medication according to the schedule you were instructed, and even if you begin to feel better, continue taking it for the full number of days. If you need an extension of the antibiotic at the end of your prescribed number of days, local emergency healthcare workers or your healthcare provider will inform and tell you how to get more medicine. They may also tell you to discontinue the antibiotic, or will change the type of antibiotic, depending on results of laboratory tests. After I have started taking ciprofloxacin to protect me from developing anthrax, what side effects could I get from taking this antibiotic? Side effects which sometimes occur include nausea, mild diarrhea, stomach pain, headache and dizziness. Talk with your doctor if you have any of these problems while you are taking the antibiotic. Certain foods and medications should not be taken with ciprofloxacin; this should be discussed at the time the antibiotic is prescribed, so that side effects will not occur from the combinations. Ciprofloxacin also can cause sun sensitivity which increases the chances of sunburn. More serious side effects include

central nervous system side effects such as confusion, tremors, hallucinations, depression, and increased risk of seizures. High blood pressure and blurred vision are also possible. Allergic reactions could cause difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; hives or severe diarrhea. Pain, inflammation, or rupture of a tendon is possible and also severe tissue inflammation of the colon could occur. Call your doctor or seek medical advice right away if you are having any of these side effects. This list is NOT a complete list of side effects reported with ciprofloxacin. Your healthcare provider can discuss with you a more complete list of side effects. After I have started taking doxycycline to protect me from developing anthrax, what side effects could I get from taking this antibiotic? Less serious side effects include diarrhea, upset stomach, nausea, sore mouth or throat, sensitivity to sunlight, vaginal yeast infection or itching of the mouth lasting more than 2 days. You should talk with your doctor if you have any of these problems while taking doxycycline. Certain foods and medications should not be taken with doxycycline, and this should be discussed with your healthcare provider at the time the antibiotic is prescribed, so that side effects will not occur from the combinations. Doxycycline also causes sun sensitivity which increases the chances of sunburn. Serious side effects of doxycycline that are possible but uncommon include: life-threatening allergic reaction (symptoms are trouble breathing; closing of the throat; swelling of the lips, tongue, or face; hives), blood problems (symptoms are unusual bleeding or bruising), liver damage (symptoms are yellowing of the skin or eyes, dark urine, nausea, vomiting, loss of appetite, abdominal pain), irritation of the esophagus. Call your doctor or seek medical attention right away if you are having any of these side effects. This list is NOT a complete list of side effects reported with doxycycline. Your healthcare provider can discuss with you a more complete list of side effects. Why is CDC recommending doxycycline instead of ciprofloxacin for the treatment and prevention of anthrax? Both doxycycline and ciprofloxacin are effective in treating Bacillus anthracis that we are dealing with in these investigations. Although CDC first recommended the use of either drug for post exposure prophylaxis for the prevention of inhalational anthrax, we are now recommending doxycycline in order to prevent other bacteria from developing resistance to ciprofloxacin. Ciprofloxacin is part of the fluoroquinolone family of drugs, a relatively new class of antibiotics used to treat infections caused by organisms for which doctors do not have information about antimicrobial susceptibility. This kind of treatment is known as empiric therapy. Ciprofloxacin and other fluoroquinolones are used for empiric treatment for a variety of serious and common infections in the United States, including pneumonia, gastrointestinal infections, and urinary tract infections. The number of people who have been exposed to B. anthracis and need antibiotics has increased dramatically since CDC first issued guidelines for treatment. If all those people take ciprofloxacin, other bacteria they carry in their bodies may develop resistance to fluoroquinolones, potentially limiting the usefulness of these drugs as empiric therapy. Doxycycline is less frequently used for empiric treatment than ciprofloxacin; therefore,

we have fewer concerns regarding this drug and the emergence of new resistant bacteria. Why are people who have been exposed to B. anthracis being given antibiotics for different amounts of time? The initial number of people placed on prophylaxis may reflect conservative estimates with wide safety margins based on limited preliminary information. As the investigation progresses and a clearer picture of exposure develops, the number of people advised to continue prophylaxis may be reduced. As of the last week of October 2001, when preliminary tests show that people have been exposed to Bacillus anthracis, those exposed may be provided with a starter packet of antibiotics; the number of days for which antibiotics are prescribed can vary according to the specific situation and person. Additional tests are then conducted of the area where exposure occurred and to determine the extent of exposure. Based on the results of these additional tests, those exposed may be instructed to return to a centralized location for additional care or to seek additional care from their primary care providers; additional antibiotics may be prescribed based on the particular situation and person. Lastly, it is recommended that people found to be at risk of inhalation anthrax be prescribed 60 days of antibiotics. These general procedures may change at any time as new information is gathered. Are there different strains of B. anthracis? Do they all respond to antibiotics? Yes, there are different strains of Bacillus anthracis. Some strains of B. anthracis may be naturally resistant to certain antibiotics and not others. In addition, there may be biologically mutant strains that are engineered to be resistant to various antibiotics. A laboratory analysis can help to define which strain of B. anthracis is present and which antibiotic would be the most effective in treating the resulting anthrax. What is the FDA telling physicians and other health professionals about prescriptions for ciprofloxacin? Although FDA does not regulate the practice of medicine, the agency is strongly recommending that physicians not prescribe ciprofloxacin for individual patients to have on hand for possible use against inhaled anthrax. Indiscriminate and widespread use of ciprofloxacin could hasten the development of drug-resistant organisms and lessen the effects of these agents against many infections. Can other fluoroquinolones be used instead of ciprofloxacin for post exposure prophylaxis (PEP)/treatment? Other fluoroquinolones, such as ofloxacin and levofloxacin, are not specifically recommended as alternatives to ciprofloxacin because of a lack of sufficient data on their efficacy. However, if first-line drugs were not available, these other fluoroquinolones may be effective.

Why do I need 60 days of antibiotics? Anthrax spores grow like plant seeds. If you plant seeds and give them sun and water, they will grow into plants. If you give anthrax spores the right environment, such as the human body, they can grow into the harmful form of the bacteria that can cause anthrax disease. It takes anthrax spores an average of 7 days to grow into the harmful form of the bacteria, but it can take longer. For this reason, you must continue taking preventive antibiotics for the full 60 days. What happens if I take ciprofloxacin, doxycycline, or amoxicillin for a few days, stop, and then restart the antibiotics? You should complete the 60-day course of antibiotics that you were given. It is best to take antibiotics as prescribed and not to skip any doses. The ciprofloxacin I am taking gives me headaches. Is there anything I can do to help this? If you dont have a history of headaches, then your headache may be related to the medicine. Changing the time of day that you take the ciprofloxacin or eating after you take the medicine may help. Pain relievers such as acetaminophen may help your headache. If your headache does not go away, you should consult your doctor. The ciprofloxacin, doxycycline, or amoxicillin I am taking makes me feel sick to my stomach. Is there anything I can do to help this? Taking your antibiotic with food may help reduce this sick feeling. Ciprofloxacin and doxycycline should not be taken within 2 hours of taking antacids. Ciprofloxacin and doxycycline should not be taken with dairy or calcium-fortified products (such as ice cream or calcium-fortified orange juice). The ciprofloxacin, doxycycline, or amoxicillin I am taking gives me diarrhea. Is there anything I can do to help this? Antibiotics may disrupt bacteria in the gastrointestinal tract, causing diarrhea. Food may help relieve the diarrhea. If the diarrhea does not go away, your doctor may recommend another antibiotic. If you develop severe, long-lasting diarrhea, you may have a serious condition and should consult your doctor. If taking one of the recommended antibiotics makes me feel terrible, can I switch to another of these antibiotics? If you have tried taking the medicine with food or changing the time of your dose but still feel terrible, you should ask your doctor about switching antibiotics.

