Tag Archives: disease

One man’s detailed SHTF plan list

(Survival Manual/ Prepper articles/ My detailed SHTF plan)

The author of the following article has gone the extra step and made out a quite detailed list of objectives to accomplish if a SHTF event were to develop. Also, because he is a sailing enthusiast with apparently a large enough boat to carry his prep supplies, he has made the list with an eye to those specific circumstances. While reading the following article, substitute what Mr. ‘Maast’ does to prepare his boat, into what you’d do to prepare your home, auto, tow vehicle, or cabin. When he discusses procedures to ensure he has fresh water on-board, you should list what it will take for you, in your circumstance, to provide fresh water on land, etc. What is so great about this list, is the obvious value to seeing the timing, decision making events and procedures all laid out. With a list like this, you’ll know what pivotal items you have in supply, when various events trigger a given reaction and what needs to be done with specific items of equipment at specific times.
 .

My detailed SHTF plan
Tue Feb 01, 2011, Zombie Squad, by Maast
http://zombiehunters.org/forum/viewtopic.php?f=6&t=75866#p1668057

Here’s my SHTF plan, the main point is that I’m planning on specific capabilities and goals and prepping to meet them vs. just accumulating things that sound good (which I did when starting out)

Hopefully people can take this as a basic framework and adapt it to their particular needs.

As it stands now I can only accomplish (see below) the ‘interim bug-in portion’ and ‘the sewer’, I dont have the sandbags (easy fix), polycarbonate panels (expensive!!), additional folding 250gal rain barrels (though I do have a 60 gallon), thermoelectric, microhydro, boat bladder tank, boat mast or coal bags (easy fix)

Below is a list of my “Gucci” plans with everything I think we’ll need to be relatively comfortable, somebody just starting out should probably just focus on the basics first: Water, Food, Shelter, Safety and then add what you think you’ll need.

Day 0
1.  Immediate
•  If earthquake: check house structural integrity, check city gas/water/power/fire hazards. Grab/wear leather welding gloves/boots/jacket/chaps and 6’ long pry-bar; check/rescue neighbors. Check phone, check cell, wind up shortwave emergency radio. Get FMRS radios, base station w/ Ann, one on self, two spares.
•  Bring preps indoors to downstairs; unload all gear from metal trashcans to indoors.
•  Check outside freeze protected foamed 250gal rain barrel for leaks.
•  Tarp and spray foam any breaks in roof or walls.
•  If EMP ops check all electronics for aluminized trashcan shielding effectiveness; vehicles/generators/radios, check ruggedized laptop and USB thumb drive data, wind up shortwave radio, assign radios and guns.
•  Evaluate if immediate bug out is necessary (rolling firestorm, rising floodwaters, approaching battle lines, etc), if so grab BOBs, med equipment/supplies, tent, camping gear prepacked in rubbermaid boxes, guns/ammo, grab the three full 15 gal boat tanks on cache tank, generator, batteries/charger/inverter and stuff as much food (MREs and Mountain House have priority) and water will fit in Subaru Baja and utility trailer.

2.  Interim Bug-In:
Shelter
•  Home unlivable/non-repairable? Relocate to boat on trailer, assemble stairs to boat. Move med equipment/supplies, bedding, clothing, food, guns.
•  Secondary backup: Move canopy garage to back yard, web roof and sides with 650lb net cord, install tent stove/chimney/thimble, assemble and install plywood door & frame, tarp ground and overlap with sides, lay 2×4 stringers on tarp, spray 1.5 inch 3 pound foam layer on inside including space between ground stringers, leave 2 vinyl windows each side unfoamed, lay plywood floor. Install cots, shelving, tables, folding camping kitchen, med equip & supplies.
•  Reconfigure house: clear all furniture from downstairs family room, close and seal doors to downstairs B/Rs to conserve heat.

3.  No Power
•  Get/check flashlights, get camping stoves & lamps from rubbermaid boxes, use coleman propane lamp and save dual fuel lamp as backup/exterior use.
•  Hook up 400AH boat battery bank from battery maintainer to generator, battery charge meter, 40A multi-input battery charge controller & 2000w SW inverter.
•  Fill three 5-gallon gas cans from 200 gals in cache tank. Cache tank kept STRICT secret, also if asked tell everyone boat and suburban near empty. Put locking gas cap on suburban, siphon full suburban to cache tank if fuel is an issue.
•  Move refer food into 5-day coolers, freezer food into outside chest freezer. Put 2 liter bottles of water in freezer to freeze. If above freezing run power to chest freezer once a day. Rotate frozen water bottles into coolers once a day.
•  Run 110v power to auto dialysis machine.
•  Run 110v power to stove insert fan
•  Run 110v power to lamp w/ 110v LED bulb in L/R
•  If city gas available, run 110v to boiler, if not and below freezing drain boiler & baseboard pipes.
•  Set up Coleman propane stove on counter, when propane gone switch to wood gassifier camping stove, reserve dual fuel camping stove as emergency backup.
– Note: Pressure cooking ONLY on camping stoves from now on, everything else on wood stove insert or wood gassifier camping stove.

4.  No Water
•  Get the six 2 gallon jugs of water from outside shed and place in kitchen for immediate use.
•  Set up base camp gravity fed water filter & bag over sink.
•  Set up 250gal foldable rain barrel on elevated cinderblock platform downstairs near outside wall, ensure top of barrel is 1 foot minimum above ground level.
•  Siphon outside under deck foamed rain barrel to downstairs barrel.
•  Get camping shower bag from camping supplies, hang in tub/shower
•  Eventually rig 12v low flow pump feeding low flow shower head from warmed water in 5 gal buckets.
•  Make up several gallons of bleach from Pool Shock calcium hypochlorite crystals.

5.  Washing Clothes/Bedding
•  Place two Rubbermaid tubs in bathroom, one for washing by stomping on clothes, one for rinsing – use only 1-2 TBS of detergent, a little goes a long way in a tub.

6.  No Sewer
•  Set up camping porta-pottie in bathroom. Dig 4 foot deep cesspit in backyard, cover w/ styrofoam sheet.
•  Attach hose to tub/shower drain, run hose to yard
•  Attach hose to sink drain, run to cesspit, foam hose if below freezing.

7.  No Heat
•  Move bags of coal from outside alongside shed to downstairs or garage, install coal grate in wood stove insert, use coal for overnight burn, if cordwood close to used up switch to straight coal and keep cordwood for starting coal fires. Monitor stove for heat warping.8

8.  Transportation?
•  Roads passable? Gasoline resupply? If no gasoline available rig mountain bike w/ rickshaw trailer and studded tires (if winter), use for all movement if possible to save gas.

9.  No/Unreliable Communications and/or Information on situation
•  String up ham radio antenna in front tree, listen to national/international
..

Day 7 with no end to emergency in sight
 Switch to severe conservation mode
•  Switch to manual P dialysis, warm bags in pot on wood stove, do absolute minimum dialysis to conserve auto solution bags, save all tubing and connections and sterilize in grain alcohol
•  Run 12v line from battery bank to distribution 4 circuit breaker box in L/R, run lines from distribution box to 12v outlet boxes and affix outlet boxes to wall in L/R, B/R, Kitchen, and downstairs ceiling, use 12v LED lighting only.
•  Change wood stove insert blower over to temporary 12v fan.
•  Absolute minimum gasoline usage, no 110v usage at all with the exception of keeping freezer frozen, too much meat in freezer to allow to thaw and go bad.
•  Assemble stove dehydrator and dehydrate meat in freezer to “crispy critter” level, store in leftover mylar bags or 1 gallon canning jars w/ O2 and moisture absorbers
.

Day 10 with no end in sight, or if it looks like Bug-Out likely
Begin Pre-Pack & Boat Reconfigure [For those not using a boat as a bug out vehicle, make a list of similar ‘reconfigurations’ for using 2 or more family cars, a pickup truck bed, 1-2 tow trailers, a RV, etc. Mr larry]
•  Lay and secure bladder fuel tank on back deck, built temp deck above bladder tank, lay plywood sheets on temp deck.
•  Run boat packing checklist – pack boat with low value preps (cordage, lumber, fasteners, lug-alls, etc) not being used for interim bug-in, assemble high value preps in downstairs.
•  Attach aluminum emergency sailing mast to pre-welded pivot point on boat cabin roof
•  Attach outriggers to pivot points
•  Load leeboards
•  Load bolt-on outboard motor rudder extension
•  Disassemble 12×20 canopy garage, load on boat
•  Strap sea canoes to cabin roof, load canoe sail kits and and outriggers.
•  Load up electric trolling motors and deep cycle batteries
•  Evaluate road conditions/accessibility to the boat launches.
.

Day 30
1.  Bug-Out/In Decision
•  Local/Regional/National/Global emergency?
•  Hard trigger: national+ emergency, store shelves bare 5 days straight, resupply status unsure but thought not likely.
•  Hard trigger: lower 48 EMP, catastrophic damage, no barge shipping
•  Hard trigger: biowarfare plague
•  Hard trigger: widespread local civil rioting/raiding
•  Evaluate medical item and prescription resupply status. If resupply available bug-in regardless of conditions.
•  Middle of a city of 300,000 people and sufficient local agriculture not even a remote possibility
•  Food available but power/water/sewer not then bug-in, without food supply will starve in 10 months without resources at BOL.
•  If no food supply people will start to starve at this point, starving people form mobs, no matter what I do neighbors will suspect, if nothing else fuel in boat. •  Some friends and coworkers already know of some preps. House is not fireproof.
•  If no food supply, no medical supplies either, no reason to stay around.
…..Sheer bulk and weight of factory dialysis solution precludes bug-out, reevaluate when enough gone to enable bug out.

2.  Bug In, Long Term:
_a) Secure House
•  Paint downstairs windows black, reinforce downstairs glass with plywood panels, screw ½ polycarbonate sheets to all indoor window frames leaving vent holes and access in kitchen, L/R and B/R. Reinforce downstairs poly with 2x4s, shovel boat pad gravel between windows and polycarbonate. Spatter mud against outside of front downstairs window.
•  Sandbag all upstairs front walls and 15’ along sides up to 4’, leave firing ports at windows.
•  Reinforce downstairs ceiling next to walls with 2×4 uprights and headers to take weight of sandbags.
•  Sandbag both sides of front door, leave vision port to see who’s at door.
•  Install doorknob wedge bar to all doors.
•  If no city gas move all firewood to garage, all usable items in garage to downstairs.

_b)  No Water Long Term
•  Set up additional foldable 250gal rain barrel downstairs next to other on elevated platform.
•  Connect both barrels in parallel, run 3 inch overflow hose to outside through wall from second barrel. Catch water from front and back downspouts in screened 5 gal buckets 4’ above ground attached to wall, run garden hose from bottom of buckets to first downstairs barrel.
•  Rig sand filter for incoming water to barrels
•  Rig intermittent 12v fish tank bubbler to barrels to keep fresh
•  Run hose from second barrel to foot pump to black ABS 12 gal barrel w/ spigot on kitchen counter at the sink.
•  Hang 10 gal aluminum rectangular water tank under mantle over stove, insulate all sides except bottom of radiant heat absorber flange, paint that flat black, adjust flange size to prevent boiling water in tank. Risk of freezing precludes using on-demand pressure pump and tapping into existing water pipes, must have all pipes/hose exposed to warmed living area.
•  Rig foot pump on from downstairs barrels to mantle warm water tank. Tank exit hose is from top, to get warmed water out you pump cold into bottom of tank.
•  Rig on-demand 12v marine pump from downstairs tank through heat exchange coil in warm water tank, install anti-scald valve at exit from warm water and run to bathroom, use automotive pressure hose.
•  Rig drainback system so water doesn’t stand in hose and get cold.
•  Put clean 32 gallon trash can near hearth in corner, keep full of snow to melt, siphon water to downstairs barrel when gets ¾ full – always leave min of ¼ full to assist in melting.

_c)  No Power Long Term
•  Move boat battery bank/charge controller/inverter/voltmeter to inside downstairs, vent battery box to outside. Set up charge controller, inverter and battery meter on wall shelf above box.
•  Rerun 110v power to freezer only.
•  Move chest freezer onto deck outside kitchen under canopy, raise on blocks and foam sides, bottom and top, leave vent for motor. Use two layers of sign plastic along lip to keep from gluing lid shut, trim flush after foam layer cured.
•  Put generator on back deck in hush box, attach muffler to exhaust.
•  Put both solar panels w/ mylar concentrators on roof, wire to charge controller.
•  Install two 50W thermoelectric generators to wood stove, ensure thermosiphon water cooling loop is filled w/ glycol solution and radiator is outside & oriented correctly. Wire to charge controller.
•  Run 12V via 8 gauge solid core ROMEX to 12V distribution box w/ breakers and then to 12V outlet boxes in kitchen, L/R, B/R and downstairs ceiling.
•  Plug in 12V LED lighting to LR, kitchen, B/R and downstairs ceiling.
•  Replace 110v blower fan on wood stove with 12v fan.
•  Tarp off edges of canopy around deck.

_d)   No Sewer Very Long Term
•  Construct sewage septic system good for 4 years min:
…..Dig 4’deep 4’ wide and 9’ long hole in backyard away from tree roots, ensure bottom is very flat and slopes 1 inch from one to the other, add first 1” sand and then 2” pea gravel on bottom.
…..Place two 55 gallon brute plastic trash cans upright side-by-side in hole.
…..Connect the two cans by drilling 3” hole 6 inches from the top of both cans and assemble 3” ABS pipe connection in form of upside down “U”, legs of the U should be 7” long pointing towards bottom of cans, marine goop liberally in place inside and out of can
…..Drill a 3rd hole on the opposite side of the can/can connection
…..Take third 55 gallon brute can and cut it in half. Affix halves brim-to-brim resulting in a trough that’s 26” wide X 66” long, drill 3/8 holes every 4 inches three inches up from cut lip.
…..Cut 3” hole in trough at one end of trough chamber at apex of curve.
…..Place chamber face down on gravel in trench next to upright cans, hole toward cans, cover with plastic hardware cloth.
…..Make another ABS upside down U, through additional hole, inside leg 7” outside leg connecting to chamber, goop it.
…..Cover with perlite to 1 inch over top of chamber, cover with 3” blue foam board.
…..Cut 3” hole in lid, place lid on first can, run ABS pipe in, have elbow at lid for support, run pipe out in level trench slightly sloping towards house sitting on foam board. Cut 2 more holes in lids; one in center of each for pumpout access.
…..Foam cans including lids, fill septic trench with perlite up to 3” below ground level, then dirt.
…..Foam all ABS pipe outside house. Cover with dirt.
•  Remove standard toilet, replace with old manual pump marine toilet w/ macerator “If its yellow let it mellow, if its brown flush it down”, SEVERELY limit toilet paper use.
•  Attach travel bidet to on-demand marine 12V pump system and plumb to warm water tank, continue plumbing into shower/tub.
•  Connect sink drain to hose and route to septic, foam exposed hose
•  Route tub/shower drain to empty 250 gal foamed foldable rain barrel outside, if below freezing foam hose. Saved greywater may be useful if bug-in for spring garden, no baths only navy showers.

_e)  Plant Garden
•  To supplement probable meager food supply build garden, climate requires greenhouse style covered garden.
•  Work out deal to cut down neighbors light blocking trees, we’ll all need firewood anyway.
•  Build offset A frame style cover, south leg of frame to be at 60 degrees, back wall insulated and covered with mylar reflectors, front wall double wall acrylic panels.
•  Build raised bed garden in greenhouse and drip irrigation system, plant in high density intensive gardening
•  Install LED grow lights to extend growing season
•  Investigate wood fired boiler to heat thermal mass in greenhouse to extend growing season year-round.
•  Save urine to use as fertilizer
•  Plant rest of yard in raised beds under cold frames and edges in wolfberry, front yard in hedge of wolfberry too – it’ll look like a decorative plant, investigate edible landscaping.
•  Plant edible blue-berry honeysuckle as hedges, fruit is edible and can be used to make jams and jellies and is high in vitamin C

3.  Bug-Out decided
_a)  Bug-Out Process
•  Disassemble interim bug-out gear, recover hoses, empty and fold up 250gal rain barrel
•  Finish boat packing checklist
•  Load high value preps in one go: food, filled fuel cans, guns, ammo, powder, generators, bug in equipment, durable cold weather clothing, 2 part spray foam canisters and equipment
•  Pump cache tank contents into 250gal bladder tank on boat
•  Pump in just enough fuel in suburban to reach boat launch +10%
•  Depart in middle of night, tell nobody of departure date or time, if asked say “Not ready yet, another 5 days or so”
•  At boat launch siphon all fuel from suburban
•  Run on kicker only to save gasoline, use emergency mast & sail if calm and winds allow.

_b)  Arrival at BOL Cove
•  Drop the tall pine trees across narrow entrance to cove
•  Retrieve 9” penstock ABS pipe sections pre-positioned and sunk on location, also retrieve 2” pipe sections and buried cordage and coils of aircraft cable.
•  Begin construction of camp, live on boat until construction complete, boat heater diesel good for ~30 days.
•  Inflate flotation bags and build floating dock from 3”-4” diameter trees. Assemble steps into boat.
vErect over-roof:
…..Thread stainless aircraft cable through 40’ of 2” ABS pipe, then stretch cable 18 feet high between two stout trees with fairly level ground between them, tension to several hundred pounds with come-along, clamp and solder cable. Pipe provide smooth folds and prevents cable abrading tarp.
….. Thread and stretch two more cables 8” high 10 feet each from centerline of first cable
…..Web roof supports using 650 net cord every 2 feet
…..Place 40×40 heavy duty tarp over wires (select tarp that has rough surface), stretch along and paint with black rubberized RV roof paint as it goes up to protect it from UV degradation.
…..Foam spots on underside to glue tarp to roof webbing
•  Erect 12×20 canopy garage under over-roof as is noted above in shelter plan, run stove chimney out through rear wall to avoid over roof.
•  Alternate shelter construction: Lower aircraft cables to 14 foot peak and 4 foot high sides, lay waterproof tarp on ground, build basic 6’wall frames under over-roof using 2×2 lumber, build door & door frame and put in place, staple ground tarp overlap to frame, staple heavy duty tarps to frame, place 2×2 floor stringers on ground, foam inside walls/floor/roof, use 3-4” of foam on roof. Install tent stove with thimble and chimney through rear wall
…..Coat area outside within 5 feet of chimney with Flameseal.
– Place paraffin based thermal mass device kettle on tent stove to even out temp swings
•  Rig perimeter bear alarm to activate noise and lights
•  Run water hose to food prep area sink, let run continually to prevent freezing, keep water hose under surface of ocean and stream as much as possible.
•  As time allows build perimeter fence.
•  Run up ham radio antenna and monitor situation
•  As time allows build corduroy walls on shelter walls for bear protection
•  As time allows sandbag outside
•  Build tent stove dehydrator
•  Install thermoelectric generators on tent stove
•  Erect solar cells and reflectors
•  Install power and warm water systems
•  Build shower, use RV roofing paint to waterproof plywood
•  Install sewer septic and manual marine toilet (don’t want to be discharging waste into area I’ll be gathering seaweed from.
•  Build penstock and lay ABS pipe for microhydro from stream that runs year-round,
•  Only use microhydro if thermoelectric and solar not enough to maintain charge in battery bank and elec trolling motor batteries.
•  Hunt deer, moose and bear, gather salmon, rockfish, other fish, gather seaweed and wild edibles IAW seashore survival books. Dry and store, use food prep stores as little as possible. Use casting net as much as possible to conserve hooks and line.
•  Plant gatherable edibles like blueberry honeysuckle and wolfberry that can withstand climate
•  Burn seashells to lime to make basic mortar, eventually replace tent stove with mortared rock stove, before foam goes bad extend shelter at least one room using debarked trees and foam inside.
•  In time as situation stabilizes explore trading possibilities with local town or other steads. Travel using sail power or trolling motors only.
•  Evaluate relocation to shore to assist in rebuilding town

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Filed under Prepper articles, Survival Manual

Malaria

(Survival Manual/ 6. Medical/ b)Disease/ Malaria)

Pasted from <http://www.mayoclinic.com/health/malaria/DS00475/DSECTION=prevention>
Pasted from <http://www.getawayafrica.com/index.php?id=432>

Definition
Malaria produces recurrent attacks of chills and fever. Caused by a parasite that’s transmitted by mosquitoes, malaria kills about 1 million people each year worldwide.

While the disease is uncommon in temperate climates, malaria is still prevalent in tropical and subtropical countries. World health officials are trying to reduce the incidence of malaria by distributing bed nets to help protect people from mosquito bites as they sleep. A vaccine to prevent malaria is currently under development.

If you’re traveling to locations where malaria is common, take preventive medicine before, during and after your trip. Many malaria parasites are now immune to the most common drugs used to treat the disease.

[Map above: Places currently affected by Malaria.]

Symptoms
A malaria infection is generally characterized by recurrent attacks with the following signs and symptoms:
•  Moderate to severe shaking chills
•  High fever
•  Profuse sweating as body temperature falls

Other signs and symptoms may include:
•  Headache
•  Nausea
•  Vomiting
•  Diarrhea

Malaria signs and symptoms typically begin within a few weeks after a bite from an infected mosquito. However, some types of malaria parasites can lie dormant in your body for months, or even years.

 When to see a doctor
Talk to your doctor if you experience a high fever while living in or after traveling to a high-risk malaria region. The parasites that cause malaria can lie dormant in your body for months. If you have severe symptoms, seek emergency medical attention.

Causes
Malaria is caused by a type of microscopic parasite that’s transmitted most commonly by mosquito bites.

Mosquito transmission cycle
•  Uninfected mosquito. A mosquito becomes infected by feeding on a person who has malaria.
•  Transmission of parasite. If you’re the next person this mosquito bites, it can transmit malaria parasites to you.
•  In the liver. The parasites then travel to your liver — where they can lie dormant for as long as a year.
•  Into the bloodstream. When the parasites mature, they leave the liver and infect your red blood cells. This is when people typically develop malaria symptoms.
•  On to the next person. If an uninfected mosquito bites you at this point in the cycle, it will become infected with your malaria parasites and can spread them to the next person it bites.

