Lab Culture Ep. 19: Dr. Mona Hanna-Attisha- Storytelling and the Flint Water Crisis

Michelle Forman interviewing Dr. Mona Hanna-Attisha.

Dr. Mona Hanna-Attisha, author of What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City, joins us for an interview about the importance of storytelling in public health. Did Dr. Mona’s successful use of narratives allow Flint’s story to be as resilient as the people who lived it?

Listen here or wherever you get your podcasts.

Links

Is water in Flint safe to drink? It’s not just a question of chemistry. [Op-ed by Dr. Mona Hanna-Attisha]

What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City

The post Lab Culture Ep. 19: Dr. Mona Hanna-Attisha- Storytelling and the Flint Water Crisis appeared first on APHL Lab Blog.

Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters

Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters | www.APHLblog.org

In the spring of 2018 patients suffering from profuse bleeding swamped emergency rooms in Illinois and Wisconsin. The cause? Synthetic cannabinoids laced with rat poison

When an outbreak of contaminated synthetic cannabinoids reached Wisconsin in 2018, scientists at the Wisconsin State Laboratory of Hygiene (WSLH) rushed to develop the first quantitative method for diagnostic testing of brodifacoum, a powerful anticoagulant used in rat poison. Thanks to their work, patients with brodifacoum poisoning can now be treated with a precisely calibrated dose of vitamin K and that treatment can be ended when it is no longer medically necessary. Previously, physicians had to guess when to end treatment and re-start it if they guessed wrong.

WSLH’s Noel Stanton, Chemical Emergency Response Coordinator, and Bill Krick, an Advanced Chemist in the Chemical Emergency Response Unit, speak with Public Affairs Director Jan Klawitter about the test’s development and the outbreak that made it necessary.

 

 

Links:

Wisconsin State Laboratory of Hygiene (WSLH)

Accolades for WSLH’s Chemical Emergency Response Team

Synthetic Cannabinoids (K2, Spice) – Wisconsin Department of Health Services

Lab Matters: Indiana and Wisconsin Respond to Synthetic Cannabinoid Contamination

Laboratory Response Network (LRN)

APHL in Action archives

The post Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters appeared first on APHL Lab Blog.

Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters

Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters | www.APHLblog.org

In the spring of 2018 patients suffering from profuse bleeding swamped emergency rooms in Illinois and Wisconsin. The cause? Synthetic cannabinoids laced with rat poison

When an outbreak of contaminated synthetic cannabinoids reached Wisconsin in 2018, scientists at the Wisconsin State Laboratory of Hygiene (WSLH) rushed to develop the first quantitative method for diagnostic testing of brodifacoum, a powerful anticoagulant used in rat poison. Thanks to their work, patients with brodifacoum poisoning can now be treated with a precisely calibrated dose of vitamin K and that treatment can be ended when it is no longer medically necessary. Previously, physicians had to guess when to end treatment and re-start it if they guessed wrong.

WSLH’s Noel Stanton, Chemical Emergency Response Coordinator, and Bill Krick, an Advanced Chemist in the Chemical Emergency Response Unit, speak with Public Affairs Director Jan Klawitter about the test’s development and the outbreak that made it necessary.

 

 

Links:

Wisconsin State Laboratory of Hygiene (WSLH)

Accolades for WSLH’s Chemical Emergency Response Team

Synthetic Cannabinoids (K2, Spice) – Wisconsin Department of Health Services

Lab Matters: Indiana and Wisconsin Respond to Synthetic Cannabinoid Contamination

Laboratory Response Network (LRN)

APHL in Action archives

The post Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters appeared first on APHL Lab Blog.

3 Reasons Why Handwashing Should Matter to You

Unseen woman washing her hands with soap in a sink.

Most of us are familiar with the parental-like voice in the back of our minds that helps guide our decision-making—asking us questions like, “Have you called your grandmother lately?” For many that voice serves as a gentle, yet constant reminder to wash our hands.

Handwashing with soap and water is one of the most important steps you can take to avoid getting sick and spreading germs to loved ones. Many diseases are spread by not cleaning your hands properly after touching contaminated objects or surfaces. And although not all germs are bad, illness can occur when harmful germs enter our bodies through the eyes, nose, and mouth. That’s why it is critical to wash hands at key times, such as after a flood or during a flu pandemic, when germs can be passed from person to person and make others sick.

