I have a suppressed immune system. Can I drink my tap water?
Ally Dering-Anderson, PharMD, clinical associate professor, UNMC College of Pharmacy: “Pay close attention to the news when they are talking about your drinking water. If, for any reason, they tell you not to drink the municipal water, don’t do it. This is especially important for people who are immune suppressed, who may be undergoing cancer chemotherapy, have had a recent burn or a disease that suppresses their immune system. It’s also very important for babies and small children. Drinking bad water would make all of us sick. But for those special people they can get very sick very quickly, so do pay attention to all of the alerts about bad drinking water.”
Should I be concerned about my well water and tap water?
Aaron Yoder, PhD, associate professor, College of Public Health, UNMC: “Stay in contact with your local authorities because biologicals that come from fecal material or raw sewage in the surface waters can go down into the wells and contaminate it. In our area we have some limited water usage advisories because our wastewater treatment plants are flooded. If we continue to put sewage into those it’s going to go into the surface water as well. So, listen to the authorities and what type of warnings they have. If you’re on personal wells, look at what the regions around you are doing and what they advise doing.”
Should I be concerned about contamination of my tap water when it floods?
Jesse Bell, MD, UNMC College of Public Health: “Yes, you should be concerned about the contamination of tap water when it floods. Gastrointestinal issues could arise from contaminated tap water and that can happen in a variety of different ways. Any time one of these flood events occurs you are getting a large flushing of a lot of different contaminates from different areas. Feed yards, waste treatment facilities, all this stuff could potentially run into the water systems and could contaminate the water. You have to be very cautious to make sure you are not drinking that water so pay attention to whatever is being issued by the local health department and the local water treatment facility. Follow the procedures they put in place. It might be good, in the beginning, to do some precautionary things like boiling the water or drinking bottled water until you know the situation is safe.”
What should I do if I suspect my water is contaminated?
Aaron Yoder, PhD, associate professor, College of Public Health, UNMC: “If you think your well water is contaminated or you just want to be sure it is not, go to your local public health departments, your extension service, local cities or regional water suppliers. Contacting them, they can always advise you. Going local first is normally the best advice as state agencies might be overwhelmed with requests. It’s important not to take chances when it comes to water quality and use of the water.”
What should I consider in recovering from a flood?
Aaron Yoder, PhD, associate professor, College of Public Health, UNMC: “It’s important to be patient. I know there’s a lot of stress and anxiety that goes along with it. But, from the safety and health standpoint, we don’t want to injure ourselves more, we want to be compassionate of those around us so we are not forcing them to do things quicker than we need to. We don’t want people to become injured.”
After floodwaters recede, what should I be concerned about?
Jesse Bell, PhD, UNMC College of Public Health: “Try to dry out and clean your basement or whatever structure the flood waters may have effected that could potentially lead mold and other bacteria to grow and develop in your house. Mold and bacteria could potentially cause respiratory issues, allergy issues and other asthma-like symptoms. It is best to avoid that situation and try and clean that up as quickly as possible. I also would recommend that if you can’t clean it up, and you can’t dry out that area fast, throw all that stuff away because it is the perfect breeding ground for mold and bacteria to grow and develop.”
I don’t remember when my last tetanus shot was and I’m cleaning up my flooded home, should I just get another one?
Eric Ernest, MD, assistant professor of emergency medicine in the College of Medicine at UNMC: “When dealing with any kind of flood recovery or clean-up efforts, we always have to be worried about the exposure to communicable diseases. Anytime there is standing flood water there’s a whole host of pathogens that can be transmitted to the human body by going into water, especially if you have any open cuts, sores, things of that nature. Any kind of injury sustained while working within flood waters would be considered a high risk injury for tetanus. The general rule of thumb is that you should have a tetanus update every 10 years. That being said, if you sustain an injury during clean-up operations, you probably need to consult with your health care practitioner.”
What kind of personal protective equipment should I wear when cleaning up my flooded home?
Eric Ernest, MD, assistant professor of emergency medicine in the College of Medicine at UNMC: “We want to think of protecting all of our body surfaces when we’re going into these environments. There may be structural hazards, so make sure that you are wearing things like a hard hat, safety goggles and protecting your skin. If there is any standing flood water, make sure you are wearing things like rubber boots or something with a hardened or steel toe to prevent a crush injury. Wear gloves. Again, we have to think about things like mold and bacteria that you can pick up and transmit to yourself and others. And then, you have to worry about the respiratory aspect, realizing that things like mold spores are within the air, especially if you are stirring things up or cleaning things out of the house. A lot of that stuff gets aerosolized and so we recommend at least a N95 level mask or respirator or higher. A simple face mask is probably not enough protection. That N95 or higher level of protection is going to be important when doing that kind of recovery work.”