Other modes of transmission
Because the parasites that cause malaria affect red blood cells, people can also catch malaria from exposures to infected blood, including:
•  From mother to unborn child
•  Through blood transfusions
•  By sharing needles used to inject drugs

Risk factors
The biggest risk factor for developing malaria is to live in or to visit tropical areas where the disease is common. Many different subtypes of malaria parasites exist. The variety that causes the most lethal complications is most commonly found in:
•  African countries south of the Sahara desert
•  The Indian subcontinent
•  Solomon islands, Papua New Guinea and Haiti

Risks of more severe disease
People at increased risk of serious disease include:
•  Young children and infants
•  Travelers coming from areas with no malaria
•  Pregnant women and their unborn children

Poverty, lack of knowledge, and little or no access to health care also contribute to malaria deaths worldwide.

 Immunity can wane
Residents of a malaria region may be exposed to the disease so frequently that they acquire a partial immunity, which can lessen the severity of malaria symptoms. However, this partial immunity can disappear if you move to a country where you’re no longer frequently exposed to the parasite.

Complications
Malaria can be fatal, particularly the variety that’s common in tropical parts of Africa. The Centers for Disease Control and Prevention estimate that 90 percent of all malaria deaths occur in Africa — most commonly in children under the age of 5.

In most cases, malaria deaths are related to one or more of these serious complications:
•  Cerebral malaria. If parasite-filled blood cells block small blood vessels to your brain (cerebral malaria), swelling of your brain or brain damage may occur.
•  Breathing problems. Accumulated fluid in your lungs (pulmonary edema) can make it difficult to breathe.
•  Organ failure. Malaria can cause your kidneys or liver to fail, or your spleen to rupture. Any of these conditions can be life-threatening.
•  Severe anemia. Malaria damages red blood cells, which can result in severe anemia.
•  Low blood sugar. Severe forms of malaria itself can cause low blood sugar, as can quinine — one of the most common medications used to combat malaria. Very low blood sugar can result in coma or death.

Recurrence may occur
Some varieties of the malaria parasite, which typically cause milder forms of the disease, can persist for years and cause relapses.

Tests and diagnosis
Blood tests can help tailor treatment by determining:
•  Whether you have malaria
•  Which type of malaria parasite is causing your symptoms
•  If your infection is caused by a parasite resistant to certain drugs
•  Whether the disease is affecting any of your vital organs
Some blood tests can take several days to complete, while others can produce results in less than 15 minutes.

Treatments and drugs
The types of drugs and the length of treatment will vary, depending on:
•  Which type of malaria parasite you have
•  The severity of your symptoms
•  Your age
•  Whether you’re pregnant

Medications
The most common antimalarial drugs include:
•  Chloroquine (Aralen)
•  Quinine sulfate (Qualaquin)
•  Recommended treatment Quinine can be given by the oral, intravenous or intramuscular routes. Quinine or quinine-containing compounds such as Quinimax ® should not be given alone for the treatment of malaria as short courses, e.g. 3 days, owing to the possibility of recrudescence (200).

When administered to patients with uncomplicated malaria, quinine should be given orally if possible, by one of the following regimens:
*  Areas where parasites are sensitive to quinine: Quinine, 8 mg of base per kg three times daily for 7 days.
*  In Areas with marked decrease in susceptibility of P. falciparum to quinine Quinine 8 mg of base per kg three times daily for 7 days plus Doxycycline 100 mg of salt daily for 7 days (not in children under 8 years of age and not during pregnancy); a pharmacologically superior regimen would include a loading dose of 200 mg of doxycycline followed by 100 mg daily for 6 days. or  Tetracycline 250 mg four times daily for 7 days (not in children under 8 years of age and not in pregnancy).

•  Hydroxychloroquine (Plaquenil)
•  Mefloquine
•  Combination of atovaquone and proguanil (Malarone)

The history of antimalarial medicine has been marked by a constant struggle between evolving drug-resistant parasites and the search for new drug formulations. In many parts of the world, for instance, resistance to chloroquine has rendered the drug ineffective.

Prevention
If you’re going to be traveling to a location where malaria is common, talk to your doctor a few months ahead of time about drugs you can take — before, during and after your trip — that can help protect you from malaria parasites.
In general, the drugs taken to prevent malaria are the same drugs used to treat the disease. Your doctor needs to know where you’ll be traveling so that he or she can prescribe the drug that will work best on the type of malaria parasite most commonly found in that region.

Doxycycline: Travellers who cannot take Mefloquine should take Doxycycline to prevent malaria if they are traveling in a malaria area. This drug is taken every day at an adult dose of 100 mg, to begin on the day before entering the malaria area, while there, and continued for 4 weeks after leaving. If Doxycycline is used, there is no need to take other preventive drugs, such as Chloroquine.

Possible side effects include skin photosensitivity that may result in an exaggerated sunburn reaction. Wearing a hat and using sunblock can minimize this risk. Women who take Doxycycline may develop vaginal yeast infections and should discuss this with their doctor before using Doxycycline.

Doxycycline should not be used by:
•  pregnant women during their entire pregnancy,
•  children under 8 years of age or
•  travellers with a known hypersensitivity to doxycycline

No vaccine yet
Scientists around the world are trying to develop a safe and effective vaccine for malaria. As of yet, however, there is still no malaria vaccine approved for human use.

 Reducing exposure to mosquitoes
In countries where malaria is common, prevention also involves keeping mosquitoes away from humans. Strategies include:
•  Spraying your home. Treating your home’s walls with insecticide can help kill adult mosquitoes that come inside.
•  Sleeping under a net. Bed nets, particularly those treated with insecticide, are especially recommended for pregnant women and young children.
•  Covering your skin. During active mosquito times, usually from dusk to dawn, wear pants and long-sleeved shirts.
•  Spraying clothing and skin. Sprays containing permethrin are safe to use on clothing, while sprays containing DEET can be used on skin.

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Filed under Survival Manual, __6. Medical, ___b) Disease

Amoxicillin

(Survival Manual/ b. Medical/ c) General Clinic/ Amoxicillin)

Disclaimer
The information, ideas, and suggestions in the 4dtraveler.net blog are not intended as a substitute for professional advice. Before following any suggestions contained in this post, you should consult your personal physician. Neither the author or Word Press shall be liable or responsible for any loss or damage allegedly arising as a consequence of your use or application of any information or suggestions in this blog.

Pasted from <http://www.drugs.com/amoxicillin.html>
Pasted from <http://www.medicinenet.com/amoxicillin/article.htm>
Pasted from <http://en.wikipedia.org/wiki/Amoxicillin>

Amoxicillin brand names: Amoxil, Dispermox, Moxatag, Trimox, Wymox

A.   Amoxicillin and its use
.
 Below, pasted from <http://www.drugs.com/amoxicillin.html>
What is amoxicillin?
Amoxicillin is a penicillin antibiotic. It fights bacteria in your body.
Amoxicillin is used to treat many different types of infections caused by bacteria, such as ear infections, bladder infections, pneumonia, gonorrhea, and E. coli or salmonella infection. Amoxicillin is also sometimes used together with another antibiotic called clarithromycin (Biaxin) to treat stomach ulcers caused by Helicobacter pylori infection. This combination is sometimes used with a stomach acid reducer called lansoprazole (Prevacid).
Amoxicillin may also be used for purposes not listed in this medication guide.

Important information about amoxicillin
Do not use this medication if you are allergic to amoxicillin or to any other penicillin antibiotic, such as ampicillin (Omnipen, Principen), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill), penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids), and others.

Before using amoxicillin, tell your doctor if you are allergic to cephalosporins such as Omnicef, Cefzil, Ceftin, Keflex, and others. Also tell your doctor if you have asthma, liver or kidney disease, a bleeding or blood clotting disorder, mononucleosis (also called “mono”), or any type of allergy.

Amoxicillin can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking amoxicillin. Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Amoxicillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking amoxicillin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Preparions: Capsules: 250 and 500 mg. Tablets: 500 and 875 mg. Chewable tablets: 125, 200, 250, and 400 mg. Powder for suspension: 50 mg/ml ; 125, 200, 250, and 400 mg/5 ml. Tablets for suspension: 200 and 400 mg
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Below, pasted from <http://www.medicinenet.com/amoxicillin/article.htm>
Storage: Store Amoxil capsules as well as 125 and 250 mg dry powder at or below 20°C (68°F); tablets, chewable tablets, as well as 200 and 400 mg dry powder should be stored at or below 25°C(77°F). Store Trimox capsules and unreconstituted powder at or below 20°C (68°F) and chewable tablets at room temperature 15°-30°C (59°-86°F). Powder that has been mixed with water should be discarded after 14 days. Refrigeration is preferred but not required for powder mixed with water.

Prescribed for: Amoxicillin is used to treat infections due to organisms that are susceptible to the effects of amoxicillin. Common infections that amoxicillin is used for include infections of the middle ear, tonsils, throat, larynx (laryngitis), bronchi (bronchitis), lungs (pneumonia), urinary tract, and skin. It also is used to treat gonorrhea.

Dosing: For most infections in adults the dosing regimens for amoxicillin are 250 mg every 8 hours, 500 mg every 8 hours, 500 mg every 12 hours or 875 mg every 12 hours, depending on the type and severity of infection.

For the treatment of adults with gonorrhea, the dose is 3 g given as one dose.

For most infections, children older than 3 months but less than 40 kg are treated with 25 mg/kg/day in divided doses every 12 hours, 20 mg/kg/day in divided doses every 8 hours, 40 mg/kg/day in divided doses every 8 hours or 45 mg/kg/day in divided doses every 12 hours depending on type and severity of the infection.
Amoxicillin can be taken with or without food.

 Drug interactions: Amoxicillin is rarely associated with important drug interactions.

Side effects: Side effects due to amoxicillin include diarrhea, dizziness, heartburn, insomnia, nausea, itching, vomiting, confusion, abdominal pain, easy bruising, bleeding, rash, and allergic reactions. Individuals who are allergic to antibiotics in the class of cephalosporins may also be sensitive to amoxicillin.

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Below, pasted from <http://www.drugs.com/amoxicillin.html>
Before taking amoxicillin
Do not use this medication if you are allergic to amoxicillin or to any other penicillin antibiotic, such as:

  • ampicillin (Omnipen, Principen);
  • dicloxacillin (Dycill, Dynapen);
  • oxacillin (Bactocill); or
  • penicillin (Bicillin C-R, PC Pen VK, Pen-V, Pfizerpen, and others).

To make sure you can safely take amoxicillin, tell your doctor if you are allergic to any drugs (especially cephalosporins such as Omnicef, Cefzil, Ceftin, Keflex, and others), or if you have any of these other conditions:

  • asthma;
  • liver disease;
  • kidney disease;
  • mononucleosis (also called “mono”);
  • a history of diarrhea caused by taking antibiotics; or
  • a history of any type of allergy.

FDA pregnancy category B. Amoxicillin is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Amoxicillin can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking amoxicillin. Amoxicillin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

 How should I take amoxicillin?

  • Take amoxicillin exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
  • You may take amoxicillin with or without food.
  • Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
  • You may place the liquid directly on the tongue, or you may mix it with water, milk, baby formula, fruit juice, or ginger ale. Drink all of the mixture right away. Do not save any for later use.
  • The chewable tablet should be chewed before you swallow it.
  • Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time.
  • To be sure this medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Your liver and kidney function may also need to be tested. Visit your doctor regularly.
    • If you are being treated for gonorrhea, your doctor may also have you tested for syphilis, another sexually transmitted disease.
    • If you are taking amoxicillin with clarithromycin and/or lansoprazole to treat stomach ulcer, use all of your medications as directed. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor’s advice.
  • Take amoxicillin for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Amoxicillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.
  • Amoxicillin can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using this medication.
  • Store this medication at room temperature away from moisture, heat, and light. You may store liquid amoxicillin in a refrigerator but do not allow it to freeze. Throw away any liquid amoxicillin that is not used within 14 days after it was mixed at the pharmacy.


What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. 

What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include confusion, behavior changes, a severen skin rash, urinating less than usual, or seizure (black-out or convulsions).

 What should I avoid while taking amoxicillin?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking amoxicillin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to. 

Amoxicillin side effects
Get emergency medical help if you have any of these signs of an allergic reaction to amoxicillin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

  • white patches or sores inside your mouth or on your lips;
  • fever, swollen glands, rash or itching, joint pain, or general ill feeling;
  • severe blistering, peeling, and red skin rash;
  • pale or yellowed skin, yellowing of the eyes, dark colored urine, fever, confusion or weakness;
  • severe tingling, numbness, pain, muscle weakness; or
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Less serious amoxicillin side effects may include:

  • stomach pain, nausea, vomiting;
  • vaginal itching or discharge;
  • headache; or
  • swollen, black, or “hairy” tongue.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

 What other drugs will affect amoxicillin?
Tell your doctor about all other medicines you use, especially:

  • An antibiotic such as azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), or telithromycin (Ketek);
  • Sulfa drugs (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others); or
  • A tetracycline antibiotic such as demeclocycline (Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), minocycline (Dynacin, Minocin, Solodyn, Vectrin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap).

This list is not complete and other drugs may interact with amoxicillin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
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Below, pasted from <http://en.wikipedia.org/wiki/Amoxicillin>
Modes of Delivery
Amoxicillin is usually taken orally, commonly as a tablet or a suspension, but can also be injected. There is recent research with mice that indicates successful delivery using intraperitoneally injected amoxicillin-bearing microparticles.

Side-effects
Side-effects include nausea, vomiting, rashes, and antibiotic-associated colitis. Loose bowel movements (diarrhea) also may occur. Rarer, but patient-reported, side-effects include mental changes, lightheadedness, insomnia, confusion, anxiety, sensitivity to lights and sounds, and unclear thinking. Immediate medical care is required upon the first signs of these side-effects.

The onset of an allergic reaction to amoxicillin can be very sudden and intense – emergency medical attention must be sought as quickly as possible. The initial onset of such a reaction often starts with a change in mental state, skin rash with intense itching (often beginning in fingertips and around groin area and rapidly spreading), and sensations of fever, nausea, and vomiting. Any other symptoms that seem even remotely suspicious must be taken very seriously. However, more mild allergy symptoms, such as a rash, can occur at any time during treatment, even up to a week after treatment has ceased. For some people who are allergic to amoxicillin the side effects can be deadly.

Use of the amoxicillin/clavulanic acid combination for more than one week has caused mild hepatis in some patients. Young children having ingested acute overdoses of amoxicillin manifested lethargy, vomiting and renal dysfunction.

 Nonallergic amoxicillin rash
Somewhere between 3% and 10% of children taking amoxicillin (or ampicillin) show a late-developing (>72 hours after beginning medication and having never taken penicillin-like medication previously), often itchy rash, which is sometimes referred to as the “amoxicillin rash.” The rash can also occur in adults.

The rash is described as maculopapular or morbilliform (measles-like; therefore, in medical literature, it is called “amoxicillin-induced morbilliform rash”). It starts on the trunk and can spread from there. This rash is unlikely to be a true allergic reaction, and is not a contraindication for future amoxicillin usage, nor should the current regimen necessarily be stopped. However, this common amoxicillin rash and a dangerous allergic reaction cannot easily be distinguished by inexperienced persons, and therefore a healthcare professional should be consulted if a rash develops.

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B.    Fish Mox (Amoxicillin)
AMAZON.COM: Fish Mox (Amoxicillin), 250mg, 100 Capsules, $16.28 + free shipping.
•  Standard pharmacy quality Amoxicillin antibiotic
•  Labeled for use in fish tanks, in pull apart capsules for easy use – 250 mg. strength

Product Description
Fish-Mox exerts a bactericidal action on gram positive and some gram negative bacteria. Useful for control of some common bacterial diseases of fish including aeromonas and pseudomonas genera and mysobacterial group (gill diseases, chondrococcus).

Add contents of one capsule (250 mg) into aquarium for each 10 gallons  of water to be treated. It is recommended that extended medication baths continue for a minimum of 5 days & for not more than 10 days. Discontinue treatment if no improvement is noted within 5 days.
[10 gallons water per 250mg Amoxicillin * 8.3 pounds water per gallon water =83 pounds of water per 250mg Amoxicillin
or 500mg Amoxicillin per 166 lbs body weight.]

 Customer reviews:
‘For most infections, the dosage weight of this drug is 500mg for an average 160-200 lbs adult, taken 2 to 3 times a day. Take a total of 1 Gram (1000  mg) per day, using 500mg Fish Mox that would be two pills a day. Water mass is considered in determining dosage, since this is a Penicillin class of drug. You can double the dosage for short term, serious infections. A bottle should cost $25 for 100 Pills. It’s a human grade pharmaceutical medication, the same pills humans take.’ Pasted from <http://www.godlikeproductions.com/forum1/message813524/pg1>

1)  Review of product “Fish Mox“, February 11, 2007 By Cathy F. Elkiss (Gettysburg, PA USA This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) “I run a sanctuary for abandoned and homeless cats in my community, and I like to keep a supply of amoxicillin and ampicillin on hand for treating the occassional upper respiratory infections to which these animals are prone. They are both excellent products – safe, inexpensive, easy to use and most important, effective. Thank you! Cathy Elkiss”
2)  It’s The Real Stuff!!, April 17, 2009 By A.A.Roxx (PA) This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) “I had a bad sinus infection, tried to get a doctors appointment and was told I had to wait 2 weeks. I ordered the Fishmox received it fast from Amazon, took it 4 times a day and within 5 days the sinus infection was gone! Stayed on it for 10 days total. I saved $100 doctors visit and $90 Amoxicillin purchase (I have no medical insurance). It is real Amoxicillin. It worked for me.’
3)   Pharmaceutical Grade Amoxicillin, February 25, 2011 By J. Ellison (Silverton, oregon) – This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) “Fish-Mox is pharmaceutical grade Amoxicillin made in Tolleson AZ, & is same as Human Antibiotic. Capsule has FDA lot & Registration number printed on each Cap. Is non-suspended yellow powder in a pull-apart gelatin capsule. It’s the Real-McCoy; Excellent value. JE Oregon”
4)  Fish Mox (Amoxicillin) 250mg, 100 Capsules, February 2, 2011 By nubbles. This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) ‘This is the real deal pharmacy grade Amoxicillin, 250mg, 100 caps. Of course it’s for aquarium use only, but if you accidentally take some yourself, for let’s say calming your abscessed tooth down, you will be very OK. and if your dog accidentally eats a couple a day it might accidentally calm down his ear yeast infection. Order with confidence! and upon arrival you can inspect the pills, enter the ID on them ‘westward 938’ into google and you will see info from FDA and others telling you these are the real deal.”
5)  100% Amoxicillan, See Below……, December 10, 2010 By Westfin. This review is from: Fish Mox (Amoxicillin) 250mg, 100 Capsules (Misc.) “I just received my order of Fish Mox, which will be used for my fish, but I was curious so I looked up the name and number from one of the capsules and here are the results: <http://www.drugs.com/imprints/west-ward-938-15375.html>&#8221; [“West-ward 938”, Pill imprint West-ward 938 has been identified as Amoxicillin 250 mg. Amoxicillin is used in the treatment of urinary tract infection; bacterial infection; bladder infection; bronchitis; upper respiratory tract infection (and more), and belongs to the drug class aminopenicillins. There is no proven risk in humans during pregnancy”….]

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See also the informative YouTube videos with, “Patriot Nurse”. The following link takes you to her discussion of the  “Top 5 Antibiotics for SHTF”:

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http://www.youtube.com/watch?v=DOfthwm_v3E&feature=relmfu

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See also the book, “The Doom and Bloom(tm) Survival Medicine Handbook” (Keep your loved ones healthy in every disaster, from wildfires to a complete societal collapse),  by  Joseph Alton, M.D. and AMY ALTON, A.R.N.P., sold through Amazon.com

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Lists of items to have ahead of a disaster

(News & Editorial/Lists of items to have ahead of a disaster)

The following lists are some things you should have in storage before an emergency grid down, war scenario, petroleum energy crisis, currency/banking collapse type situation develops (these items are also good to have on hand in case of job or income loss, extreme weather situations, or earthquake-tsunami-volcanic events:

A.  Emergency Survival Food list
_1. Grocery Store & Bulk Foods
•  Rice
•  Legumes: Pinto beans, Black beans, split peas, etc.
•  Oatmeal, cornmeal
•  Canned Fruits (lots), various canned vegetables & canned tomatoes, soups & stew.
•  Milk: Canned/Evaporated, powdered, sweetened/condensed
•  Eggs, powdered
•  Peanut Butter, nuts, popcorn
•  Dehydrated fruits & vegetables
•  Jerky,  Trail Mix
•  Wasa Multigrain flat bread, Graham crackers, Saltines, etc.
•  Chocolate, cocoa, Tang, punch
•  Honey, syrup,white sugar, brown sugar
•  Spices (the basics: salt, pepper, cinnamon, garlic, onion salt, etc,)
•  Soy Sauce, vinegar, bouillon cubes or granules
•  Canned Meats: Tuna, chicken, Spam, ham, etc.
•  Cooking Oil & spray
•  Baking Supplies & flour, yeast, packaged muffin mix & pancake mix
•  Coffee, tea
•  Vitamins, Minerals & Supplements
•  Water: Quickly figure 1 gallon drinking water/person/day. As cases of bottled water, or from a filer unit like the ‘Big Berkey’ (Google it), a 55 gallon ‘rain barrel prefilled with public utility water, water purification with household bleach or boiling. Don’t store everything else first and skip the water. You can live a month without food, but only about 3 days without water…start out with the proper priorities.