Washing hands with soap and water is the best way to reduce the number of germs on them, however during a disaster clean, running water may not be available. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.

Here are three key reasons why you should always care about handwashing:Your hands carry germs you can't see. Wash your hands.

  1. Handwashing can keep children healthy and in school. Handwashing education can reduce the number of young children who get sick and help prevent school absenteeism.
  2. Handwashing can help prevent illness. Getting a yearly flu vaccine is the most important action you can take to protect yourself from flu. Besides getting a flu vaccine, CDC recommends everyday preventive actions including frequent handwashing with soap and water.
  3. Handwashing is easy! Effective handwashing is a practical skill that you can easily learn, teach to others, and practice every day to prepare for an emergency. It takes around 20 seconds, and can be done in five simple steps:
    1. Wet your hands with clean, running water, turn off the tap, and apply soap
    2. Lather your hands by rubbing them together with the soap
    3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice
    4. Rinse your hands well under clean, running water
    5. Dry your hands using a clean towel or air-dry them

Promote Handwashing in Your Community

Global Handwashing Day is celebrated annually on October 15 to promote handwashing with soap as an easy and affordable way to prevent disease in communities around the world. This year’s theme, “Clean Hands—A Recipe for Health,” calls attention to the importance of handwashing at key times, such as before eating or feeding others, and before, during, and after preparing food.

Learn how you can get involved and promote handwashing at home, your child’s school or daycare, and your local community:

Four Corners States Biomonitoring Collaborative: Leveraging lab capacity toward regional health concerns

Four Corners States Biomonitoring Collaborative: Leveraging lab capacity toward regional health concerns | www.APHLblog.org

By Kim Krisberg

2,4-Dichlorophenoxyacetic acid—otherwise known as 2,4-D—is the active ingredient in a variety of weed killers and one of the most common, widely used herbicides in the world. Studies in lab animals have found that high doses of 2,4-D are associated with negative health effects. Research on human exposure is more of a mixed bag.

According to the Agency for Toxic Substances and Disease Registry, it doesn’t appear that contact with small amounts of 2,4-D is harmful to people. Some studies on workers with relatively high exposure rates, such as professional herbicide applicators, have identified a possible link to cancers of the lymph system. Other studies found no strong evidence linking 2,4-D to cancers. The US Environmental Protection Agency (EPA) says there’s not enough evidence to either refute or support 2,4-D as a human carcinogen, while the International Agency for Research on Cancer has deemed 2,4-D as “possibly carcinogenic” based on “inadequate evidence.” In other words, we need more research.

One place where that research is happening is inside the public health labs of Arizona, Colorado, New Mexico and Utah, where a collaborative known as the Four Corners States Biomonitoring Consortium (4CSBC) hopes to gather new insights into environmental exposures that could impact people’s health. With funding from the Centers for Disease Control and Prevention’s (CDC) National Biomonitoring Program, 4CSBC began its work in 2014, building on the previous efforts of the Rocky Mountain Biomonitoring Consortium, of which all four states had been a member. The collaborative’s mission is to generate the data on environmental conditions and contaminants that can inform protective public health actions. It’s also an exercise in optimizing public health lab capacity toward regional environmental health risks and shared concerns regarding air and water quality.

“I think this is one of the most relevant grant-funded projects we do,” said Eric Petty, chemistry program manager within the Colorado Department of Public Health and Environment’s Laboratory Services Division and his state’s lead for 4CSBC. “It produces so much meaningful data and it’s pretty unlimited regarding the number of studies we can design. There’s so much out there that hasn’t been looked at.”

The consortium is focused on three main studies: heavy metal exposure from private well drinking water; pesticide, herbicide and phthalates exposure; and the San Luis Valley (Colorado) Children’s Study, which assesses hazardous chemical exposure among children ages 3 to 13. In each state, public health labs partner with environmental health workers and epidemiologists to find residents who want to take part, collect water and urine samples for testing, and eventually reconnect with residents to discuss results and any health-protective recommendations. The 4CSBC labs spread out the testing responsibilities according to capacity, so as to not burden any one state—for example, every state does its own metals testing; New Mexico and Utah test for metabolites of pyrethroids, a group of chemicals found in certain pesticides; Arizona handles all the testing for phthalate metabolites; and Colorado tests for 2,4-Dichlorophenol and 2,5-Dichlorophenol, the latter of which is found in household products. However, testing duties can change depending on circumstances and capacity. Testing results are interpreted, in part, by using baseline data from CDC’s National Health and Nutrition Examination Survey.

