Preventing, Identifying and Managing Infectious Disease, by Nancy S.

It is of extreme importance in any TEOTWAWKI situation that precautions be taken to prevent contracting or spreading infectious disease. If infectious disease is contracted, it is important to be able to recognize and manage it. This article will present some infectious diseases to be aware of, how they are contracted, what measures to take to minimize the risk of infection, and what to do if you have been exposed. 

Infectious or Communicable? 
Infectious diseases are caused by microorganisms such as bacteria, viruses, fungi or parasites that invade the body. Commonly confused with communicable diseases, infectious diseases, not surprisingly, cause illness through exposure to an infectious agent, even if it cannot be spread from one person to another. Comparatively, a communicable disease is an infectious disease that can be spread from person to person. 

For example, while the common cold can be transmitted between people with little to no contact, an infectious disease such as malaria can only be transferred to a person from a vector – in this case, a mosquito. Malaria cannot, however, be transmitted from person to person and is therefore not communicable. 
Illness caused by an infectious disease pathogen can range from a minor cold, to life threatening hepatitis. The virulence of the microorganism and one’s general health typically determine the severity of the infection. Other sensitivities, such as autoimmune suppression, or pediatric or geriatric status, can be a factor in susceptibility to infection as well as the ability to overcome disease.
Infectious Diseases
The infectious diseases that pose important risks during a TEOTWAWKI situation pose serious threats not only to you and your loved one but to the community. While local circumstances and conditions can raise different risks, some infectious diseases to be aware of and prepared for include:

Influenza is a virus that causes upper respiratory infection. Spread quickly and contracted easily, the cold can knock you down for several days. With emerging mutations of the flu appearing every year, and with the expected emergence of a disastrously virulent strain, you must make an effort to prevent contagion. Prevent infection by maintaining good hand hygiene and avoiding touching your face, including rubbing your eyes.

Norovirus, [often and erroneously] called “the stomach flu,” causes severe gastrointestinal distress and, thus, results in dehydration due to vomiting and diarrhea. Influenza is caused by the influenza virus and is correctly referred to as the “flu”. The flu is a serious illness can can lead to complications and death in many people with risk factors associated with certain chronic diseases or conditions. The common cold is caused by completely different viruses. Contaminated food, water and surfaces spread the virus, which are the leading cause of food poisoning.

While norovirus is typically not serious for otherwise healthy adults, in a TEOTWAWKI situation, the dehydration it causes can lead to death. Even in normal times, Norovirus can be a severe illness among those who are elderly, very young or have certain chronic conditions. Deaths have occurred because of complications that resulted from pre-existing conditions. To prevent contracting it, make sure all surfaces and hands used for food preparation are clean. Wash your hands correctly before every meal. Always. Never touch bathroom doorknobs with your bare hands. While you cannot ensure that others will do the same, limit your exposure by reducing the number of times you eat food prepared by others. If you do become infected, rehydrate soon and often. Restore electrolyte imbalance by consuming cell salts or another source of electrolytes. Provide team support to the beneficial flora in your gut by taking a supplement such as HMF powder.

Cholera is caused by a bacteria that affects the small intestine and results in severe diarrhea. Found in contaminated water and food, it typically occurs in regions under heavy distress. Ensuring clean water and sanitation are essential for preventing cholera and other water-borne diseases, such a giardia in the event of a failure of municipal water systems. In any TEOTWAWKI situation, you must be prepared and vigilant about the safety of all water you consume or use for food preparation. Learn about and be supplied for performing water purification on your own.

Staph exists on the skin of a large percentage of the population but does not necessarily pose a risk until it enters the body through a break in the skin surface. An fairly recent emergence of Methicillin Resistant Staph Aureas (MRSA) poses a life-threatening risk from the bacteria that comprise the staph group. Any staph-related infection is serious and should be avoided and quickly treated.

Hepatitis is a disease that causes inflammation of the liver. Not only can infected persons not have any signs or symptoms for years, but the pathogen can survive outside the body for days. Hepatitis A is transmitted via the fecal-oral route. Hepatitis B and C are blood-borne and both are very hearty viruses that can survive outside of the body and remain viable for quite a while. Hep A and B both can be prevented by vaccinations. Hep B and C can both be treated depending on the type of Hep B or C. (This is a simple explanation for a complex viral disease) Hep B and C is commonly transmitted through IV drug use, tattoos, and possibly sexually.