_2. Long Term Emergency Foods (MRE’s and/or a mix of Freeze Dried and  Dehydrated foods stored in either nitrogen packed #10 gallon cans or in 5 gallon plastic buckets, depending on the product.)
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B.  List of 55 other, sometimes overlooked items you should maintain in stock
1.  Toilet Paper, and other sanitation items such as feminine hygiene products, diapers for infants, etc. These are items that should be mass stored if possible.
2.  Paper Towels. Too many uses to mention, store as many as you can.
3.  Coffee Filters. For those drinkers of coffee of course, but these are excellent filters for many other purposes.
4.  Trash Bags. All sizes. You can also store many free plastic grocery bags from the store every time you get them after shopping. Important for bagging up refuse and preventing disease.
5.  Zip type Freezer Bags. Lot of uses.
6.  Coolers, various sizes. If you have room, can be used to keep things cool or cold, but also used to keep items from freezing in very cold weather.
7.  Shovels. All sizes from small garden type to those used for digging. Very important to have after a disaster.
8.  Soaps and Cleansers. Sponges and other scratchy pads. You are likely not going to have a dishwasher after a disaster and you have to have some means of cleaning pots, pans, dishes.
9.  Cotton Rounds. First aid uses, Excellent Fire-starter (mixed with Vaseline).
10.  Paper to write on. This includes note pads, index cards.
11.  Pens and Pencils, especially the click pencil type that don’t need a sharpener.
12.  Rubber bands. This also includes hair bands. Used to keep items organized and from flying apart.
13.  Tape. All kinds from duct, masking, electric, to scotch. Many uses.
14.  Sewing Kits. Threads, needles, buttons, zippers, you are going to need them.
15.  Matches. Keep them dry and store lots of them.
16.  Salt. You won’t believe in certain areas how hard it is to get this necessary mineral for survival. Store as much as you can.
17.  Aluminum Foil Wrap. Good for cooking and many other uses.
18.  Candles. All sizes. Not only for light at night, but can be used to heat small items up in small cookware.
19.  Can Opener. Without many of these you will have a bad time trying to get your canned food out.
20.  Basic Tools. This includes hammers, screwdrivers, saws, axes, utility knives, scissors. Anything extra that you can store from your tool chest.
21.  Small hardware. Nails, screws, hooks, wires, etc. Store in clear jars with lids or in original packages.
22.  5 or 6 gallon plastic gas containers. Can be used for gas or other fuels as well as for water that are durable.
23.  Magnifying glasses. Use to see small items, main use to start fire if matches are wet or out of them.
24.  Envelopes. All sizes for storage. Smaller for seeds you can get from the wild as one example. Tough postal envelopes are also good for storage after a disaster.
25.  Empty boxes. You are really going to need this if you have to suddenly move somewhere quick for clothes and other items. Many grocery stores will give you free fruit boxes that are sturdy and have lids. Also large plastic boxes with lids. Try to store empty boxes within the empty spaces of each other.
26.  Shoe laces. Many people have shoes that are still wearable and need shoe laces. Shoe laces are also good for tying off material with other purposes.
27.  Paper plates, plastic eating utensils, disposable drinking glasses and cups. IF you can store enough, excellent way to save your soap supplies by not having to wash the dishes.
28.  Bedding. Blankets, sheets, pillows, pillow cases. Just because you are in emergency does not mean you have to live like a refuge.
29.  Bathroom towels. All sizes from hand to bath. You will be very grateful to be able to dry yourself off with something you are used to.
30.  Fishing line and string. Lots of uses.
31.  Nylon rope, cord, clothes lines. Do not be without.
32.  Dental needs. Toothbrushes, dental floss. Even without toothpaste you can still keep your teeth healthy.
33.  Q-tips. Not only personal use, but uses for fine detailed work.
34.  Honey. Lasts practically forever and a good sweetener for many foods.
35.  Spray bottles. Use to disperse insect repellent as one of many uses.
36.  First aid kit. Most items such as bandages, gauze, tweezers, nail clippers, scissors, wrapping tape, etc. can be stored without rotating.
37.  Newspaper. Yes, newspaper for starting fires, wrapping delicate items, insulation. Keep dry and preferably in sealed boxes.
38.  Safety pins. Fastening of almost anything that has broken. Bobby pins also good.
39.  Cheap plastic sunglasses. You will really need to protect your eyes after an emergency, glare is something that people forget about
if they have to be outdoors for extended periods of time.
40.  Hats. One size fits all baseball type caps, scarfs, ski caps. A lot of heat is lost through an uncovered head, also sunburn.
41.  Gloves. So important from keeping hands warm to protection of your hands from hazards such as broken glass.
42.  Extra clothes that you will not wear other than after a disaster. Don’t forget the extra comfortable shoes, socks, underwear, warm jackets.
43.  Small hand-held mirrors. For signaling but also for personal grooming and seeing what your eyes can’t without a mirror.
44.  Cloth grocery bags with handles. A very good way of collecting usable things such as food from the wild.
45.  Stapler with plenty of staples. Also paper clips to seal off small items and fastening paper. Your package of survival seeds as for example.
46.  Electric extension cords. You may actually still have electricity from some source such as a generator. Can be used as a substitute for light duty style rope also.
47.  Brushes. From nail, paint, to hair brushes.
48.  Measurement devices. Tape measurers, rulers.
49.  Games & pastimes.
50.  Books, eReader: Anything that will give you information and instructions on survival, cooking, plant identification, map books. Your bookcase may not be around after a disaster, store information you will need someday.
51.  Wind up clocks and watches.
52.  Closable plastic containers,  Ziploc, Tupperware, etc., anything that can air seal something, several sizes.
53.  Note pad, Sticky notes. Use to label what you have after the disaster. Secure it better with scotch tape if you want.
54.  Money. Store a few hundred $$ at home in small denominations. Cash may be the only way to buy anything following a disaster.
55.  Plastic tarps. Big enough of r a tent (12×16+) and others sized to cover a table (10×10), to collect rain water, have several and leave them unused in their store wrapping.
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C.  Pet Supplies
•  Extra Water for Pets (About 1 cup/day for a 10 lb cat. For dogs under 20 pounds, the rule of thumb is 1 cup of water per each  5 pounds of body weight per day. Dogs over 20 pounds consume between 0.5 and 1 ounce of water/ pound/ day, so a 50 pound dog would consume between 25 and 50 ounces  (about a quart) of water/day. )
•  Pet Food: Extra dry or canned food
•  Pet Food storage containers, already in use
•   Pet Emergency Medical supply kit (for ticks, fleas, deworming, topical antibiotics, antibiotic pill or powder)
•   Portable Pet Crates (a must for pet emergencies)
•   Basic First Aid, pet first aid booklet.
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Also, look through the following ‘100 Things’ list, and buy those items your specific conditions will require  or best serve you, in a SHTF scenario.

D.  100 Things that Disappear First in a Disaster
1.  Generators: Good ones cost dearly. Gas storage, risky. Noisy…target of thieves; maintenance, etc.
2.  Water containers: An urgent item to obtain. Any size. Hard plastic only. Minimum storage volumes of 1 gallon/ person/day. Plan accordingly.
3.  Water Filters and chemical purifiers.
4.  Hand pumps and siphons: For water and for fuels.
5.  Portable Toilets: Increasing in price every two months.
6.  Toilet paper, Kleenex, paper towels: Imagine life without TP.
7.  Guns, Ammunition, Pepper Spray, Knives, Clubs, Bats and Slingshots
8.  Big dogs and plenty of dog food.
9.  Honey, syrups, white & brown sugar: honey is a very long-term storage item.
10.  Rice – Beans – Wheat (flour): Quick start, get 15 lb each.
11.  Vegetable/olive oil: for cooking, without it food burns/must be boiled, have at least 2 quarts
on hand.
12.  Milk – Powdered and Condensed: Shake liquid every 3 to 4 months.
13.  Canned goods: Fruits, veggies, soups, stews, meats (tuna-in oil, salmon, chicken, spam), etc.: While shopping, buy a couple extra cans every week in order to ‘double stock’ your cupboards.
14.  Baking supplies: flour, yeast, salt, baking powder, baking soda: Have at least a double supply of the basics.
15.  Pet food, bedding, waste disposal and vet supplies; Double supplies on canned, and long-term with the dry goods.
16.  Garlic, spices (esp. cinnamon), Soy sauce, vinegar, bouillon/gravy/soup base.
17.  Chocolate/Cocoa/Tang/Punch (water enhancers)
18.  Coffee, Tea
19.  Aluminum foil (Reg. and Heavy Duty): Great cooking and barter item.
20.  Cigarettes
21.  Wine/Liquors: For bribes, medicinal, etc. Tradable units should be in smaller volumes/trade
units, ie, 375 ml. or ½ pint.
22.  Chewing gum/candies
23.  Graham crackers, saltines, pretzels, Trail mix, Jerky
24.  Popcorn, Peanut Butter, Nuts
25.  Vitamins: Critical, due to potential of having canned food diets over an extended period.
26.  Hand-Can openers and hand egg beaters, whisks: are life savers!
27.  Garbage bags: Impossible to have too many.
28.  Cook stoves: Propane, Coleman and Kerosene
29.  Propane Cylinder Handle-Holder: Urgent: Small canister use is dangerous without this item.
30.  Propane cylinders, Coleman fuel: Definite shortages will occur. Safe to store, with long-term shelf life.
31.  Propane Heater(s), i.e., Mr. Heater: and all accessories that go with it: extra propane tanks,heads, hoses, etc.
32.  Mantles: Aladdin, Coleman, etc. : Without this item, longer-term lighting is difficult.
33.  Grain Grinder: Non-electric
34.  Cast iron cookware: Sturdy, efficient, adapt to camp fire use.
35.  Matches, butane lighters: “Strike Anywhere” matches preferred, boxed, wooden matches will disappear first.
36.  Charcoal and Lighter fluid: Will become scarce suddenly.
37.  Gasoline containers (Type II, Metal)
38.  Seasoned Firewood: About $250 per cord; wood takes 6 – 12 mos. to become dried, for home uses.
39.  Lamp Oil, Wicks, Lamps: First choice: Buy CLEAR oil. If scarce, stockpile ANY!
40.  Coleman Fuel: URGENT $2.69-$3.99/gal. Impossible to stockpile too much.
41.  Fishing accessories: line, hooks, bobbers, etc.
42.  Lighting sources: For short-term and long-term: Flashlights, hurricane lamps, light sticks, etc. Have Mantles and common repair parts on hand.
43.  Batteries: Rechargeable: if possible, try to have all devices work from one or two battery sizes, i.e., AA and/or AAA.
44.  Solar panel, storage battery & inverter kit: to recharge your AA & AAA batteries; cell phone, iPod, lap top and other small electronics.
45.  Paper plates/cups/utensils: Stock up, folks.
46.  Bow saw, axe, hatchet and Wedges, honing oil: For preparing firewood.
47.  Seasoned firewood, 1+ cord: (4 ft x 4 ft x 8 ft) Cut & split, takes 6-12 month to dry for use.
48.  Coleman’s Pump Repair Kit: 1(800) 835-3278
49.  Carbon Monoxide Alarm (battery-powered)
50.  Fire extinguishers: In every room…In a social breakdown, services may not be available.
51.  First aid kits: Topical skin treatments, anti acids, Tylenol, Vagicile, antibiotics, antiseptics, bandages and gauze, anti diahhreal, laxative, eye wash… Google “Patriot Nurse” and see her many YouTube videos.
52.  N95 disposable face masks, ½ face respirator/full face respirator with N100 and All hazard filters, Tyvek suit, rubber gloves, Potassium iodide pills: For pandemic, radioactive dust, biological agents.
53.  Coleman lantern, kerosene lamps, lantern hangers.
54.  Guns, spare clips, ammunition, body armor, Pepper spray, knives, extendable steel baton, bats & slingshot.
55.  Writing paper/pads/pencils/solar calculators. Journals, Diaries and Scrapbooks: To jot down ideas, feelings, experiences of the historic times!
56.  Insulated ice chests: Good for keeping items from freezing in wintertime.
57.  Candles: 9 hour lantern candles are available through Amazon and in Wal-Mart camping
department.
58.  Plastic containers: bathing (per person); communal: laundry, dish wash & rinse, misc.
59.  Laundry detergent, liquid.
60.  Garbage cans Plastic: Great for storage, water, transport – if you buy one with wheels.
61.  Atomizers: For cooling/bathing.
62.  Fishing supplies and tools.
63.  Mosquito coils, repellent sprays, creams.
64.  Duct tape: Several rolls.
65.  Tarps/stakes/twine/nails/rope/spikes: Tarps large enough to make a tent (12×16+) others for ground cloths, to catch rain water, other.
66.  Backpacks, Duffle bags (BOB): If no BOB, then a back pack for each member of the family.
67.  Scissors, fabrics and sewing supplies.
68.  Clorox Household Bleach: Plain, NOT scented: 4 to 6% sodium hypochlorite. Water purification, sanitation.
69.  Garden seeds (Non-hybrid): A must.
70.  Garden tools and supplies.
71.  Canning supplies: Jars/lids/wax.
72.  Knives and Sharpening tools: files, stones, steel.
73.  Bicycles…Tires/tubes/pumps/chains, etc.
74.  Sleeping bags and blankets, pillows & mats.
75.  Cots and Inflatable Mattresses: For emergency ‘guests’.
76.  Survival guide-book(s), Boy Scout Handbook.
77.  Board games, cards, dice, books, crossword puzzles: To help pass the time. The greater the disaster, the more time you’ll have.
78.  Baby Wipes, oils, waterless and Anti-bacterial soap: Saves a lot of water.
79.  Feminine Hygiene, Hair care, Skin products: Tampons, shampoo, lip balm, moisturizing lotion, sun tan lotion.
80.  Men’s Hygiene: Shaving supplies, shampoo, toothbrush/paste, mouthwash, floss, nail clippers.
81.  Basin, washboard, mop bucket with wringer: for Laundry.
82.  Clothespins, clothes line, hangers: A must. Have clothes pins in stock and eye bolts for line
installed ahead of time.
83.  Adequate clothing: Work boots, belts, Levis denim trousers and durable shirts for cool weather.‘Tennis shoes’ and light twill, khaki pants and light-colored shirts for hot climates.
84.  Spare glasses, reading glasses.
85.  Gloves: Work/warming/gardening, etc.
86.  Socks, Underwear, T-shirts, etc: Extras
87.  Thermal underwear: Tops and bottoms.
88.  Hats and cotton neckerchiefs. Polymer filled, ‘Cool wrap’ neck bandanas.
89.  Woolen clothing, scarves/ear-muffs/mittens.
90.  Rain gear, rubberized boots, etc.
91.  Roll-on Window Insulation Kit, clear and black plastic sheeting: Enough to cover all windows and entry doors.
92.  Lumber: All types, a couple of sheets of plywood, some 2×4 and 2x2s.
93.  Wagons and carts: For transport to and from open Flea markets.
94.  “Survival-in-a-Can”/compact survival kit.
95.  Screen Patches, glue, nails, screws, nuts and bolts.
96.  Paraffin wax
97.  D-Con Rat poison, MOUSE PRUFE II, Roach Killer.
98.  Mousetraps, Ant traps and cockroach magnets.
99.  Glue, nails, nuts, bolts, screws, etc.
100.  Small livestock: Goats, sheep, chickens
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D.  72 Hour Emergency Kit
One storage category often discussed in prep circles is the 72-hour kit. The homemade kit comes in two basic structures, 1)  A relatively light Bug Out Bag that you could carry, maybe one per person. The BOB (emergency evacuation kit) is used if you have to run out of the house with very little warning. 2) Shelter in Place. This kit structure presumes you’ll be staying in your house to weather the after effects of the disaster. The storage items can be bulk stored in large plastic boxes, plastic or metal trash cans or even cardboard boxes slid under the bed.

_1.  The basic B.O.B. for natural disasters
The US Government’s Homeland Security website provides a list of in-home emergency kit items. The list focuses on the basics of survival: fresh water, food, clean air and materials to maintain body warmth. The recommended basic emergency kit items include:
•  Water, at least one gallon of water per person for each day for drinking & sanitation (should be rotated every 3 months)
•  Food, non-perishable food for at least three days which is not required to be cooked or refrigerated
•  Emergency Food Bars, preferably the products with 2,400 or 3,600 calories and contain no coconut or tropical oils to which many people may have an allergic reaction, in addition to non-perishable food which does not require cooking or refrigeration
•  Battery- and/or hand-powered radio with the Weather band
•  Flashlight (battery- or hand-powered)
•  Extra batteries for anything needing them
•  First aid kit
•  Copies of any medical prescriptions
•  Whistle to signal
•  Dust mask, plastic sheeting and duct tape to shelter-in-place
•  Moist towelettes, garbage bags and plastic ties for personal sanitation
•  Wrench or pliers to turn off water valves
•  Can opener for canned food
•  Local maps
•  Spare Keys for Household & Motor Vehicle
•  Sturdy, comfortable shoes & lightweight rain gear, hoods are recommended
•  Contact & Meeting Place Information for your household

_2. Your ‘Shelter In Place’ household disaster kit should include:
a)  Water
Store at least one gallon of water per person per day (two quarts for drinking and two quarts for sanitation and food preparation. Children, nursing mothers and ill people will need more). Store water in plastic containers such as soft drink bottles. Avoid using anything that may decompose or break. Water should be replaced every six months.

b) Food
Store at least a 3-5 day coordinated as complete meals, supply of non-perishable food. Select foods that are compact and lightweight, require no refrigeration, preparation or cooking and little or no water. If you must heat food, pack a can of Sterno Canned Heat, but use outside and away from flammable objects, otherwise have a Coleman (or similar) propane or white gas camp stove.
•  Ready-to-eat canned meats, fruits and vegetables.
•  Emergency food bars
•  Canned juices
•  Staples (salt, sugar, pepper, etc.)
•  Food/formula for infants
•  Food for family members with special dietary requirements
•  Vitamins
•  Comfort/stress foods to lift morale (chocolate)
•  Remember to pack a non-electric can opener.

c)  First Aid kit
•  (20) adhesive bandages, various sizes
•  5″ x 9″ sterile dressing
•  Conforming roller gauze bandage
•  Triangular bandages
•  3 x 3 sterile gauze pads
•  4 x 4 sterile gauze pads
•  Roll 3″ cohesive bandage
•  Adhesive tape, 2″ width
•  Anti-bacterial ointment
•  Cold pack
•  Germicidal hand wipes or waterless alcohol-based hand sanitizer
•  Six (6) antiseptic wipes
•  Pair large medical grade non-latex gloves
•  Scissors (small, personal)
•  Tweezers
•  CPR breathing barrier, such as a face shield

d) Medications, medical supplies, and information
•  Keep enough essential medications on hand for at least three days (preferably seven days).
•  Keep a photocopy of your medical insurance cards or Medicare cards.
•  Keep a list of prescription medicines including dosage, and any allergies.
•  Aspirin, antacids, anti-diarrhea, etc.
•  Extra eyeglasses, hearing-aid batteries, wheelchair batteries, oxygen tank.
•  List of the style and serial numbers of medical devices such as pacemakers.
•  Label any equipment, such as wheelchairs, canes or walkers that you would need.
•  Instructions on personal assistance needs and how best to provide them.
•  Individuals with special needs or disabilities should plan to have enough supplies to last for up to two weeks (medication syringes, colostomy supplies, respiratory aids, catheters, padding, distilled water, etc.).

e) Tools and supplies
Keep some of these basic tools:
•  Battery operated radio and extra batteries
•  Flashlight and extra batteries
•  Cash or travelers checks
•  A copy of your disaster plan and emergency contact numbers.
•  Map of your city and state (to evacuate the area and/or to find shelters)
•  Utility knife
•  Non-electric can opener
•  Fire extinguisher: several ABC type
•  Pliers and wrench
•  Tape
•  Waterproof matches
•  Paper, pens and pencils
•  Needles, thread
•  Plastic sheeting
•  Aluminum foil

f) Sanitation supplies
•  Toilet paper (enough for a month anyway), towelettes
•  Soap, liquid detergent
•  Feminine supplies
•  Personal hygiene items
•  Diapers
•  Plastic garbage bags, ties (for personal sanitation uses)
•  Plastic bucket with tight lid
•  Disinfectant
•  Household chlorine bleach (gallon)
•  Hand sanitizer

g) Clothing and bedding
Include at least one complete change of clothing and a pair of sturdy shoes per person. You also want to consider packing blankets or sleeping bags, rain gear, hats and gloves, thermal underwear and sunglasses.
If you live in a cold climate, you must think about warmth. It is possible that you will not have heat. Think about your clothing and bedding supplies. Be sure to include one complete change of clothing and shoes per person, including:
•  Jacket or coat.
•  Long pants.
•  Long sleeve shirt.
•  Sturdy shoes.
•  Hat, mittens, and scarf.
•  Sleeping bag or warm blanket (per person).

If you live in a hot, desert climate, dress to reflect the sunlight and keep cool.
•  Light colored, loose-fitting clothes
•  Several layers of clothing for the cooler night weather.
•  Wide brim light-colored hat.
•  Bandana or cool tie neck-band with water absorbing polymer beads
• Thin leather gloves.
•  Desert shoes or boots with canvas tops and durable, heat-resistant soles.
•  Sunglasses rated to reduce UV as well as overall glare.

h) Important family documents
•  Keep copies of important family documents in a waterproof container.
•  Will, insurance policies, contracts, deeds, stocks and bonds
•  Social security cards, passports, immigration papers, immunization records
•  Bank account numbers
•  Credit card account numbers and companies
•  Family records (birth, marriage, death certificates)
•  Medical insurance and Medicare cards

i) Entertainment
•  Deck of cards
•  Books, eBook readers
• Small personal electronic device with music
•  For children, include a small toy, stuffed animal or coloring book and crayon
•  If you have a small solar charger you’ll be able to continue using your small personal electronics for music, prerecorded podcasts, reading eBooks and games.

In addition to your 72 hour kit, whether it’s a BOB or ‘Shelter In Place’ type, keep a written list of information including family and important contacts, emergency bug-out-plan, and encrypted information of your insurance and financial accounts. Record this information in a small spiral notepad that you can keep dry in a zip lock bag.

If you’re interested in more information on the lists above read the 4dtraveler posts listed below (all found in the category shown):
(Survival Manual/2. Social issues/Checklists and things that disappear first)
(Survival Manual/2. Social issues/Your 72+hour emergency kit)
(Survival Manual/2. Social Issues/Bug Out Bag, generic)
(Survival manual/4. Shelter issues/Tarp and tent)
(Survival manual/3. Food & Water/Water)

There are general categories of disaster scenarios, some require practically no back up, other my find you in a few day to several week situation, and some could become horrific very gradually (major volcanic eruption) or quickly (EMP).

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Antibiotic use

 (Survival Manual/ 6. Medical/ d) Medicine & Supplement/ Antibiotics use)

Disclaimer The information, ideas, and suggestions in the 4dtraveler.net blog are not intended as a substitute for professional advice. Before following any suggestions contained in this post, you should consult your personal physician. Neither the author or Word Press shall be liable or responsible for any loss or damage allegedly arising as a consequence of your use or application of any information or suggestions in this blog.