I am having terrible yeast infections while taking ciprofloxacin, doxycycline, or amoxicillin. Is there anything I can take for this? Occasionally, women develop yeast infections while taking amoxicillin. You may treat the infection with over-the-counter medicines such as clotrimazole. If the symptoms do not go away, you should consult your doctor. I feel much better if I take only one pill of ciprofloxacin, doxycycline, or amoxicillin each day. Is that okay? No. The drug must be taken twice a day to kill the bacteria. If your body contains anthrax bacteria and you do not take the full dose, the bacteria may start to grow again and become harder to kill. My prescription says to take one pill every 12 hours. If 15 hours have passed since my last dose, is it still okay to take the pill? Yes. It is okay to take the next pill even if 15 hours have elapsed. However, you should not make a habit of this. The medicine works best when taken every 12 hours. What side effects are serious enough that I should go to a doctor? Any side effect that forces you not to take your medicine is serious enough that you should consult or see your doctor. Serious side effects of ciprofloxacin include seizures, mental confusion, rash that does not go away, or excessive diarrhea. If you have any of these effects, call your doctor. Serious side effects of doxycycline include jaundice (yellow eyes or skin), rash that does not go away, or excessive diarrhea. If you have any of these effects, call your doctor. Any reaction that causes a rapid swelling of the lips and face, shortness of breath, or hives is a medical emergency. You should call 911. These types of reactions are extremely rare. Can I drink alcohol if I am taking ciprofloxacin, doxycycline, or amoxicillin? Social drinking of alcohol (fewer than 2 drinks a day) should not cause any side effects unless you already have a liver problem. However, drinking too much alcohol can cause the medicine to leave your body faster, which will decrease the effectiveness of the medicine. If you drink more than two drinks a day, you should tell your doctor so that different medicines can be prescribed. The ciprofloxacin, doxycycline, or amoxicillin I am taking makes me feel itchy all over. Is there anything I can do to help this? Rashes that appear suddenly or do not go away after a few days may be signs of an allergic reaction. You should see your doctor immediately.

The ciprofloxacin, doxycycline, or amoxicillin gave me an allergic reaction and I stopped taking it. What should I do? If the allergic reaction was severe or rapid, you should notify your doctor before taking another antibiotic. Your doctor will prescribe a different antibiotic that will kill the bacteria without causing an allergic reaction. Remember: you should complete the entire 60 days of treatment even if you change antibiotics. Why cant I take a shot, wear a patch, or take one large dose of the medicine instead of taking it for 60 days? Spores can stay in your body for some time before they start growing and causing you to become ill. When the spores are not growing, antibiotics are not effective. Only after the spores start to grow can the antibiotics work. Therefore, you need a constant level of antibiotic in your body for 60 days to make sure that when the spores start to grow, the antibiotic is there to kill them. Ciprofloxacin and doxycycline look different and come in different doses. Is one better than the other? Ciprofloxacin 500 mg and doxycycline 100 mg both have the same killing power in your bloodstream and are equally effective against anthrax bacteria. Doxycycline is available in both tablet and capsule form. Both will give you the same amount of medicine in your bloodstream to kill the bacteria. Should all patients who have flu-like symptoms be treated with antibiotics? No. CDC does not recommend treating all patients who have flu-like illness with antibiotics. Antibiotics do not kill viruses, which cause the flu. If the patient is not at risk for developing anthrax, antibiotics are not recommended because the person may experience serious side effects. Also, taking antibiotics can increase the chance that the medicine will not be as effective against other bacterial infections. Does a patient have immunity after recovering from anthrax infection? We do not have enough data at this time to make this determination. However, it is theoretically possible to gain post-infection immunity. How do doctors treat inhalational anthrax to reduce the risk of death in patients? When inhalational anthrax is suspected, physicians prescribe antibiotics to treat the disease. To be effective, antibiotic therapy should be initiated as soon as possible after exposure. Other treatment includes supportive care in hospital. B. anthracis usually responds effectively to several antibiotics including penicillin, doxycycline, and fluoroquinolones (such as ciprofloxacin).

I was told that I had been exposed to Bacillus anthracis and prescribed antibiotics. I took the medicine for a couple weeks. Wouldnt that weaken any anthrax thats in my body? You should take the full 60 days of antibiotics even if you feel better. Inhaled anthrax spores become lodged in the body and may activate after initial exposure. Antibiotics have little or no effect when the spores are inactive. To be effective in preventing inhalational anthrax, the antibiotics must be in your system when the spores activate. It is necessary to take the medicine for at least 60 days to ensure the best protection against inhalational anthrax. Why was ciprofloxacin ever publicized as the best drug for anthrax? How can we know which antibiotic is best? At the beginning of the recent anthrax outbreak, investigators did not know which drugs would kill the strains of Bacillus anthracis responsible for the outbreak. They used ciprofloxacin because very few bacteria are resistant to it. Recent laboratory tests using all of the B. anthracis strains from the recent outbreak have indicated that all the strains are susceptible to ciprofloxacin, doxycycline, and other antibiotics. Besides anthrax, what else is ciprofloxacin prescribed for? Has there been resistance to ciprofloxacin when used in other instances (historically)? Ciprofloxacin is a broad-spectrum, highly effective antibiotic that has been part of the international travelers kit at CDC for at least a year. It can be used against most bacterial infections. However, ciprofloxacin is frequently overused for many diseases that can be treated with less powerful, narrower-spectrum drugs. Right now, most bacteria are susceptible to ciprofloxacin, which is why we want to be cautious about its use. Overuse of ciprofloxacin could lead to the development of resistance. Is there a generic form of ciprofloxacin? No, there is currently no generic form of ciprofloxacin in the United States. CBRN CBRN chemical, biological, radiological and nuclear attack A growing concern among Homeland Security professionals, is that terrorists will someday unleash CBRN materials, in an attack against an unsuspecting public. CBRN is a term that covers four distinct groups of hazards Chemical. Poisoning or injury caused by chemical substances, including ex-military chemical warfare agents or legitimate but harmful household or industrial chemicals. Biological. Illnesses caused by the deliberate release of dangerous bacteria, viruses or fungi, or biological toxins (e.g. ricin, a natural toxin occurring in plants).

Radiological (radioactive). Illness caused by exposure to harmful radioactive materials contaminating the environment. Nuclear. Death and injury caused from caused from the effects of an explosion that includes blinding light, intense heat (thermal radiation), initial nuclear radiation, blast, fires started by the heat pulse, and secondary fires caused by the destruction. CBRN weapons have been little used so far, largely due to the difficulty of obtaining the materials and the complexity of using them effectively. Where terrorists have tried to carry out CBRN attacks, they have generally used relatively simple materials. However, Al Qaida and related groups have expressed a serious interest in using CBRN. The impact of any terrorist CBRN attack would depend heavily on the success of the chosen method of dissemination and the weather conditions at the time of the attack. The likelihood of a CBRN attack remains low at this time, but should be considered in your preparedness planning. As with other terrorist attacks, you may not receive prior warning of a CBRN incident. Moreover, the exact nature of an incident may not be immediately obvious. First indicators may be the sudden appearance of powders, liquids or strange smells within the building, with or without an immediate effect on people. CYANIDE What cyanide is: Cyanide is a rapidly acting, potentially deadly chemical that can exist in various forms. Cyanide can be a colorless gas, such as hydrogen cyanide (HCN) or cyanogen chloride (CNCl), or a crystal form such as sodium cyanide (NaCN) or potassium cyanide (KCN). Cyanide gas sometimes is described as having a bitter almond smell, but it does not always give off an odor, and not everyone can detect this odor. Cyanide is also known by the military designations AN (for hydrogen cyanide) and CK (for cyanogen chloride).

Where cyanide is found and how it is used

Cyanide is naturally present in some foods and in certain plants such as cassava. Cyanide is contained in cigarette smoke and the combustion products of synthetic materials such as plastics. Combustion products are substances given off when things burn. In manufacturing, cyanide is used to make paper, textiles, and plastics. It is present in the chemicals used to develop photographs. Cyanide salts are used in metallurgy for electroplating, metal cleaning, and removing gold from its ore. Cyanide gas is used to exterminate pests and vermin in ships and buildings. If accidentally ingested (swallowed), chemicals found in acetonitrile-based products that are used to remove artificial nails can produce cyanide. Hydrogen cyanide, under the name Zyklon B, was used as a genocidal agent by the Germans in World War II.

Reports have indicated that during the Iran-Iraq War in the 1980s, hydrogen cyanide gas may have been used along with other chemical agents against the inhabitants of the Kurdish city of Halabja in northern Iraq.

