Public Health

Whether you are trying to stay away from the seasonal flu or more serious diseases, having good hygiene and following simple steps can help keep you and your family healthy. Contagious diseases such as colds, the flu, whooping cough, bacterial meningitis, mumps, measles, rubella, smallpox or chicken pox, can be spread by coughs, sneezes, handshakes or just touching surfaces that are contaminated with tiny droplets from a person's nose or mouth.

Follow these tips to limit the spread of germs and stop infection:

  • Stay away from people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.

  • If possible, stay home from work, school and errands when sick. This will help stop others from catching your illness.

  • Cover your mouth and nose with a tissue when coughing or sneezing. It may stop those around you from getting sick.

  • Wash hands often to help protect you from germs.

  • Try not to touch your eyes, nose or mouth. Germs are often spread when a person touches something that is unclean with germs and then touches his or her eyes, nose or mouth.

  • Practice other good health habits. Get plenty of sleep. Be physically active. Manage your stress. Drink plenty of fluids. Eat healthy food.

  • Follow your doctor’s advice on vaccinations.

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You can get ready for an influenza pandemic long before there is one. Knowing both the scope of what can happen during a pandemic outbreak and what you can do to help lower the impact of an influenza pandemic on you and your family.

Use this checklist to put together information and resources you may need in case of a flu pandemic.

  • Store a two week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand.
  • Periodically check your regular prescription drugs to make sure you have a constant supply in your home.
  • Have nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
  • Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.
  • Volunteer with local groups to prepare and help with emergency response.
  • Get involved in your community as it works to get ready for an influenza pandemic.


Smallpox is a virus that can be caught through direct contact with an infected person. In a terrorist attack, exposure to smallpox could occur by breathing a sprayed airborne virus.

Generally, direct and fairly lengthy face-to-face contact is needed to spread smallpox from one person to another. Animals and insects do not carry or spread the smallpox virus. A person who has been exposed to smallpox becomes contagious after a rash appears and stays contagious until the last smallpox scab falls off.

Exposure to smallpox is followed by an incubation period during which people do not have any symptoms and may feel fine. This incubation period averages about 12 to 14 days, but can range from seven to 17 days. During this time, people are not contagious.

The first symptoms of smallpox include fever, malaise, head and body aches and sometimes vomiting. The fever is usually high, in the range of 101 to 104 degrees. At this time, people are usually too sick to carry on their normal activities. This phase may last for two to four days. A rash emerges first as small red spots on the tongue and in the mouth. These spots develop into sores that break open and spread large amounts of the virus into the mouth and throat. At this time, the person is the most contagious.

Within 24 hours, a rash appears on the skin, starting on the face and then spreading to the arms and legs and then to the hands and feet. Usually the rash spreads to all parts of the body within 24 hours. As the rash appears, the fever usually falls and the person may start to feel better.

By the third day, the rash becomes raised bumps.

By the fourth day, the bumps fill with a thick, opaque fluid and often have a depression in the center that looks like a belly-button. (This is a major distinguishing characteristic of smallpox.) Fever often will rise again at this time and remain high until scabs form over the bumps.

Days 5-10, the bumps become "pustules" -- sharply raised, usually round and firm to the touch. They feel like there's a small round object under the skin. People often say it feels like there is a BB pellet embedded under the skin.

Days 11-14, the pustules begin to form a crust and then scab. By day 14, most of the sores have scabbed over.

Days 15 - 21, the scabs begin to fall off, leaving marks on the skin that eventually become pitted scars. The person is contagious to others until all of the scabs have fallen off. Most scabs will fall off after three weeks.

After the 21st day, scabs have fallen off. Person is no longer contagious. Humans are the only natural hosts of smallpox, which is caused by the variola virus that began in human populations thousands of years ago. Except for laboratory stockpiles, the virus has been removed as a disease.