Below pasted from <http://www.survivalistboards.com/showthread.php?t=152129&page=2>
I.    Antibiotic Usage and Duration of Treatment
Under normal circumstances, antibiotics are intended to be used for approximately one to two weeks. This duration is prescribed in order to kill more slowly growing germs, such as those initially in spore forms that require incubation for disease expression.

Emergency situations may require less careful treatment durations. This is particularly true if antibiotic shortages occur as expected following a biological weapons attack. In this case, rationing may be necessary and helpful in saving more lives. The shortest duration of antibiotic coverage recommended following a biological attack is from the onset of symptoms to at least 72 hours after the person’s symptoms completely disappear.

Ideally, antibiotic prophylaxis (for prevention of disease) should begin as soon as a biological weapons attack is confirmed for individuals at risk of exposure. In other words, it is best to leave risky environments in advance of possible exposures. Certainly, urban populations are at greatest risk for biological and chemical weapons attacks.

Three self destructive self medication tendencies
1. Don’t assume if a little medication is good then a lot must be better.
2. Don’t stop taking the medication too soon, this only educated the microbes without killing the entire culture.3. Don’t take too small a dose to cure the ailment. Learn the correct dosage by reading medical texts, nursing manuals and pill books. In the case of veterinary supplies, users must learn to interpret  densities; learn to extrapolate that out into the correct dosages set out in literature for your specific needs.

 .
A.  Shelf life
Your prescription medicines, including your antibiotics, probably had about a two-year expiration date from the time of their production. Your pharmacist puts a one-year expiration date on your particular bottle of medicine because of the time that has lapsed since production as well as the uncontrolled variables in storage outside the pharmacy. The practice is followed to increase the likelihood that the medicines you take are of the proper potency and quality.

Typically, the shelf life of a medicine is that period during which the potency of the medication drops a certain amount — often 10 percent. It can be less than this 10 percent figure when a drug is not effective unless a very precise amount of medicine is delivered in each dose. Conversely, if the dosage of the drug is less crucial, the potency of the drug can drop more than 10 percent and still be effective.

How long it takes for a drug to drop a certain percentage of its strength is influenced by the chemistry of the active and inactive ingredients. The condition in which a medicine is stored also influences its shelf life. Most are given a shelf life assuming that they will be stored in a 70-degree medicine cabinet in a closed container. Heat, humidity, air circulation and sunlight can dramatically shorten the shelf life of most medicines. In other words, don’t expect that open bottle of aspirin that has been rattling around in your car for two years to be much good.

Diseases tend to mutate out of reach of modern high powered antibiotics. As a practical matter, every microbe is developing an antibiotic resistance. Antibiotics fail to kill all the targeted microbes on the first pass through. If only one in a billion is resistant to an antibiotic treatment, that microbe reproduces its billions engendering even more organisms that are not killed, and so it goes until we have a non curable disease.
.

B.  Antibiotics 101
Antibiotics are a class of drugs that treat bacterial infections by stopping growth of bacteria or killing the bacteria directly. It’s important to remember that antibiotics are ineffective in treating infections causes by viruses, which include the majority of colds, sore throats (with the exception of streptococcus-induced, or so-called “strep throat”), coughs, and flu-like illnesses.

In fact, taking antibiotics when they are not really necessary will not speed your recovery and can even contribute to a problem known as antibiotic resistance. Antibiotic resistance refers to the capacity of many bacteria to become resistant to a particular antibiotic so that it is no longer effective against these bacteria. It is known that the increasing use of antibiotics when they really aren’t needed has contributed to this problem and has led to the evolution of many bacterial strains that no longer respond to treatment with common antibiotics; a phenomenon known as antibiotic resistance.

The evolution of antibiotic-resistant strains of Staphylococcus aureus [methicillin-resistant Staph aureus or MRSA, and vancomycin-resistant enterococci (VRE)] has received much attention in recent years, and a new strain of the bacterium Clostridium difficile, which can cause intestinal illness in people taking antibiotics for other conditions, has arisen which is much more difficult to treat and is associated with a higher death rate.

The following points are critical to remember when taking any antibiotic:

  1. Take all the medication that your doctor has prescribed for the recommended length of time. Because antibiotics tend to work fairly rapidly, you may feel much better after taking only a few days’ worth of a prescribed seven-day course of antibiotics. Never stop taking the medication because you feel better. Taking the full prescribed course of antibiotics ensures that the infection is eradicated and won’t recur.
  2. Because your doctor chooses antibiotics based upon your individual medical history along with the type of bacteria likely to be causing your infection, never assume that an antibiotic prescribed for someone else will be effective for you – never “borrow” antibiotics. Sharing any prescription medications is a dangerous practice and can even be deadly. Likewise, never “save up” antibiotics for your own later use.
  3. Antibiotics generally work rapidly. Be sure to ask your doctor when to expect results and find out what you should do if you experience no improvement after a couple of days.
  4. Antibiotics can cause a number of side effects. Nausea, diarrhea, and allergic reactions are some known side effects of antibiotics. Antibiotics also may kill naturally-occurring bacteria that protect the body from yeast infection, so yeast infections may occur while you are taking antibiotics. Be sure to ask your doctor what kind of side effects you may experience with a particular antibiotic. Always call your doctor if the side effects are severe or worrisome.
  5. If your doctor directs you to stop taking an antibiotic or switch to a different antibiotic, properly dispose of all unused medication. Ask your pharmacist about take-back programs and places where you can return unused or expired medications for safe disposal. A person needing an antibiotic should be evaluated by a physician each time an antibiotic is needed – don’t save old antibiotics to treat future infections.
  6. Ask your doctor or pharmacist whether or not you should take the medication with food and if you should change your habits during the course of treatment (for example, avoiding direct sunlight, not drinking alcohol or eating certain foods).
  7. Be certain that you have a clear idea of the directions for taking an antibiotic. If you have questions, ask. For example, does “four times a day” mean every six hours even in the night, or just at meals and at bedtime?

.
C.  Preventive Foresight Regarding Pharmaceutical Supplies
The likeliest source of breaking news concerning a biological or chemical attack, launched by terrorists or other foes, is the mainstream media. By the time you hear such reports, it is likely that hospital emergency rooms, and doctor’s offices, will be full of ailing victims. It typically takes a day or longer for symptoms of infectious diseases to manifest. The first signs and symptoms of a covert attack include inexplicable headaches and flu-like symptoms.

Such is the case with anthrax. The first indication of an anthrax attack, providing the strain had not been modified, is cattle becoming sick and dying. This can happen in a matter of hours. Moreover, this is an indication to begin antibiotic prophylaxis.
Under such trying circumstances, you can expect there to be tremendous demand for medical supplies and pharmaceuticals in the wake of a terrorist attack. It is, therefore, highly advisable to consider beforehand what medical supplies might be essential for your survival and the protection of your loved ones.
Obviously, people on a regimen of prescription drugs should stock, perhaps, a three months supply in a cool, dark, and dry closet or basement.
Antibiotics can be purchased in bulk from pharmacists or livestock and veterinarian supply stores.

In case you need to leave your home or workplace in an emergency, try to plan, in advance, transporting your antibiotics and other medicinal requirements with you. Maintain access to standard emergency kits, particularly during times of possible trouble. Keeping one in your car is a good idea, providing the car doesn’t overheat.

Given these constraints, diabetics, on the move in an emergency, should try to keep their insulin at room temperature until they are resettled. Above 80 degrees and while freezing insulin will begin to degrade.
In general, when traveling or storing antibiotics and medications in your car, be aware of extreme temperatures. Extreme heat and cold often inactivates, like insulin, many medicines.

.
D.  A Simplified Guide to Antibiotics and Their Uses
1.  Penicillins
The original penicillin-G (Pen G), along with more the common penicillin-V (Pen V), are used to fight gram-positive bacteria, such as anthrax. Pentids, the brand name for penicillin-G, come in 400 and 800mg pills. Brand names for penicillin-V include V-Cillin-K and Pen Vee K. The basic Pen G may be purchased from farm and veterinary stores for far less expense than through pharmacies, though make sure you only buy the refrigerated brand. The active ingredients in the unrefrigerated variety are far lower and potentially inadequate.

Pen G must be taken on an empty stomach. This is not as critical for Pen V. A dose of 250mg (i.e., 400,000 units), for people weighing 50 pounds or more, is taken four times daily. A rule of thumb for children weighing less than 50 pounds, the dosage should be reduced by 20% for every 10 pounds of less body weight.

These penicillins are more likely to cause allergic reactions, and fatalities, than synthetic penicillins such as ampicillin. Some of the allergic reactions are caused by procaine (Novocain) that is added in some Pen G formulas.

 Ampicillin
Brand names of this synthetic penicillin include Principen, Omnipen, Polycillin and Totacillin. These are also affective against gram-positive microbes such as anthrax.
Dosages of ampicillin are the same prescribed for penicillin. This antibiotic should be taken, ideally, on an empty stomach.
Strains of anthrax that resist penicillin may be more susceptible to destruction by ampicillin. Also, ampicillin may be more helpful than penicillin for killing a broader spectrum of infections.

 2.  Cephalosporins
These are also effective against anthrax. One gram of Cephalexin taken every six hours is recommended. Brand names for this are Keflex, Keflet and Keftab. One gram of the related Cefadroxil, brand named Duricef, should be taken every twelve hours.
Erythromycin (Macrolide family of antibiotics)
Erythromycin and its relatives provide a broader spectrum of coverage than penicillins. Brand names of Erythromycin Pediamycin, Erythrocin, Eryc, EES, Ery-Tab, PCE, Ilosone, and E-Mycin. Other related antibiotics, such as clarithromycin (Biaxin) and azithromycin (Z-pak or Zithromax) may also be effective. A liquid form of erythromycin, called Gallimycin, is available for injection. The oral dose of this injectable product is the same.

Taken on an empty stomach, this may be used to treat more difficult cases of anthrax. If upset stomach occurs, it should be consumed with a bit of food. Avoid eating citrus fruits or products, which deactivate these antibiotics during digestion. Note: Fatal heart attacks may result from taking these antibiotics in combination with Seldane (terfenadine), Hismanal, or Seldane-D.
For individuals weighing 150 pounds or more, a 500mg dose is recommended. People weighing less should reduce their dosage proportionately.

3.  Aminoglycosides
These antibiotics that are effective against anthrax, tularemia, and the Bubonic plague, include: Streptomycin, Gentamycin, and Neomycin. They can all be extremely toxic. Primary organs at risk for destruction by the aminoglycosides include the kidneys and inner ears.

Each of the aminoglycosides must be injected, and cannot be taken orally. The oral dosage forms of these antibiotics are effective only against gastrointestinal (GI) tract infections of the stomach and intestines.

Gentamycin (Garacin) powder can be purchased in bulk. It cannot be absorbed when taken orally, but it can be effective against certain biologicals striking the GI tract such as botulism.

Streptomycin, taken two to four times daily, in one to four gram doses, equally spaced throughout the day. It can be used in combination with tetracycline until the person’s fever breaks. Then the tetracycline can be continued alone. Otherwise, streptomycin should be used consistently for a week to ten days.

Gentamycin, is effective against tularemia and the plague. It should be injected intramuscularly or intravenously every eight hours in emergency measures of 1.7mg per kilogram body weight. As soon as symptoms of disease disappear, the dose should be reduced to 1.0mg per kilogram of body weight for the remaining 7-10 day period.

This antibiotic is available in bulk through veterinary stores. It is likely that this less expensive product may be successfully used orally to defend against the plague or tularemia germs infecting the gut.

Neomycin, when given in doses of 500mg, four times daily, may be helpful against anthrax, plague, and tularemia, though it has not been traditionally prescribed for these. Use this only if the other aminoglycoside antibiotics are unavailable.

4.  Fluoroquinolones
In daily doses of 300mg per kg. of body weight (i.e., 65mg. per pound), Ciproflavoxin (Cipro) is effective against tularemia and anthrax. The daily dose should be divided into four doses taken every six hours for two weeks. Following the terrorist attacks on September 11, 2001 on the Pentagon and World Trade Center, this extremely expensive drug has been in high demand as the FDA’s antibiotic of choice against anthrax. Disturbing politics regarding this selection and its manufacturer-Bayer-may be found at http://www.tetrahedron.org.

5.  Chloramphenicol
Effective against anthrax, tularemia and plague, Chloramphenicol (Chloromycetin) has a relatively high rate of lethal side effects. Thus, persons allergic to safer antibiotics should only use it, or in the event other medications are unavailable. More expensive than other antibiotics, this injectable product can also be consumed orally and absorbed effectively into the bloodstream. Ideally, taken on an empty stomach, it may be consumed with food to reduce stomach upsets.

Chloramphenicol has the same spectrum of activity as erythromycin. Thus, it should never be given with erythromycin unless under emergency conditions at the first sign of biowarfare-induced illness. It may, however, be taken with Tetracycline for a broader spectrum of effectiveness. This combination may be wise if it is unclear which biological weapon is causing illness, and if rationing is not in effect.
The injectable form of chloramphenicol tastes awful! For people weighing 200 pounds or more, 2,500mg doses recommended.

6.  Tetracyclines
Tetracyclines (brand named Sumycin and Achromycin-V) are broad-spectrum antibiotics available from farm supply shops and veterinary stores in the form of oxytetracycline. These can be used effectively against all most strains of anthrax, plague, and tularemia.

Oxytetracycline comes in bulk powder form under the brand name Terramycin-343. It also comes in combination with livestock feed (Advance Calf Medic). This could be used in a pinch if other antibiotics were unavailable. There are 3 grams of active antibiotic in each pound of feed. A low dose could be provided by consuming almost 1.5 ounces; a high dose twice that could be measured and eaten.

Two newer classes of tetracycline are Doxycycline and Minocycline . Brand names for these tetracyclines include the Doxycyclines-Vibramycin, Vibra-tabs, Monodox and Doryx; and the Minocyclines called Minocin.

Tetracycline is typically taken four times a day, doxycyclines once per day or twice per day when taken with Minocycline. The two newer cyclines can be taken with food, not the older tetracycline. They, thus, tend to cause fewer stomach upsets. Doxycycline is typically less costly than traditional tetracycline, and Doxycycline and Minocycline provide a broader spectrum of antibiotic effectiveness than the old standard. Stains of biological weapons the may have been manufactured to resist tetracycline might be more susceptible to the newer cyclones.

Tetracycline should be taken one hour before or two hours after antacids, laxatives, and calcium supplements.

As a rule of thumb, four 250mg doses of tetracycline are prescribed daily, that is, one dose every six hours for your typical 100-pound person. For persons weighing less than 100 pound, reduce this dose accordingly. For instance, if a 100-pound person receives 1,000mg per day, then a 50-pound person would receive 500mg per day, or four 125mg doses q. 6 hours. The Doxycycline dosage is typically 200mg the first day, and 100mg doses following for up to ten days. The oxytetracycline (Terramycin) dose is the same as standard tetracycline. Another alternative tetracycline, called demeclocycline (Declomycin), may be substituted for standard tetracycline employing the same dose schedule as well.

Throw away any tetracycline that is out of date. Old tetracycline can cause serious problems with the kidneys.
.

E.  Preserving and Administering Your Antibiotics
Most antibiotics and drugs can be preserved by refrigeration, so long as they are kept dry. If traveling through extreme temperatures, antibiotics should be encased in Styrofoam containers, at best, and efforts should be made to avoid heat or freezing cold.

Warning: No drug should be consumed beyond its expiration date, especially Tetracycline antibiotics. Severe reactions may result from this expired antibiotic. However, when faced with a life-or-death situation, as might be presented with biological warfare or bioterrorism, such chances might have to be taken.

Antibiotics are typically administered orally or by injection. However, if the patient is comatose, the oral route may be circumvented rectally by using a plastic oral syringe available in most drugstores. This should be inserted as deeply into the rectum as possible. Use of a few drops of water, then larger amounts of cocoa butter, for dissolving the antibiotic. Cocoa butter is available in most drugstores in sticks that are melted in a jar placed in hot water. The butter is commonly used for suppositories and will hold the antibiotic for absorption better than water. Water may run out of the rectum and thereby precious antibiotic may be lost. So if water is all you have, use as little as possible to dissolve and inject the measured amount of powdered antibiotic.

Antibiotic tablets can be crushed and powdered by placing them between two napkins on a hard surface and pounding them with another flat hard object or instrument.

The absorption of active antibiotic is less, given the rectal route of administration. For this reason, the dosages should be increased to compensate.

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II.   Self medication observations:

•  Medications designed for horses especially are higher purity and therefore higher quality than the exact same medication designed for human use. Generally, they are stronger (more potent) and safer as well. In fact, just about any medication designed for a farm type animal is at least as good as human grade and frequently it is higher quality than human grade medications.
Pasted from <http://www.survivalistboards.com/showthread.php?t=14441>

•  Ok, I have taken fish penicillin for a nasty tooth infection. Cleared it right up. Came in 250 mg tablets and took 2 every 6 hours. I would not suggest taking large animal antibiotics, but the fish stuff is great. My new husband has been taking them for years.
Pasted from <http://www.greenspun.com/bboard/q-and-a-fetch-msg.tcl?msg_id=001w9g>

•  In response to JIT’s comment, RE: a 25 gram goldfish; this is the thing. A 250 mg tablet of penicillin treats a 10 gal aquarium, which weighs approximately 83 pounds. So if you weigh 160 pounds, the dose would be 500 mg. of penicillin. Funny, that works out to just about what my doctor prescribed for me the last time. I used to manage a pet shop that specialized in aquarium fish and accessories, plus their medical needs. We went ’round and ’round with the health dept. trying to abolish our ability to sell these types of antibiotics; because it was becoming known at that time (about 5-8 years ago) that people were using the meds on themselves. I find it interesting that the Health Dept. main reason for wanting to outlaw the sales, was not fear that the drugs weren’t safe for humans; but their main argument was that most people are unlearned in the proper dosages they should use and might harm themselves due to simple ignorance.
Pasted from <http://www.greenspun.com/bboard/q-and-a-fetch-msg.tcl?msg_id=001w9g>

•  Hmmm, I am a veterinarian and I buy the conventional drugs from the exact same suppliers as your pharmacist in most cases.
They are the same generics you get at any drug store. I recommend cipro, amoxi, and doxycycline as basics in a survival situation.
There are a few antibiotics that animals get that are not safe for humans… enrofloxicin (Baytril) is not metabolized well by humans, and Chloramphenical is rarely used in humans, but has very very serious, often lethal side effects. Clinadamycin is commonly used in pets but can cause pretty bad diarrhea in humans.
At any rate, antibiotics should only be used in emergency situations. We have already created some superbugs by misuse, and the drugs are not harmless in our own bodies, no matter how innocuous they may seem.
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•  I have used and will continue to keep fish Mox and Fish Mycin on hand for various problems. The brands sold by Thomas pharmaceuticals are prescription grade and work very well. I get bronchitis and have gotten walking pneumonia in the past, as well as ear-throat infections for my kids, and having antibiotics on hand makes solving these problems easy. I mentioned it to my GP physician and he said just to be careful with them. (he knows that I am) they even have a fish cypro (which I plan on having on hand next time I place an order as it will wipe out an anthrax infection)
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•  The animal antibiotics are high quality. Many people have valuable race horses, show dogs and cats and if their antibiotics were not quality the vets would get sued.
Doxycycline, tetracycline, oxytetracycline are available over the counter for live stock in farm supply stores.
Doxycycline is very good because it successfully fights the biowar/new/emerging/chronic diseases.
Like MRSA, Lyme, CFS, Gulf War Illness, MS, arthritis, diabetes, chrones,
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•  10 to 30 mg/kg per day is a good rule of thumb. If there is no doctor to diagnose and treat, then stick with the 30 mg/kg per day (split into two doses morning and evening) to treat most common infections that a person would get without a doctor being readily available.
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•  I also had a friend of mine look up the fish meds in a PDR, it’s the EXACT same pill. Not made crudely not made cheaper than regular meds.. same pill, same stamp and same factory.
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•  I asked my obgyn and he put it this way, “If for any reason there was no medical supply to be had and the fish antibiotics were all that were available, and the person would probably suffer/die/ if not given treatment, then what would you think I would tell you to do? Do not use them when the regular meds are available but I would rather have them than nothing”.
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•  Go to www.michaelhyatt.com and visit his Discussion Forum. Go to Health. Go to the archives under Health. You will find reams of advice on vet antibiotics. Nurses moderate the Health area, and an occasional doctor contributes. They reassured us that these vet antibiotics are IDENTICAL to the ones, produced by the SAME pharmaceutical houses, even in the same pill color/shape as the human antibiotics. They explained that the drug houses will only charge what the traffic will bear: thus, the high cost to US citizens for the same medications they sell cheaply in Mexico, Canada, and all other countries!! They know people would not pay high for pet antibiotics.
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III.  Antibiotic Resistance Spreads Rapidly Between Bacteria
Apr. 13, 2011, ScienceDaily
http://www.sciencedaily.com/releases/2011/04/110411163918.htm
“…More and more bacteria are becoming resistant to our common antibiotics, and to make matters worse, more and more are becoming resistant to all known antibiotics. The problem is known as multi-resistance, and is generally described as one of the most significant future threats to public health Antibiotic resistance can arise in bacteria in our environment and in our bodies. Antibiotic resistance can then be transferred to the bacteria that cause human diseases, even if the bacteria are not related to each other…

The research team has studied a group of the known carriers of antibiotic resistance genes: IncP-1 plasmids. Using advanced DNA analysis, the researchers have succeeded in mapping the origin of different IncP-1 plasmids and their mobility between different bacterial species. “Our results show that plasmids from the IncP-1 group have existed in, and adapted to, widely differing bacteria. They have also recombined, which means that a single plasmid can be regarded as a composite jigsaw puzzle of genes, each of which has adapted to different bacterial species,” says Peter Norberg, a researcher in the Institute of Biomedicine at the University of Gothenburg. This indicates very good adaptability and suggests that these plasmids can move relatively freely between, and thrive in, widely differing bacterial species.

