Bureau of Epidemiology
Bureau of Epidemiology November 1999 Utah Department of Health
  Disaster Preparedness and Public Health Response
  Communicable Disease Rule Update
  World TB Day Conference
  Monthly Morbidity Summary

Disaster Preparedness and Public Health Response

What does disaster preparedness mean to you? People often associate preparedness with catastrophic events, such as a major earthquake or an airplane crash. They may also feel that any steps they could take to prepare would not be effective because these events would be so horrendous. The truth is that while most of us may never experience a major disaster, the majority of us will experience disasters on a smaller scale. Fires, floods, harsh winter conditions, chemical spills, serious industrial accidents, terrorist activities, and even a tornado have all occurred in Utah. Disaster preparedness is a way of thinking ahead about how to prepare for and respond to the unexpected. It is something we all should do.

Traditional disaster preparedness has been the responsibility of public safety, law enforcement, and emergency response agencies. However, in recent years, the need for public health services before, during and after an emergency is increasing. People trained in public health can support traditional response activities by providing accurate information about how to recognize disease threats that may arise in a disaster situation and how to prevent illnesses from occurring. Public health workers and the entire medical community now have an additional role in disaster preparedness. If a biologic agent were used as a weapon, the initial exposure may go unrecognized. It would instead be incumbent upon medical and public health personnel to recognize a sudden influx of sick people as an unusual event, and to respond quickly and appropriately.

Any disaster will impair the ability of public health to respond to that disaster, and it will likely increase the demand for public health services. What adjustments can be made to the public health infrastructure that will improve its ability to respond? When most of us think about what to do in the event of a disaster, we first think of our families, our home and ourselves. Emergency responders, including public health personnel, have the additional concerns of taking care of the public. It is imperative that public health employees involved with disaster response ensure that they have prepared adequate personal resources. Their families should be properly trained to deal with the emergencies so that the employee can devote full attention to the public. When the disaster strikes, there isn’t much time to act.

There are four phases to a disaster that should be addressed by the following: the family, the community, the state and the nation (Table 1). How does one get ready? Here are five steps to consider:

STEP 1: Find out what could happen.


What kinds of disasters are most likely to happen and what will their impact be?


How will warnings be given about those disasters?


Think about the needs of children, disabled and elderly persons, and family pets.


Find out what the plans are if the disaster strikes while family members are at school, work, or other places frequently visited.


Phase of Disaster

When Phase Occurs

Activities Conducted During the Phase

Preparedness Before a disaster Analyze the potential for a disaster to occur. Plan and practice disaster responses.
Response During a disaster Quickly tailor and implement the plan.
Recovery After a disaster Clean-up, repair, possibly seek financial aid.
Mitigation Before, during and after a disaster Reduce the chance of the disaster occurring and reduce the damaging effect of the disaster.

STEP 2: Create a disaster plan.


Discuss with family members what could happen, and how they will be warned.


Pick two places to meet: 1) just outside of the home, and 2) outside of the neighborhood.


Get an out-of-state friend to be your family contact. After a disaster it may be easier to make a long distance phone call.


Develop and practice an evacuation plan. Have an evacuation kit ready to go into the car.


Remember to plan for children, disabled and elderly persons, and family pets.

STEP 3: Prepare your home.


Post emergency numbers by the phone.


Check for adequate insurance coverage.


Maintain a working fire extinguisher.


Install smoke and carbon monoxide detectors.


Conduct a home hazard hunt. Anything that can move, fall, break or cause a fire is a home hazard. For example, a hot water heater or a book shelf can fall.


Prepare any equipment for escaping from your home such as ladders for upper level windows.


Stock emergency supplies and a Disaster Supplies Kit (a 72 hour survival kit). Pack this kit so that you can move it quickly to your car or assembly area if needed.


Family Disaster Supply Kit


Water - at least one gallon per person per day


Food - 72 hours of ready to eat high energy foods (remember there may not be any power so use foods that do not need to be refrigerated or cooked)


Food preparation supplies


First aid kit and non-prescription medications


Sanitary supplies


Shelter (a tent, camper or trailer)




Extra clothing




Special items for babies, disabled and elderly persons and family pets


Copies of important family documents


Money (you may not be able to access your bank accounts)

STEP 4: Train your family.


Know how to contact local emergency medical services.


Know how to turn off water, gas and electricity.


Know how to use the fire extinguisher.


Know how to do first aid and CPR.


Know how to escape and where to assemble.

STEP 5: Practice and maintain your plan.


Quiz family members every six months.


Conduct fire and emergency evacuation drills.


Replace outdated supplies.


Maintain equipment.


Replace batteries.

For more detailed information visit the Federal Emergency Management Agency (FEMA) web site on line at http://www.fema.gov. Check lists for developing a family disaster plan and developing a family disaster supply kit are available in the FEMA on line library at http://www.fema.gov/library/.



