A Realistic Assessment of Epidemic Disease After TEOTWAWKI- Part 2, by Dr. DMC

As we learned yesterday, malaria, like so many other important epidemic illnesses, is a disease of poverty. The poverty we refer to here implies poor housing, poor nutrition, unsanitary and crowded living conditions, and most important, bad water. Remember that the mosquitoes that spread malaria are still around. If America’s high standard of living is destroyed, people will be exposed to the mosquito again, and with time, the parasite will find its way back into the U.S. Malaria is not the only disease to consider either. We have already looked at upper respiratory infections, including influenza (flu), and measles. Today, we will continue examining other threats and how we can minimize them after TEOTWAWKI.


Bad water, reduced immunity and inadequate sanitation are conditions that inevitably lead to diarrhea epidemics. In a disaster situation, those epidemics are dangerously deadly. Think about the diarrhea outbreaks on the spotless cruise ships that one sees so often in the news. And those occur where sanitation is excellent, where toilets flush and people wash their hands! After disasters, the situation is much worse.

The Haiti Earthquake

The 2010 Haiti earthquake provides an example. The deadly disease cholera did not occur in Haiti prior to the massive earthquake, but a few months after the shaking stopped, the first cases of this disease were reported near the nation’s capitol. By 2016, nearly 750,000 had been affected and about 10,000 had died. This was actually a success story, because the death rate of cholera in such situations is usually much worse. Eventually, the United Nations admitted that their own disaster relief troops from Nepal had introduced the causative bacterium to the island through careless sanitation. Ten years later, the epidemic continues.

Flies Spread Disease in Disaster Situation

The disaster situation often takes a toll on housing so that people have to sleep outdoors. This was certainly the case in Haiti, because damaged buildings were dangerous during the multiple aftershocks. In such situations, flies become cholera-dispersal units, moving between standing sewage and peoples’ mouths and eyes. The flies’ feet and mouth parts transport the cholera bacteria easily, exposing even the cleanest of individuals to the disease.

But cholera is not the only diarrheal disease that can be spread by the typical filth fly. Many diseases already in the U.S. can be spread even more easily. One more example will illustrate this.


During Operations Desert Storm and Desert Shield, American troops suffered an outbreak of diarrhea caused by a bacterium called shigella. The author was stationed with a Marine Corps unit in Saudi Arabia at the time and saw this first hand. The American troops had never been exposed to this organism before and were very vulnerable to it. The germ had been introduced to the troops through locally grown foods fertilized with human waste or “night soil”. The sick Marines had to use the open latrines where enormous swarms of flies picked up the germs and then transmitted them to the lips and eyes of other Marines.

Shigella is highly infectious and can be spread by only a few organisms; the feet of a fly can transmit thousands. So the outbreak grew and persisted. The fighting ability of several military units was ruined overnight by a combination of bad food, poor sanitation, and a huge swarm of flies.

Similar Effects in TEOTWAWKI When Sewers Stop Working

A TEOTWAWKI event would have similar effects, especially in an urban environment where sewers stop working long before the digestive systems of the local population stop. Of all the diseases that would affect a surviving remnant, diarrhea may be the most likely and the most dangerous.

Vector-borne Disease

A vector is a living organism that picks up a disease-causing germ from one animal and transmits it to another. Malaria is a vector-borne disease, because a mosquito picks up the parasite from an infected human and transmits it to another. There are many more such diseases in the world. In the United States, the most important are probably Lyme disease (spread by a tick) and West Nile virus (spread by a mosquito). Thousands have been affected by these diseases, but they would probably not be the ones that would be of the biggest concern in a post-disaster America.


One vector-borne disease that could have surprising impact and that few people think about today is typhus. This disease is truly a disease of poverty and poor sanitation. It is spread by the body louse. The body louse is different from the head louse that nearly every child is exposed to at some time. The body louse lives in the seams of clothing and spreads the typhus organism with remarkable efficiency. It feeds on humans, and then it moves back to the clothing where it is protected. In modern society, typhus is seen in two vulnerable populations: the homeless and refugees. These groups often live in conditions that prevent them from bathing and laundering their clothes. This is heaven for the body louse. Once typhus enters a population, it spreads like wildfire, and it is truly deadly.

How Deadly is Typhus?