How people can be exposed to cyanide

Cyanide enters water, soil, or air as a result of both natural processes and industrial activities. In air, cyanide is present mainly as gaseous hydrogen cyanide. People may be exposed to cyanide by breathing air, drinking water, eating food, or touching soil that contains cyanide. Smoking cigarettes is probably one of the major sources of cyanide exposure for people who do not work in cyanide-related industries.

How cyanide works

Poisoning caused by cyanide depends on the amount of cyanide a person is exposed to, the route of exposure, and the length of time that a person is exposed. Breathing cyanide gas causes the most harm, but ingesting cyanide can be toxic as well. Cyanide gas is most dangerous in enclosed places where the gas will be trapped. Cyanide gas evaporates and disperses quickly in open spaces, making it less harmful outdoors. Cyanide gas is less dense than air, so it will rise. Cyanide prevents the cells of the body from getting oxygen. When this happens, the cells die. Cyanide is more harmful to the heart and brain than other organs because the heart and brain use a lot of oxygen.

Immediate signs and symptoms of cyanide exposure

People exposed to a small amount of cyanide by breathing it, absorbing it through their skin, or eating foods that contain it may have some or all of the following symptoms within minutes: o Rapid breathing o Restlessness o Dizziness o Weakness o Headache o Nausea and vomiting o Rapid heart rate Exposure to a large amount of cyanide by any route may cause these other health effects as well: o Convulsions o Low blood pressure o Slow heart rate o Loss of consciousness o Lung injury

Respiratory failure leading to death

What the long-term health effects may be Survivors of serious cyanide poisoning may develop delayed neurological effects, most commonly symptoms resembling Parkinsons disease. How people can protect themselves and what they should do if they are exposed to cyanide

First, get fresh air by leaving the area where the cyanide was released. Moving to an area with fresh air is a good way to reduce the possibility of death from exposure to cyanide gas. o If the cyanide release was outside, move away from the area where the cyanide was released. o If the cyanide release was indoors, get out of the building. If leaving the area that was exposed to cyanide is not an option, stay as low to the ground as possible. Remove any clothing that has liquid cyanide on it. If possible, seal the clothing in a plastic bag, and then seal that bag inside a second plastic bag. Rinse the eyes with plain water for 10 to 15 minutes if they are burning or vision is blurred. Wash any liquid cyanide from the skin thoroughly with soap and water. If cyanide is known to be ingested (swallowed), do not induce vomiting or give fluids to drink. Seek medical attention right away. Stay calm. Dial 911 and explain what has happened. Wait for emergency personnel to arrive.

How cyanide poisoning is treated Cyanide poisoning is treated with antidotes and supportive medical care. The most important thing is for victims to seek medical treatment as soon as possible. How people can get more information about cyanide People can contact one of the following:

Regional poison control center (1-800-222-1222) Centers for Disease Control and Prevention Public Response Hotline (CDC) o English (888) 246-2675 o Espaol (888) 246-2857 o TTY (866) 874-2646 Agency for Toxic Substances and Disease Registry (ATSDR) (1-888-422-8737) Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH),

SULFUR MUSTARD What sulfur mustard is:

Sulfur mustard is a type of chemical warfare agent. These kinds of agents are called vesicants or blistering agents, because they cause blistering of the skin and mucous membranes on contact. Sulfur mustard is also known as mustard gas or mustard agent, or by the military designations H, HD, and HT. Sulfur mustard sometimes smells like garlic, onions, or mustard and sometimes has no odor. It can be a vapor (the gaseous form of a liquid), an oily-textured liquid, or a solid. Sulfur mustard can be clear to yellow or brown when it is in liquid or solid form.

Where sulfur mustard is found and how it is used

Sulfur mustard is not found naturally in the environment. Sulfur mustard was introduced in World War I as a chemical warfare agent. Until recently, it was available for use in the treatment of a skin condition called psoriasis. Currently, it has no medical use.

How people are exposed to sulfur mustard

If sulfur mustard is released into the air as a vapor, people can be exposed through skin contact, eye contact, or breathing. Sulfur mustard vapor can be carried long distances by wind. If sulfur mustard is released into water, people can be exposed by drinking the contaminated water or getting it on their skin. People can be exposed by coming in contact with liquid sulfur mustard. Sulfur mustard can last from 1 to 2 days in the environment under average weather conditions and from weeks to months under very cold conditions. Sulfur mustard breaks down slowly in the body, so repeated exposure may have a cumulative effect (that is, it can build up in the body).

How sulfur mustard works

Adverse health effects caused by sulfur mustard depend on the amount people are exposed to, the route of exposure, and the length of time that people are exposed. Sulfur mustard is a powerful irritant and blistering agent that damages the skin, eyes, and respiratory (breathing) tract. It damages DNA, a vital component of cells in the body. Sulfur mustard vapor is heavier than air, so it will settle in low-lying areas.

Immediate signs and symptoms of sulfur mustard exposure

Exposure to sulfur mustard is usually not fatal. When sulfur mustard was used during World War I, it killed fewer than 5% of the people who were exposed and got medical care.

People may not know right away that they have been exposed, because sulfur mustard often has no smell or has a smell that might not cause alarm. Typically, signs and symptoms do not occur immediately. Depending on the severity of the exposure, symptoms may not occur for 2 to 24 hours. Some people are more sensitive to sulfur mustard than are other people, and may have symptoms sooner. Sulfur mustard can have the following effects on specific parts of the body: o Skin: redness and itching of the skin may occur 2 to 48 hours after exposure and change eventually to yellow blistering of the skin. o Eyes: irritation, pain, swelling, and tearing may occur within 3 to 12 hours of a mild to moderate exposure. A severe exposure may cause symptoms within 1 to 2 hours and may include the symptoms of a mild or moderate exposure plus light sensitivity, severe pain, or blindness (lasting up to 10 days). o Respiratory tract: runny nose, sneezing, hoarseness, bloody nose, sinus pain, shortness of breath, and cough within 12 to 24 hours of a mild exposure and within 2 to 4 hours of a severe exposure. o Digestive tract: abdominal pain, diarrhea, fever, nausea, and vomiting.

What the long-term health effects may be

Exposure to sulfur mustard liquid is more likely to produce second- and thirddegree burns and later scarring than is exposure to sulfur mustard vapor. Extensive skin burning can be fatal. Extensive breathing in of the vapors can cause chronic respiratory disease, repeated respiratory infections, or death. Extensive eye exposure can cause permanent blindness. Exposure to sulfur mustard may increase a persons risk for lung and respiratory cancer.

How people can protect themselves and what they should do if they are exposed to sulfur mustard

Because no antidote exists for sulfur mustard exposure, the best thing to do is avoid it. Immediately leave the area where the sulfur mustard was released. Try to find higher ground, because sulfur mustard is heavier than air and will settle in low-lying areas. If avoiding sulfur mustard exposure is not possible, rapidly remove the sulfur mustard from the body. Getting the sulfur mustard off as soon as possible after exposure is the only effective way to prevent or decrease tissue damage to the body. Quickly remove any clothing that has liquid sulfur mustard on it. If possible, seal the clothing in a plastic bag, and then seal that bag inside a second plastic bag. Immediately wash any exposed part of the body (eyes, skin, etc.) thoroughly with plain, clean water. Eyes need to be flushed with water for 5 to 10 minutes. Do NOT cover eyes with bandages, but do protect them with dark glasses or goggles. If someone has ingested sulfur mustard, do NOT induce vomiting. Give the person milk to drink. Stay calm. Dial 911 and explain what has happened.

Wait for emergency personnel to arrive.