“IncP-1 plasmids are very potent ‘vehicles’ for transporting antibiotic resistance genes between bacterial species. Therefore, it does not matter much in what environment, in what part of the world, or in what bacterial species antibiotic resistance arises. Resistance genes could relatively easily be transported from the original environment to bacteria that infect humans, through IncP-1 plasmids, or other plasmids with similar properties, as ‘vehicles’,” says Professor Malte Hermansson of the Department of Cell and Molecular Biology at the University of Gothenburg…

It has been known for some time that plasmids are important in the spread of antibiotic resistance. The research team’s findings show that IncP-1 plasmids can move, and have moved, between widely differing bacterial species and in addition have interacted directly with one another, which can increase the potential for gene spreading.”

 

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Tuberculosis

 (Survival Manual/ 6. Medical/b) Disease/Tuberculosis)

 The global epidemic of tuberculosis (TB)
It is estimated that approximately 1.7 million people died of tuberculosis in 2009. There were an estimated 9.4 million new cases of tuberculosis in 2009 of which the majority were in Asia and Africa. It is thought that the rates of new tuberculosis infections and deaths per capita have probably been falling globally for several years now. However, the total number of new tuberculosis cases is still slowly rising due to population growth.

One-third of the world’s population is currently infected with TB or tuberculosis.
<http://www.unmultimedia.org/radio/english/2012/03/world-tb-day-raises-awareness-about-the-global-epidemic/>
24 Mar 2012
The World Health Organization says TB remains a leading cause of death from infectious diseases worldwide, second only to HIV/AIDS. Last year alone, 8.4 million people contracted TB and 1.4 million died from the disease.

Control of Tuberculosis (TB)
In the 1950s the US and many European countries introduced immunization programs. As a result the incidence of TB fell dramatically. In the late 1980s there was a resurgence of TB cases in the large cities of the US and in Europe. There have been for a number of reasons for the increase, among them: Homelessness; overcrowding in shelters, prisons and in homes for the poor; increased immigration from countries with a high incidence of TB; drug abuse; HIV/AIDS.

Definition
Tuberculosis (TB) is a potentially serious infectious disease that primarily affects your lungs. The bacteria that cause tuberculosis are spread from person to person through tiny droplets released into the air via coughs and sneezes.

Tuberculosis was once rare in developed countries, but the number of TB cases began increasing in 1985. Part of the increase was caused by the emergence of HIV, the virus that causes AIDS. HIV weakens a person’s immune system so it can’t fight the TB germs.
Many strains of tuberculosis can resist the effects of the drugs most commonly used to treat the disease. People who have active tuberculosis must take several different types of medications together for many months to eradicate the infection and prevent development of antibiotic resistance.

A.  Symptoms
<http://www.mayoclinic.com/health/tuberculosis/DS00372/DSECTION=coping-and-support>
Although your body may harbor the bacteria that cause tuberculosis, your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between:
•  Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn’t contagious.
•  Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later. Most people infected with TB germs never develop active TB.

Signs and symptoms of active TB include:
•  Cough
•  Unexplained weight loss
•  Fatigue
•  Fever
•  Night sweats
•  Chills
•  Loss of appetite

What organs are affected?
Tuberculosis usually attacks your lungs. Signs and symptoms of TB of the lungs include:
•  Coughing that lasts three or more weeks
•  Coughing up blood
•  Chest pain, or pain with breathing or coughing

But tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your lungs, symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.

 When to see a doctor
See your doctor if you have a fever, unexplained weight loss, drenching night sweats or a persistent cough. These are often signs of TB, but they can also result from other medical problems. Your doctor can perform tests to help determine the cause.

Causes
Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.
Although tuberculosis is contagious, it’s not especially easy to catch. You’re much more likely to get tuberculosis from someone you live with or work with than from a stranger. Most people with active TB who’ve had appropriate drug treatment for at least two weeks are no longer contagious.

HIV and TB
Since the 1980s, the number of cases of tuberculosis has increased dramatically because of the spread of HIV, the virus that causes AIDS. Tuberculosis and HIV have a deadly relationship — each drives the progress of the other.
Infection with HIV suppresses the immune system, making it difficult for the body to control TB bacteria. As a result, people with HIV are many times more likely to get TB and to progress from latent to active disease than are people who aren’t HIV-positive.

Drug-resistant TB
Another reason tuberculosis remains a major killer is the increase in drug-resistant strains of the bacterium. Ever since the first antibiotics were used to fight tuberculosis 60 years ago, the germ has developed the ability to survive attack, and that ability gets passed on to its descendants. Drug-resistant strains of tuberculosis emerge when an antibiotic fails to kill all of the bacteria it targets. The surviving bacteria become resistant to that particular drug and frequently other antibiotics as well.

Risk factors
Anyone can get tuberculosis, but certain factors can increase your risk of the disease. These factors include:
Weakened immune system
A healthy immune system can often successfully fight TB bacteria, but your body can’t mount an effective defense if your resistance is low. A number of diseases and medications can weaken your immune system, including:
•  HIV/AIDS
•  Diabetes
•  End-stage kidney disease
•  Cancer treatment, such as chemotherapy
•  Drugs to prevent rejection of transplanted organs
•  Some drugs used to treat rheumatoid arthritis, Crohn’s disease and psoriasis
•  Malnutrition
•  Advanced age
.
International connections
TB risk is higher for people who live in or travel to countries that have high rates of tuberculosis, such as:
•  Sub-Saharan Africa
•  India
•  China
•  Mexico
•  The islands of Southeast Asia and Micronesia
•  Parts of the former Soviet Union

Poverty and substance abuse
_
Lack of medical care:
If you are on a low or fixed income, live in a remote area, have recently immigrated to the United States or are homeless, you may lack access to the medical care needed to diagnose and treat TB.
_ Substance abuse: Long-term drug or alcohol use weakens your immune system and makes you more vulnerable to tuberculosis.

Where you work or live
_
Health care work:
Regular contact with people who are ill increases your chances of exposure to TB bacteria. Wearing a mask and frequent hand-washing greatly reduce your risk.
_ Living or working in a residential care facility. People who live or work in prisons, immigration centers or nursing homes are all at risk of tuberculosis. That’s because the risk of the disease is higher anywhere there is overcrowding and poor ventilation.
_ Living in a refugee camp or shelter: Weakened by poor nutrition and ill health and living in crowded, unsanitary conditions, refugees are at especially high risk of tuberculosis infection.

Complications
Without treatment, tuberculosis can be fatal. Untreated active disease typically affects your lungs, but it can spread to other parts of the body through your bloodstream. Examples include:
•  Bones. Spinal pain and joint destruction may result from TB that infects your bones. In many cases, the ribs are affected.
•  Brain. Tuberculosis in your brain can cause meningitis, a sometimes fatal swelling of the membranes that cover your brain and spinal cord.
•  Liver or kidneys. Your liver and kidneys help filter waste and impurities from your bloodstream. These functions become impaired if the liver or kidneys are affected by tuberculosis.
•  Heart. Tuberculosis can infect the tissues that surround your heart, causing inflammation and fluid collections that may interfere with your heart’s ability to pump effectively. This condition, called cardiac tamponade, can be fatal.

Tests and diagnosis
During the physical exam, your doctor will check your lymph nodes for swelling and use a stethoscope to listen carefully to the sounds your lungs make when you breathe.
The most commonly used diagnostic tool for tuberculosis is a simple skin test. A small amount of a substance called PPD tuberculin is injected just below the skin of your inside forearm. You should feel only a slight needle prick. Within 48 to 72 hours, a health care professional will check your arm for swelling at the injection site. A hard, raised red bump means you’re likely to have TB infection. The size of the bump determines whether the test results are significant.

 Results can be wrong
The TB skin test isn’t perfect. Sometimes, it suggests that people have TB when they really don’t. It can also indicate that people don’t have TB when they really do. A false-positive test may happen if you’ve been vaccinated with the bacillus Calmette-Guerin (BCG) vaccine. This tuberculosis vaccine is seldom used in the United States but is widely used in countries with high TB infection rates. False-negative results may occur in certain populations — including children, older people and people with AIDS — who sometimes don’t respond to the TB skin test. A false-negative result can also occur in people who’ve recently been infected with TB but their immune system hasn’t had time to react to the bacteria yet.

Blood tests
Blood tests may be used to confirm or rule out latent or active tuberculosis. These tests use sophisticated technology to measure your immune system’s reaction to TB bacteria. These tests may be useful if you’re at high risk of TB infection but have a negative response to the skin test, or if you received the BCG vaccine.

Chest X-ray
If you’ve had a positive skin test, your doctor is likely to order a chest X-ray. This may show white spots in your lungs where your immune system has walled off TB bacteria, or it may reveal changes in your lungs caused by active tuberculosis.

Sputum tests
If your chest X-ray shows signs of tuberculosis, your doctor may take a sample of your sputum — the mucus that comes up when you cough. The samples are tested for TB bacteria. These bacteria can also be tested to see if they are resistant to the effects of medications commonly used to treat tuberculosis. This helps your doctor choose the medications that are most likely to work.

Treatments and drugs
Medications are the cornerstone of tuberculosis treatment. But treating TB takes much longer than treating other types of bacterial infections. With tuberculosis, you must take antibiotics for at least six to nine months. The exact drugs and length of treatment depend on your age, overall health, possible drug resistance, the form of TB (latent or active) and its location in the body.

Most common TB drugs
If you have latent tuberculosis, you may need to take just one type of TB drug. Active tuberculosis, particularly if it’s a drug-resistant strain, will require several drugs at once. The most common medications used to treat tuberculosis include:
•  Isoniazid
•  Rifampin (Rifadin, Rimactane)
•  Ethambutol (Myambutol)
•  Pyrazinamide

Medication side effects
Side effects of TB drugs aren’t common but can be serious when they do occur. All tuberculosis medications can be highly toxic to your liver. When taking these medications, call your doctor immediately if you experience any of the following:
•  Nausea or vomiting
•  Loss of appetite
•  A yellow color to your skin (jaundice)
•  Dark urine
•  A fever that lasts three or more days and has no obvious cause

Completing treatment is essential
After a few weeks, you won’t be contagious and you may start to feel better. It might be tempting to stop taking your TB drugs. But it is crucial that you finish the full course of therapy and take the medications exactly as prescribed by your doctor. Stopping treatment too soon or skipping doses can allow the bacteria that are still alive to become resistant to those drugs, leading to TB that is much more dangerous and difficult to treat.
To help people stick with their treatment, a program called directly observed therapy (DOT) is sometimes recommended. In this approach, a health care worker administers your medication so that you don’t have to remember to take it on your own.
.

B.  TB Medical Advisory Board Statement on the Treatment of Active Tuberculosis in Adults
http://www.in.gov/isdh/19686.htm
1. Recommended Treatment Regimens
Unless there are contraindications, patients with active tuberculosis should be treated initially with four drugs: isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB). Four drugs are recommended because (1) EMB helps to prevent the emergence of RIF-resistant organisms when primary resistance to INH may be present; (2) INH resistance continues to occur in our state, (3) foreign-borne persons from countries with high rates of drug resistance make up a growing number of TB cases in Indiana, and (4) six-month treatment regimens are not possible without the use of PZA.

 2. Drug Administration
The preferred regimen in our state is the ‘Denver Regimen.’ In this regimen, the patient is treated with daily medication for the first two weeks, followed by twice-weekly dosing until a total of 26 weeks of therapy are completed. This regimen must be given using directly observed therapy (DOT), meaning that a public health worker delivers medication to the patient and observes the patient ingest the medication. Completion of treatment is defined by the total number of doses ingested as well as the duration of treatment. Note: twice-weekly therapy is contraindicated for HIV-infected patients with CD4+ lymphocyte counts < 100 cells/µl. An overview of the ‘Denver Regimen’ is provided in Table 2 as “Option 1.” Doses for anti-tuberculosis medications are as follows:

Table 1

Table 2

Daily dosing for 5 rather than 7 days per week is an option for the daily portion of treatment options 1 and 2, but should only be used if dosing 7 days per week is not feasible. DOT must be used with this option.

INH, rifampin and pyrazinamide should be continued for the entire first two months. Ethambutol may be discontinued after the drug susceptibility test shows that the patient’s organism is susceptible to both INH and RIF.

3. Major Adverse Effects
All patients should be counseled to watch for symptoms of hepatotoxicity.  If hepatotoxicity develops (ALT or AST greater than five times the upper limit of normal, elevated bilirubin, or symptoms of hepatotoxicity), all drugs should be discontinued, and ISDH should be consulted immediately. The ISDH TB Medical Advisory Board has published guidelines on the management of hepatotoxicity. Other significant adverse reactions are listed in the table below:

Table 3

Drug Major Adverse Effects
Isoniazid Hepatitis, peripheral neuropathy
Rifampin Drug nteractions, hepatitis
Pyrazinamide Hepatitis, GI upset, hyperuricemia
Ethambutol Optic neuritis

.
4. Drug Dosages and Toxicity

The ISDH TB Medical Advisory Board does not recommend prescribing anything other than standard therapeutic doses (Table 1). Prior to treatment, measure CBC with platelets, liver enzymes, uric acid, visual acuity, and perform color vision screening. Then, assess monthly for side effects and order laboratory tests as indicated.

[What is hepatotoxicity? Hepatotoxicity is a general term for liver damage.
The signs and symptoms of hepatotoxicity vary depending on how badly the liver is damaged. Symptoms of liver damage include: nausea, vomiting, abdominal, pain, loss of appetite, diarrhea, feeling tired or weak, jaundice (yellowing of the skin and eyes), hepatomegaly (liver enlargement)
Pasted from< http://www.thebody.com/content/art12772.html>]

5. Use of Drugs Other Than INH, RIF, PZA, or EMB
There are no substitutes for any of the first-line agents. Before rifampin was available, TB patients had to take medication for 18-24 months. The combination of INH and rifampin allowed completion of therapy within 9 months. Routine addition of PZA during the first two months has shortened duration of therapy to 6 months for most cases. Ethambutol is known as a ‘companion drug,’ and has bacteriostatic activity. Its primary purpose is to suppress the further development of resistance in situations where INH resistance is already present at diagnosis. Ethambutol can be discontinued as soon as the organism is known to be susceptible to both INH and RIF.

The drugs are not interchangeable. Second-line agents must be used when patients cannot take first-line drugs because of resistance or intolerance. These second-line agents are substantially less active, and not without risks of toxicity. Patients taking second-line drugs in lieu of both INH and RIF require treatment durations of up to 2 years with frequent monitoring for side effects.

Prevention
http://www.mayoclinic.com/health/tuberculosis/DS00372/DSECTION=coping-and-support
If you test positive for latent TB infection, your doctor may advise you to take medications to reduce your risk of developing active tuberculosis. The only type of tuberculosis that is contagious is the active variety, when it affects the lungs. So if you can prevent your latent tuberculosis from becoming active, you won’t transmit tuberculosis to anyone else.

Protect your family and friends
If you have active TB, keep your germs to yourself. It generally takes a few weeks of treatment with TB medications before you’re not contagious anymore. Follow these tips to help keep your friends and family from getting sick:
Stay home. Don’t go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.
Ventilate the room. Tuberculosis germs spread more easily in small closed spaces where air doesn’t move. If it’s not too cold outdoors, open the windows and use a fan to blow indoor air outside.
Cover your mouth. Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.
Wear a mask. Wearing a surgical mask when you’re around other people during the first three weeks of treatment may help lessen the risk of transmission.
Finish your entire course of medication. This is the most important step you can take to protect yourself and others from tuberculosis. When you stop treatment early or skip doses, TB bacteria have a chance to develop mutations that allow them to survive the most potent TB drugs. The resulting drug-resistant strains are much more deadly and difficult to treat.
Vaccinations. In countries where tuberculosis is more common, infants are vaccinated with bacillus Calmette-Guerin (BCG) vaccine because it can prevent severe tuberculosis in children. The BCG vaccine isn’t recommended for general use in the United States because it isn’t very effective in adults and it causes a false-positive result on a TB skin test. Researchers are working on developing a more effective TB vaccine.

Coping and support
Undergoing treatment for tuberculosis is a complicated and lengthy process. But the only way to cure the disease is to stick with your treatment. You may find it helpful to have your medication given by a nurse or other health care professional so that you don’t have to remember to take it on your own. In addition, try to maintain your normal activities and hobbies, and stay connected with family and friends.
Keep in mind that your physical health can affect your mental health. Denial, anger and frustration are normal when you must deal with something difficult and unexpected. At times, you may need more tools to deal with these or other emotions. Professionals, such as therapists or behavioral psychologists, can help you develop positive coping strategies.

[End of article]

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Syphilis

(Survival Manual/6. Medical/b) Disease /Syphilis)
 Source information pasted from <http://emedicine.medscape.com/article/786191-overview>
<http://menshealth.about.com/od/sexualdiseasesstds/a/syphilis_treat.htm>
<http://www.stdservices.on.net/std/syphilis/management.htm>
<http://www.drugs.com/dosage/tetracycline.html>

History of Syphilis
<http://en.wikipedia.org/wiki/History_of_syphilis>
The first well-recorded European outbreak of what is now known as syphilis occurred in 1495 among French troops besieging Naples, Italy. It may have been transmitted to the French via Spanish mercenaries serving King Charles of France in that siege. From this centre, the disease swept across Europe. As Jared Diamond describes it, ” When syphilis was first definitely recorded in Europe in 1495, its pustules often covered the body from the head to the knees, caused flesh to fall from people’s faces, and led to death within a few months.” The disease then was much more lethal then, than it is today. Diamond concludes,” By 1546, the disease had evolved into the disease with the symptoms so well known to us today.” The epidemiology of this first syphilis epidemic shows that the disease was either new or a mutated form of an earlier disease.
Researchers concluded that syphilis was carried from the New World to Europe after Columbus’ voyages.
Many of the crew members who served on this voyage later joined the army of King Charles VIII in his invasion of Italy in 1495, resulting in the spreading of the disease across Europe and as many as five million deaths.

Syphilis is caused by a bacteria called Treponema pallidum. The bacteria like the warm moist linings of the genital passages, the rectum and mouth, but dies quickly outside the body. Syphilis has an incubation period of between 9 days and 3 months. Syphilis is almost always a result of unprotected sex with an infected person.

 Definition
Syphilis is a bacterial infection usually spread by sexual contact. The disease starts as a painless sore — typically on your genitals, rectum or mouth. Syphilis spreads from person to person via skin or mucous membrane contact with these sores.
After the initial infection, the syphilis bacteria can lie dormant in your body for decades before becoming active again. Early syphilis can be cured, sometimes with a single injection of penicillin. Without treatment, syphilis can severely damage your heart, brain or other organs, and can be life-threatening.
Syphilis rates in the United States have been rising since 2000, particularly among men who have sex with men. The genital sores associated with syphilis can make it easier to become infected with HIV, the virus that causes AIDS.

Symptoms
Syphilis develops in stages, and symptoms vary with each stage. But the stages may overlap, and symptoms don’t always occur in the same order. You may be infected with syphilis and not notice any symptoms for years.
Primary syphilis
 
[Photo at left, Primary Syphilis]
The first sign of syphilis is a small sore, called a chancre (SHANG-kur). The sore appears at the spot where the bacteria entered your body. While most people infected with syphilis develop only one chancre, some people develop several of them. The chancre usually develops about three weeks after exposure. Many people who have syphilis don’t notice the chancre because it’s usually painless and it may be hidden within the vagina or rectum. The chancre will heal on its own within six weeks.

.
Secondary syphilis
[Photo at right, Secondary Syphilis]
Within a few weeks of the original chancre healing, you may experience a rash that begins on your trunk but eventually covers your entire body — even the palms of your hands and the soles of your feet. This rash is usually not itchy and may be accompanied by wart-like sores in the mouth or genital area. Some people also experience muscle aches, fever, sore throat and swollen lymph nodes. These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year.

Latent syphilis
If you aren’t treated for syphilis, the disease moves from the secondary to the latent (hidden) stage, when you have no symptoms. The latent stage can last for years. Signs and symptoms may never return, or the disease may progress to the tertiary (third) stage.
Tertiary or late syphilis
About 15 to 30 percent of people infected with syphilis who don’t get treatment will develop complications known as tertiary, or late, syphilis. In the late stages, the disease may damage your brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur many years after the original, untreated infection.
Congenital syphilis
Babies born to women who have syphilis can become infected through the placenta or during birth. Most newborns with congenital syphilis have no symptoms, although some experience a rash on the palms of their hands and the soles of their feet. Later symptoms may include deafness, teeth deformities and saddle nose — where the bridge of the nose collapses. 

When to see a doctor
Call your doctor if you or your child experiences any unusual discharge, sore or rash — particularly if it occurs in the groin area.

Causes
The cause of syphilis is a bacterium called Treponema pallidum. The most common route of transmission is through contact with an infected person’s sore during sexual activity. The bacteria enter your body through minor cuts or abrasions in your skin or mucous membranes. Syphilis is contagious during its primary and secondary stages, and sometimes in the early latent period.
Less commonly, syphilis may spread through direct unprotected close contact with an active lesion (such as during kissing) or through an infected mother to her baby during pregnancy or childbirth (congenital syphilis).
Syphilis can’t be spread by using the same toilet, bathtub, clothing or eating utensils, or from doorknobs, swimming pools or hot tubs.
Even if you’ve been cured of syphilis, you can become re-infected if you have contact with someone’s syphilis sore.

Risk factors
You face an increased risk of acquiring syphilis if you:
•  Engage in unprotected sex
•  Have sex with multiple partners
•  Are a man who has sex with men
•  Are infected with HIV, the virus that causes AIDS

Complications
Without treatment, syphilis can lead to damage throughout your body. Syphilis also increases the risk of HIV infection and, for women, can cause problems during pregnancy. Treatment can help prevent future damage but can’t repair or reverse damage that’s already occurred.
•  Small bumps or tumors
Called gummas, these bumps can develop on your skin, bones, liver or any other organ in the late stage of syphilis. Gummas usually disappear after treatment with antibiotics.
•  Neurological problems
Syphilis can cause a number of problems with your nervous system, including: Stroke, Meningitis, Deafness, Visual problems,,Dementia
•  Cardiovascular problems
These may include bulging (aneurysm) and inflammation of the aorta — your body’s major artery — and of other blood vessels. Syphilis may also damage heart valves.
•  HIV infection
Adults with sexually transmitted syphilis or other genital ulcers have an estimated two- to fivefold increased risk of contracting HIV. A syphilis sore can bleed easily, providing an easy way for HIV to enter your bloodstream during sexual activity.
•  Pregnancy and childbirth complications
If you’re pregnant, you may pass syphilis to your unborn baby. Congenital syphilis greatly increases the risk of miscarriage, stillbirth or your newborn’s death within a few days after birth.