What kinds of unseen bacteria or other things are in the flood water that could be on my personal property that I should be aware of?
Eric Ernest, MD, assistant professor of emergency medicine in the College of Medicine at UNMC: “A big thing would be mold, especially black mold. Any time something is left wet and damp for long periods of time the risk of mold goes up significantly. There’s lots of things that can get into the water especially areas along the Platte and Missouri Rivers or other areas where the waste water treatment plants have been shut down. Those waters are considered contaminated with raw sewage. And, so, things like hepatitis, different types of bacteria and viruses and whatnot - especially if you have open wounds or if it gets in through the mouth and into the airway - would be considered highly infectious. It’s important to take precautions to protect yourself. And, if you are exposed to those things and you get a rash, or your open wound that you had before you even started, starts to look infected go to the hospital or to the doctor’s office and have it evaluated and start on appropriate antibiotics.”
If I have no choice but to wade through stagnant flood water as I clean up, what should I look for on my skin afterwards?
Eric Ernest, MD, assistant professor of emergency medicine in the College of Medicine at UNMC: “If you are in the process of cleaning up your home or a business and you’re having to wade through stagnant flood waters especially if they haven’t receded yet, make sure that you’re using personal protective equipment as much as possible so water can’t get on your skin. If, for some reason, you do get splashed or it penetrates through your pants, we want to look for any kind of rash, redness, any kind of oozing from a wound, things of that nature. The skin, by itself, as long as it’s intact, does a pretty good job at protecting us. But in very contaminated flood waters, the risk of infection can be very high. After you’re done with clean up make sure that you’re washing with clean water, soap and if you’re still noticing a rash, a wound, say an old wound that looks infected you need to get evaluated by a medical professional.”
What other health hazards should I aware of after a flood?
Eric Ernest, MD, assistant professor of emergency medicine in the College of Medicine at UNMC: “In terms of general health hazards, there’s the direct exposure from flood waters as we previously talked about in terms of infectious disease risk, tetanus, things of that nature. We also have to remember that just like with any strenuous activity you should be mindful of your own limitations. What we will see, just like when we get heavy snows or anything else, is that people go out and try to over exert themselves, and do physical activity that they’re normally not used to. So, if you’re lifting big and heavy objects use good lifting techniques, use a partner, have people help you. Also, make sure you’re taking frequent breaks. Have access to good clean water and don’t get dehydrated. Make sure that you’re eating frequent meals. And then, also just be aware of your surroundings, a lot of people don’t understand that floods can produce a wide variety of damage and unseen hazards that we don’t otherwise think about such as things floating in the water, sharp objects and wild animals.”
What do I do if my medications have been washed away/lost because of flooding?
Ally Dering-Anderson, PharMD, clinical associate professor, UNMC College of Pharmacy: “Every insurance company, including Medicare and Medicaid, have built systems that allow pharmacies that are open to get immediate overrides to get you refills, even if it seems like it is too soon.”
I lost power during the flood. Is my insulin safe to use?
Ally Dering-Anderson, PharMD, clinical associate professor, UNMC College of Pharmacy: “For people with concerns about insulin, most of the time you will be able to use it, even if it has been out of the refrigerator for a couple of days. Call the pharmacist and ask just to be sure. But remember, most insulin can actually be stored at room temperature. ... If you have no access to your insulin or your needles, go to any pharmacy and they will do their very best to help you. Most insurance companies will help you find a way to get insulin and supplies.”
Can any pharmacist help me get a refill?
Ally Dering-Anderson, PharMD, clinical associate professor, UNMC College of Pharmacy: “Nebraska law allows for pharmacists in emergencies to use their professional judgement. And we get fantastic support from all of our prescribing colleagues - from the doctors and the dentists and the nurse practitioners and the physician assistants. If you are out of medication please go to any pharmacy, the pharmacist will use professional judgement to get you a short supply of medication until we can contact your original pharmacy, your original prescriber. We will get support from all of the prescribing community to help take care of you. Bring any information you may have. If you have lost everything, that’s OK. We still have a way to talk you through what you have used. And if it was paid for by an insurance company your insurance company will help us figure out what you need.”