“We have similar geological settings, we all have a legacy of mining in heavy metals, we’re agricultural states, our populations can be sparse, we have common problems regarding arsenic and pesticides,” said Sanwat Chaudhuri, PhD, 4CSBC’s principal investigator and scientific advisor for chemical and environmental services at the Utah Public Health Laboratory. “It just makes more sense that we work together to try to solve our problems.”

To date, Chaudhuri said the consortium has tested more than 900 urine samples and about 500 water samples. Labs work closely with their state colleagues in epidemiology and environmental health—or in Utah and New Mexico, with CDC-funded participants in the National Environmental Public Health Tracking Program—in determining where in the states to focus their biomonitoring efforts and what kind of data gaps the consortium can help fill. Chaudhuri added that the consortium leverages its unique work to help particularly vulnerable communities reduce their risk of harmful exposure. 4CSBC’s focus on private well drinking water is a good example of that. Because such water often goes unregulated, 4CSBC can help alert residents to potential contaminants, while collecting the data that allow health officials to measure changes in environmental risk.

If lab technicians detect a particularly high concentration of a contaminant—like naturally occurring uranium that can seep into private well water—residents are notified and offered guidance about how to fix or mitigate the problem. In some instances, Chaudhuri said, local health officials are engaged and notified. 4CSBC teams regularly share data with each other, evaluate their progress and plan for the future during monthly phone calls and at two face-to-face meetings each year.

“We couldn’t have stretched [the CDC biomonitoring funds] across four states if wasn’t for our collaborations,” Chaudhuri said. “We get so much in-kind support from our environmental health and tracking partners—who else can better appreciate the need for biomonitoring data?”

On the ground, the biomonitoring collaborative not only hopes to offer new insights, but to boost capacity for more traditional public health responsibilities, such as safeguarding drinking water quality. For example, in New Mexico, about 20 percent of residents depend on drinking water sources—like private wells—that aren’t regulated by either federal or state oversight. At the same time, said Heidi Krapfl, MS, chief of the New Mexico Department of Health’s Environmental Health Epidemiology Bureau, the state’s geology means private well water drinkers may be at heightened risk of harmful arsenic and uranium exposures. Urine uranium concentrations above a certain threshold are already a notifiable condition in New Mexico.

To better understand that risk, New Mexico’s 4CSBC team partners closely with the state’s environmental health tracking program to collect and analyze water samples. To date, according to Barbara Toth, PhD, MS, epidemiologist supervisor at the New Mexico Department of Health, the biomonitoring effort in New Mexico has collected about 150 household water samples for heavy metal testing and just more than 200 urine samples for heavy metal and phthalate testing. If researchers find troubling levels in any of the specimens, they or their partners follow up with residents. So far, Toth said they haven’t detected any levels that would be deemed harmful.

“Tracking is about exposure and health outcomes,” Toth said, “and biomonitoring is the method by which we understand that exposure.”

Krapfl added: “Those three legs of the stool—tracking, biomonitoring and private well water testing—provide a strong foundation for taking supporting public health actions in the state. You really need all three.”

One of the 4CSBC’s main projects—the San Luis Valley Children’s Study—is focused on a specific community of children in Colorado. According to Petty, the 4CSBC lead in Colorado, the area has a particularly shallow water table and has a history of agricultural use. To get a clearer picture of the risk, 4SCBC is partnering with a researcher from the University of Colorado who’s already begun studying children’s exposure in the San Luis Valley. The researcher conducts the field work and collects samples, while the Colorado public health lab does the testing—to date, Petty said the lab has tested more than 200 urine samples and 100 water samples.

“The consortium is a great way to consolidate resources,” Petty said. “Ultimately, there’s so much information these studies can provide in the future.”

Well water quality is a priority issue in Arizona too, according to Jason Mihalic, chief of the Chemistry Office at the Arizona Department of Health Services and the state’s principal 4CSBC investigator. Any Arizona resident who uses well water can take part in the biomonitoring effort. But to sweeten the deal—and attract as many participants as possible—the Arizona lab offers a free water analysis for 19 metals using an EPA-approved method. The Arizona 4CSBC effort is also partnering with existing well water programs at the University of Arizona to spread word about the biomonitoring effort—for example, news of the biomonitoring testing even made it onto a local master gardener listserv®.