Tests and diagnosis
Syphilis can be diagnosed by testing samples of:
•  Blood. Blood tests can confirm the presence of antibodies that the body produces to fight infection. The antibodies to the bacteria that cause syphilis remain in your body for years, so the test can be used to determine a current or past infection.
•  Fluid from sores. Your doctor may scrape a small sample of cells from a sore to be analyzed by microscope in a lab. This test can be done only during primary or secondary syphilis, when sores are present. The scraping can reveal the presence of bacteria that cause syphilis.
•  Cerebral spinal fluid. If it’s suspected that you have nervous system complications of syphilis, your doctor may also suggest collecting a sample of cerebrospinal fluid through a procedure called a lumbar puncture (spinal tap).

Treatments and drugs
When diagnosed and treated in its early stages, syphilis is easy to cure. The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis. If you’re allergic to penicillin, your doctor will suggest another antibiotic.
A single injection of penicillin can stop the disease from progressing if you’ve been infected for less than a year. If you’ve had syphilis for longer than a year, you may need additional doses.
Penicillin is the only recommended treatment for pregnant women with syphilis. Women who are allergic to penicillin can undergo a desensitization process that may allow them to take penicillin. Even if you’re treated for syphilis during your pregnancy, your newborn child should also receive antibiotic treatment.
* The first day you receive treatment you may experience what’s known as the Jarisch-Herxheimer reaction. Signs and symptoms include fever, chills, nausea, achy pain and headache. This reaction usually doesn’t last more than one day.

Treatment follow-up
•  After you’re treated for syphilis, your doctor will ask you to:
•  Have periodic blood tests and exams to make sure you’re responding to the usual dosage of penicillin.
•  Avoid sexual contact until the treatment is completed and blood tests indicate the infection has been cured.
•  Notify your sex partners so that they can be tested and get treatment if necessary.
•  Be tested for HIV infection.

 * The main of therapy for syphilis is antibiotic treatment, usually penicillin. Doxycycline may be used if you have a penicillin allergy.

Penicillin is given either intramuscularly or intravenously depending on the stage of syphilis. Follow up blood tests (RPR) are usually taken to track the efficacy of the treatment.

If the appropriate antibiotic treatment is given for syphilis in its primary and secondary stages it completely cures this disease. In the latent and tertiary or final stage of syphilis treatment can still eradicate and stop further damage occurring. The damage that has already happen has to be treated but is often difficult or impossible to repair.

Tetracycline dosages for syphilis:
http://www.drugs.com/dosage/tetracycline.html#Usual_Adult_Dose_for_Syphilis___Early
Usual Adult Dose for Syphilis – Early (less than 2 years duration)
Tetracycline should be used only if penicillins are contraindicated.
Doxycycline 200 mg orally daily for 20 days or tetracycline HCl 500 mg orally 6 hourly for 20 days

Usual Adult Dose for Syphilis – Latent
500 mg orally every 6 hours for 28 days; alternatively, 30 to 40 g in divided doses over a period of 10 to 15 days has been recommended.
Tetracycline should be used only if penicillins are contraindicated.

Usual Adult Dose for Tertiary Syphilis
doxycycline 200 mg orally daily for 30 days or tetracycline HCl 500 mg orally 6 hourly for 30 days

Prevention
To help prevent the spread of syphilis, follow these suggestions:
•  Abstain or be monogamous. The only certain way to avoid syphilis is to forgo having sex. The next-best option is to have mutually monogamous sex with one partner who is uninfected.
•  Use a latex condom. Condoms can reduce your risk of contracting syphilis, but only if the condom covers the syphilis sores.
•  Avoid recreational drugs. Excessive use of alcohol or other drugs can cloud your judgment and lead to unsafe sexual practices.

[End of post]

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Filed under Survival Manual, __6. Medical, ___b) Disease

Personal Protective Equipment

(Survival Manual / 6. Medical / c) General Clinic / Personal Protective Equipment)

Personal Protection Equipment (PPE) by hazard
<http://en.wikipedia.org/wiki/Personal_protective_equipment#Biological_hazard_protection>
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Biological hazard protection
Protective equipment for biological hazards includes masks worn by medical personnel (especially in surgery to avoid infecting the patient but also to avoid exposing the personnel to infection from the patient.) Gloves, frequently changed, are used to prevent infection but also transfer between patients.

*** PPE should always be regarded as a ‘last resort’ to protect against risks to safety and health.

Ballistic
Ballistic personal protective equipment (or armor) is used in combat by soldiers and in lesser conflicts by law enforcement.

Blunt Trauma
Law enforcement and Corrections officers wear Blunt Trauma PPE for crowd management, civil disturbances, cell extractions, riot control, violent disturbances, and other emergency response operations.

Fire
Fire proximity suit

Sports
Protective clothing is also worn for contact sports, such as ice hockey and American football. Baseball players wear sliding shorts and a cup under their pants. See baseball clothing and equipment, cuirass, goalie mask, jockstrap. Law in many countries requires protective headgear and eyewear for riding a motorcycle.

Air-Purifying Respirator
Respirators such as “gas masks” and particle respirators filter chemicals and gases or airborne particles. A second type of respirator protects users by providing clean, respirable air from another source. This type includes airline respirators and self-contained breathing apparatus (SCBA). In work environments, respirators are used when adequate ventilation is not available or other engineering control systems are not feasible.
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Biological & Chemical Hazard

1.  Principles for using biological (and chemical ) Personal Protective Equipment (PPE)
In all cases, the following principles apply:
• 
PPE reduces but does not completely eliminate the possibility of  infection (contamination).
•  PPE is only effective if used correctly and at all times where contact may occur.
•  Any contact between contaminated (used) PPE and surfaces / clothing / people outside the isolation area must be avoided.
•  Used PPE must be sealed in appropriate disposal bags and sterilized or decontaminated. If staff temporarily leave the isolation area, a complete change of PPE and hand washing required.
•  The use of PPE does not replace basic hygiene measures such as hand-washing, washing is still essential to prevent transmission.
•  Exposure to the infected patientt should be kept to an absolute minimum necessary for the level of care required.

Who should use Personal Protective Equipment?
•  All those who are handling infected or suspected to be infected poultry and poultry products. These include cullers and animal husbandry/veterinary staff.
•  All doctors, nurses and health care workers who provide direct patient care to avian influenza cases (keep to minimum necessary for patients’ condition);
•  All support staff including medical aides, X-ray technicians, cleaners, transport staff, laundry staff (keep staff to the minimum necessary, designate avian influenza laundry staff, etc.);
•  All laboratory staff who handle patient specimens from suspect cases (keep to the minimum the staff necessary for laboratory procedures);
•  Family members who care for avian influenza patients (visits should be avoided where possible); The patient(s) should wear a mask (N95 preferable) when other people are in the isolation area. Contacts and international travelers during home isolation/quarantine must wear a mask (N95 preferable).

Personal Protective Equipment (lowest level threats)
The items included are:
•  Masks (N-95; N/P/R-100, If not available N80 or surgical masks as last resort)
•  Gloves
•  Gloves and aprons
•  Hair Covers
•  Eye protective ware (goggle)
•  Boots or shoe covers
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2.  Basic Sanitation techniques (If you need to wear PPE then you should be following the steps listed below):
Hand washing
•  It is the single most important and effective component for preventing the transmission of infection and removal of contamination.
•  Running water and soap with friction should be ideally used for 15 to 20 seconds.
•  It is important to dry hands after washing.
•  A 70% alcohol-based hand rub solution after hand washing can be used.

Hand washing  should be done:
•  After removing gloves
•  Before and after patient contact or contact with potentially infected material
•  After contact with blood and body fluids
•  After taking samples
•  After taking blood-pressure or vital signs from patient
•  After using bath room
•  After blowing/wiping nose
•  Before eating and preparing food.
•  When leaving the isolation unit.

Waste disposal
The practices as approved by the Hospital Infection Control Committee or hospital authorities must be followed. Some of these are:
•  Waste should be collected in designated color coded plastic bags for sterilization and disposal.
•  Double bag system for transport should be used.

Cleaning and disinfection of hospital environment and equipment
The practices as approved by the Hospital Infection Control Committee or hospital authorities must be followed. Some of these are:
•  Cleaning staff should wear full PPE
•  Cleaning should be done thoroughly to be followed by disinfection
•  Items and areas requiring cleaning and disinfection are:
•  Bedside table, bed stand, accessible areas of bed and floors (Use 0.1% sodium hypochlorite as disinfectant)
•  If any surface is grossly contaminated, pour 1% sodium hypochlorite first and leave it for 10-15 minutes to be followed by cleaning and usual disinfection (0.1% sod. hypochlorite).
•  Basins and bedpans should be cleaned and disinfected before being used for another patient.
•  Spray disinfectant is prohibited.

PPE reduces but does not completely eliminate the possibility of infection or contamination.
•  PPE is only effective if used correctly and at all times where contact may occur.
•  Any contact between contaminated (used) PPE and surfaces / clothing / people outside the isolation area must be avoided.
•  Used PPE must be sealed in appropriate disposal bags and sterilized or decontaminated. If staff temporarily leave the isolation area, a complete change of PPE and hand washing required.
•  The use of PPE does not replace basic hygiene measures such as hand-washing, washing is still essential to prevent transmission.
•  Exposure to the infected patient should be kept to an absolute minimum necessary for the level of care required.
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3.  Discussion of general protective clothing
•  Surgical mask: Surgical masks are designed to protect the sterile field of the patient from contaminants generated by the wearer. Although surgical masks filter out large-size particulates, they offer no respiratory protection against chemical vapors. These masks are effective against respiratory droplets and are used when treating infected patients who require “droplet precautions” such as pneumonic plague.
•  Protective Clothing: Most protective clothing is aimed at protection against chemicals and CWAs because intact skin provides an effective barrier against all BWAs except the trichothecene mycotoxins.
• Chemical-protective clothing: Chemical-protective clothing (CPC) consists of multilayered garments made out of various materials that protect against various hazards. Because no single material can protect against all chemicals, multiple layers of various materials are usually used to increase the degree of protection. Aluminum-lined, vapor-impermeable garments increase the level of protection. Protection is maximized by total encapsulation. An assortment of types of chemical-protective hats, hoods, gloves, and boot covers complements the garments.
•  Barrier gown and latex gloves: Barrier gowns are waterproof and protect against exposure to biological materials, including body fluids, but do not provide adequate skin or mucous membrane protection against chemicals. Latex gloves also protect wearers from biological materials but are inadequate against most chemicals.
Barrier gowns, latex gloves, and leg and/or shoe covers together comprise “contact precautions” and are useful for agents such as viral hemorrhagic fevers.
•  Chemical-protective gloves: Chemical-protective glove sets consist of a protective outer glove made out of butyl rubber and an inner glove for absorption of perspiration. Glove sets are available in 4 sizes and 3 thicknesses (7, 14, and 25 mL) with varying tactile sensitivities. Gloves may be worn for 12 hours in the contaminated environment. After visual inspection, gloves may be reused for another 12 hours. After use, gloves may be decontaminated and reused.
•  Chemical-protective footwear covers: Chemical-protective footwear covers (CPFC) are single-sized butyl rubber footwear covers that protect combat boots against all agents. Vinyl over boots are also available.
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4.  Biohazard Levels
<http://en.wikipedia.org/wiki/Biological_hazard>
The United States’ Centers for Disease Control and Prevention (CDC) categorizes various diseases in levels of biohazard, Level 1 being minimum risk and Level 4 being extreme risk. Laboratories and other facilities are categorized as BSL (BioSafety Level) 1-4 (Pathogen or Protection Level) as follow:

Biohazard Level 1:
• 
Bacteria and viruses including Bacillus subtilis, canine hepatitis, Escherichia coli, varicella (chicken pox), as well as some cell cultures and non-infectious bacteria.
•  At this level precautions against the biohazardous materials in question are minimal, most likely involving gloves and some sort of facial protection.
•  Usually, contaminated materials are left in open (but separately indicated) waste receptacles. Decontamination procedures for this level are similar in most respects to modern precautions against everyday viruses (i.e.: washing one’s hands with anti-bacterial soap, washing all exposed surfaces of the lab with disinfectants, etc.). In a lab environment, all materials used for cell and/or bacteria cultures are decontaminated via autoclave.

Biohazard Level 2:
•  Bacteria and viruses that cause only mild disease to humans, or are difficult to contract via aerosol in a lab setting, such as hepatitis A, B, and C, influenza A, Lyme disease, salmonella, mumps, measles, scrapie, dengue fever, and HIV.
•   “Routine diagnostic work with clinical specimens can be done safely at Biosafety Level 2, using Biosafety Level 2 practices and procedures. Research work (including co-cultivation, virus replication studies, or manipulations involving concentrated virus) can be done in a BSL-2 (P2) facility, using BSL-3 practices and procedures.

Biohazard Level 3:
•  Bacteria and viruses that can cause severe to fatal disease in humans, but for which vaccines or other treatments exist, such as anthrax, West Nile virus, Venezuelan equine encephalitis, SARS virus, variola virus (smallpox), tuberculosis, typhus, Rift Valley fever, Rocky Mountain spotted fever, yellow fever, and malaria. Among parasites Plasmodium falciparum, which causes Malaria, and Trypanosoma cruzi, which causes trypanosomiasis, also come under this level.

Biohazard Level 4:
•  Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, Dengue hemorrhagic fever, Marburg virus, Ebola virus, hantaviruses, Lassa fever, Crimean-Congo hemorrhagic fever, and other hemorrhagic diseases.
•  When dealing with biological hazards at this level the use of a Hazmat suit and a self-contained oxygen supply is mandatory.
•  The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.
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5. Employer Guidelines for appropriate PPE (Personal Protective Equipment)
<http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9767>Personal protective equipment is divided into four categories based on the degree of protection afforded.
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PPE Level A 
(To be selected when the greatest level of skin, respiratory, and eye protection is required.  )
Definition: The hazardous substance has been   identified or is an unknown, and requires the highest level of protection for   skin, eyes, and the respiratory system based on either the measured (or   potential for) high concentration of atmospheric vapors, gases, or   particulates; or the site operations and work functions involve a high   potential for splash, immersion, or exposure to unexpected vapors, gases, or   particulates of materials that are harmful to skin or capable of being   absorbed through the skin.
—Substances with a high degree of hazard to   the skin are known or suspected to be present, and skin contact is possible;   or
—Operations must be conducted in confined,   poorly ventilated areas, and the absence of conditions requiring Level A have   not yet been determined.
—When an event is uncontrolled or   information is unknown about: the type of airborne agent, the dissemination   method, if dissemination is still occurring or it has stopped.
Components: A fully encapsulated, liquid and vapor   protective ensemble selected when the highest level of skin, reparatory and   eye protection is required.
Positive pressure, full face-piece   self-contained breathing apparatus (SCBA), or positive pressure supplied air   respirator with escape SCBA, approved by the National Institute for Occupational Safety and Health (NIOSH).  Closed-circuit Rebreather/ open   circuit SCBA.
Totally-encapsulating chemical-protective suit.
—Gloves, outer, chemical-resistant.
—Gloves, inner, chemical-resistant.
—Boots, chemical-resistant, steel toe and   shank, outer booties.
—Disposable protective suit, gloves and   boots (depending on suit construction, may be worn over totally-encapsulating   suit).
—Coveralls.
*—Long underwear.
*—Hard hat (under suit), personal cooling   system, chemical resistant tape.
**Optional/as needed.
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PPE Level B  (The highest level of respiratory protection is necessary but a lesser level of skin protection is needed.) 
Definition:
The type and atmospheric concentration of   substances have been identified and require a high level of respiratory   protection, but less skin protection.
—The atmosphere contains less than 19.5   percent oxygen; or
—The presence of incompletely identified   vapors or gases is indicated by a direct-reading organic vapor detection   instrument, but vapors and gases are not suspected of containing high levels   of chemicals harmful to skin or capable of being absorbed through the skin.
—A liquid-splash-resistant ensemble used   with the highest level of reparatory protection.
—The suspected aerosol is not longer being   generated, but other conditions may present a splash hazard.
Components: A liquid-splash-resistant ensemble used   with the highest level of reparatory protection.
Positive pressure, full-face piece   self-contained breathing apparatus (SCBA), or positive pressure supplied air   respirator with escape SCBA (NIOSH approved).
Hooded chemical-resistant clothing   (overalls and long-sleeved jacket; coveralls; one or two-piece   chemical-splash suit; disposable chemical-resistant overalls).
—Gloves, outer, chemical-resistant.
—Gloves, inner, chemical-resistant.
—Boots, outer, chemical-resistant steel toe   and shank.
—Boot-covers, outer, chemical-resistant.
—Hard hat, personal cooling system,   chemical resistant tape.
*—Coveralls.
*—Face shield.
**Optional/as needed.
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PPE Level C  (The concentration and type of airborne substance is known and the criteria for using air purifying respirators are met)
Definition: The atmospheric contaminants, liquid   splashes, or other direct contact may adversely affect or be absorbed through   any exposed skin.
—The types of air contaminants have been   identified, concentrations measured, and an air-purifying respirator is   available that can remove the contaminants; and
—All criteria for the use of air-purifying   respirators are met.
Components: A liquid-splash-resistant ensemble, with   the same level of skin protection as Level B, used when the concentration(s)   and type(s) of airborne substances(s) are known and the criteria for using   air-purifying respirators are met.
Full-face or half-mask, air purifying respirators (NIOSH   approved).
Hooded chemical-resistant clothing   (overalls; two-piece chemical-splash suit; disposable chemical-resistant   overalls).
Gloves, outer, chemical-resistant.
Gloves, inner, chemical-resistant.
—Boots (outer), chemical-resistant steel   toe and shank.
—Boot-covers, outer, chemical-resistant.
Coveralls.
*—Hard hat, face shield, personal cooling   system.
*—Escape mask.
*—Face shield.
**Optional/as needed.
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PPE Level D
Definition: Selected when the atmosphere contains no   known hazards.   Work   functions preclude splashes, immersion, or the potential for unexpected   inhalation of or contact with hazardous levels of any chemicals.   This level has no respiratory protection   and minimal skin protection. Level D protection is the normal work clothes   and non- respiratory PPE. Work shirt, safety boots and safety glasses are all   examples of PPE used at this level. Dust masks used on a voluntary basis   would still fall under Level D protection. In   hospitals, Level D consists of surgical gown, mask, and latex gloves   (universal precautions). Level D PPE provides no respiratory protection and   only minimal skin protection.
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Level   D Modified
– This Level is the same as Level D for respiratory protection,   but the skin protection is increased to that of Level C. Components: A work uniform affording minimal   protection: used for nuisance contamination only.
—Coveralls.
—Boots/shoes, chemical-resistant steel toe   and shank.
—Boots, outer, chemical-resistant   (disposable).
*—Gloves.
*—Safety glasses or chemical splash   goggles.
*—Hard hat.
*—Escape mask.
*—Face shield.
**Optional/as needed.
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6.  Types of Respirators
Surgical masks
Surgical masks are not respirators and are not certified as such; they do not protect the user adequately from exposure. The primary purpose of a surgical facemask is to help prevent biological particles from being expelled by the wearer into the environment. Persons suspected of having avian influenza should be separated from others and asked to wear a surgical mask. If a surgical mask is not available, tissues should be provided and patients should be asked to cover their mouth and nose when coughing.
The benefit of wearing surgical masks by well persons in public settings has not been established and is not recommended as a public health control measure at this time. Surgical masks are not adequate PPE for airborne infections. Even though influenza is primarily spread via droplet, there may also be airborne spread. An N95 respirator or PAPR should be recommended, at least in the initial stages of a pandemic and while supplies last.
In contrast to healthcare workers who necessarily have close contact with ill patients, the general public should try to avoid close contact with ill individuals. Nevertheless, persons may choose to wear a mask as part of individual protection strategies that include cough etiquette, hand hygiene, and avoiding public gatherings. Mask use may be most important for persons who are at high risk for complications of influenza and those who are unable to avoid close contact with others or must travel for essential reasons such as seeking medical care.
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Respirators
Respirators are designed to help reduce the wearer’s exposure to airborne particles. Respirators protect the user in two basic ways.
•  a) The first is by the removal of contaminants from the air. Respirators of this type include particulate respirators, which filter out airborne particles [ie., volcanic ash, dust storms]; and, b )  “gas masks” which filter out chemicals and gases [‘tear gas’, smoke, many hazardous chemical and dangerous biological agents].
•  Other respirators protect by supplying clean respirable air from another source. Respirators that fall into this category include airline respirators, which use compressed air from a remote source; and self-contained breathing apparatus (SCBA), which include their own air supply.

Respirators are designed to reduce exposures of the wearer to airborne hazards. Biological agents, such as viruses, are particles and can be filtered by particulate filters with the same efficiency as non-biological particles having the same physical characteristics (size, shape, etc.). However, unlike most industrial particles there are no exposure limits established for biological agents. Therefore, while respirators will help reduce exposure to avian influenza viruses, there is no guarantee that the user will not contract avian flu. Respirators may help reduce exposures to airborne biological contaminants, but they don’t eliminate the risk of exposure, infection, illness, or death.

Beards, long mustaches, and stubble may interfere with a good seal and cause leaks into the respirator.

Recent CDC infection control guidance documents provide recommendations that health care workers protect themselves from diseases potentially spread through the air (such as SARS or Tuberculosis) by wearing a fit-tested respirator at least as protective as a NIOSH-approved N-95 respirator. The N95 only offers protection down to .3 microns, and viruses are smaller than this — human SARS coronaviruses measure between 0.1 and 0.2 microns. But viruses often travel on larger particles, such as globs of mucus, which can be filtered. Available data suggest that infectious droplet nuclei may range in size from 1 mm to 5 mm; therefore, respirators used in health care settings should be able to efficiently filter the smallest particles in this range.