How sulfur mustard exposure is treated The most important factor is removing sulfur mustard from the body. Exposure to sulfur mustard is treated by giving the victim supportive medical care to minimize the effects of the exposure. Though no antidote exists for sulfur mustard, exposure is usually not fatal. Where people can get more information about sulfur mustard For more information about sulfur mustard, people can contact the following:

Regional poison control center (1-800-222-1222) Centers for Disease Control and Prevention Public Response Hotline (CDC) o English (888) 246-2675 o Espaol (888) 246-2857 o TTY (866) 874-2646 Agency for Toxic Substances and Disease Registry (ATSDR) (1-888-422-8737)

PNEUMONIC PLAGUE Plague is an infectious disease that affects animals and humans. It is caused by the bacterium Yersinia pestis. This bacterium is found in rodents and their fleas and occurs in many areas of the world, including the United States. Y. pestis is easily destroyed by sunlight and drying. Even so, when released into air, the bacterium will survive for up to one hour, although this could vary depending on conditions. Pneumonic plague is one of several forms of plague. Depending on circumstances, these forms may occur separately or in combination: Pneumonic plague occurs when Y. pestis infects the lungs. This type of plague can spread from person to person through the air. Transmission can take place if someone breathes in aerosolized bacteria, which could happen in a bioterrorist attack. Pneumonic plague is also spread by breathing in Y. pestis suspended in respiratory droplets from a person (or animal) with pneumonic plague. Becoming infected in this way usually requires direct and close contact with the ill person or animal. Pneumonic plague may also occur if a person with bubonic or septicemic plague is untreated and the bacteria spread to the lungs. Bubonic plague is the most common form of plague. This occurs when an infected flea bites a person or when materials contaminated with Y. pestis enter through a break in a persons skin. Patients develop swollen, tender lymph glands (called buboes) and fever, headache, chills, and weakness. Bubonic plague does not spread from person to person. Septicemic plague occurs when plague bacteria multiply in the blood. It can be a complication of pneumonic or bubonic plague or it can occur by itself. When it occurs alone, it is caused in the same ways as bubonic plague; however, buboes do not

develop. Patients have fever, chills, prostration, abdominal pain, shock, and bleeding into skin and other organs. Septicemic plague does not spread from person to person. Symptoms and Treatment With pneumonic plague, the first signs of illness are fever, headache, weakness, and rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery sputum. The pneumonia progresses for 2 to 4 days and may cause respiratory failure and shock. Without early treatment, patients may die. Early treatment of pneumonic plague is essential. To reduce the chance of death, antibiotics must be given within 24 hours of first symptoms. Streptomycin, gentamicin, the tetracyclines, and chloramphenicol are all effective against pneumonic plague. Antibiotic treatment for 7 days will protect people who have had direct, close contact with infected patients. Wearing a close-fitting surgical mask also protects against infection. Plague is an infectious disease that affects animals and humans. It is caused by the bacterium Yersinia pestis. This bacterium is found in rodents and their fleas and occurs in many areas of the world, including the United States. Y. pestis is easily destroyed by sunlight and drying. Even so, when released into air, the bacterium will survive for up to one hour, although this could vary depending on conditions. Pneumonic plague is one of several forms of plague. Depending on circumstances, these forms may occur separately or in combination: Pneumonic plague occurs when Y. pestis infects the lungs. This type of plague can spread from person to person through the air. Transmission can take place if someone breathes in aerosolized bacteria, which could happen in a bioterrorist attack. Pneumonic plague is also spread by breathing in Y. pestis suspended in respiratory droplets from a person (or animal) with pneumonic plague. Becoming infected in this way usually requires direct and close contact with the ill person or animal. Pneumonic plague may also occur if a person with bubonic or Septicemic plague is untreated and the bacteria spread to the lungs. Bubonic plague is the most common form of plague. This occurs when an infected flea bites a person or when materials contaminated with Y. pestis enter through a break in a persons skin. Patients develop swollen, tender lymph glands (called buboes) and fever, headache, chills, and weakness. Bubonic plague does not spread from person to person. Septicemic plague occurs when plague bacteria multiply in the blood. It can be a complication of pneumonic or bubonic plague or it can occur by itself. When it occurs alone, it is caused in the same ways as bubonic plague; however, buboes do not develop. Patients have fever, chills, prostration, abdominal pain, shock, and bleeding into skin and other organs. Septicemic plague does not spread from person to person. Symptoms and Treatment With pneumonic plague, the first signs of illness are fever, headache, weakness, and rapidly developing pneumonia with shortness of breath, chest pain, cough, and

sometimes bloody or watery sputum. The pneumonia progresses for 2 to 4 days and may cause respiratory failure and shock. Without early treatment, patients may die. Early treatment of pneumonic plague is essential. To reduce the chance of death, antibiotics must be given within 24 hours of first symptoms. Streptomycin, gentamicin, the tetracyclines, and chloramphenicol are all effective against pneumonic plague. Antibiotic treatment for 7 days will protect people who have had direct, close contact with infected patients. Wearing a close-fitting surgical mask also protects against infection. A plague vaccine is not currently available for use in the United States. RICIN What Is Ricin?

Ricin is a poison that can be made from the waste left over from processing castor beans. It can be in the form of a powder, a mist, or a pellet or it can be dissolved in water or weak acid. It is a stable substance. For example, it is not affected much by extreme conditions such as very hot or very cold temperatures.

Where Is Ricin Found, and How Is It Used?

Castor beans are processed throughout the world to make castor oil. Ricin is part of the waste mash produced when castor oil is made. Amateurs can make ricin from castor beans. Ricin has some potential medical uses, such as bone marrow transplants and cancer treatment (to kill cancer cells).

How Can People Be Exposed to Ricin?

It would take a deliberate act to make ricin and use it to poison people. Accidental exposure to ricin is highly unlikely. People can breathe in ricin mist or powder and be poisoned. Ricin can also get into water or food and then be swallowed. Pellets of ricin, or ricin dissolved in a liquid, can be injected into peoples bodies. Depending on the route of exposure (such as injection), as little as 500 micrograms of ricin could be enough to kill an adult. A 500-microgram dose of ricin would be about the size of the head of a pin. A much greater amount would be needed to kill people if the ricin were inhaled (breathed in) or swallowed.

Ricin poisoning is not contagious. It cannot be spread from person to person through casual contact. In 1978, Georgi Markov, a Bulgarian writer and journalist who was living in London, died after he was attacked by a man with an umbrella. The umbrella had been rigged to inject a poison ricin pellet under Markovs skin. Some reports have indicated that ricin may have been used in the Iran-Iraq war during the 1980s and that quantities of ricin were found in Al Qaeda caves in Afghanistan.

How Does Ricin Work?

Ricin works by getting inside the cells of a persons body and preventing the cells from making the proteins they need. Without the proteins, cells die, and eventually the whole body can shut down and die. Specific effects of ricin poisoning depend on whether ricin was inhaled, swallowed, or injected.

What Are the Signs and Symptoms of Ricin Exposure?

Inhalation: Within a few hours of inhaling significant amounts of ricin, the likely symptoms would be coughing, tightness in the chest, difficulty breathing, nausea, and aching muscles. Within the next few hours, the bodys airways (such as lungs) would become severely inflamed (swollen and hot), excess fluid would build up in the lungs, breathing would become even more difficult, and the skin might turn blue. Excess fluid in the lungs would be diagnosed by x-ray or by listening to the chest with a stethoscope.

Ingestion: If someone swallows a significant amount of ricin, he or she would have internal bleeding of the stomach and intestines that would lead to vomiting and bloody diarrhea. Eventually, the persons liver, spleen, and kidneys might stop working, and the person could die. Injection: Injection of a lethal amount of ricin at first would cause the muscles and lymph nodes near the injection site to die. Eventually, the liver, kidneys, and spleen would stop working, and the person would have massive bleeding from the stomach and intestines. The person would die from multiple organ failure. Death from ricin poisoning could take place within 36 to 48 hours of exposure, whether by injection, ingestion, or inhalation. If the person lives longer than 5 days without complications, he or she will probably not die.

How Is Ricin Poisoning Treated?

No antidote exists for ricin. Ricin poisoning is treated by giving the victim supportive medical care to minimize the effects of the poisoning. The types of

supportive medical care would depend on several factors, such as the route by which the victim was poisoned (that is, by inhalation, ingestion, or injection). Care could include such measures as helping the victim breathe and giving him or her intravenous fluids and medications to treat swelling. How Do We Know for Sure Whether People Have Been Exposed to Ricin?

If we suspect that people have inhaled ricin, a possible clue would be that a large number of people who had been close to each other suddenly developed fever, cough, and excess fluid in their lungs. These symptoms could be followed by severe breathing problems and possibly death. No widely available, reliable test exists to confirm that a person has been exposed to ricin.

