Hygiene and Sanitation

During and after an emergency, practicing good basic personal hygiene and sanitation are critical to helping prevent the spread of illness and disease. During this time, finding clean running water can be difficult. The following information will tell you how to plan for good hygiene and sanitation in the event of an emergency.

Disaster Supplies Kit (Hygiene Supplies)

Before an emergency, make sure you have created a Disaster Supplies Kit. The CDC and the American Red Cross have prepared a shopping list of emergency water, hygiene, and sanitation supplies that should be contained in your kit.

Handwashing

Keeping hands clean during an emergency helps prevent the spread of germs. Always wash your hands with soap and water that has been boiled or disinfected. However, when water is not available, alcohol-based hand products (sanitizers) made for cleaning hands can be used. For more information on the proper steps for hand washing and how hand washing can save lives, visit CDC’s Clean Hands Save Lives.

When and How to Wash Hands

Wash hands with soap and clean, running water (if available):

• Before and after preparing food
• Before and after eating food
• After using the toilet
• After changing diapers and cleaning children
• During times of illness
• After handling an animal or animal waste
• After handling garbage

If soap and/or clean, running water is not available, then use an alcohol-based gel (>60% alcohol) (1) to clean hands; however, alcohol-based hand sanitizers will not kill all germs (e.g., Cryptosporidium spp.)

Handwashing Station

If running water is not available, a temporary Handwashing Station can be created using a large water spigot jug that contains water from an approved source. If being used indoors, use a catch basin to catch the water. Also have soap, paper towels, and a trash can available.

Other Hand Hygiene Resources

• Clean Hands Save Lives: Emergency Situations
• Hand Hygiene After A Disaster
• Sanitation And Hygiene After A Flood

Bathing

Bathing after a water-related emergency should only be done with treated water. Do not use flood water or other water sources that have the possibility of being contaminated for brushing your teeth. To help make water safe, follow the directions in the educational handout Keep Water Safe (PDF, 45.50 kb, 1 page). If clean water is hauled to a community in a water storage tank for bathing, be sure that the tanker follows advice from the World Health Organization offered in the document Cleaning and Disinfecting Water Storage Tanks and Tankers (PDF, 378.07 kb, 4 pages).

Dental Hygiene

When practicing dental hygiene after a water-related emergency, use either bottled or stored water. Do not use flood water or other water sources that have the possibility of being contaminated for brushing your teeth. To make water safe, visit CDC Healthy Water's Safe Drinking Water for Personal Use page. Visit the CDC’s website on Oral Health for complete dental hygiene information.

For simple steps to improve kids' smiles, read CDC's "Brush Up on Healthy Teeth" (también en Español). This is a health education campaign including a Brush Up Quiz for parents, tip sheet, and poster.

Wound Care

Flood waters may contain fecal material or other organisms from overflowing sewage systems or run-off from agricultural areas. As a result, exposing open wounds to contaminated flood waters can cause infections of the wound. Keeping wounds clean and covered is crucial during an emergency, especially a water-related disaster. If you have any open cuts or sores, keep them as clean as possible by washing well with soap and either bottled or clean stored water to control infection. If a wound develops redness, swelling, or drainage, seek immediate medical attention.

When providing first aid for a wound, clean hands can help prevent contamination. Visit Emergency Wound Care After a Natural Disaster to find complete information on caring for wounds. Healthcare professionals should visit Emergency Wound Management for Healthcare Professionals.

Cleaning & Sanitizing with Bleach

To properly clean and sanitize items during and after an emergency, use regular unscented 5.25% household bleach. Read and follow the safety instructions on the bleach container’s label. The following are the most important safety guidelines while using bleach:

• Never mix bleach with ammonia or any other cleaner.
• Wear rubber boots, rubber gloves, and eye protection.
• Try not to breathe bleach fumes. If using bleach indoors, open windows and doors to allow fresh air to enter.

Cleaning Recommendations

The amount of bleach to mix with water depends on what you are cleaning or sanitizing. The following chart describes some items or surfaces that should and can be cleaned, the amount of bleach to mix with water, and cleaning steps for specific purposes.

Area or Item to be Cleaned	Amount of Bleach and Water to Mix		Cleaning Steps
	Bleach Amount	Water Amount
Clean and Sanitize Food Cans and Surfaces
Food-contact surfaces that may have touched floodwater [Examples: countertops, plates] Note: Throw away wooden cutting boards, baby bottle nipples, and pacifiers	1 teaspoon (4.9 mL)	1 gallon	Wash with soap and warm, clean water. Rinse with clean water. Sanitize using a mixture of 1 teaspoon (4.9 mL) of bleach per gallon of clean water. Allow to air dry.
Food cans that are not bulging, open, or damaged	1 cup (240 mL)	5 gallons	Remove can labels. Wash cans with soap and clean water. Dip cans in mixture of 1 cup (240 mL) of bleach per 5 gallons of water. Relabel cans with a marker.
Clean and Sanitize Other Household Surfaces and Items
Surfaces that do not soak up water and that may have touched floodwater [Examples: floors, stoves, sinks, certain toys, countertops, flatware, plates, and tools]	1 cup (240 mL)	5 gallons	Clean surface with soap and clean water. Disinfect with a mixture of 1 cup (240 mL) of bleach to 5 gallons of water. Allow to air dry. For more information see: After a Flood: Cleanup
Clean Mold Growth Off Hard Surfaces
Mold growth on hard surfaces [Examples: floors, stoves, sinks, certain toys, countertops, flatware, plates, and tools]	1 cup (240 mL)	1 gallon	Mix 1 cup (240 mL) of bleach in 1 gallon of water. Wash the item with the bleach mixture. If the surface of the item is rough, scrub the surface with a stiff brush. Rinse the item with clean water. Dry the item or leave it out to dry. For more information see: Protect Yourself from Mold

1. Centers for Disease Control. Guidelines for Hand-Hygiene in Healthcare Settings: Recommendation of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Available at http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf. (PDF, 495 kb, 56 pages)