For many of the compounds included in 4CSBC testing—such as pyrethroid insecticides used to reduce risk of tick-borne diseases like Rocky Mountain spotted fever or the plastic chemicals known as phthalates that are now ubiquitous in our environment—biomonitoring will produce the first regional baseline data available, Mihalic noted.

And more precise data means public health can be even more effective in protecting communities against potentially harmful exposures.

“I love biomonitoring,” Mihalic said. “It’s a wonderful way for the public health lab and epidemiology to work together in tackling real-world problems.”

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APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing”

APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing” | www.APHLblog.org

APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing” | www.APHLblog.org

The Association of Public Health Laboratories (APHL) is very concerned about the decline in federal funding for public health functions such as detection, surveillance and response in the administration’s budget for fiscal year 2019. “It is extremely disheartening and disappointing to see such severe cuts to public health programs at CDC, HRSA, USAID and the Department of State at a time when the services they support are most in need,” said Scott Becker, executive director of APHL. “What is more, these cuts to public health funding come after a historic bipartisan agreement between Congress and the White House to increase federal spending overall for the next two years.”

CDC cuts include:

HRSA cuts include:

Global Health Programs:

  • $1.26 billion cut to Department of State Global Health Programs which includes funding provided to CDC for PEPFAR; and
  • $1.11 billion cut to USAID Global Health Programs.

While the majority of the president’s budget proposal is grim for public health, there were a few areas that are not as dark. APHL was pleased to see that the budget request designates $175 million to CDC to address the growing opioid crisis. Additionally, funding for the Global Disease Detection Program would increase by $51 million and funding for the Public Health Emergency Preparedness program would increase by $4.5 million.

As Scott Becker explained, “The director of the president’s Office of Management and Budget said, ‘the budget is a messaging document.’ In that case, the message to the American people seems to be, ‘Good luck if there is an outbreak or other public health emergency because federal early warning and response programs won’t be there to help you through.’”

APHL will continue work with Congress to assure that funding levels continue at the much-higher amounts provided in previous years. Adequate levels of federal support for state and local laboratory contributions are critical to the nation’s public health security.

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Educating Children After Hurricane Maria

In September 2017, Hurricanes Irma and Maria roared through the Caribbean just 12 days apart. The schools on St. Croix and St. Thomas in the U.S. Virgin Islands (USVI) did not re-open until October 24. Teachers talked about how many of the books and materials in their classrooms were moldy and how teachers and staff had to help the janitorial staff clean up classrooms. Parents shared stories of their children coming home from school with mosquito bites all over their arms and legs. Schools could not always run the air-conditioning because they were operating using generators.

Finding a natural fit

As a team lead in the Division of Adolescent and School Health, I have expertise in how health departments and federal agencies should work with schools. So when I was deployed to support health communication activities in the US Virgin Islands after Hurricane Maria, I offered to support the USVI Department of Health doing health communication outreach to schools. We worked quickly to connect with schools and distribute materials to students and their families about how to stay safe and healthy after a hurricane.

Making a vision a realityChildren are the key to primary prevention because they are the drivers of the health behaviors we hope to change. -Malaika Washington

I worked with Director of Public Relations, Nykole Tyson, at the USVI Department of Health and the USVI Department of Education to determine how many children were enrolled on St. Croix, St. Thomas, and St. John and which educational materials from CDC to distribute. With support from the CDC Foundation, we printed and distributed flyer packets for over 16,000 K-12 students on the three islands to take home to their families. The packets contained CDC-developed materials about how to stay safe after a hurricane, including tips for food and water safety, how to prevent mosquito bites, the health risks from mold, how to avoid carbon monoxide poisoning, and mental health. Since 35% of the children on St. Croix speak Spanish, we made the messages available in both English and Spanish.

Each child was also given a copy of the Ready Wrigley Flooding and Mold Activity Book as part of the flyer packet. Ready Wrigley is a series of CDC-developed activity books for children 5-9 years old and their families to help them talk about and prepare for emergencies. There are nine Ready Wrigley books that provide tips, activities and a story about disaster preparedness. The flooding and mold activity book talks specifically about safe mold clean-up after a flood and how kids should never touch mold and always tell a grown-up if they see mold.

Giving children a voice

Malaika Washington reading the Ready Wrigley Flooding and Mold activity book to students in USVI.
Sharing the Ready Wrigley Flooding and Mold activity book with students in USVI.