What Can People Do If They Think They May Have Been Exposed to Ricin? Unintentional ricin poisoning is highly unlikely. CDC has no reports of intentional ricin poisoning. If people think they might have been exposed to ricin, however, they should contact the regional poison control center at 1-800-222-1222. SARIN What Sarin is:

Sarin is a man-made chemical warfare agent classified as a nerve agent. Nerve agents are the most toxic and rapidly acting of the known chemical warfare agents. They are similar to certain kinds of insecticides called organophosphate insecticides in terms of how they work and what kind of harmful effects they cause; however, nerve agents are much more potent than insecticides. Sarin originally was developed in 1938 in Germany as an insecticide. Sarin is a clear, colorless, and tasteless liquid that has no odor in its pure form. However, sarin can evaporate into a vapor (gas) and spread into the environment. Sarin is also known as GB.

Where sarin is found and how it is used?

Sarin is not found naturally in the environment. Sarin and other nerve agents may have been used in chemical warfare during the Iran-Iraq War in the 1980s. Sarin was used in two terrorist attacks in Japan in 1994 and 1995.

How people can be exposed to sarin?

If sarin is released into the air, people may be exposed through skin contact or eye contact. They may also be exposed by breathing air that contains sarin. If sarin is released into water, people may be exposed by touching or drinking water that contains sarin.

If sarin comes in contact with food, people may be exposed by eating the contaminated food. A persons clothing can release sarin for about 30 minutes after it has come in contact with sarin vapor. Other people can be exposed to sarin if they breathe this sarin gas. Because sarin breaks down slowly in the body, people who are repeatedly exposed to sarin may suffer more harmful health effects.

How sarin works?

The extent of poisoning that sarin causes depends on three factors: (1) the amount of sarin to which they were exposed, (2) how they were exposed, and (3) the how long the exposure lasted. Symptoms will appear within a few seconds after exposure to the vapor form of sarin and within a few minutes up to 18 hours after exposure to the liquid form. All the nerve agents cause their toxic effects by preventing the proper operation of the chemical that acts as the bodys off switch for glands and muscles. Without an off switch, the glands and muscles are constantly being stimulated. They may tire and no longer be able to sustain breathing function. Sarin vapor is heavier than air, so it would be more likely to settle in low-lying areas. Because sarin mixes easily with water, water can easily be contaminated. Sarin is the most volatile of the nerve agents, which means that it can easily and quickly evaporate from a liquid into a vapor and spread into the environment. People can be exposed to the vapor even if they do not come in contact with the liquid form of sarin. Because it evaporates so quickly, sarin presents an immediate, but short-lived, threat.

Immediate signs and symptoms of sarin exposure

People may not know that they were exposed because sarin has no odor. People exposed to a low or moderate dose of sarin by breathing contaminated air, eating contaminated food, drinking contaminated water, or touching contaminated surfaces may experience some or all of the following symptoms within seconds to hours of exposure: o Runny nose o Watery eyes o Small, pinpoint pupils o Eye pain o Blurred vision o Drooling and excessive sweating o Cough o Chest tightness o Rapid breathing o Diarrhea

Increased urination Confusion o Drowsiness o Weakness o Headache o Nausea, vomiting, and/or abdominal pain o Slow or fast heart rate o Low or high blood pressure Even a small drop of sarin on the skin can cause sweating and muscle twitching where sarin touched the skin. Exposure to large doses of sarin by any route may result in the following harmful health effects: o Loss of consciousness o Convulsions o Paralysis o Respiratory failure possibly leading to death
o o

What the long-term health effects are Mild or moderately exposed people usually recover completely. Some studies in animals and people suggest that severe nerve agent poisoning can cause long-term central nervous system effects, such as changes in brain activity. However, it is unclear what such changes may mean, if anything, regarding the function and long-term health status of a person who has been mildly or moderately exposed to sarin. How people can protect themselves and what they should do if they are exposed to sarin?

Recovery from sarin exposure is possible with treatment, but the antidotes available must be used quickly to be effective. Therefore, the best thing to do is avoid exposure. If exposure cannot be avoided, rapidly decontaminate and get medical care as quickly as possible. Leave the area where the sarin was released and get to fresh air. Quickly moving to an area where fresh air is available is highly effective in reducing the possibility of death from exposure to sarin vapors. o If the sarin release was outdoors, move away from the area where the sarin was released. Go to the highest ground possible, because sarin is heavier than air and will sink to low-lying areas. o If the sarin release was indoors, get out of the building. Remove any clothing that has liquid sarin on it, and if possible, seal the clothing in a plastic bag. Then seal the first plastic bag in a second plastic bag. Removing and sealing the clothing in this way will protect you and others from any chemicals that might be on your clothes. If helping other people remove their clothing, try to avoid touching any contaminated areas, and remove the clothing as quickly as possible.

Rinse the eyes with plain water for 10 to 15 minutes if they are burning or if vision is blurry. As quickly as possible, wash any liquid sarin from the skin with large amounts of soap and water. Washing with soap and water will protect people from any chemicals on their bodies. If sarin has been swallowed, do not induce vomiting or give fluids to drink. Seek medical attention immediately. Stay calm. Dial 911 and explain what has happened. Wait for emergency personnel to arrive.

How sarin poisoning is treated? Sarin poisoning is treated with antidotes, if necessary, and with supportive medical care. The most important thing is for victims to be rapidly decontaminated and to be given medical treatment as soon as possible. SMALLPOX VACCINE The smallpox vaccine is the best protection you can get if you are exposed to the smallpox virus. Most people experience normal, usually mild reactions that include a sore arm, fever, and body aches. In recent tests, one in three people felt bad enough to miss work, school, or recreational activity or had trouble sleeping after receiving the vaccine. However, the vaccine does have some risks. In the past, about 1,000 people for every 1 million people vaccinated for the first time experienced reactions that, while not life-threatening, were serious. These reactions include a vigorous (toxic or allergic) reaction at the site of the vaccination and spread of the vaccinia virus (the live virus in the smallpox vaccine) to other parts of the body and to other people. These reactions typically do not require medical attention. Rarely, people have had very bad reactions to the vaccine. In the past, between 14 and 52 people per 1 million vaccinated experienced potentially lifethreatening reactions, including eczema vaccinatum, progressive vaccinia (or vaccinia necrosum), or postvaccinal encephalitis. Based on past experience, it is estimated that between 1 and 2 people out of every 1 million people vaccinated will die as a result of life-threatening reactions to the vaccine. Careful screening of potential vaccine recipients is essential to ensure that those at increased risk do not receive the vaccine. People most likely to have side effects are people who have, or even once had, skin conditions, (especially eczema or atopic dermatitis) and people with weakened immune systems, such as those who have received a transplant, are HIV positive, or are receiving treatment for cancer. Anyone who falls within these categories, or lives with someone who falls into one of these categories, should NOT get the smallpox vaccine unless they are exposed to the disease. Pregnant women should not get the vaccine because of the risk it poses to the fetus. Women who are breastfeeding should not get the vaccine. Children younger than 12 months of age should not get the vaccine. Also, the Advisory Committee on

immunization Practices (ACIP) advises against non-emergency use of smallpox vaccine in children younger than 18 years of age. Who should NOT get the vaccine? People who should not get the vaccine include anyone who is allergic to the vaccine or any of its components; pregnant women; women who are breastfeeding; anyone under 12 months of age; people who have, or have had, skin conditions (especially eczema and atopic dermatitis); and people with weakened immune systems, such as those who have received a transplant, are HIV positive, are receiving treatment for cancer, or are taking medications (like steroids) that suppress the immune system. (The Advisory Committee on Immunization Practices [ACIP] advises against non-emergency use of smallpox vaccine in anyone is under 18 years of age.) These people should not receive the vaccine unless they have been exposed to smallpox. Should you get the smallpox vaccine if you have a weakened immune system (e.g., you are immuno compromised)? No, you should not be vaccinated, unless there is a smallpox outbreak and you have been directly exposed to the smallpox virus. Vaccination can cause deaths in people with weakened immune systems. Thus, there is no need to take the risks associated with smallpox vaccination unless you have been directly exposed to smallpoxand even then, you should first consult a physician or health care provider. Pregnant women are discouraged from getting the vaccine. Is there a danger to them (or to an unborn child) if broader vaccination occurs, increasing the potential for contact with vaccinated people? Pregnant women should NOT be vaccinated in the absence of a smallpox outbreak because of risk of fetal infection. Inadvertent transmission of vaccinia virus to a pregnant woman could also put the fetus at risk. Vaccinated persons must be very cautious to prevent transmission of the vaccine virus to pregnant women or other contacts. Is there any way to treat bad reactions to the vaccine? Two treatments may help people who have certain serious reactions to the smallpox vaccine. These are Vaccinia Immune Globulin (VIG) and cidofovir. By the end of December 2002 there will be more than 2,700 treatment doses of VIG (enough for predicted reactions with more than 27 million people) and 3,500 doses of cidofovir (enough for predicted reactions with 15 million people). Additional doses of VIG are being produced, and measures are underway to increase supplies of cidofovir as well. VIG and cidofovir are both administered under investigational new drug (IND) protocol. Is a child under the age of 1 year in the household a contraindication to vaccination? No, the presence of a child under the age of 1 year in the household is not a contraindication to vaccination. The Advisory Committee on Immunization Practices (ACIP) met on January 14, 2003 to consider, among several issues, the question of