One example of how deadly typhus can be stands out above all others. In 1812, Napoleon invaded Russia with 600,000 soldiers. When he returned, he had between 30,000 and 60,000 men. Only about 1,000 men recovered enough to return to active duty with the French army. This was one of the greatest military disasters of all time, and it was caused by a variety of factors: the Russian winter, the Russian Army, and typhus. Of all of these, typhus is considered to be the greatest factor leading to Napoleon’s defeat. The men had no opportunity to bathe or to clean their clothing.

They huddled together at night to conserve body heat. This was a wonderful environment for the lice that moved from body to body, spreading the typhus disease agent freely and killing tens of thousands of French soldiers. Typhus is one of the unexpected diseases with the potential to cause untold human suffering in a disaster situation. Other vector-borne diseases with the potential for a big comeback include malaria, yellow fever, and dengue.


Another disease, though not really a vector-borne disease, is worth mentioning: rabies. This disease is spread through the bite of certain mammals and sometimes through other methods, such as saliva aerosols in bat caves. Americans have kept this disease at bay through immunization of their pets and other animals. As a result, dogs are considered members of our families. That is not true in places where rabies is rampant. In those countries, children are taught to fear dogs, because even a nip from a puppy can be deadly. In a disaster situation, our pets may be invaluable to us, but they can turn on us as well. The urban disaster zone of Detroit demonstrates this by its roving packs of pit bull mixed breeds. Rabid pit bulls could make this situation even scarier.


The diseases discussed here are only some of the ones with potential for major resurgence after a disaster event in the U.S. There are, however, bright spots to consider. At least we know what causes these diseases now, and we know how to prevent them. Typhus can be prevented by regular bathing and laundering of clothing. Diarrhea can be prevented with good water treatment and sanitation.

Smallpox and Polio

There are bright spots to consider. Smallpox has actually been eradicated from the wild. This disease probably caused the greatest disaster in human history: the depopulation of much of the New World after its introduction by colonizing Europeans in the 1500’s. At least this scourge is gone, unless someone with a biological weapon re-introduces it. It is too bad that another disease, polio, has not been eradicated as well. Until recently, polio was well on its way to eradication. Only a few dozen cases were occurring annually. Then the Syrian civil war occurred. The disease resurged there and in other countries where inadequate security interfered with immunization programs (Afghanistan and Pakistan, specifically). War, in general, and civil war, specifically, is deadly to public health programs.

The Basic Preparations For Prevention

When considering survival after a catastrophic and widespread event, it is important to consider the basics: food, water, shelter, and security. But even the most prepared can be vulnerable to the unexpected. The unexpected can be re-emerging infectious diseases. Some things can be done to prepare. For instance, the yellow fever vaccine is probably good for 20 years, maybe for life. The military re-immunizes its personnel every 10 years. The vaccine is safe, long-lasting, and effective. Unfortunately, most diseases do not have an easy answer like yellow fever. Protection from most diseases must rely on the factors that reduced malaria in America even before modern drugs and insecticides became available. Those factors were good housing, good nutrition, good sanitation, and pure water. There is no replacement for any of these.

See Also:

SurvivalBlog Writing Contest

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  1. You mentioned the disaster in Haiti. I volunteer with Crisis Response International. We go into disaster areas and meet basic needs with the gospel. In Puerto Rico, we have been handing out solar lights and water filters. What low tech, non aerosol items could we hand out that would be effective against flies, mosquitos, and lice? They would have to be small and fit in our personal luggage, esp since we are probably talking about 3 separate items per household. I’m talking about getting hundreds in quickly.

    1. Nurse,
      Besides DDT (which I’m not sure you would be able to procure and transport), the second best item would be mosquito netting for use at night.

      1. We personally use mosquito netting. But it’s too bulky to hand out in quantity given our space and means of transportation. I have used fly paper with good results at home. Not sure it would be as effective for disastets

    2. I think you may be referring to anthrax, which is sometimes called “sheep shearer’s disease”. It causes the cutaneous form of the disease which is indeed rarely fatal. However, there are other poxes out there like cow pox, camel pox, rat pox and monkey pox. They can be confusing. dmc

    3. There is no magic bullet, but there are some very useful things that you can do. The military and outdoorsmen use permethrin sprays on their clothing. Once dry, it lasts for a long time as a repellent. It is pretty safe, too. That would keep down the body lice and prevent a lot of mosquito biting…ticks, too. As far as flies go, there are a lot of things that will kill flies…baits, traps, tapes…but the reality is that they can out-reproduce any of these methods. As my article stated, there is nothing to replace good sanitation. Finally, elsewhere in the responses some people mentioned mosquito nets. These can be very useful, but are better if treated with the same permethrin spray that hunters use on their clothing. This will prevent the insects from biting you through the netting. Hope this helps.