[Photo at right: NIOSH approved N95 Particle/ Dust filter mask]

An N-95 respirator is one of nine types of disposable particulate respirators.
Particulate respirators are also known as “air-purifying respirators” because they protect by filtering particles out of the air you breathe. Workers can wear any one of the particulate respirators for protection against diseases spread through the air — if they are NIOSH approved and if they have been properly fit-tested and maintained. NIOSH-approved disposable respirators are marked with the manufacturer’s name, the part number (P/N), the protection provided by the filter (e.g. N-95), and “NIOSH.”
A N-95 filters at least 95% of airborne particles.
Higher level particulate respirators [i.e., N-100 filter at least 99.97% airborne] may also be used.

[Image below: The North® 7600 Full Face Mask Respirator: designed to provide eye, face and N100 respiratory protection, while ensuring optimal comfort and performance. Dual flange silicone seal with superior fitting characteristics, a hard-coated polycarbonate lens w/ over 200° field of vision & protects against irritating gases, vapors and flying particles. Includes 5-strap harness, oral nasal cup, chin cup and speaking diaphragm. NIOSH/MSHA approved.]

An N100 mask is well suited for those who want NIOSH’s highest rated filtration efficiency in a maintenance free respirator. It provides a minimum filter efficiency of 99.97% against non-oil based particles. It is nearly 200 times more effective than the N95 filter (typical style seen above), and is also about ten times more expensive.

Protective Respiratory Devices
Two basic types of respirators are available: atmosphere supplying (self-contained breathing apparatus [SCBA], supplied-air respirator [SAR]) and air purifying respirator (APR).

•  Self-contained breathing apparatus: SCBA consists of a full facepiece connected by a hose to a portable source of compressed air.
•  Supplied-air respirator: SAR consists of a full face piece connected to an air source away from the contaminated area via an airline.
•  Air-purifying respirator: An APR consists of a face piece worn over the mouth and nose with a filter element that filters ambient air before inhalation. Three basic types of APRs are available: powered, disposable, and chemical cartridge or canister.
_a)  Nonpowered APRs operate under negative pressure, depending on the inspiratory effort of the wearer to draw air through a filter. Because PAPRs function under positive pressure, they provide the greatest degree of respiratory protection. Various chemical cartridges or canisters, which eliminate various chemicals including organic vapors and acid gases, are available.
_b)  Disposable APRs are usually half masks, which do not provide adequate eye protection. This type of APR depends on a filter, which traps particulates. The use of a high-efficiency particulate air (HEPA) filter or use in combination with a chemical cartridge enhances disposable APRs.

One measure of respiratory filtration efficiency relevant to BWA exposures is the percent penetration of droplet nuclei into the face piece. For exposures to biological aerosols, a) PAPRs with HEPA filters are most efficient, b) followed by elastomeric half-mask HEPA filter respirators and, c) non-HEPA disposable APRs.
All APRs are limited by the adequacy of their face seals. Accordingly, APRs do not provide adequate respiratory protection in environments immediately dangerous to life or health.
•  High-efficiency particulate air filter (HEPA)
HEPA filters remove particles of 0.3-15 µm diameter with an efficiency of 98-100%, efficiently excluding aerosolized BWA particles in the highly infectious 1- to 5-µm range. HEPA filters are incorporated into various protective respiratory devices including PAPRs and elastomeric half-mask respirators. This type of filtration is required when caring for a patient infected with a disease requiring “airborne precautions” such as smallpox and viral hemorrhagic fevers. Use of an N-100 filter should provide the same protection as the HEPA filter.

7.   Masks
A.  North 760008A Full Face M/L Facepiece (by Honeywell Corporation)
<http://www.amazon.com/North-Products-Facepiece-Respirators-760008A/dp/B002KFAHGU/ref=sr_1_1?s=hi&ie=UTF8&qid=1330858157&sr=1-1>
AMAZON Price (2011): $148.94 +$6.58 = $155.52
Technical Details
•  Type: Full Face
•  Size: Medium/Large
•  Material: Silicone
•  Harness Type: 5 Point
•  For Use With: North Cartridges and Filters
Product Description
Half Full Facepieces – Respiratory Protection Type: Full Face Size: Medium/Large Material: Silicone Harness Type: 5 Point For Use With: North Cartridges and Filters Connection Type: Threaded
Technical Details
Designed to provide eye, face and respiratory protection while ensuring optimal comfort and performance. Dual flange silicone seal give this facepiece superior fitting characteristics. Hard-coated polycarbonate lens provides over 200° field-of-vision and protects the wearer’s eyes and face against irritating gases, vapors and flying particles. Lens meets ANSI standards for high impact and penetration resistance. Compatible with North cartridges, filters and accessories. NIOSH approved.

 B.  North 770030 Medium Silicone Half Mask Respirator 7700 Series, Mask Only
http://www.amazon.com/North-Safety-7700-half-Small/dp/B001429P1S
AMAZON Price: $19.99 +$5.90=$$25.89
The 7700’s soft non-allergenic silicone seal provides excellent protection, comfort and fit. The half masks cradle suspension system allows the facepiece to seal evenly on the face without creating pressure points. It’s low profile gives workers a wide field to vision and does not interfere with protective eyewear. The low inhalation and exhalation resistance of the 7700 Series makes breathing easier to reduce worker fatigue. NIOSH approved when used with North cartridges and/or filters. Dual Cartridge Silicone Half Mask: Silicone facepiece material conforms to facial features and doesn’t harden with age. Silicone is easy to clean, durable and resists distortion. Contoured sealing flange and cradle suspension system eliminates discomfort caused by pressure points on facial nerves. Nose area design is comfortable and well-fitting. Minimal dead air space limits re-breathing of exhaled air. Direct cartridge-to-facepiece seal minimizes replacement parts and simplifies maintenance. The most comfortable and durable half mask available. Does not interfere with protective eyewear.  Size: 770030S – Small 770030M – Medium 770030L – Large.
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8.  Biohazard protection
•  North 7700 N100 filter; Recommended half mask for H1N1-type flu virus (Swine flu).
•  Hantavirus: Use of an N-100 filter should provide the same protection as the HEPA filter. Available evidence suggests that Hantavirus is transmitted by inspiring small (less than 5 micron) viral particles in aerosols which the N-100 is the most effective in removing.

A.  Mask particle filter protection efficiency
USA Filter Standards     Efficiency *
NIOSH N95                      94%
NIOSH N99                      99%
NIOSH N100                    99.97%

Assigned Protection Factors

Type of respirator Dust respirator Quarter mask Half mask Full
facepiece
Helmet/
hood
1. Air-Purifying Respirator max 4 5 10 50 …………..
2. Powered Air-Purifying Respirator (PAPR) ………….. 50 1,000 1,000
4. Self-Contained Breathing Apparatus (SCBA)  Pressure-demand or other positive-pressure mode circuit) ………….. ………….. 10,000 10,000

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Two of North’s many filters
(these are my choices for an emergency kit): One for dust, blowing sand and ash, the other for many chemical and biological hazards.
See at <http://www.amazon.com/North-Safety-Defender-Multi-purpose-cartridge/dp/B002D94BZQ/ref=pd_cp_hi_0>

List of North filter cartriges/pictures/prices:
<http://www.respiratormaskprotection.com/Respirator-Cartridge-Filter-Reference-Chart.html>
Most can be bought at Amazon at better prices than found elsewhere.

  

9.  DuPont TY127S Disposable White Tyvek Coverall Suit 1428
Amazon Price $5.49 + $4.57 S&H (same price as local Home Depot and Lowes paint department, less (my 8.25%) your state sales tax. Choose one size larger than your normal, to ensure al fit over your clothing and allow flexibility.
Technical Details
•  Serged seams, attached hood, front zipper closure, elastic wrists, and elastic ankles.
•  Inherent barrier protection against dry particulate hazards.
•  Applications range from agriculture to spray painting to lead remediation.
•  Even after abrasions, stops microporous particles better than other reusable garments.
•  The best balance of protection, durability and comfort.
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What are the features of  Tyvek disposable coveralls?
•  It is made from a tough material that helps prevent skin contact with wet/dry, harmful objects, or chemicals in the environment.
•  Microscopic particles as small as 0.5 microns are retarded in access through a Tyvek coverall.
•  It can’t be easily scratched or torn
•  The coverall is made from one material in one layer
•  The Tyvek disposable coverall has the ability to let air and moisture pass through which can reduce possible heat stress.
•  Tyvek suits create a barrier to water from mild splash occurrences.
•  It is proved to be six times more breathable than microporous materials
•  It can be used in various low hazard applications. As Personal Protective Equipment it fulfills body/skin protection necessary for many Level D and C threats and partial protection for Level B threats.
•  Tyvek disposable coveralls are perfect for disaster clean-up work in order to protect the wearer with maximum comfort and protection. It comes in hooded coveralls for overall protection.

 

Sports Body Armor
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Types of sports body armor
Padded pants are full-length protective armor for use when protection of hips, quads, shins, and calves is needed.
Upper body armor provides excellent soft-padded protection for the back, sides, shoulders, and arms.

Titan Sport Jacket, by Fox Racing, Amazon $139.95
<http://www.amazon.com/gp/product/B005VBFZQ2/ref=pd_lpo_k2_dp_sr_2?pf_rd_p=486539851&pf_rd_s=lpo-top-stripe-1&pf_rd_t=201&pf_rd_i=B0033PRRCS&pf_rd_m=ATVPDKIKX0DER&pf_rd_r=1P8A4A6CC24CMTQCET0Y>

Full body under jersey coverage has a new standard with the Titan Sport Jacket. Its complete plastic plating of key contact areas is unmatched. Its full mesh main body offers a precise, bunch-free fit. Add in the intelligently engineered ventilation zones and the Titan Sport Jacket truly becomes the ultimate battle suit.

Fox Racing’s new Titan Sport Jacket is probably the first hard-shell under-jersey body armor for down hill (DH) and free ride that doesn’t make you look like a linebacker. Despite protecting all critical upper-body contact areas, including shoulders and elbows, with lightweight, high-impact plastic the Titan is surprisingly svelte. The main body is made of a comfortable stretchy mesh fabric that prevents the jacket from bunching up under your jersey. Smartly designed vents in the chest and back plates also work with the mesh to help keep you cool. A major improvement is the addition of a hard-plastic chest-plate. The articulated spine protector is designed to move fluidly with a rider but can also be zipped off easily. Adjustment straps at the shoulders and ribs allow for a precise fit and better protection. The Velcro on the kidney belt has the mildly annoying habit of attaching itself to the jacket’s soft meshy parts, but that’s probably an unavoidable feature of good Velcro. While the Titan jacket is designed to be worn under your jersey, the anatomically shaped Batman aesthetic almost makes it cool enough to wear on its own.

Design & Function
• 
Anatomic high impact two piece plastic chest plate
•  Removable articulated plastic back coverage
•  High impact plastic shoulder and elbow coverage
•  Soft vented mesh main body fabric for enhanced fit,
•  Comfort and ventilation
•  Center zipper for easy on and off

An Upper Body Bike padded top is often used with the following extreme sports and activities:
Skate: Derby, Mountain Board
Bike: Down Hill, Single Track, Street, Mountain
Motor bike: ATV, Dirt, Street, Street Bike, Motocross, Super Moto, Track
Field sports: Polo
Other sports: Clown Work, Equestrian, Martial Arts, Street Louge.
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 Ballistic Body Armor

How to choose body armor: < http://bulletproofme.com/How_to_Select_Body_Armor.shtml>
Pictures/prices/sales: <http://www.qmuniforms.com/Body-Armor/?src=SHIPFREE&gclid=CKmDrub_zK4CFQFeTAod0lHK_Q>

Body Armor Threat Levels
Deciding which body armor to purchase is as important as any purchase you will make.
Before deciding on brands, you need a little knowledge about body armor to help with your decision.
All body armor products are categorized into one of six levels.

The levels begin with Level I which offers the least amount of protection and go up to Level IV which offers the most amount of protection. This level system is the most important factor in making a purchase. You don’t need a Level IV – which will stop rifle rounds – if the purpose of the vest is to give you protection from sharp edged weapons while walking a tier a Garden State Prison. However, if you are on a tactical entry team used for high risk assaults or handling prison riots, you will need armored protection that will stop more than just knives.

An old but still very valuable street cop rule-of-thumb is to have a level of ballistic performance that stops, at a minimum, the round you carry in your service weapon. This rule is as relevant and true today as it was when body armor was first available.
Be advised, though, there are many variables.
The ballistic threat of a round depends on more than just the round. Variables include its composition, shape, caliber, mass, angle of impact, and impact velocity. Because of the wide variety of rounds and cartridges available in a given caliber and because of the existence of hand loaded ammunition, body armor that will defeat a standard test round may not defeat other loadings in the same caliber.
The National Institute of Justice (NIJ) is the research, development, and evaluation agency of the United States Department of Justice. It is from the NIJ where we get the levels of body armor. It is called the National Institute of Justice (NIJ) Ballistic Resistance of Police Body Armor.

Below is a list describing the available levels of ballistic performance of body armor:

Level I  (22 LR; 38 Special)
Level I vests offer the most basic level of protection.  This level of protection is virtually obsolete due to the common use of higher velocity ammunition. During testing the ammunition used is a .38 caliber traveling at 850 feet per second and a .22 caliber fired from a long rifle with a traveling speed of 1,050 feet per second.  Level I vests only stop fragmentation and low-velocity pistol ammunition. They are not recommended for pistol ballistic protection but can be used for riot gear or for playing paintball.

Level II-A  (Lower Velocity 357 Magnum; 9 mm)
Level II-A vests are typically 4mm thick and tested using a 9mm full metal jacket at 1,090 feet per second and a .357 Magnum jacketed soft point ammunition at 1,250 feet per second.  These bulletproof jackets offer the minimum level of protection required to protect against most threats faced on the streets.  Since this vest is thinner than a level II or III-A it offers greater comfort and concealability at the cost of offering less protection against blunt trauma.

Level II  (Higher Velocity 357 Magnum; 9 mm)
Level II vests are typically 5mm thick and tested using 9mm full metal jacket ammunition at 1,175 feet per second and .357 jacketed soft point ammunition at 1,395 feet per second.  Since they are thicker they offer more protection against blunt trauma while remaining comfortable to wear and easy to conceal.  These bulletproof vests are ideal when vests need to be concealed, worn for a long time, or when the ability to move a lot is necessary.  Theses vests are often worn by police officers.  Since Level II vests are thicker they offer great levels of protection against blunt trauma caused by higher-velocity rounds.

Level III-A  (44 Magnum; Submachine Gun 9 mm)
Level III-A vests are between 8 to 10 millimeters thick and are tested for 9 mm full metal jacket ammunition at 1,400 feet per second (the velocity of a submachine gun) and .44 Magnum Lead Semi-Wadcutter ammunition at 1,400 feet per second.  These vests offer the highest level of blunt trauma protection while remaining concealable.  Level III-A vests are suited to protect against most handguns as well as all the weapons tested on the lower-level vests.  Among all the concealable bulletproof vests they are the most expensive, thick, stiff, and heavy.  They are ideal for high-risk situations including protection against explosions and grenade attacks.

Type IV  (Armor-Piercing Rifle)
This armor protects against 30 caliber armor-piercing bullets (U.S. military designation APM2), with nominal masses of 10.8 g (166 gr) impacting at a velocity of 868 m (2850 ft) per second or less. It also provides at least single hit protection against the threats mentioned in lower levels.

• Some professionals are more concerned they will be attacked with a knife or a blunt object, so when looking at armor select for penetration protection as well.
 

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List  of ammunition shown in the photograph above:

1. .22 Magnum 40 gr. JHP (1209 FPS   / 369 MPS)
2. .32 ACP 60 gr. Silvertip JHP (936 FPS / 285 MPS)
3. .380 ACP 95 gr. FMC (902 FPS / 275 MPS)
4. .38 Special 125 gr. Nyclad SWHP (1009 FPS / 308 MPS)
5. .38 Special +P 110 gr. JHP (1049 FPS / 320 MPS)
6. .38 Special +P 140 gr. JHP (869 FPS / 265 MPS)
7. 9mm 124 gr. FMC (1173 FPS / 358 MPS)*
8. 9mm 125 gr. JSP (1121 FPS / 342 MPS)
9. 9mm 147 gr. Black Talon (1010 FPS / 308 MPS)
10. 9mm 147 gr. Golden Saber (1083 FPS / 330 MPS)
11. 9mm 147 gr. Hydra Shok (1011 FPS / 308 MPS)
12. .357 Magnum 158 gr. JSP (1308 FPS / 399 MPS)
13. .357 Magnum 110 gr. JHP (1292 FPS / 394 MPS)
14. .357 Magnum 125 gr. JHP (1335 FPS / 407 MPS)
15. .40 Caliber 180 gr. FMJTC (992 FPS / 302 MPS)
16. .40 Caliber 170 gr. FMJTC (1095 FPS / 334 MPS)
17. 10mm 155 gr. FMJTC (1024 FPS / 312 MPS)
18. 10mm 170 gr. JHP (1137 FPS / 347 MPS)
19. .41 Magnum 210 gr. LSWC (1141 FPS / 348 MPS)
20. .44 Magnum 240 gr. LFP (1017 FPS / 310 MPS)
21. .45 Long Colt 250 gr. LRN (778   FPS / 237 MPS)
22. .45 ACP 230 gr. FMJ (826 FPS / 252 MPS)
23. 12 Ga. 00 Buck (9 pellet) (1063 FPS / 324 MPS)
24. 9mm 124 gr. FMJ (1215 FPS / 370 MPS)*
25. 9mm 115 gr. Silvertip JHP (1252 FPS / 382 MPS)
26. 9mm 124 gr. Starfire JHP (1174 FPS / 358 MPS)*
27. .357 Magnum 158 gr. JSP (1453 FPS / 443 MPS)*
28. .357 Magnum 145 gr. Silvertip JHP (1371 FPS / 418 MPS)
29. .357 Magnum 125 gr. JHP (1428 FPS / 435 MPS)
30. 10mm 175 gr. Silvertip JHP (1246 FPS / 380 MPS)
31. .41 Magnum 210 gr. JSP (1322 FPS / 403 MPS)
32. .44 Magnum 240 gr. SJHP (1270 FPS / 387 MPS)
33. 9mm 124 gr. FMJ (1440 FPS / 439 MPS)*
34. 9mm 115 gr. FMJ Israeli (1499 FPS / 457 MPS)
35. 9mm 123 gr. FMJ Geco (1372 FPS / 418 MPS)
36. 9mm 124 gr. FMJ Cavin (1259 FPS / 384 MPS)
37. .44 Magnum 240 gr. LSWC (1448 FPS / 441 MPS)*
38. .44 Magnum 240 gr. HSP (1320 FPS / 402 MPS)
39. 12 ga. 1 oz. Rifled Slug (1290 FPS / 393 MPS)
40. 12 ga. 1 oz. Rifled Slug (1254 FPS / 382 MPS)

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Filed under Survival Manual, __6. Medical, ___c) General Clinic

Vaccination notes

(Survival Manual/6. Medical/c) General Clinic/Vaccination notes)

The romantic 1800s
14 December 2009, Health Sentinal, by Roman Bystrianyk
<http://healthsentinel.com/joomla/index.php?option=com_content&view=article&id=2662:historic-data-shows-vaccines-not-key-in-declines-in-death-from-disease&catid=5:original&Itemid=24>
Many of us have a picture of the 1800s that has been colored by a myriad of filters that have led us to a nostalgic and romantic view of that era. We picture a time where gentleman callers came to call upon a well-dressed lady in a finely furnished parlor. We imagine a time where people leisurely drifted down a river on a paddle wheel riverboat while sipping mint juleps and a time of more elegant travel aboard a steam train traveling through the countryside. We picture an elegant woman dressed in a long flowing gown leaving a sleek horse drawn carriage with the aid of a well-dressed man in a top hat. We think of those times where life was simple, ordered, in a near utopian world free of the many woes that plague modern society.

But if we remove those filters and cast a more objective light upon that time a different view emerges. Now imagine a world where workplaces had no health, safety, or minimum wage laws. It was a time where people put in 12 to 16 hours a day at the most tedious menial labor. Imagine bands of children roaming the streets out of control because their parents are laboring long days. Picture the city of New York surrounded not by suburbs, but by rings of smoldering garbage dumps and shantytowns. Imagine cities where hogs, horses, and dogs and their refuse were commonplace in the streets. Many infectious diseases were rampant throughout the world and in particular in the larger cities. This is not a description of the Third World, but was a large portion of America and other western cities only a century or so ago.

Our perceptions of history encompass a lot of willful rejection of knowledge. It is easier and more convenient to wax nostalgically rather than acknowledge an uncomfortable reality. We insist on creating a more pleasant historical illusion, but by doing so we cloud a historical issue in a way that promotes a bad misunderstanding of the past, and has every potential to result in bad misunderstandings of the future.
•  1807-1812: Glasgow, England – Measles accounts for 11% of all deaths.
•  1830s: United States – Eastern seaboard cities have a mortality rate from tuberculosis of 400 per 100,000.
•  1845-1850: Ireland – Great Famine claims approximately 2 million lives, some from starvation, but far more from typhus and other epidemics consequent upon malnutrition and social collapse.
•  1854: New York City – Nearly 2,500 people are killed by cholera.
•  1847-1861: 2,589,843 Russians contract Cholera and over 1,000,000 die.
•  1861-1865: American Civil War – The Union Army loses 186,216 men to disease, twice the number killed in action; nearly half were claimed by typhoid and dysentery.
•  1855: Yellow fever rages in Norfolk and Portsmouth Virginia, Louisiana, and Mississippi. In the Virginia plague area one out of five die of the fever, its victims buried wholesale in trenches without coffins.
•  1865: New York City – Fifteen thousand tenement houses have been built, many of which are hardly more than “fever nests”.
•  1867-1872: Hospice des Enfants Assists reports 1,256 cases of measles and 612 deaths with a mortality of 49%. Malnutrition was known to be rife in orphanages at the time.
•  1871: A terrible smallpox epidemic which threw both New York and Philadelphia into morning. It killed over eight hundred people in the former city, more than ever before in its history, while the latter the deaths nearly reached two thousand.
•  1871-1872: England – Smallpox epidemic 42,200 deaths suggesting 200,000 or more cases.
•  1870-1875 Europe – One of the worst epidemics in European smallpox history is estimated to have killed at least 500,000 people.
•  Prussia – Great smallpox epidemic. Despite strict vaccination laws 69,839 die from smallpox more than in any other northern state.
•  Chicago – Despite a high vaccination rate, over 2000 people contract smallpox and more than a fourth of these die. The fatality among children under five is the highest ever recorded.
•  1873: Memphis – Suffers attacks of yellow fever, smallpox, and cholera simultaneously. People flee the city leaving half of the houses vacant.
•  1874: Bloomington, Illinois – All kinds of garbage and human and animal waste had been thrown into small streams running into Sugar Creek and became known as the “North and South Sloughs”. Over the years the Sloughs “became a … sodden pool of stench that was the breeding places for disease … because it drained sewage into the community’s primary water source, Sugar Creek.”