whether a child under the age of 1 year in the household should be added to the conditions or situations that are considered a contraindication to smallpox vaccination. A vote was taken and it was confirmed that the presence of an infant in the household is not a contraindication to vaccination. Approved language from this meeting on this subject was: "The ACIP does not recommend vaccination of children and adolescents less than 18 years in the current pre-vaccination program, and smallpox vaccine is contraindicated for infants less than 1 year of age. The presence of an adolescent or child (including an infant) in the household, however, is not a contraindication to vaccination of other members of the household. Data suggests that the risk of serious complications from transmission from an adult to a child is extremely small. However, the ACIP recognizes that some programs may defer vaccination of household contacts of infants less than 1 year of age because of data suggesting a higher risk of adverse events among primary vaccines in this age group, compared with that among older children." Vaccinated parents of young children need to be careful not to inadvertently spread the virus to their children. They should follow site care instructions that are essential to minimizing the risk of contact transmission of vaccinia. These precautions include covering the vaccination site, wearing a sleeved shirt, and careful hand washing anytime after touching the vaccination site or anything that might be contaminated with virus from the vaccination site. If these precautions are followed, the risk for children is very low. Individuals who do not believe that they can adhere to such instructions should err on the side of caution and not be vaccinated at this time. Are there any eye conditions that would preclude vaccination? The concern surrounding eyes is that frequent touching of the eyes by someone who has gotten the smallpox vaccine may increase the chances that that person will experience spread of the vaccinia virus to the eyes (inadvertent inoculation of the eye) by touching the vaccine site or something contaminated with live virus and then touching their eyes before they wash their hands. This side effect is a serious one because it can lead to damaged vision, or even blindness. People who wear contact lenses, or touch their eyes frequently throughout the day can get the smallpox vaccine, but they must be especially careful to follow instructions for care of the smallpox vaccination site. Frequent and thorough hand washing will minimize the chance of contact spread of the vaccinia virus. As an additional precaution to minimize the risk of this type of transmission in selected groups of people, on January 14, 2003, the Advisory Committee on Immunization Practices (ACIP) decided that anyone with eye diseases or other conditions (e.g. recent LASIK surgery) that require the use of corticosteroid drops in the eye should wait until they no longer require such treatment before getting vaccinated.

SOMAN What soman is:

Soman is a human-made chemical warfare agent classified as a nerve agent. Nerve agents are the most toxic and rapidly acting of the known chemical warfare agents. They are similar to insecticides called organophosphate insecticides in terms of how they work and what kinds of harmful effects they cause. However, nerve agents are much more potent than insecticides. Soman was originally developed as an insecticide in Germany in 1944. Soman is also known as GD. Soman is a clear, colorless, tasteless liquid with a slight camphor odor (for example, Vicks Vapo-Rub) or rotting fruit odor.

Where soman is found and how it is used?

Soman is not found naturally in the environment. It is possible that soman or other nerve agents were used in chemical warfare during the Iran-Iraq War in the 1980s.

How people can be exposed to soman?

Following release of soman into the air, people can be exposed through skin contact, eye contact, or inhalation (breathing in the soman mist). Following release of soman into water, people can be exposed by drinking contaminated water or getting contaminated water on their skin. Following contamination of food with soman, people can be exposed by eating the contaminated food. A persons clothing can release soman for about 30 minutes after contact with soman vapor, which can lead to exposure of other people. Soman breaks down slowly in the body, meaning that repeated exposures to soman and/or other nerve agents can have a cumulative effect (build up in the body).

How soman works:

The extent of poisoning caused by soman depends on the amount of soman a person was exposed to, how the person was exposed, and the length of time of the exposure. Symptoms will appear within a few seconds after exposure to the vapor form of soman, and within a few minutes to up to 18 hours after exposure to the liquid form. All the nerve agents cause their toxic effects by preventing the proper operation of the chemical that acts as the bodys off switch for glands and muscles. Without an off switch, the glands and muscles are constantly being stimulated. They may tire and no longer be able to sustain breathing function.

Soman vapor is heavier than air, so it would be more likely to settle in low-lying areas. Soman mixes easily with water, so it could be used to poison water. Compared with other nerve agents, soman is more volatile than VX but less volatile than sarin. The higher a chemicals volatility, the more likely it will evaporate from a liquid into a vapor and disperse into the environment. People can be exposed to the vapor even if they do not come in contact with the liquid form. Because of its high volatility, soman is an immediate but short-lived threat and does not last a long time in the environment. Because soman is more volatile than the nerve agent VX (the most potent nerve agent), it will remain on exposed surfaces for a longer period of time compared with VX.

Immediate signs and symptoms of soman exposure

Although soman has a camphor or fruity odor, the odor may not be noticeable enough to give people sufficient warning against a toxic exposure. People exposed to a low or moderate dose of soman by inhalation, ingestion (swallowing), or skin absorption may experience some or all of the following symptoms within seconds to hours of exposure: Runny nose Watery eyes o Small, pinpoint pupils o Eye pain o Blurred vision o Drooling and excessive sweating o Cough o Chest tightness o Rapid breathing o Diarrhea o Increased urination o Confusion o Drowsiness o Weakness o Headache o Nausea, vomiting, and/or abdominal pain o Slow or fast heart rate o Abnormally low or high blood pressure Even a tiny drop of nerve agent on the skin can cause sweating and muscle twitching here the agent touched the skin.
o o

Exposure to a large dose of soman by any route may result in these additional health effects:
o o o o

Loss of consciousness Convulsions Paralysis Respiratory failure possibly leading to death

What the long-term health effects are

Mild or moderately exposed people usually recover completely. Some studies in animals and people suggest that severe nerve agent poisoning can cause longterm central nervous system effects, such as changes in brain activity. However it is unclear what such changes may mean, if anything, regarding the function and long-term health status of a person who has been mildly or moderately exposed to soman.

How people can protect themselves and what they should do if they are exposed to soman?

Recovery from soman exposure is possible with treatment, but the antidotes available must be used quickly to be effective. Therefore, the best thing to do is avoid exposure. If exposure cannot be avoided, rapidly decontaminate and get medical care as quickly as possible. Leave the area where the soman was released and get to fresh air. Quickly moving to an area where fresh air is available is highly effective in reducing the possibility of death from exposure to soman vapor. If the soman release was outdoors, move away from the area where the soman was released. Go to the highest ground possible, because soman is heavier than air and will sink to low-lying areas. If the soman release was indoors, get out of the building. Remove any clothing that has liquid soman on it, and if possible, seal the clothing in a plastic bag. Then seal the first plastic bag in a second plastic bag. Removing and sealing the clothing in this way will protect you and others from any chemicals that might be on your clothes. If helping other people remove their clothing, try to avoid touching any contaminated areas, and remove the clothing as quickly as possible. Rinse the eyes with plain water for 10 to 15 minutes if they are burning or vision is blurred. As quickly as possible, wash any liquid soman from the skin with large amounts of soap and water. Washing with soap and water will protect people from any chemicals on their bodies. If soman has been ingested (swallowed), do not induce vomiting or give fluids to drink. Seek medical attention right away. Stay calm. Dial 911 and explain what has happened. Wait for emergency personnel to arrive.