Tuberculosis is a bacterial respiratory infection spread by a patient’s sneezing or coughing. If an outbreak occurs in your area, take precautions to avoid infected persons and locations and used recommended protection for filtering respiration. In some parts of the world, the disease has mutated to resist every single antibiotic formerly used to treat it.

Salmonella can be contracted from contaminated chicken and eggs as well as from the handling of reptiles. Thoroughly wash all chicken meat and eggs before use and  safely contain all remnants and packaging. Follow the handling of chicken products and reptiles with thorough decontamination of the hands. 

Rabies is caused by a virus that can be contracted through the saliva of infected animals through a bite or scratch. Rabies has a 99.9% fatality rate. Avoid all contact with wild animals whenever possible, particularly if they are behaving oddly. If you do receive an injury from such an animal, immediately seek medical care.

Tetanus is caused by a toxin produced by Clostridium tetani. It can be contracted from a sharp surface contaminated with the tetanus bacteria that lives in the soil. While it is a common misconception that mere metal, such as a nail, is a habitat for the bacterium, reality is that the metal (or other object) must be contaminated from contact with the soil or other carrier. The average nail in your shed is not likely to pose a tetanus risk. Stepping on a nail in your garden does. Keep your tetanus vaccination current to prevent contracting this disease.

HIV is present in blood, semen and other body fluids of those infected and can be transmitted sexually (regardless of a person’s sexual orientation) as well. The virus can also be transmitted from mother to child, IV drug use, or through blood transfusions. HIV can result in acquired immune deficiency syndrome, commonly known as AIDS. However, a person may not know he or she is infected and may not exhibit signs or symptoms for years. 

Routes of Entry
There are four major routes of entry for infectious disease pathogens to enter the body, including inhalation, ingestion, injection, and absorption.
Inhalation occurs with exposure to airborne pathogens, usually by coughing and sneezing. Aerosolized droplets containing pathogens can be breathed in, even if you are some distance away from the carrier.
Ingestion can happen when infected body fluids splash into your mouth. A person who is bleeding, coughing or sneezing can project pathogens this way. Eating food contaminated with salmonella or eating from contaminated surfaces or with contaminated hands can also put you at risk of infection. Don’t self-infect!
Injection can occur when the skin is punctured or cut by contaminated sharp objects. Jagged debris, nails or working with a patient’s needle equipment, such as a diabetic’s glucometer kit or  an Epi-pen used to treat anaphylaxis, can put you at risk for infection. Similarly, tetanus can be contracted through puncture by a contaminated sharp object, and rabies, lyme disease and other infectious diseases can be contracted through puncture or the breaking of the skin from an animal bite or scratch.
Absorption occurs when tissues such as the nose and eyes come in contact with a pathogen, usually through rubbing them without proper hand washing. 
Typically, communicable disease pathogens are either airborne or blood-borne. Other infectious diseases, such as tetanus and salmonella, are generally contracted without any person-to-person contact.

Airborne pathogens, quite obviously, spread through the air. Blood-borne pathogens are transmitted through contact with infected blood or other body fluids containing blood. Bloody saliva or vomit, used dressings and dry wounds can all be sources of blood-borne pathogens. Other potentially infectious materials, known as OPIM, include fluids found throughout the body, such as nasal secretions, cerebrospinal fluid, and fluid in the joints, abdomen and chest cavity. To maximize your safety, however, you must treat all body fluids as if they are infectious.

Exposure occurs through either direct contact transmission or indirect contact transmission. Direct contact transmission occurs when a person transmits a pathogen directly to another person. For example, getting infected blood in a cut on your skin can allow pathogens to infect you. Indirect contact transmission occurs from coming into contact with contaminated surfaces or objects then transferring pathogens into your body by, for example, rubbing your eyes.
Minimizing Risk
To minimize your risk of exposure to pathogens, you must take affirmative action to protect yourself. Not only should you avoid any obviously contagion-transmitting situations whenever possible, but, if you must assist in any kind of health or safety emergency, you should take precautions by practicing good hand hygiene, wearing protective equipment and treating all body fluids as if they are infectious.
Hand Hygiene
Contaminated hands are a leading cause of the contraction of infectious diseases. Hand washing and antisepsis recommendations issued by the Centers for Disease Control and Prevention should become common practice every day – don’t wait for a TEOTWAWKI scenario.
For visibly contaminated hands, wash with either plain or antimicrobial soap.
Wet your hands, then apply the amount of product recommended by the manufacturer. Vigorously rub your hands together for at least fifteen to twenty seconds, covering all surfaces. Rinse , then dry thoroughly with a disposable towel. 
Use the towel to turn the faucet off and throw the towel away.