These historic points show that infectious diseases were a constant and deadly threat during these times. England was the country that early in 1838 began to keep statistics on causes of death and is the best source to find out the devastating impact of these infectious diseases.
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What would happen if we stopped vaccinations?
<http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm>
In the U.S., vaccination programs have eliminated or significantly reduced many vaccine-preventable diseases. However, these diseases still exist and can once again become common—and deadly—if vaccination coverage does not continue at high levels.

Polio
Stopping vaccination against polio will leave people susceptible to infection with the polio virus. Polio virus causes acute paralysis that can lead to permanent physical disability and even death. Before polio vaccine was available, 13,000 to 20,000 cases of paralytic polio were reported each year in the United States. These annual epidemics of polio often left thousands of victims–mostly children–in braces, crutches, wheelchairs, and iron lungs. The effects were life-long.
In 1988 the World Health Assembly unanimously agreed to eradicate polio worldwide. As a result of global polio eradication efforts, the number of cases reported globally has decreased from more than 350,000 cases in 125 countries in 1988 to 2,000 cases of polio in 17 countries in 2006, and only four countries remain endemic (Afghanistan, India, Nigeria, Pakistan). To date polio has been eliminated from the Western hemisphere, and the European and Western Pacific regions. Stopping vaccination before eradication is achieved would result in a resurgence of the disease in the United States and worldwide.

Measles
Before measles immunization was available, nearly everyone in the U.S. got measles. An average of 450 measles-associated deaths were reported each year between 1953 and 1963.

In the U.S., up to 20 percent of persons with measles are hospitalized. Seventeen percent of measles cases have had one or more complications, such as ear infections, pneumonia, or diarrhea. Pneumonia is present in about six percent of cases and accounts for most of the measles deaths. Although less common, some persons with measles develop encephalitis (swelling of the lining of the brain), resulting in brain damage.

As many as three of every 1,000 persons with measles will die in the U.S. In the developing world, the rate is much higher, with death occurring in about one of every 100 persons with measles.

Measles is one of the most infectious diseases in the world and is frequently imported into the U.S. In the period 1997-2000, most cases were associated with international visitors or U.S. residents who were exposed to the measles virus while traveling abroad. More than 90 percent of people who are not immune will get measles if they are exposed to the virus.

According to the World Health Organization (WHO), nearly 900,000 measles-related deaths occurred among persons in developing countries in 1999. In populations that are not immune to measles, measles spreads rapidly. If vaccinations were stopped, each year about 2.7 million measles deaths worldwide could be expected.
In the U.S., widespread use of measles vaccine has led to a greater than 99 percent reduction in measles compared with the pre-vaccine era. If we stopped immunization, measles would increase to pre-vaccine levels.

Haemophilus Influenzae Type b (Hib) Meningitis
Before Hib vaccine became available, Hib was the most common cause of bacterial meningitis in U.S. infants and children. Before the vaccine was developed, there were approximately 20,000 invasive Hib cases annually. Approximately two-thirds of the 20,000 cases were meningitis, and one-third were other life-threatening invasive Hib diseases such as bacteria in the blood, pneumonia, or inflammation of the epiglottis. About one of every 200 U.S. children under 5 years of age got an invasive Hib disease. Hib meningitis once killed 600 children each year and left many survivors with deafness, seizures, or mental retardation.

Since introduction of conjugate Hib vaccine in December 1987, the incidence of Hib has declined by 98 percent. From 1994-1998, fewer than 10 fatal cases of invasive Hib disease were reported each year.

This preventable disease was a common, devastating illness as recently as 1990; now, most pediatricians just finishing training have never seen a case. If we were to stop immunization, we would likely soon return to the pre-vaccine numbers of invasive Hib disease cases and deaths.

Pertussis (Whooping Cough)
Since the early 1980s, reported pertussis cases have been increasing, with peaks every 3-5 years; however, the number of reported cases remains much lower than levels seen in the pre-vaccine era. Compared with pertussis cases in other age groups, infants who are 6 months old or younger with pertussis experience the highest rate of hospitalization, pneumonia, seizures, encephalopathy (a degenerative disease of the brain) and death. From 2000 through 2008, 181 persons died from pertussis; 166 of these were less than six months old.

Before pertussis immunizations were available, nearly all children developed whooping cough. In the U.S., prior to pertussis immunization, between 150,000 and 260,000 cases of pertussis were reported each year, with up to 9,000 pertussis-related deaths.

Pertussis can be a severe illness, resulting in prolonged coughing spells that can last for many weeks. These spells can make it difficult for a person to eat, drink, and breathe. Because vomiting often occurs after a coughing spell, persons may lose weight and become dehydrated. In infants, it can also cause pneumonia and lead to brain damage, seizures, and mental retardation.

The newer pertussis vaccine (acellular or DTaP) has been available for use in the United States since 1991 and has been recommended for exclusive use since 1998. These vaccines are effective and associated with fewer mild and moderate adverse reactions when compared with the older (whole-cell DTP) vaccines.

During the 1970s, widespread concerns about the safety of the older pertussis vaccine led to a rapid fall in immunization levels in the United Kingdom. More than 100,000 cases and 36 deaths due to pertussis were reported during an epidemic in the mid 1970s. In Japan, pertussis vaccination coverage fell from 80 percent in 1974 to 20 percent in 1979. An epidemic occurred in 1979, resulted in more than 13,000 cases and 41 deaths.

Pertussis cases occur throughout the world. If we stopped pertussis immunizations in the U.S., we would experience a massive resurgence of pertussis disease. A study found that, in eight countries where immunization coverage was reduced, incidence rates of pertussis surged to 10 to 100 times the rates in countries where vaccination rates were sustained.

Pneumococcal
Before pneumococcal conjugate vaccine became available for children, pneumococcus caused 63,000 cases of invasive pneumococcal disease and 6,100 deaths in the U.S. each year. Many children who developed pneumococcal meningitis also developed long-term complications such as deafness or seizures. Since the vaccine was introduced, the incidence of invasive pneumococcal disease in children has been reduced by 75%. Pneumococcal conjugate vaccine also reduces spread of pneumococcus from children to adults. In 2003 alone, there were 30,000 fewer cases of invasive pneumococcal disease caused by strains included in the vaccine, including 20,000 fewer cases in children and adults too old to receive the vaccine. If we were to stop immunization, we would likely soon return to the pre-vaccine numbers of invasive pneumococcal disease cases and deaths.

Rubella (German Measles)
While rubella is usually mild in children and adults, up to 90 percent of infants born to mothers infected with rubella during the first trimester of pregnancy will develop congenital rubella syndrome (CRS), resulting in heart defects, cataracts, mental retardation, and deafness.

In 1964-1965, before rubella immunization was used routinely in the U.S., there was an epidemic of rubella that resulted in an estimated 20,000 infants born with CRS, with 2,100 neonatal deaths and 11,250 miscarriages. Of the 20,000 infants born with CRS, 11,600 were deaf, 3,580 were blind, and 1,800 were mentally retarded.

Due to the widespread use of rubella vaccine, only six CRS cases were provisionally reported in the U.S. in 2000. Because many developing countries do not include rubella in the childhood immunization schedule, many of these cases occurred in foreign-born adults. Since 1996, greater than 50 percent of the reported rubella cases have been among adults. Since 1999, there have been 40 pregnant women infected with rubella.

If we stopped rubella immunization, immunity to rubella would decline and rubella would once again return, resulting in pregnant women becoming infected with rubella and then giving birth to infants with CRS.

Varicella (Chickenpox)
Prior to the licensing of the chickenpox vaccine in 1995, almost all persons in the United States had suffered from chickenpox by adulthood. Each year, the virus caused an estimated 4 million cases of chickenpox, 11,000 hospitalizations, and 100-150 deaths.

A highly contagious disease, chickenpox is usually mild but can be severe in some persons. Infants, adolescents and adults, pregnant women, and immunocompromised persons are at particular risk for serious complications including secondary bacterial infections, loss of fluids (dehydration), pneumonia, and central nervous system involvement. The availability of the chickenpox vaccine and its subsequent widespread use has had a major impact on reducing cases of chickenpox and related morbidity, hospitalizations, and deaths. In some areas, cases have decreased as much as 90% over prevaccination numbers.

In 2006, routine two-dose vaccination against chickenpox was recommended for all children, adolescents, and adults who do not have evidence of immunity to the disease. In addition to further reducing cases, this strategy will also decrease the risk for exposure to the virus for persons who are unable to be vaccinated because of illness or other conditions and who may develop severe disease. If vaccination against chickenpox were to stop, the disease would eventually return to prevaccination rates, with virtually all susceptible persons becoming infected with the virus at some point in their lives.

Hepatitis B
More than 2 billion persons worldwide have been infected with the hepatitis B virus at some time in their lives. Of these, 350 million are life-long carriers of the disease and can transmit the virus to others. One million of these people die each year from liver disease and liver cancer.

National studies have shown that about 12.5 million Americans have been infected with hepatitis B virus at some point in their lifetime. One and one quarter million Americans are estimated to have chronic (long-lasting) infection, of whom 20 percent to 30 percent acquired their infection in childhood. Chronic hepatitis B virus infection increases a person’s risk for chronic liver disease, cirrhosis, and liver cancer. About 5,000 persons will die each year from hepatitis B-related liver disease resulting in over $700 million in medical and work loss costs.

The number of new infections per year has declined from an average of 450,000 in the 1980s to about 80,000 in 1999. The greatest decline has occurred among children and adolescents due to routine hepatitis B vaccination. Infants and children who become infected with hepatitis B virus are at highest risk of developing lifelong infection, which often leads to death from liver disease (cirrhosis) and liver cancer. Approximately 25 percent of children who become infected with life-long hepatitis B virus would be expected to die of related liver disease as adults.

CDC estimates that one-third of the life-long hepatitis B virus infections in the United States resulted from infections occurring in infants and young children. About 16,000 – 20,000 hepatitis B antigen infected women give birth each year in the United States. It is estimated that 12,000 children born to hepatitis B virus infected mothers were infected each year before implementation of infant immunization programs. In addition, approximately 33,000 children (10 years of age and younger) of mothers who are not infected with hepatitis B virus were infected each year before routine recommendation of childhood hepatitis B vaccination.

Diphtheria
Diphtheria is a serious disease caused by a bacterium. This germ produces a poisonous substance or toxin which frequently causes heart and nerve problems. The case fatality rate is 5 percent to 10 percent, with higher case-fatality rates (up to 20 percent) in the very young and the elderly.

In the 1920’s, diphtheria was a major cause of illness and death for children in the U.S. In 1921, a total of 206,000 cases and 15,520 deaths were reported. With vaccine development in 1923, new cases of diphtheria began to fall in the U.S., until in 2001 only two cases were reported.

Although diphtheria is rare in the U.S., it appears that the bacteria continue to get passed among people. In 1996, 10 isolates of the bacteria were obtained from persons in an American Indian community in South Dakota, none of whom had classic diphtheria disease. There was one death reported in 2003 from clinical diphtheria in a 63 year old male who had never been vaccinated.

There are high rates of susceptibility among adults. Screening tests conducted since 1977 have shown that 41 percent to 84 percent of adults 60 and over lack protective levels of circulating antitoxin against diphtheria.

Although diphtheria is rare in the U.S., it is still a threat. Diphtheria is common in other parts of the world and with the increase in international travel, diphtheria and other infectious diseases are only a plane ride away. If we stopped immunization, the U.S. might experience a situation similar to the Newly Independent States of the former Soviet Union. With the breakdown of the public health services in this area, diphtheria epidemics began in 1990, fueled primarily by persons who were not properly vaccinated. From 1990-1999, more than 150,000 cases and 5,000 deaths were reported.

Tetanus (Lockjaw)
Tetanus is a severe, often fatal disease. The bacteria that cause tetanus are widely distributed in soil and street dust, are found in the waste of many animals, and are very resistant to heat and germ-killing cleaners. From 1922-1926, there were an estimated 1,314 cases of tetanus per year in the U.S. In the late 1940’s, the tetanus vaccine was introduced, and tetanus became a disease that was officially counted and tracked by public health officials. In 2000, only 41 cases of tetanus were reported in the U.S.

People who get tetanus suffer from stiffness and spasms of the muscles. The larynx (throat) can close causing breathing and eating difficulties, muscles spasms can cause fractures (breaks) of the spine and long bones, and some people go into a coma, and die. Approximately 20 percent of reported cases end in death.

Tetanus in the U.S. is primarily a disease of adults, but unvaccinated children and infants of unvaccinated mothers are also at risk for tetanus and neonatal tetanus, respectively. From 1995-1997, 33 percent of reported cases of tetanus occurred among persons 60 years of age or older and 60 percent occurred in patients greater than 40 years of age. The National Health Interview Survey found that in 1995, only 36 percent of adults 65 or older had received a tetanus vaccination during the preceding 10 years.

Worldwide, tetanus in newborn infants continues to be a huge problem. Every year tetanus kills 300,000 newborns and 30,000 birth mothers who were not properly vaccinated. Even though the number of reported cases is low, an increased number of tetanus cases in younger persons has been observed recently in the U.S. among intravenous drug users, particularly heroin users.

Tetanus is infectious, but not contagious, so unlike other vaccine-preventable diseases, immunization by members of the community will not protect others from the disease. Because tetanus bacteria are widespread in the environment, tetanus can only be prevented by immunization. If vaccination against tetanus were stopped, persons of all ages in the U.S. would be susceptible to this serious disease.

Mumps
Before the mumps vaccine was introduced, mumps was a major cause of deafness in children, occurring in approximately 1 in 20,000 reported cases. Mumps is usually a mild viral disease. However, serious complications, such as inflammation of the brain (encephalitis) can occur rarely. Prior to mumps vaccine, mumps encephalitis was the leading cause of viral encephalitis in the United States, but is now rarely seen.

Serious side effects of mumps are more common among adults than children. Swelling of the testes is the most common side effect in males past the age of puberty, occurring in up to 37 percent of post-pubertal males who contract mumps. An increase in miscarriages has been found among women who develop mumps during the first trimester of pregnancy.

Before there was a vaccine against mumps, mumps was a very common disease in U.S. children, with as many as 300,000 cases reported every year.  After vaccine licensure in 1967, reports of mumps decreased rapidly. In 1986 and 1987, there was a resurgence of mumps with 12,848 cases reported in 1987. Since 1989, the incidence of mumps has declined, with 266 reported cases in 2001. This recent decrease is probably due to the fact that children have received a second dose of mumps vaccine (part of the two-dose schedule for measles, mumps, rubella or MMR).  Studies have shown that the effectiveness of mumps vaccine ranges from 73% to 91% after 1 dose and from 79% to 95% after 2 doses and that 2 doses are more effective than 1 dose.

We can not let our guard down against mumps. A 2006 outbreak among college students led to over 6500 cases and a 2009-10 outbreak in the tradition-observant Jewish community in 2 states led to over 3400 cases. Mumps is a communicable disease and while prolonged close contact among persons my facilitate transmission, maintenance of high 2-dose MMR vaccine coverage remains the most effective way to prevent and limit the size of mumps outbreaks.

Other Notes:
•  Some counter culture types talk naively about living with nature in a society stripped of modern trappings and benefits. What they fail to recall is that, down through history, Mother Nature has been a real bitch.
•  Modern survival must entail using as many modern means and techniques as possible.
•  Nearly 100% of US deaths from disease now are chronic diseases of old age, such as heart disease, stroke and cancer.

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Viral Hemorrhagic Fevers

(Survival Manual/6. Medical/b) Disease/Viral hemorrhagic fevers)

  http://www.mayoclinic.com/health/viral-hemorrhagic-fevers/DS00539

Definition
Viral hemorrhagic (hem-uh-RAJ-ik) fevers are infectious diseases that interfere with the blood’s natural ability to clot. These diseases can also damage the walls of tiny blood vessels, making them leaky. The internal bleeding that results can range from relatively minor to life-threatening.

Some viral hemorrhagic fevers include:
•  Dengue – (see Survival Manual/6. Medical/b) Disease/ Dengue)
•  Ebola – (see Survival Manual/6. Medical/b) Disease/ Ebola)
•  Lassa – (see Survival Manual/6. Medical/b) Diseas/Lassa fever)
•  Marburg
•  Yellow fever – (see Survival Manual/6. Medical/b) Disease/Yellow Fever)

These diseases most commonly occur in tropical areas of the world. When viral hemorrhagic fevers occur in the United States, they’re usually found in people who’ve recently traveled internationally.
Viral hemorrhagic fevers are spread by contact with infected animals, people or insects. No current treatment can cure viral hemorrhagic fevers, and immunizations exist for only a few types. Until additional vaccines are developed, the best approach is prevention.

Symptoms
Signs and symptoms of viral hemorrhagic fevers vary by disease. In general, initial symptoms may include:
•  High fever
•  Fatigue
•  Dizziness
•  Muscle aches
•  Weakness
[Photograph at right: The face of this patient appeared flushed due to dilation of the capillaries. Severe     vomiting could also cause rupture of the blood vessels in the eyes.]

Symptoms can become life-threatening
Severe cases of some types of viral hemorrhagic fevers may cause bleeding:
Under the skin
•  In internal organs
•  From the mouth, eyes or ears
Other signs and symptoms of severe infections can include:
•  Shock
•  Nervous system malfunctions
•  Coma
•  Delirium
•  Seizures
•  Kidney failure

 When to see a doctor
The best time to see a doctor is before you travel to a developing country to ensure you’ve received any available vaccinations and pre-travel advice for staying healthy. If you develop signs and symptoms once you return home, consider consulting a doctor who focuses on international medicine or infectious diseases. A specialist may be able to recognize and treat your illness faster. Be sure to let your doctor know what areas you’ve visited.

Causes
The viruses that cause viral hemorrhagic fevers live naturally in a variety of animal and insect hosts — most commonly mosquitoes, ticks, rodents or bats.
Each of these hosts typically lives in a specific geographic area, so each particular disease usually occurs only where that virus’s host normally lives. Some viral hemorrhagic fevers also can be transmitted from person to person.

 How is it transmitted?
The route of transmission varies by specific virus. Some viral hemorrhagic fevers are spread by mosquito or tick bites. Others are transmitted by contact with infected blood or semen. A few varieties are breathed in if you’re around infected rat feces or urine.
If you travel to an area where a particular hemorrhagic fever is common, you may become infected there and then develop symptoms after you return home.

Risk factors
Simply living in or traveling to an area where a particular viral hemorrhagic fever is common will increase your risk of becoming infected with that particular virus. Several other factors can increase your risk even more, including:
Working with the sick
•  Slaughtering infected animals
• Sharing needles to use intravenous drugs
•  Having unprotected sex
•  Working outdoors or in rat-infested buildings

Complications
Viral hemorrhagic fevers can damage your: Brain, Eyes, Heart, Kidneys, Liver, Lungs and/ or Spleen; in some cases, the damage is severe enough to cause death.

Tests and diagnosis
Diagnosing specific viral hemorrhagic fevers in the first few days of illness can be difficult because the initial signs and symptoms — high fever, muscle aches, headaches and extreme fatigue — are common to many other diseases.
To reach an accurate diagnosis, your doctor is likely to ask about your medical and travel history and any exposure to rodents or mosquitoes. Be sure to describe international trips in detail, including the countries you visited and the dates, as well as any contact you may have had with possible sources of infection.
Laboratory tests, usually using a sample of your blood, are needed to confirm a diagnosis. Because viral hemorrhagic fevers are particularly virulent and contagious, these tests are usually performed in specially designated laboratories using strict precautions.

Treatments and drugs
While no specific treatment exists for most viral hemorrhagic fevers, the antiviral drug ribavirin (Virazole, Rebetol) may help shorten the course of infection and prevent complications in some cases.

 Therapy
Supportive care is essential. To prevent dehydration, you may need fluids to help maintain your balance of electrolytes — minerals that are critical to nerve and muscle function.

Surgical and other procedures
Some people may benefit from kidney dialysis, an artificial way of cleaning wastes from your blood when your kidneys fail.
Patients receive supportive therapy, but generally speaking, there is no other treatment or established cure for VHFs. Ribavirin, an anti-viral drug, has been effective in treating some individuals with Lassa fever or HFRS.

Prevention
 Preventing viral hemorrhagic fevers, especially in developing nations, presents enormous challenges. Many of the social, economic and ecological factors that contribute to the sudden appearance and spread of infectious diseases — war, displacement, destruction of habitat, lack of sanitation and proper medical care — are problems that have no easy or quick solutions.
If you live in or travel to areas where viral hemorrhagic fevers are common, you should take precautions to protect yourself from infection.

 Get vaccinated
The yellow fever vaccine is generally considered safe and effective, although in rare cases, serious side effects can occur. Check with the Centers for Disease Control and Prevention about the status of the countries you’re visiting — some require certificates of vaccination for entry. The yellow fever vaccine isn’t recommended for children under 9 months of age or for pregnant women, especially during the first trimester. Vaccines for several less common types of viral hemorrhagic fevers are currently in development.

 Avoid mosquitoes and ticks
Wear light-colored long pants and long-sleeved shirts or, better yet, permethrin-coated clothing. Don’t apply permethrin directly to the skin. Avoid unnecessary activities at dusk and dawn when mosquitoes are most active and apply mosquito repellent with a 20 to 25 percent concentration of DEET to your skin and clothing. If you’re staying in tented camps or local hotels, use bed nets and mosquito coils.

 Guard against rodents
To prevent rodent infestations in your home:
•  Keep pet food covered and stored in rodent-proof containers.
•  Store trash in rodent-proof containers, and clean the containers often.
•  Dispose of garbage on a regular basis.
•  Make sure doors and windows have tightfitting screens.
•  Place woodpiles and stacks of bricks and other materials at least 100 feet from your house.
•  Mow your grass closely and keep brush trimmed to within 100 feet from your house.

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