How soman poisoning is treated Soman poisoning is treated with antidotes and supportive medical care. The most important thing is for victims to be rapidly decontaminated and get medical treatment as soon as possible. TABUN What tabun is:

Tabun is a human-made chemical warfare agent classified as a nerve agent. Nerve agents are the most toxic and rapidly acting of the known chemical warfare agents. They are similar to insecticides called organophosphate insecticides in terms of how they work and what kinds of harmful effects they cause. However, nerve agents are much more potent than insecticides. Tabun was originally developed as an insecticide in Germany in 1936. Tabun is also known as GA. Tabun is a clear, colorless, tasteless liquid with a faint fruity odor.

Where tabun is found and how it is used

Tabun is not found naturally in the environment. It is possible that tabun or other nerve agents were used in chemical warfare during the Iran-Iraq War in the 1980s.

How people can be exposed to tabun

Following release of tabun into the air, people can be exposed through skin contact, eye contact, or inhalation (breathing in the tabun mist). Following release of tabun into water, people can be exposed by drinking contaminated water or getting contaminated water on their skin. Following contamination of food with tabun, people can be exposed by eating the contaminated food. A persons clothing can release tabun for about 30 minutes after contact with tabun vapor, which can lead to exposure of other people. Tabun breaks down slowly in the body, meaning that repeated exposures to tabun and/or other nerve agents can have a cumulative effect (build up in the body).

How tabun works

The extent of poisoning caused by tabun depends on the amount of tabun a person was exposed to, how the person was exposed, and the length of time of the exposure. Symptoms will appear within a few seconds after exposure to the vapor form of tabun, and within a few minutes to up to 18 hours after exposure to the liquid form. All the nerve agents cause their toxic effects by preventing the proper operation of the chemical that acts as the bodys off switch for glands and muscles. Without

an off switch, the glands and muscles are constantly being stimulated. They may tire and no longer be able to sustain breathing function. Tabun vapor is heavier than air, so it would be more likely to settle in low-lying areas. Tabun mixes easily with water, so it could be used to poison water. Compared with other nerve agents, tabun is more volatile than VX but less volatile than sarin. The higher a chemicals volatility, the more likely it will evaporate from a liquid into a vapor and disperse into the environment. People can be exposed to the vapor even if they do not come in contact with the liquid form. Because of its high volatility, tabun is an immediate but short-lived threat and does not last a long time in the environment. Because tabun is more volatile than VX, it will remain on exposed surfaces for a shorter period of time compared with VX. Because tabun is less volatile than sarin, it will remain on exposed surfaces for a longer period of time compared with sarin.

Immediate signs and symptoms of tabun exposure

Although tabun has a faint fruity odor, the odor may not be noticeable enough to give people sufficient warning against a toxic exposure. People exposed to a low or moderate dose of tabun by inhalation, ingestion (swallowing), or skin absorption may experience some or all of the following symptoms within seconds to hours of exposure: Runny nose Watery eyes Small, pinpoint pupils Eye pain Blurred vision Drooling and excessive sweating Cough Chest tightness Rapid breathing Diarrhea Increased urination Confusion Drowsiness Weakness Headache Nausea, vomiting, and/or abdominal pain Slow or fast heart rate Abnormally low or high blood pressure Even a tiny drop of nerve agent on the skin can cause sweating and muscle twitching where the agent touched the skin. Exposure to a large dose of tabun by any route may result in these additional health effects: Loss of consciousness Convulsions Paralysis Respiratory failure possibly leading to death

What the long-term health effects are Mild or moderately exposed people usually recover completely. Some studies in animals and people suggest that severe nerve agent poisoning can cause long-term central nervous system effects, such as changes in brain activity. However, it is unclear what such changes may mean, if anything, regarding the function and long-term health status of a person who has been mildly or moderately exposed to tabun. How people can protect themselves and what they should do if they are exposed to tabun

Recovery from tabun exposure is possible with treatment, but the antidotes available must be used quickly to be effective. Therefore, the best thing to do is avoid exposure. If exposure cannot be avoided, rapidly decontaminate and get medical care as quickly as possible. Leave the area where the tabun was released and get to fresh air. Quickly moving to an area where fresh air is available is highly effective in reducing the possibility of death from exposure to tabun vapor. o If the tabun release was outdoors, move away from the area where the tabun was released. Go to the highest ground possible, because tabun is heavier than air and will sink to low-lying areas. o If the tabun release was indoors, get out of the building. Remove any clothing that has liquid tabun on it, and if possible, seal the clothing in a plastic bag. Then seal the first plastic bag in a second plastic bag. Removing and sealing the clothing in this way will protect you and others from any chemicals that might be on your clothes. If helping other people remove their clothing, try to avoid touching any contaminated areas, and remove the clothing as quickly as possible. Rinse the eyes with plain water for 10 to 15 minutes if they are burning or vision is blurred. As quickly as possible, wash any liquid tabun from the skin with large amounts of soap and water. Washing with soap and water will protect people from any chemicals on their bodies. If tabun has been ingested (swallowed), do not induce vomiting or give fluids to drink. Seek medical attention right away. Stay calm. Dial 911 and explain what has happened. Wait for emergency personnel to arrive.

How tabun poisoning is treated Tabun poisoning is treated with antidotes and supportive medical care. The most important thing is for victims to be rapidly decontaminated and get medical treatment as soon as possible. TULAREMIA Tularemia is an infectious disease caused by a hardy bacterium, Francisella tularensis, found in animals (especially rodents, rabbits, and hares).

People can get tularemia many different ways, such as through the bite of an infected insect or other arthropod (usually a tick or deerfly), handling infected animal carcasses, eating or drinking contaminated food or water, or breathing in F. tularensis. Symptoms of tularemia could include sudden fever, chills, headaches, muscle aches, joint pain, dry cough, progressive weakness, and pneumonia. Persons with pneumonia can develop chest pain and bloody spit and can have trouble breathing or can sometimes stop breathing. Other symptoms of tularemia depend on how a person was exposed to the tularemia bacteria. These symptoms can include ulcers on the skin or mouth, swollen and painful lymph glands, swollen and painful eyes, and a sore throat. Symptoms usually appear 3 to 5 days after exposure to the bacteria, but can take as long as 14 days. Tularemia is not known to be spread from person to person, so people who have tularemia do not need to be isolated. People who have been exposed to F. tularensis should be treated as soon as possible. The disease can be fatal if it is not treated with the appropriate antibiotics. A vaccine for tularemia is under review by the Food and Drug Administration and is not currently available in the United States. How Soon Do Infected People Get Sick? Symptoms usually appear 3 to 5 days after exposure to the bacteria, but can take as long as 14 days. What Should I Do if I Think I Have Tularemia? Consult your doctor at the first sign of illness. Be sure to let the doctor know if you are pregnant or have a weakened immune system. How Is Tularemia Treated? Your doctor will most likely prescribe antibiotics, which must be taken according to the directions supplied with your prescription to ensure the best possible result. Let your doctor know if you have any allergy to antibiotics. A vaccine for tularemia is under review by the Food and Drug Administration and is not currently available in the United States. What Can I Do To Prevent Becoming Infected with Tularemia? Tularemia occurs naturally in many parts of the United States. Use insect repellent containing DEET on your skin, or treat clothing with repellent containing permethrin, to prevent insect bites. Wash your hands often, using soap and warm water, especially after handling animal carcasses. Be sure to cook your food thoroughly and that your water is from a safe source.