  2. Such has it ever been throughout history, during war, more armies have been stopped, more deaths have been caused by disease vectors then by bloodshed.

  3. “Diarrhea can be prevented with good water treatment and sanitation.”

    Only if everyone does it.

    Flies fly. Mosquitos fly. Vectors move.

    Your health is at risk based on what everyone else does. Prepare accordingly.

    I don’t know a fly’s range, but personally I’d want to be outside of it.

  4. As another commenter said mosquitoe nets are an excellent idea. So good that the Bill and Melinda Gates Foundation has provided thousands to Africa. They are available now.

    Smallpox is never really eradicated from the wild and those who sheer sheep will get s mild
    form of it which needs treatment. The government has 300 million doses of smallpox vaccine stockpiled so that is a good sign I suppose.

  5. CDC notes that people aged 60 years and older may have increased risk of an adverse reaction to the yellow fever vaccine — but they do not advise against getting the vaccine if at high risk of being exposed to the disease itself (travel to or living in risky areas of South America and Africa.)


    Since the vaccine is required for entry to some countries, older survivalists might want to double check that bugout to South America.

  6. when I grew up, we had possible rabies from wild feral dogs, diseases from ticks, so my mother had a big copper kettle to boil our clothes in at least once a week, several bonuses there, very clean clothes and killed any nasties hiding in the seams and creases in the cloth, we also bathed in hot water and fresh homemade soap at least 4 or 5 times a week, living in the country was like that, we also shot a lot of rabbits for food, had to check for myxy though, our pet dogs and cats were also sprayed with Apple cider vinegar and other remedys, we used nets for mosquitoes at night and fly screens on all windows even now, this link works for delousing your pets ( say’s for cats but also works just as well for dogs.


    My firm prediction is that when the power goes off for good, having a wood fire burning under your backyard big copper will be a very important item !



  7. In current news, Denver, Seattle, San Diego and many places in Michigan are having Hepatitis A outbreaks. That is normally passed by fecal matter and not washing your hands adequately.

    We are already having a breakdown.

    It seems to be a problem with the Homeless (where they don’t have sanitary facilities, and they banned plastic shopping bags which were the alternative) and Refugees.

    The refugees coming in to places like Nebraska, Minnesota, and Kansas have also brought with them Tuberculosis, and even antibiotic resistant varieties.

    One side note on Typhus – There will be Typhoid Marys who are carriers – they don’t appear sick but have the disease and are infectious. Without modern public health to find and quarantine (and hope you have antibiotics to cure them), you aren’t going to get rid of Typhus.

    Something worse but not mentioned is Sexually Transmitted diseases. We already have a pandemic. The oldies of Ghonorhea and Syphillis are becoming resistant and epidemic, but Chlaymidia can cause sterility and often has few syptoms. HIV will be fatal when you can’t get the anti-virals. Herpes and HPV are also permanently infectious and need drugs to mitigate. And there’s more, lots more. Even those who found Christ aren’t always healed. And considering the existing pandemic with a working health system, what happens when it isn’t there?

  8. Don’t forget the Bubonic and Pneumonic Plague, which are not wiped out at all and live in the wild, with a few deaths each year. It was spread by rats and still lives in the wild in other varmints.

    I had a cousin die of it in the 50’s but I hear about a death every few years, so it’s ready to surface when the rats take over the cities in a huge event.

    1. You are right that plague is still around. I did not include it in my article because there is some evidence that it is not the same bacterium that it was a few hundred years ago. Diseases have a tendency to attenuate or weaken over the years, causing milder forms of the disease. I’m sorry to hear of your cousin; it is proof that plague is still dangerous, especially the pneumonic form.

  9. Vaccines are no longer about public health and disease control but a profit center for big pharma(a child now is supposed to get hundreds of vaccinations)with little to no proven efficacy and unsafe ingredients(mercury,antifreeze etc). If they were safe or effective they wouldn’t need perfect immunity under the law.

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