American Education Week takes place every November. The USVI Department of Education contacted Director Tyson and asked her to read to elementary school students on St. Croix. She asked me if I would like to join her visits to kindergarten and first grade classrooms. I jumped at the chance to interact with students in-person and suggested we read the Ready Wrigley Flooding and Mold Activity Book. I even colored the pictures in the book and completed the activities so the children could follow along. We shared the Ready Wrigley books with the teachers at each school we visited, giving teachers enough copies of the book for every student to take one home.

All of the students really wanted their stories heard. One first grader recounted how his mother and grandparents told him to stay far away from the cleaning products while they cleaned up the mold in their home. Another little girl shared how she was personally impacted by mold. She had to sleep on the sofa in her home because there was mold all over her bed and the other furniture in her bedroom. Several other children described the mold they found on the front door of their homes after the hurricane.

Fulfilling a passion

Working with school-aged children is so rewarding. This deployment experience was the best I could have hoped for. The time I spent in the USVI made me realize my personal and professional goal to provide public health education materials to children and their families. I have always believed that public health prevention work should begin with school-aged youth and it is my lifelong public health mission to ensure that they have a voice.

Malaika Washington has been a Commissioned Corps Officer in the United Stated Public Health Service since October 2009. She is a team lead in the Division of Adolescent and School Health, the only division at CDC that funds education agencies directly. Her deployment to the U.S. Virgin Islands for the 2017 HHS Hurricane Response was the first time she deployed for a public health emergency.

New Lab Matters: Biomonitoring

New Lab Matters: Biomonitoring | www.APHLblog.org

In the 1970s, the National Health and Nutrition Examination Survey (NHANES) showed that gasoline lead was a major exposure for children and adults—a huge finding that would not have been known otherwise. Today NHANES provides a critical baseline for national background levels of exposure to other chemicals, but state efforts to test and document local, possibly elevated exposures to the new “alphabet soup” of PFOAs and PFOSs have been little funded and lagging. As our feature article shows, public health laboratories aim to change that through new technologies and the establishment of the new National Biomonitoring Network.

Here are just a few of this issue’s highlights:

Subscribe and get Lab Matters delivered to your inbox, or download the Lab Matters app via iTunes or Google Play.

The post New Lab Matters: Biomonitoring appeared first on APHL Lab Blog.

What you need to know about harmful algal blooms

What you need to know about harmful algal blooms | www.APHLblog.org

By Julianne Murphy, intern, Environmental Health

Warm weather brings nature walks, picnics and sunny days by the shore, but it can also bring unwanted changes to your favorite beach. As the temperature rises, lake and ocean waters can turn from blue to mossy green as algae proliferates in unsightly and potentially harmful algal blooms.

What are harmful algal blooms?

Algae are plant-like organisms of one or more cells that use sunlight to make food. Together they can form colonies called algal blooms in both marine and freshwater systems. Some of these algal blooms are hazardous to health, but not all algal blooms are harmful.

Harmful algal blooms may release toxins at concentrations unsafe to humans and animals and may drastically reduce oxygen available to aquatic life. In fresh water bodies, cyanobacteria, aka “blue-green algae,” can produce dangerous cyanotoxins; in saltwater or brackish water, acid-generating plankton – dinoflagellates and diatoms – can pose a health threat.

Should I be concerned about algal blooms?

Algal blooms can pose a risk for human and animal health. People and animals can become ill through eating, drinking, breathing or having direct skin contact with harmful algal blooms and their toxins. Illnesses vary based on the exposure, toxins and toxin levels. Public health and environmental laboratories test samples from harmful algal blooms to confirm the presence and level of toxicity. Remember, not all algal blooms are harmful.

How are public health officials responding to the increase in algal bloom events?

As climate change events amplify conditions favorable to algal blooms, public health scientists are studying when and where associated illnesses are occurring and how to mitigate the effects of exposure. Their efforts have led to increased laboratory testing and electronic surveillance measures at the state and federal level.