Use an alcohol-based hand rub if your hands are not visibly soiled in order to reduce the population of pathogens on your hands. For optimum effectiveness, the sanitizer must contain at least sixty-percent alcohol. Use the amount recommended by the manufacturer, covering all surfaces, then rub your hands together until dry. For additional protection, make sure to get the product under any rings, and under and around the fingernails.

Standard Precautions
The term “standard precautions” refers to infection control practices designed to provide protection from infectious body fluids. You should employ these precautions when assisting anyone with a medical emergency or suspected infectious disease whether or not he or she appears infectious. While it is typical in emergency medial response to use gloves, gowns, masks and protective eyewear during patient care, you should, at the very minimum, use gloves.

Gloves are highly effective in preventing contamination. However, because small, undetected holes can result in exposure, you should cover any broken skin and apply alcohol rub before putting gloves on. Careless removal can also result in exposure. To correctly remove them, grip the cuff of one glove and pull it inside out and off. Slip your un-gloved thumb or a finger under the cuff of the other glove. Pull the glove inside out and off  so it contains the first glove inside it. Dispose of the gloves after one use so you don’t put anyone else at risk, then decontaminate with an alcohol rub. 

To protect your face form contamination, wear wrap-around goggles. For full protection for the eyes, nose or mouth, full-face shields may be worn. Surgical masks can also help protect the face, have the added benefit of limiting inhalation of aerosolized particles and can also be placed on a sick patient. A HEPA or N95 respirator mask have a high level of filtering protection. Remember to throw away all disposable equipment after one use.  You should also avoid eating, drinking, smoking or touching your face or eyes in any situation that poses an infection risk.

In addition, disinfect all surfaces and reusable equipment after working in the vicinity of a person who may have an infectious disease. Take each of these precautions seriously and get in the habit of using gloves, masks and goggles when working with dust or contaminants of any kind. This will help you familiarize yourself with the equipment and practiced in putting it on and removing it correctly and safely. The maintenance of an adequate immunization schedule can be an additional line of defense against many common diseases to consider.
If an Exposure Occurs
Make every effort to avoid exposure to infectious disease. If you become ill, you not only put your safety and survival at risk, you risk those in your family and community. The most powerful defense you have against contracting infectious disease is yourself. 

Nevertheless, exposures can still occur, even when you have employed vigilant efforts to prevent it. If you do become exposed, you should immediately take mitigating steps. If your clothing has become contaminated, remove it as soon as possible. Wash all contaminated skin surfaces, especially your hands, and use a disinfecting product to further minimize risk. If your mouth, nose or eyes have been contaminated, flush them with water or saline. They optimal flushing period for the eyes is twenty minutes. In the case of exposure to serious infectious diseases, you should immediately seek medical care. For example, while you can provide self care from assisting a person infected with the common cold, any possibility that you have contracted rabies, tetanus, hepatitis, tuberculosis and other serious diseases requires immediate medical attention.

Because infectious diseases can spread so quickly from person to person and through communities, you should expect any TEOTWAWKI situation to pose a threat of infectious disease. While the risks of contracting diseases such a rabies may be of minor significance, your risk of contracting infectious disease spread from person to person is much more likely. You must be extremely cautious when providing emergency care for any injured or sick person. The same can be said for travel through any location frequented by others. Public transportation, buildings with air circulation systems and public service buildings such as grocery stores and schools are ripe grounds for transmission. Minimize your time in them and be aware of the extremely high risk that other people pose, particularly in emergency situations where resources are limited. You must be self sufficient and prepared to assume responsibility for your own health as well as being willing to prevent any illness you do contract from spreading to others.

Take self-care seriously and invest the energy of prevention into your protocols for survival and the protection of others. You will usually not be able to tell whether someone is carrying an infectious disease or even what specific risks they pose.  But being knowledgeable and prepared are the best line of defense and management when faced with the risks of life-threatening disease.

Centers for Disease Control and Prevention.
National Library of Medicine, National Institutes of Health.