Note any change in the behavior of your pets (especially rodents, rabbits, and hares) or livestock, and consult a veterinarian if they develop unusual symptoms. Can Tularemia Be Used As a Weapon? Francisella tularensis is very infectious. A small number (10-50 or so organisms) can cause disease. If F. tularensis were used as a weapon, the bacteria would likely be made airborne for exposure by inhalation. People who inhale an infectious aerosol would generally experience severe respiratory illness, including life-threatening pneumonia and systemic infection, if they are not treated. The bacteria that cause tularemia occur widely in nature and could be isolated and grown in quantity in a laboratory, although manufacturing an effective aerosol weapon would require considerable sophistication. More Questions & Answers Q. What is tularemia? A. Tularemia, also known as rabbit fever, is a disease caused by the bacterium Francisella tularensis. Tularemia is typically found in animals, especially rodents, rabbits, and hares. Tularemia is usually a rural disease and has been reported in all U.S. states except Hawaii. Q. How do people become infected with tularemia? A. Typically, people become infected through the bite of infected insects (most commonly, ticks and deerflies), by handling infected sick or dead animals, by eating or drinking contaminated food or water, or by inhaling airborne bacteria. Q. Does tularemia occur naturally in the United States? A. Yes. Tularemia is a widespread disease in animals. About 200 human cases of tularemia are reported each year in the United States. Most cases occur in the southcentral and western states. Nearly all cases occur in rural areas, and are caused by the bites of ticks and biting flies or from handling infected rodents, rabbits, or hares. Cases also resulted from inhaling airborne bacteria and from laboratory accidents. Q. What are the signs and symptoms of tularemia? A. The signs and symptoms people develop depend on how they are exposed to tularemia. Possible symptoms include skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, mouth sores, diarrhea or pneumonia. If the bacteria are inhaled, symptoms can include abrupt onset of fever, chills, headache, muscle aches, joint pain, dry cough, and progressive weakness. People with pneumonia can develop chest pain, difficulty breathing, bloody sputum, and respiratory failure. Tularemia can be fatal if the person is not treated with appropriate antibiotics. Q. Why are we concerned about tularemia being used as a bio-weapon? A. Francisella tularensis is highly infectious. A small number of bacteria (10-50 organisms) can cause disease. If Francisella tularensis were used as a bio-weapon, the bacteria would likely be made airborne so they could be inhaled. People who inhale the bacteria can experience severe respiratory illness, including life-threatening pneumonia and systemic infection, if they are not treated.

Q. Can someone become infected with the tularemia bacteria from another person? A. People have not been known to transmit the infection to others, so infected persons do not need to be isolated. Q. How quickly would someone become sick if he or she were exposed to tularemia bacteria? A. The incubation period (the time from being exposed to becoming ill) for tularemia is typically 3 to 5 days, but can range from 1 to 14 days. Q. What should someone do if he or she suspects exposure to tularemia bacteria? A. If you suspect you were exposed to tularemia bacteria, see a doctor quickly. Treatment with antibiotics for a period of 10-14 days or more after exposure may be recommended. If you are given antibiotics, it is important to take them according to the instructions you receive. All of the medication you are given must be taken. Local and state health departments should be notified immediately so an investigation and infection control activities can begin. Q. How is tularemia diagnosed? A. When a person has symptoms that appear related to tularemia, the healthcare worker collects specimens, such as blood or sputum, for testing in a diagnostic or reference laboratory. Laboratory test results for tularemia may be presumptive or confirmatory. Presumptive (preliminary) identification may take less than 2 hours, but confirmatory testing will take more time, often 24 to 48 hours or longer depending on the methods that need to be used. Depending on the circumstances, a person may be given treatment based on symptoms before the laboratory results are returned. Q. Can tularemia be effectively treated with antibiotics? A. Yes. Early antibiotic treatment is recommended whenever it is likely a person was exposed to tularemia or has been diagnosed as being infected with tularemia. Several types of antibiotics have been effective in treating tularemia infections. The tetracycline class (such as doxycycline) or fluoroquinolone class (such as ciprofloxacin) of antibiotics are taken orally. Streptomycin or gentamicin are also effective against tularemia, and are given by injection into a muscle or vein. Health officials will test the bacteria in the early stages of the response to determine which antibiotics will be most effective. Q. How long can Francisella tularensis exist in the environment? A. Francisella tularensis can remain alive for weeks in water and soil. Q. Is there a vaccine available for tularemia? A. A vaccine for tularemia was used in the past to protect laboratory workers, but it is not currently available.

VIRAL HEMORRHAGIC FEVER What is VHF? VHFs refer to a group of illnesses that are caused by several distinct families of viruses. In general, the term "viral hemorrhagic fever" is used to describe a severe multi-system syndrome, where multiple organ systems in the body are affected. VHFs include four families of viruses: filiviruses such as the Ebola and Marburg viruses, arenaviruses such as Lassa, bunyavirus such as Rift Valley Fever and flaviviruses such as yellow fever and dengue. They can all cause serious, life-threatening illnesses. Some, including Ebola, Marburg and Lassa, are contagious. Although the Ebola virus gained notoriety in various films such as Outbreak and books, VHFs arent expected to be prime bio-weapon candidates since people die so quickly from them and often dont get a chance to infect others. During World War II, the Japanese army fed botulinum toxin to prisoners of war in Manchuria, with lethal results. How Is It Spread? VHFs naturally occur in humans only after contact with an infected insect, rodent or larger mammal. Transmission can happen via touching fecal matter, receiving an insect bite or handling contaminated meat. Its possible VHFs can be manufactured for aerosol dissemination but the bacterium generally dont fare well in this form. What Are the Symptoms of Exposure? Characteristically, the overall vascular system is damaged, and the bodys ability to regulate itself is impaired. These symptoms are often accompanied by hemorrhage (bleeding); however, the bleeding is itself rarely life-threatening. While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause severe, life-threatening disease. All types in severe cases can cause hemorrhagic syndromes that cause severe internal and external bleeding in places such as internal organs, under the skin and from the eyes, nose, mouth and ears. Symptoms generally include high fever, dizziness, muscle aches and exhaustion. The first symptoms may be felt from two days to three weeks after exposure. Advanced symptoms include shock, nervous system malfunction, seizures and coma. Fatality rates range from 90 percent for Ebola to 1 percent for Lassa. How Is It Treated? Treatment is available for some VHFs, but not all. In the event of an outbreak, routine infection control procedures, isolation and decontamination are usually enough to stop transmission. Treatments vary depending on which virus a victim has. No treatments or vaccines exist for Ebola or Marburg, but therapy can prevent shock and help organs function. Antiviral drug ribavirin can treat some VHFs fairly well if given early on. A yellow fever vaccine is available. Other treatments are under development.

Who Has It/Where Can It Be Found? The most worrisome VHFs, such as Marburg and Ebola, are hard to acquire from the wild because their natural host is unknown and outbreaks are rare. VHFs are studied in some labs, mainly high-security ones. Research on Ebola and several others was done by the Soviet Union before its biowarfare program was dismantled. Experts warn that because microbe collections in Russia, Kazakhstan, Georgia and Uzbekistan are not adequately secured, terrorist groups or states might be able to steal or otherwise obtain weaponized strains of plague, tularemia and VHFs. SUPPLIES FOR A RECESSION Get out of debt ASAP. Right now the best thing to do is diversify. Have one bank for personal checking account and a different bank for savings, yet another for each business account you run. That way a crash doesn't wipe you out. Obviously, this is a great time to only keep in the bank what you need to pay such as the current bills, and keep the rest either at home, or converted to gold, silver, or euros. With the dollar plunging as fast as it is, the "straddle" will be gone in just a few days. Buy seeds. How will you feed yourself without having to trade for food? Keep your job as long as possible. Buy gold coins and silver coins. If you are going to buy gold or silver coins, avoid "collectible coins" and just go with straight metal. It is easier to get your money back out of investment coins than numismatic ones. Collector's value will decline with the economy, so avoid the fancy ones. Stick with maple leaves, half eagles, krugerands, etc. Think about how you are going to cook. Invest in solar power, or build a windmill. Try to build a Vertical Wind Turbine Stock up on nonperishable foods, canned foods, dry milk, sugar, flour, rice and beans. Have a supply of bottled water. Stock up on personal items. Soap, shampoo, toothpaste, insect repellent, candles. A good axe, a few flints, large amount of matches (dip them in melted candle wax to waterproof) store in a few separate containers, and a few lighters. spade, water purification tablets, duct tape. A pair of strong knives for hunting, cutting, etc. Bow and arrows. A fishing pole. Comfortable warm clothing, including hats, gloves, boots, and blankets. A sturdy tent or two, a few big tarpaulins,

Basic medical supplies like aspirin, alcohol, first aid kit. A couple of guns and a good supply of ammo. Two-way radios, short wave radios, watches that don't run on batteries, and an LED flashlight. A map and compass. A bicycle.