For example, public health and environmental officials in Alaska have been tracking and testing harmful algal blooms. The Alaska Harmful Algal Bloom Network, a collaboration of the Alaska Department of Health and Social Services (DHSS) and regional monitoring programs, analyzes fish kills, unusual animal behaviors and other related phenomenon to provide early warning of developing coastal marine blooms. DHSS scientists analyze human specimens for illnesses associated with harmful algal blooms, such as paralytic shellfish poisoning (PSP) caused by saxitoxins. PSP is a potentially fatal poisoning with no treatment except supportive care. Samples from symptomatic patients are forwarded to the Centers for Disease Control and Prevention (CDC) for confirmatory testing as needed. Testing of asymptomatic individuals may be included in future studies.

In addition, Alaska Department of Environmental Conservation (DEC) laboratories test marine shellfish meat samples protect public health and safety as well as for regulatory purposes, illness investigations and non-commercial shellfish upon request. This monitoring literally saves lives.

David Verbrugge, chief chemist at the DHSS Division of Public Health, explains the value of Alaska’s testing of harmful algal blooms, “[Laboratory analysis] helps us to understand the nature of PSP exposures: frequency of occurrence, confirmation when lacking meals to test, and the presence or absence of toxins in asymptomatic co-exposed groups. It also allows us to let people know what they are eating before they eat it.”

Is the CDC involved in testing and surveillance for harmful algal blooms?

Yes, only for freshwater. In 2016, CDC created the One Health Harmful Algal Bloom System to provide a voluntary, electronic reporting system for states, federal agencies and their partners. Using the system, which integrates human, animal and environmental health data using a One Health approach, public health departments and their environmental and animal health partners can report bloom events, and human and animal cases of associated illness. Members of the public may report a bloom event or a case of human or animal illness to the One Health system by contacting their local or state health department.

What is the outlook for future testing and surveillance of harmful algal blooms?

As climatic conditions become more favorable to development of harmful algal blooms, state and local health departments will have to ramp up surveillance and testing to protect public health and to preserve local revenue from beaches. These actions will come with a price tag, requiring action at all levels of government. Resources can be leveraged through collaboration to research and expand clinical testing capacity for these persistent health threats.

Learn More:

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Hurricane preparation and response resource list

Hurricane preparation and response resource list | www.APHLblog.org

Updated September 15, 2017

In the wake of hurricanes Harvey and Irma, public health laboratories in affected regions will be busy testing for potential environmental contamination, monitoring for increased water- and mosquito-borne diseases, or repairing damage to their own facilities. APHL has activated its Incident Command System (ICS) to support member laboratories with their response. The ICS team is participating in CDC’s Emergency Operations Center (EOC) State/Local and Partner Conference Calls, and will assist member labs with their response, facilitate communications between CDC and member labs, and share lab needs/stories with policy makers and the public.

Below are helpful resources for those communities hit by the recent storms. Many of these resources are useful for any severe weather event, not just Hurricanes Harvey and Irma.

Preparing for and weathering the storm

Hurricanes, Preparation and Response, EPA
Hurricane Preparedness Checklist, FDA
Preparing for a Hurricane or Tropical Storm, CDC
Flooding Toolkit, National Public Health Information Coalition
Disaster Assistance.gov, US government platform for locating disaster-related resources
Federal Emergency Management Agency (FEMA) Toll-free FEMA hotline for survivors of Hurricane Harvey: 1-800-621-FEMA

Keeping your family and community healthy after the storm

Food Safety:
Food Safety Tips for Areas Affected by Hurricane Irma, USDA press release
Protect Food and Water Before, During and After a Storm, FDA

Infectious Diseases:
Emerging and Zoonotic Infectious Diseases, CDC
Vector-borne Diseases, CDC​​​​​​​
Waterborne Disease Prevention, CDC

Drinking Water:
Drinking Water Safety and Testing Information for Texas, Texas Commission on Environmental Quality (accredited labs for microbial testing of drinking water, advice for customers of public water systems, disinfecting your well, etc.)
Drinking Water Testing and Information for Houston, TX, City of Houston
Private Wells: What to Do after the Flood, EPA
Private Wells: Water-related Diseases and Contaminants, CDC
Health Department Laboratory, Drinking Water Testing and Information, City of Houston

Other:
Carbon Monoxide Poisoning – Clinical Guidance, CDC
Mold: Cleanup and Remediation, CDC
Mold: Flood Cleanup, EPA
Waste Management, EPA

Rebuilding and repair

Cleanup after a Hurricane, CDC
Status of Systems in Areas Affected by Harvey, Texas Commission on Environmental Quality – drinking water, waste water and sewage, residential wells, flood waters, water infrastructure

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