Communicable Disease Rule Update

The Bureau of Epidemiology is pleased to announce that the Communicable Disease Rule R386-702 has been updated. Utah’s list of reportable diseases is as follows:


Acquired Immunodeficiency Syndrome








Chlamydia trachomatis



Colorado tick fever

Creutzfeldt-Jakob Disease


Cyclospora infection



Ehrlichiosis, human granulocytic and human monocytic

Encephalitis: primary, post-infectious, arthropod-borne and unspecified

Enterococcal infection, vancomycin-resistant

Escherichia coli O157:H7


Gonorrhea: sexually transmitted and ophthalmia neonatorum

Haemophilus influenzae, invasive disease

Hansen Disease (Leprosy)

Hantavirus Infections and Pulmonary Syndrome

Hemolytic Uremic Syndrome, postdiarrheal

Hepatitis A

Hepatitis B, cases and carriers

Hepatitis, other viral: type C, and non-A non-B

Human Immunodeficiency Virus Infection.

Influenza, laboratory confirmed

Kawasaki Syndrome



Lyme disease



Meningitis, aseptic and bacterial (specify etiology)

Meningococcal Disease, invasive


Pelvic Inflammatory Disease



Poliomyelitis, paralytic


Q Fever

Rabies, human and animal

Relapsing fever, tick-borne and louse-borne

Reye Syndrome

Rheumatic fever

Rocky Mountain spotted fever


Rubella congenital syndrome



Staphylococcal Diseases (all outbreaks and staphylococcus aureus with resistance or intermediate resistance to vancomycin or resistance to methicillin isolated from any site)

Streptococcal Disease (invasive, group A isolated from a normally sterile site)

Streptococcal Toxic Shock Syndrome

Streptococcus Pneumoniae (drug-resistant invasive disease, isolated from a normally sterile site)

Syphilis, all stages and congenital


Toxic-Shock Syndrome




Typhoid, cases and carriers

Yellow fever

Any sudden or extraordinary occurrence of infectious or communicable disease is also reportable. Any disease occurrence, pattern of cases, suspect cases, or increased incidence of any illness which may indicate an outbreak, epidemic or related public health hazard, including but not limited to suspected or confirmed outbreaks of food borne or waterborne disease, newly recognized or re-emergent diseases or disease producing agents, shall be reported immediately by telephone to the Bureau of Epidemiology, Utah Department of Health, 801-538-6191.

Another addition to the rule is not only the reporting of selected drug-resistant diseases (see above), but the mandatory submission of specified organisms to the State public health laboratory. These organisms include:

Bacillus anthracis;

Bordetella pertussis;

Campylobacter species;

Clostridium botulinum;

Corny bacterium diphtheriae;

Enterococcus, vancomycin-resistant;

Escherichia coli, enterohemorrhagic;

Francisella tularensis;

Haemophilus influenzae, from normally sterile sites;

Influenza, types A and B;

Legionella species;

Listeria monocytogenes;

Mycobacterium tuberculosis complex;

Neisseria gonorrhoeae;

Neisseria meningitidis, from normally sterile sites;

Salmonella species;

Shigella species;

Staphylococcus aureus with resistance or intermediate resistance to vancomycin isolated from any site;

Vibrio cholera;

Yersinia species.

The language in the rule has also been updated and simplified to conform with new disease control recommendations, especially the sections dealing with rabies and typhoid fever.

If you have any questions regarding these changes, please call the Bureau of Epidemiology at (801)538-6191.







Old impacts and new public threats.

Place: State Capitol Building Main Auditorium

Date: March 24, 2000

Time: 8:30 A.M. to 4:00 P.M. (Registration 8:00—8:30)


$35.00 Advance Registration

$40.00 Day of Registration

$20.00 Student Advance Registration

$24.00 Student Day of Registration


For More Information Call

American Lung Association of Utah
1930 South 1100 East
Salt Lake City, Utah 84106

484-4456 or 1-800-LUNG-USA



Utah Department of Health, Bureau of Epidemiology
Monthly Morbidity Summary - November 1999 - Provisional Data

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The Epidemiology Newsletter is published monthly by the Utah Department of Health, Division of Epidemiology and Laboratory Services, Bureau of Epidemiology, to disseminate epidemiologic information to the health care professional and the general public.

Send comments to:  The Bureau of Epidemiology, Box 142104, Salt Lake City, UT 84114-2104, or call (801) 538-6191

Approval 8000008:  Appropriation 3705

Rod Betit, Executive Director, Utah Department of Health
Charles Brokopp, Dr.P.H., Division of Epidemiology and Laboratory Services
Craig R Nichols, MPA, Editor, State Epidemiologist, Director Bureau of Epidemiology
Gerrie Dowdle, MSPH, Managing Editor
Connie Dean, Production Assistant